From:
dr_bruce_williams
Date: 2002-02-09 21:32:00 UTC
Subject: Re: EE
--- In Ferret-Health-list@y..., JTRADFORD@w... wrote:
> Hi
> Would someone please explain this disease to me.....???
> Would like to know symptoms,how it's diagnosed,and what meds are
> prescribed.
> If possible,would a DR answer???
Dear Tara:
Eosinophilic enteritis is a sporadic disease of ferrets which is most
often seen in young male ferrets. It is a disease that was discovered
about ten years ago, and unfortunately, we know little more about it
today that we did back then. Eosinophilic enteritis is a variant of
the complex of diseases known cumulatively as "inflammatory bowel
disease" in ferrets, but whose appearance is characteristic enough to
have earned it a name of its own.
Eosinophilic enteritis is actually a misnomer, as the lesions in this
disease extend far beyond the intestinal tract, and can be seen in
any abdominal organ (I commonly see it in liver, mesenteric lymph
nodes, and pancreas), and has even been documented in the thorax as
well.
Eosinophilis are a type of white blood cell that moderates allergic
and antiparasitic reactions in the normal animal. For this reason, we
have long believed that it arises from a food allergy or parasitic
infection, however, there is no real evidence to back this up.
The problem with EE is that eosinophils are filled with some very
destructive compounds which they normally use against parasites. In
this disease, large numbers of eosinophils degranulate in the tissue,
causing intense tissue damage. It is almost like a chain reaction,
devitalizing tissue in many organs of the body.
The diagnosis of EE is somewhat difficult - because of the range of
tissues that it affects, the clinical signs are often vague. If the
intestine is affected, the main sign is diarrhea, anorexia, and
weight loss. If the disease is more widespread in the abdomen, you
may also see pain on abdominal palpation.
Bloodwork may show elevated levels of eosinophils, and any
significant increase in eosinophils in an animal with GI signs should
make the prudent practitioner think of EE as a possibility.
Definitive diagnosis, however, is made by biopsy of affected tissue
during exploratory laparotomy. Note to vets: while it may be
difficult to identify inflamed areas in the abdomen in cases of EE,
always biopsy the mesenteric lymph node as part of your sampling - it
very commonly exhibits large infiltrates of eosinophils in affected
animals.
As we don't really know the cause of this disease, treatment revolves
around minimizing the damage done to the body's tissues by the
eosinophils. Prednisone helps to stabilize the membranes of these
cells, keeping them from degranulating as easily, and it also
decreases their ability to congregate in large numbers. However, it
can't work miracles, and often the disease is well advanced before we
even know an animal has EE, and damage in the GI tract or other parts
of the abdomen is too advanced for a good prognosis. If we can get a
handle on the disease with prednisone, treatment is generally life-
long - removal of the prednisone results in a relapse. The key is to
find the lowest dose that controls the signs and maintain on that.
Another important part of treating these animals is do change the
diet. Most animals will benefit by a switch from traditional chicken-
based-protein foods. Foods that have been used to good effect are
turkey-and barley based foods or Hill's z/d, a prescription food in
which the chicken protein is hydrolyzed so that the body does not
recognize it as chicken. Initially, turkey based baby food will help
those in acute phases of the disease, or during flareups.
Years ago, I gave EE cases a poor prognosis. Today, the outlook for
these animals is much better, and most can live to an old age.
With kindest regards,
Bruce Williams, dVM