From:
ELNRRGBY1@aol.com
Date: 2002-09-05 08:43:22 UTC
Subject: Friable small bowel with perforation
To: ferrethealth@smartgroups.com
Message-ID: <2f.2c9de4a7.2aa8732a@aol.com>
Hello all,
My ferret Bonzai had to have emergency surgery this morning. He went from
running around playing to being collapsed in the litter box in about two
hours' time on Sunday. No vomiting or diarrhea prior to this, normal
appetite and only two quick gags/hacks right after we found him collapsed (he
was awake and able to move, but just very lethargic and weak). Labs and
x-rays were pretty normal/nonspecific and we opted to treat first empirically
for infection with Clavamox, Interferon and fluids. There was no improvement
within 36 hours of starting treatment so we hospitalized him yesterday at
another clinic over an hour away for observation, repeat testing, and
treatment. Free fluid was found in abdomen on repeat x-rays this morning.
Cytology on the fluid showed white cells, but no bacteria. I got a call this
morning with the newest information and agreed to proceed with exploratory.
The main findings were a small bowel perforation and the entire small bowel
from the duodenum to the descending colon was extremely friable. The vet
said he was going to try to do an anastomosis, but there was no place in the
small bowel where the tissue was usable, so he just closed the perforation
instead. He also said there was also a lot of fibrin covering pretty much
every visible surface according to the vet and a small red, round nodule of
tissue that was attached to the mesentery (I think) that was removed and that
everything in the peritoneal cavity was inflamed. No other tissue samples
were obtained though because of the friability issue, problems with bleeding
when they tried to remove some of the adherent fibrin, and development of
bradycardia. If he recovers from this, we've already discussed the
possibility of an additional surgery in the near future to try to get tissue
samples for a diagnosis.
I know without tissue samples there is no way to know what is going on, but
what are some of the more likely causes of this type of diffuse friability?
Is it possible that even this extensive amount of small bowel involvement
could somehow still be secondary to the peritonitis rather than a primary
pathologic process? I don't have the specifics on the fluid cytology done
presurgically, but I'm fairly certain the main thing that showed up was high
numbers of neutrophils. Whether that is significant or not, I don't have a
clue. All I can say is that the overall appearance did not fit with anything
in particular according to the vet. Not an obvious trauma, ulceration, or
foreign body and no distinguishable tumorous appearing nodules.
Bonzai is 3.5 years old, a late alter, and weighs almost 4 pounds right now.
He has always been very healthy and never shown any sign of serious illness
until now and again, this was a very sudden onset of symptoms and the
symptoms were very nonspecific, but severe.
Thanks in advance,
Stacia