From:
williamsdvm@comcast.net
Date: 2003-07-02 01:56:53 UTC
Subject: RE: 1 year old "Snert"
To: ferrethealth@smartgroups.com
Message-ID: <5999317.1057111013300.JavaMail.root@thallium.smartgroups.com>
Dear Kim -
I am having a bit of trouble gettting a mental picture of the extent of the "bony" proliferation. AS a general rule, bony lesions (especially those that appear somewhat motheaten) are most often chordomas, and occasionally osteosarcomas. I have yet to see a fungal or bacterial infection at these sites.
Both of these bony tumors do not carry a good prognosis, and are pretty aggressive. I don't think that biopsies are especially risky, as long as you are not going for a deep core biopsy (this may inadvertently result in a fracture of the weakened vertebra. I have seen a number of these, and have been able to make a diagnosis in almost all of them, even if the biopsy is fairly superficial.
Bony tumors are generally painful affairs (at least they are in humans). I generally look at activity and appetite as the best indicators of pain. If a ferret doesn't move, doesn't show any excitement when you come into proximity, and isn't eating - those are generally my criteria - but they certainly aren't the only, or necessarily the best ones.
With kindest regards,
Bruce Williams, DVM
Author wrote:
> The vet I visited first was the only ferret-accepting vet open on Sat, so I took
> him to a 2nd vet (Jun 17) who recommended a 3rd vet (Jun 30). 2nd vet did a
> CBC and X-ray and I included his report at the end of this e-mail.
> Vets 2 and 3 exchanged records and both are perplexed, and have pretty grim
> prognosis for Snert. Snert has a bony proliferation in the 4th thoraxic
> vertebrate and his physical condition is quite weak. Vet 3 said a biopsy is
> risky. His guess for diagnosis was either (1)osteosarcoma, (2)osteomyelitis,
> bacterial or fungal, or (3) a congential defect.
> Biopsy for a "certain diagnosis" is quite tricky so Vet 3 is reluctant to operate
> and recommends maybe contacting a certified surgeon at U of Tenn or
> someone in Raleigh. (I am in Asheville, NC) When I asked about risks vs. cost,
> Vet 3 said it would still be quite risky and the cost around $2,000 and it was
> possible that what they would find is something very grave.
> He put Snert on SMZ-TMP Pediatric Suspension 0.77CC twice/day. Because it
> was the safest attempt at treating an uncertain diagnosis. Prednisone would
> cause problems if it is infection, Vet 3 says. So I made a choice to see what
> happens with the antibiotic. Snert took it last night and today- he is the same
> as before the visit.
> My questions are:
> 1) Is there any method you know of to get a more certain diagnosis which is
> not so risky and costly? Sometimes research facilities have more advanced
> tools so maybe this is something that could be done safely?
> 2)If there are no safe and reasonable ways to diagnose for sure- and you were
> in a position to take a guess based on the data so far...what would your
> opinion be?
> 3) I do not want Snert to be in pain. Right now he sleeps lots, will eat hand fed
> baby food mixture (recommended on your site, I add 1 oz water to help
> hydration) readily, enjoys being held and can walk around but stumbles a bit
> on back legs. He is eager, but too weak to explore and play. I realize there is
> a possibility I will have to have him put to sleep. Of course, I want to avoid this
> totally or at least as long as possible, but not at the expense of waiting so long
> that he is in pain. Is there any way to tell when this time is near? How long
> could he have pain-free based on his current condition?
> I am including the lab data and vet data from vet #2 visit to , if needed I can
> send results from Vet 3 after tomorrow. Vet 3 looked at vet 2 data and did
> urine sugar test (normal), barium GI test (normal), fecal exam, internal
> parasite-negative.
> Thank you again for any help you may be able to provide.
> Kim Wilkes
> Complete blood count:
> Test Results Reference range
> Hemoglobin 18.5 (HIGH) 13-18
> Hematocrit 55.4 (HIGH) 43-55
> WBC 8.3 (HIGH) 2.5-8.0
> RBC 11.10 (HIGH) 6.5-11
> MCV 50 46-65
> MCH 16.7 15.5-19
> MCHC 33.4 29-36
> Platelet count 10 (LOW) 300-700
> Platelet clumps are detected in this sample. Platelet clumping prevents precise
> determination of a count and falsely decreases platelet number. The repoorted
> count reflects the estimated contribution of the platelet clumps.
> Platelet Estimate Decreased
> Differential Absolute %
> Neutrophils 1328 16
> Bands 0 0
> Lymphocytes 6391 77
> Monocytes 166 2
> Eosinophils 332 4
> Basophils 83 1
> Mammalian Comprehensive Chemistries
> Test Results Reference range
> Glucose 105 80-120
> Urea Nitrogen 28 10-33
> Creatinine 0.6 0.2-0.8
> Total protein 6.3 5.5-7.6
> Albumin 3.4 2.4-4.5
> Total bilirubin 0.1 0.0-1.0
> Alkaline phosphatase 236 (HIGH) 15-45
> ALT(SGPT) 88 10-280
> AST(SGOT) 47(LOW) 50-280
> Cholesterol 139 60-300
> Calcium 8.4 7.7-11.0
> Phosphorous 6 4.2-8.5
> Sodium 149 140-160
> Potassium 4.9 4.3-5.8
> Chloride 115(HIGH) 90-110
> Globulin 2.9 2.9-4.9
> CPK 136
> Insulin 5.1 5-20
> Ratio 7
> XX XX Veterinary report on 6/17/03
> Male neutered 1 year old ferret. 1270g, Temp=102.3 Blood glucose 81.
> Only feeding by hand (chicken baby food, soften kibble and water). Lethargic
> for 2 weeks. Weak in rear but not down. Chest (can't read this part) OK. X-ray
> bony proliferation in 4th thoraxic vetebrate. Chest and abdomen look OK.
> Fecal- large #'s of rods, float negative.
> Albon 15cc. Give 1/2cc daily for 10 days.
> Tx: SQLRS 30cc Albon, nutrical
> A: RO include osteosarcoma, viral infection, chronic intestinal imbalance-
> colitis.
> 6/20/03 addition to report:
> Called owner. Ferret somewhat stronger not 100%. Offered referral to UT for
> ultrasound.
> 6/30/03 faxed records to XX XX