Message Number: SG3035 | New FHL Archives Search
Date: 2003-01-16 23:37:10 UTC
Subject: Need advice, please... 6 yr old Mina with acute onset of anorexia and lethargy. Lymphoma ?
Message-ID: <4110225.1042760230090.JavaMail.root@scandium>

Hello everybody,

I already lost Mina's longlife partner last summer during surgical removal of insulinoma, and therefore, I want to maximize the resources in managing her care now that she has fallen sick...

Mina is a 6 yr old female ferret who has been doing very well up until 5 days ago when she has become somnolent, lethargic and anorexic. First, it became apparent that her stools diminished in quantity and frequency - they appeared darker (not black) and thicker in consistency. Over the next two days it became obvious that she also has not eating and drinking much and even refusing her favourite treats. On one occasion I observed her retching, however, she produced no vomitus. Her weakness is most apparent in hindlegs - she has been having difficulty climbing onto the sofa and sways during walking. There is no hair loss, no obvious weight loss, no fever, no cough, no diarrhea or signs of bleeding, her urine looks normal to my eye, and oral cavity has grossly normal appearance. She sleeps a lot and does not want to play.

Her past medical history is only significant for a surgical removal of a hairball at 1 year of age. All her life, she has been fed with Iams Premium Kitten Food (purple bag). She has never been on any medications except those given during her surgery 5 years ago. She weighs 2 pounds (always has been petite).

I took her to my vet for examination and basic workup. Physical examination was significant only for an enlarged spleen; plain X-Ray showed that it occupied greater than 50% of abdomen, but had well defined margins and smooth appearance. Midly enlarged liver with enlarged abdominal lymph nodes were noted as well. Barium swallow was given to rule out obstruction, however, passage into colon was observed in under 20 minutes.

CBC and chemistry results were as follows:

Hct = 48.6%
Hgb = 17.8 g/dL
MCHC = 36.6 g/dL
WBC = 16.8 x 10^9 /L
L/M = 9.7 x 10^9 /L
Grans = 7.1 x 10^9 /L
Neuts = 3.0 x 10^9 /L
EOS = 4.1 x 10^9 /L
Plts = 76 x 10^9 /L
Retics = 0.4 %

ALB = 35 g/L
ALKP = 703 U/L
ALT = 233 U/L
AMYL = 47 U/L
TBIL = 30 umol/L (sample hemolyzed)
TP = 110 g/L
GLOB = 75 g/L
Chol = 3.94 mmol/L
Ca = 3.83 mmol/L
Phos = 1.7 mmol/L
Urea = 18.12 mmol/L
Creat = 68 umol/L
Glucose = 7 mmol/L

On the basis on the above results, the vet suggested a strong possibility of lymphoma. I also notice that glucose is on the low side (I already lost one ferret to insulinoma, however - his affliction took about 2-3 months to manifest itself, whereas Mina is progressing much faster). I took her home to ponder my options and plan to take care of her feeds for now. She also has been prescribed Prednisolone 1 mg BID.

What is the best course of action for us to take ? I am contemplating having the vet do a biopsy of non-abdominal nodes to rule out lymphoma; would she benefit from a gastric biopsy to look at the possibility of Helicobacter infection ? Is there any other suggested work-up to account for her lab results, specifically, increased WBC and ALKP ?

I would appreciate any suggestions. Thank you in advance,

Peter Koziarz
Hamilton, Ontario, Canada