From:
grape_apes@charter.net
Date: 2003-09-20 01:22:40 UTC
Subject: =?iso-8859-1?Q?Extreme,_fast-onset_weight_gain_(LONG=3F)?=
To: ferrethealth@smartgroups.com
Message-ID: <6027727.1064020960677.JavaMail.root@thallium.smartgroups.com>
Sukie, Pam, et al-I hope this isn't too long; I don't know what else to do.=
..
I hope that this will make it onto the digest, even in parts-I am really de=
sperate for some help, and my vets and I are all using all of our resources=
, so I=92m hoping that the vets and owners who=92ve had similar experiences=
will be willing to review all the details and help me out; any vets who ca=
n help and might be willing to do a phone consult or the like would be grea=
tly appreciated, and I=92d be willing to pay consulting fees.
Shannon is a 3-yr-old (we=92re pretty sure about the age) spayed female bla=
ck hooded sable I adopted last summer. She was found in the attic of an ap=
artment building and turned in to the Rescue League, and her age is an esti=
mate, though her teeth, etc. seem to indicate that she was 2 when I got her=
. She eats a mix of Totally Ferret, Path Valley Farms, Marshall=92s (I do =
a lot of fostering, so I keep it in my mix despite stinkier poop), Zupreem,=
Superior Choice, and Bob Church=92s Chicken Gravy (thanks, Bob! All my fer=
ts except Cora love it!). She gets Ferretone and Laxatone a couple times a=
week, and occasional treats of Totally Ferret treats, N-Bone chicken chews=
, Bandit chews, Foamy Fries, Yogis. She doesn=92t eat a lot of treats, tho=
ugh, preferring much of the time, especially with Foamy Fries and N-Bone ch=
ews, to get all excited about them and stash them, only to find later that =
someone else has helped themselves=85 ;). These days, however, she has ra=
re interest in even stashing treats, let alone eating them. Her appetite a=
nd fluid intake haven=92t changed at all that I can tell during this latest=
medical mystery.
A bit of history: About two weeks after I adopted her last year, she inges=
ted part of my old carpet (yay) and cost me over $2000 between my discounte=
d bills at the clinic where I work and at another hospital (love those =93f=
ree=94 pets!); she vomited up all the carpet, confirmed by X-rays and an em=
ergency abdominal ultrasound, but developed a potentially stress-induced, p=
otentially coincidental, virus.
Regardless, she recovered fully; the ultrasound showed an incidental findin=
g of a right adrenal mass (=93the right adrenal was enlarged, rounded and h=
ypoechoic,=94 measuring =9310.3mm in diameter=94 and it was =93greater in l=
ength.=94 She was not symptomatic for adrenal disease; it really was an in=
cidental finding.
In June of this year, at a routine weight check (I weigh my guys generally =
at least once a month), she was 695 grams (about 1.5 lbs); her weight throu=
ghout the year fluctuates between a low of 635 grams and a high of 815 in t=
he winter (that high was only for about 2 months; she averages usually arou=
nd 750 grams). Two months later, she shot up to 890 grams and became extre=
mely lethargic; her appetite has not changed much. =
While she has never really been one to play with toys or enjoy wrestling or=
games of tag, she has ALWAYS had a strong interest in exploring new places=
-she=92s one that can=92t stand to not know what=92s behind a door and clim=
bs into highly unlikely places to nap (i.e. in the center of a sweater pile=
on the top shelf of my closet-still don=92t know how she got to the first =
shelf to make the climb!), and would at least run through the tubes, occasi=
onally playing with other ferrets in them. She has now lost interest in ev=
en exploring new environments-when placed in a totally foreign room in a fr=
iend=92s house, which previously would have sent her chattering and scoping=
out the perimeter for an hour or so, she now just finds somewhere to curl =
up and sleep. =
At our own house, when I let them all out to run in my very large and latel=
y off-limits (renovations) bedroom, I=92ll bring her all the way to the oth=
er side of the upstairs and she=92ll return her butt right back to bed in h=
er hammock in a carrier in the ferret room. I have been trying to encourag=
e her to explore and be active, bringing just her downstairs with me, and s=
he has gone all the way to the front of the house and climbed up the stairs=
and curled up on the hard floor in front of the closed door to the ferret =
room. I also frequently find her sleeping out in the middle of the floor, =
inching further and further out of her sleep sack or hammock till she=92s o=
ut in the open completely. All she does mostly is sleep. She has always b=
een the groomer of the group, going from ferret to ferret to give everyone =
baths, but she is now almost aggressive about grooming when someone climbs =
into bed with her-this seems to be her only adrenal-type symptom.
She is not just a little chubby-she is REALLY fat, and it is not a pear-sha=
pe. She has that skinny little body type, so she looks especially ridiculo=
us. Her lymph nodes all over her body appear enlarged, but, as I=92ll deta=
il later, fine needle aspirate revealed only fat! She has rolls of fat, ba=
sically.
She has been x-rayed, with largely unremarkable findings-her heart appeared=
to possibly be slightly enlarged compared to last year=92s films, but th=
is could have been an artifact based on the distance of the x-ray machine f=
rom her (though the rest of the x-ray seemed fairly similar size-wise). An=
ultrasound and echocardiogram done based on this finding showed a perfectl=
y normal heart. =
Other findings on the 8/20/03 abdominal ultrasound:
=93Chief Complaint: Lethargy, abdominal distension, enlarged heart on radi=
ographs
Abdominal ultrasound:
1. Liver- The liver appears normal in overall size, shape and echogenicity=
. No obvious masses are noted. The gall bladder and hepatic vessels are n=
ormal.
2. Spleen-The spleen is enlarged in size but has a smooth even echotexture=
.=
3. Kidneys-The kidneys are normal in overall size, shape and corticomedull=
ary definition. Left 2.9, right 2.7 cm.
4. Bladder-There is urine in the bladder. No obvious calculi, masses or w=
all abnormalities are noted.
5. Stomach-No abnormalities are noted. Wall layering appears well defined=
.=
6. Random loops of intestine-No abnormalities noted. The walls are not th=
ickened and wall layering is clearly defined.
7. Pancreas-Not seen clearly but no abnormalities noted in the area of the=
pancreas.
8. Adrenals-The left is not found. The right is replaced by the presence =
of a large (2.4 x 3.6 cm) mass-like lesion. The mass appears moderately en=
capsulated.
9. Other-There is no obvious ascites or lymphadenopathy. There is a thick=
ened and irregular mesentery in the cranial and left lateral abdomen. The =
thickening may represent pancreas and/or mesenteric lymphoma.
Echocardiogram:
=
LA=3D0.75 IVSs=3D0.43 =
Ao=3D0.57 LVDs=3D0.78 =
RVDd=3D(no value given) PWs=3D0.48 =
IVSs=3D0.36 SF=3D39 =
LVDd=3D1.14 =
PWd=3D0.41 EPSS=3D(no value given) =
Doppler: No mitral regurgitation/tricuspid regurgitation/aortic insufficie=
ncy detected.
Conclusions:
1. Normal heart
2. Right adrenal mass
3. Lethargy, prescapular lymphadenopathy, possible mesenteric or pancreati=
c thickening: rule out pancreatitis vs. infiltrative disease (lymphoma, ot=
her).
Recommendations: =
1. Fine needle aspiration enlarged peripheral lymph nodes
2. If nondiagnostic, consider fine needle aspiration of abnormal abdominal=
organs vs. exploratory celiotomy with adrenalectomy and biopsies.=94
Okay. We did the fine needle aspirate of the lymph nodes on both sides of =
her neck (the bilateral prescapulars)-nothing but fat came out, so not sent=
for biopsy; my vet was pretty thorough in her sampling. =
A small mammal bloodwork panel had only the following abnormal values: PCV=
80, Monocytes 0, Albumin 6.3, Calcium 13.2 (this level was high according =
to the lab-I don=92t have any other resource in front of me at the moment-h=
owever, I suspect that the reference range Avian & Exotics Labs uses is off=
-I have NEVER seen ferret bloodwork come back from there that didn=92t say =
the calcium was high!!!), Creatinine 0.9, Total Protein 9.8. Due to the cr=
eatinine especially, we did 60 cc of SQ LRS every day for a week, though sh=
e otherwise didn=92t seem too dehydrated. (Ironically, last year when she =
got sick, her creatinine was too low at 0.1, her monocytes were too high at=
9=85 and her calcium was even higher last year; PCV at that time was 70 an=
d too high.) Her glucose level was great at 104.
We have not yet done the other recommendations from the echo/ultrasound. I=
think I would like to proceed with an adrenalectomy and exploratory, repea=
t PCV in house, but we are questioning whether or not she may have thyroid =
disease as well; we know it is not well-documented, so anyone with experien=
ce with hypothyroid ferrets who can contribute to our search for a diagnosi=
s is welcome to contact me! =
She may just be fat because she=92s gotten lazy, but I really feel that her=
lethargy, given its sudden onset, has some medical cause=85.
All help appreciated!
Dooks,
April Armstrong Campbell
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