From:
Caitlyn Martin
Date: 2002-04-04 11:29:00 UTC
Subject: Pertwee's latest ailment (long)
Hi, everyone,
Pertwee has been losing weight again, and various attempts at treating
different possible causes have had mixed results. His energy level is
also down. What follows is a summary of his medical history and the
results of his most recent blood work (now two weeks old), as well as my
vet's current thoughts. Dr. Williams, if you have a chance to look
through this I would really appreciate it. Comments from other vets and
experienced ferret owners are more than welcome.
History:
Pertwee is a 3 year, 9 month old albino male ferret. Normal body weight
when healthy appears to be around 1,300-1,400 grams. He was treated for
heliobacter at age one and lost a fair amount of weight at that time.
Weight loss continued, but no other symptoms presented themselves. An
ultrasound was done in 3/00 showing a single renal cyst, but nothing
else. In 4/00 other symptoms of adrenal disease (hair loss,
agressiveness) presented and surgery was done. The left adrenal gland
was removed. Pertwee recovered for about two weeks and then symptoms
recurred. In 5/00 the right adrenal gland was removed. Both tumors
were carcinomas. Pertwee did not recover, and his weight dropped to 729
grams. At that point two vets recommended putting him down. My regular
vet did a final exploratory surgery in 7/00 and found the right kidney
was a hardened mass. A nephrectomy was done, and pathology showed
polycystic disease. The left kidney appeared to be normal at that time.
Pertwee recovered well, with a return to a fully normal activity level
and a body weight which varied seasonally between 1,305 and 1,394 grams.
In the fall of 2001 Pertwee lost weight when he should have gained
weight for winter. At that time blood work was completely normal. His
medication at that time was fludrocortisone .15ml (0.03mg/ml) 2x day and
dexamethasone .15ml 2x day (0.5mg/ml). (Dexamathesone was used because
he had completely failed to respond to prednisone after the second
adrenal surgery.) My vet wanted to do a test called a TLI to check for
pancreatitis, but no lab was doing that test for ferrets or had normal
ferret values. He was started on ¼ tsp viokase mixed with his chicken
gravy and dexamethasone was increased to .2ml to stimulate appetite.
There was a brief improvement, but he then started losing weight again.
An ultrasound was done and nothing abnormal was visible. As of two weeks
ago he was down to 821 grams, but his appetite continued to be excellent
and his activity level remained high. Blood work was done with the
following results (lots of abnormal values here):
Sodium 145 mEq/L
Potassium 5.8 mEq/L (high)
NA/K Ratio 25.17
Chloride 105 mEq/L
CO2 26.5 mEq/L
Anion Gap (Calc) 20.3 mEq/L
Osmolality, calc 309.96 mOsm/kg
Glucose 155 mg/dL (high)
Cholesterol 282 mg/dL (high)
BUN 28 mg/dL
Creatinine 1.4 mg/dL (high)
Calcium 11.0 mg/dL (high)
Phospohorus 4.2 mg/dL (low)
Total Bilirubin 0.3 mg/dL (high)
ALK Phosphatase 60 IU/L
GGT 33 IU/L (high)
AST (SGOT) 78 IU/L
ALT (SGPT) 118 IU/L
CK 278 IU/L
Total Protein 9.4 g/dL (high)
Albumin 4.9 g/dL (high)
Globulin (calc) 4.50 g/dL (high)
A/G ration 1.09
Amylase 41 U/L
Lipase 414 U/L
As a result of the high potassium level fludrocortisone was increased to
.17ml. Viokase was increased to ½ tsp. Pediapred was added at .1ml 2x
day. My vet's best guess (after consulting with several other vets) is
lymphosarcoma in the intestine. Without a biopsy he can't know for
sure, and at Pertwee's current weight he wasn't comfortable operating.
In the past two weeks Pertwee's activity level has markedly decreased,
though when he plays he still acts like his old self. He is arching his
back when lying flat, something we saw when he had his kidney problem.
My vet attributes this to abdominal pain. He has lost a lot of muscle
mass, but his weight has increased to 930 grams over the past two weeks,
the only positive sign. Another complete blood workup is two weeks off
at this point. His appetite remains excellent if not ravenous. My vet
is convinced that this is an absorption problem of some sort, and still
believes lymphosarcoma to be the most likely cause.
Pertwee's diet, in case this matters, is Totally Ferret (sometimes mixed
with TFS Supreme or Zupreem) supplemented with as much of Bob Church's
chicken gravy as he cares to eat with viokase added, typically three
times a day. He almost always eats a whole small bowl full at a time. We
also give him Ferretvite as a high cal treat in the evening.
Right now all I am looking for are ideas and suggestion to pass on to my
vet. Thanks in advance for any insight y'all can provide.
All the best,
Caity
Franklin Co., NC