From:
williamsdvm@comcast.net
Date: 2003-03-15 02:21:01 UTC
Subject: RE: Cirrhosis of the liver
To: ferrethealth@smartgroups.com
Message-ID: <4393680.1047694861564.JavaMail.root@scandium>
Anemia and some liver changes, but look - the bilirubin is normal. Some of the values suggest that the liver may be involved, but with a normal bilirubin, I don't think the liver is the cause. The anemia appears regenerative at this point, with an elevated level of reticulocytes (immature red blood cells) and an elevated mean corpuscular hemoglobin level.)
The albumin is very low also - while liver failure could result in a value this low, it is far more common in inflammatory bowel disease.
However, that is not helping you. Is the liver shrunken on the X-ray? I know that you are treating for cirrhosis, but as yet, I haven't seen a lot of proof that that is the root problem.
Cirrhosis, unfortunately, is a diagnosis best made by biopsy - all bloodwork can do is make one suspicious of it, and the one value that is most damning is still normal here.
I hate these cases - especially since he is not doing well, but this is one that is going to be very tough to help over the Internet.
With kindest regards,
Bruce Williams, DVM
Author wrote:
> It's taken a bit, but I finally have some blood results.
> General Panel
> cbc with differential
> White cell cnt 7.2
> Red cell cnt 6.38 L
> Hemoglobin 110 L
> Hematocrit 0.312 L
> Mean Corp Yol. 49
> Mean Corp Hemoglobin 17.3 H
> Mean Corp Hemoglobin Conc 354
> RDV 20.4
> Platelet cot INV
> Mean Platelet Volume INV
> Differential
> Counts (ABS)
> Basos 0 0
> Eos 72 1
> Bonds 0 0
> Polys 4536 63
> Lymph 1512 21
> Monos 1080 15 Total 7200
> Morphology
> Poikilo Slight
> Platelet Adequate
> Slight echinocytosis
> Platelets clumped
> Retic 3%
> Chemistry screen
> Glucose 6.0
> Blood Urea Nitrogen 3.4 L
> Creatinine 41 L
> Bun/Cr Ratio 21
> Sodium 144
> Potassium 3.6 L
> Na/K Ratio 40
> Calcium 1.94 L
> Phosphorus 1.11
> Total protein 53
> Albumin 19 L
> Globulin 34
> Albumin/Globulin Ratio 0.6
> Bilirubin total 3
> Alkaline phosphastase 234 H
> Sgpt [alt] 757 H
> Gamma gt 119 H
> Chloride 119 H
> Carbon Dioxide 15 L
> Calculated Osmolality 283.9
> Anion Cap 14
> Creatine phosphokinase 301 H
> Sgot [ast] 313
> Please look them over and let me know what you think. We've had him
> on the Denosyl for about 4-5 days when the blood was taken. Hopefully
> it didn't change the values too drastically and give a false reading.
> Gadget is now about 1/2 way through the 30 day trial we were going to
> put him on it. This past weekend, he did take a turn for the worst. He is
> not eating and forcing food down him has been very stressful on him. He
> was doing well in the week prior and even gaining a little weight. Last
> night we decided that it was best for him if he would eat anything on his
> own. So he is now on a diet of mice. Before getting ill he would suck
> them back one right after another (useally about 5 hoppers). Yesterday
> and today, he has decided the only the upper half of the body is worth
> eating. It's something... it's food... and we don't have to force it down him.
> His energy has picked up a little and I've noticed that he has started
> taking in more water again.
> worried... and desperate...
> betty
> > Dear Betty:
> > First things first. You said that Dr. J biopsied the liver because it did
> not look right, but he was in there for adrenal surgery at the time.
> > What if the liver isn't at the root of his problem - yes it looks bad, but
> have you checked his blood values - are the liver values (expecially the
> bilirubin) elevated. > I see a fair number of livers that aren't pretty, but
> they seem to work. The most common cause of liver changes is far and
> away heart disease - the blood backs up into the liver if the heart isn't
> pumping well (what we call right-sided congestive heart failure). There
> are some other causes (copper toxicosis has been identified in ferrets),
> but these are pretty rare. > Now I don't think that the Denosyl will hurt,
> but there is no information on how this will help a ferret. It is one of
> those drugs which eveyon agrees should help, but we really don't know
> if or how it does. > But if you truly determine that his ill thrift is due to the
> liver, it's certainly worth a try.
> > With kindest regards,
> > Bruce Williams, DVM