From:
dr_bruce_williams
Date: 2002-02-26 09:40:00 UTC
Subject: Re: Pathology Results from Wyoming
--- In Ferret-Health-list@y..., "cjansa99" <cjansa@f...> wrote:
> Hello Gang,
>
> The Pathology report is back on one of my 3 ferrets that all died
> last month. I don't pretend to understand any of it, and my vet
has
> been unavailable to sit down with me and explain the findings in
> detail. From the looks of it I guess it was ECE that killed
them.
> I still dont understand why the kit succumbed to the virus and
died. > > MICROSCOPIC:
> Liver: Diffusely, hepatocytes have marked fatty change.
> Centrilobular veins are congested. Pancreas: The interstitium and
> the pancreatic parenchyma are suffused with extravasated blood.
> Kidney: Low numbers of tubules are necrotic. Blood vessels are
> congested, and extensive foci of hemorrhage are noted in the
> parenchyma. Intestine: One section contains luminal digested
blood
> or bile. A separate section of intestine has superficial mucosal
> necrosis with crypt and villous regeneration and mild infiltrates
of
> lymphocytes and plasma cells. Small foci of fibrin deposition and
> hemorrhage are also noted in the mucosa. Spleen: Small foci of
> hemorrhage are noted in the red pulp, and some of the macrophages
> contain hemosiderin. The following tissues are histologically
within
> normal limits: stomach (autolyzed), adipose.
>
> DIAGNOSIS:
> 1. Severe hepatic lipidosis.
> 2. Acute segmental necrotizing enteritis, intestine.
> 3. Acute hemorrhage, pancreas, kidney, spleen.
> 4. Mild renal tubular necrosis.
>
> COMMENT:
> Hepatic lipidosis in this case was severe and likely associated
with
> significant hepatic insufficiency. The extensive hemorrhage in a
> number of tissues may be due to coagulopathy associated with this
> process. This ferret also had segmental acute necrotizing
> enteritis. This lesion may have been due to stress-related
erosion,
> bacterial overgrowth, or viral infection. The tissue is otherwise
> too autolyzed to further characterize. The melena detected in a
> separate section of intestine is likely due to the previously
> described intestinal lesion. The gastric mucosa was completely
> autolyzed, but there did not appear to be a significant
inflammatory
> cell infiltrate in the stomach. The cause for the mucoid diarrhea
> described clinically could not be determined, but the clinical
> presentation is similar to that of enteric coronavirus infection of
> ferrets. This ferret did not appear to have the chronic form of
> inflammatory bowel disease that is commonly seen in ferrets. With
> the exception of autolysis and melena in the lumen of the
intestine,
> this section of intestine was judged to be histologically within
> normal limits.
Dear Cindy:
Let's take a look at this report and see if it sheds any light on
this outbreak.
To start with, the high mortality and rapid demise of the affected
animal is not consistent with ECE, especially the death of a kit.
Please remember that not all cases of diarrhea, even ones affecting
multiple animals are not due to ECE.
From the top:
Hepatic lipidosis is an accumulation of fat in the liver, usually due
to not eating and the mobilization of peripheral fat stores to the
liver for conversion to glucose and utilization for energy. There is
no correlation between this physiologic response and hepatic
insufficiency - that statement is simply wrong. We see fatty livers
in many diseases, and it is not a cause of disase, only a sequel.
It is difficult ot interpret the "necrotizing enteritis" in this
case. While some cases of ECE have necrotizing enteritis, this may
also be an ulcer as well. The fact that only one pice of intestine
was submitted for evaluation of an intestinal disease is not good -
mulitple sections from all levels of the bowel should always be
submitted. Many intestinal disease have a segmental distribution,
and one section of the intestine may show characteristic signs, while
many others may not.
The blood in the intestinal lumen as well as in other organs is a
sign of shock, and shock also accounts for the necrosis in the
kidneys. Renal necrosis of tubules is often seen in cases of shock
due to lack of oxygen.
Bottom line is that there is really no evidence in this case, other
than the pathologists assessment that mucoid diarrhea is seen in ECE
to incriminate ECE as the cause of the deaths in these animals.
If tissue is available on any of these animals, or paraffin blocks
can be retrieved from IDEXX, I am happy to look at the intestine and
run some tests that may more definitively rule in or out the
possibility of ECE in this case.
With kindest regards,
Bruce Williams, DVM