From:
Melissa Litwicki
Date: 2001-12-23 10:55:00 UTC
Subject: Advice needed; Puff and diag. of p. vera
Hello,
You may recall that I have posted over the past 6 weeks about my ferret
Puff and her diagnosis of polycythemia vera. Puff is a 5yo spayed
female, ~1000g, no other health problems. Here is a summary:
day 0: yearly checkup and CBC result in all normal blood values except
packed cell volume = 72%, and red blood cell count = 15k
week 2: followup CBC. PCV 75%, RBC = 16k
week 3: attempted phlebotomy, 3cc's drawn. PCV 75%
week 4: second phlebotomy. 5cc's drawn. PCV 75% (what else to do with all
that blood? spin it out. :)
week 6: PCV 65%.
week 8: PCV 75% (present day)
One month after having 5cc's of blood taken, Puff's PCV is back to 75%.
Post-phlebotomy, she has been about 20% more lethargic. Her weight is
down slightly to 980g. Before her phlebotomies she was a normally active
older ferret who experienced cyclic malaise - eating less, sleeping
constantly, no fever, normal poop. These spells would last 2-3 days, and
then she'd be back to normal activity levels for a few weeks.
Over the past few days she seems to have caught a cold bug that's going
around. Vomiting, sleeping, drinking but not eating, no temperature,
normal poop. Her PCV, at 65% only two weeks ago, is back up to 75%. As I
mentioned, she's been 'down' during the month since her phlebotomy - more
sleeping and less eating than normal. It's possible she's been fighting a
bug for that time; her neck lymph nodes are up (no other nodes in her body
are) and she's making the 'smacking' noise with her mouth that I associate
with sore throats in ferrets (I currently have a sore throat as well).
My questions are: First, why would her PCV jump 10% in two weeks? I'm
willing to believe her current malaise is related to that as well as to
her having a cold, but we had hoped to 'buy more time' with the
phlebotomy. My vet speculates her body could be trying to keep her PCV at
75%. Our approach so far has been to try the phlebotomy and see what
transpires. Obviously, we have had disappointing results. Second, what
now? We're going back in a week for another PCV and to talk about drug
therapies. Prednisone has been mentioned, as has a drug which suppresses
the bone marrow's RBC production.. Can anyone identify this drug and
explain its usage and side effects in ferrets? My vet's colleague had
used it in a no-other-hope case, but my vet couldn't recall the name
during my visit yesterday.
With the exception of high PCV/RBC, neck lymph nodes being up, and
observed malaise, there are no symptoms to indicate anything is wrong. In
the next few visits we will do another full CBC and explore other
treatment options, as mentioned above. The only other high PCV symptomatic
ferret my vet had seen was the untreatable lung malignancy to which I
referred above; obviously I hope that doesn't turn out to be the case
here.
Can people lend their thoughts and experiences to a discussion on this?
High PCV/RBC values seem to be an unusual case in ferrets, and all
information - and speculation - is welcome.
Thanks,
Melissa