From:
Bruce Williams, DVM
Date: 2001-11-27 23:02:00 UTC
Subject: Re: path interp
--- In Ferret-Health-list@y..., Ruesterx1@h... wrote:
> Dr.Williams,
>
> Thanks for the path interp of my ferret with the gastric problems.
In
> an effort to be brief I didn't give you the full comment by the
> pathologist. Maybe this will make more sense to you, and does it
> suggest the EE diagnosis you were talking about?
>
> Path comment:
> Lessions in the stomach and intestine are compatible with IBD. IB
> disease is usually presumed to be caused by hypersensitivity to
> antigens within the bowel lumen, and eosinophils in the lesions
would
> be compatible with such a pathogenesis in this case. Other proposed
> causes include motility disorder, mucosal permeability barrier
> defect, infection and bacterial overgrowth. Mitotic figures were
> occassionally seen among the lymphocytes in the stomach, this along
> with the deep location of the lymphocytes raises a slight suspicion
> that lymphosarcoma may arise in the stomach, although unequivocal
> evidence of such was not observed. One of the tissues consists of
> marked edema with scattered lymphocytes. The tissue may represent a
> severly edematous lymph node.
>
> Thanks again for taking the time to respond, and I apologize for
not
> including the full comments.
Dear Julie:
I try to keep the theory and supposition out of comments, as they
only serve to cloud issues and may result in inappropriate
treatments. In this particular case, while all of these conditions
have been associated with IBD in dogs, none have been proven in
ferrets, and the entire diagnosis of IBD is still unproven in this
species. In this particular case, I think that the clinical signs
and histology certainly point first and foremost to Helicobacter as
the cause of the inflammation - and if ignored, then treatment will
likely not be successful. Treat for IBD if you desire, but certainly
treat for Helicobacter.
Let's stick to the facts here - severe chronic inflammation of the
stomach. You can have some mitotic figures in a hot inflammatory
lesion, but they shouldn't be used as criteria for projecting the
possibility of lymphoma. Lymphoma may arise in a percentage of
chronic cases of inflammation in the gut, intestine, or regional
lymph nodes, but we have no way of telling which ones if any will do
so, or what the triggering mechanisms are.
With kindest regards,
Bruce Williams, dVM