From:
ssiu@cgl.uwaterloo.ca
Date: 2004-02-19 15:32:21 UTC
Subject: immune mediated anemia
To: ferrethealth@smartgroups.com
Message-ID: <1570337.1077204741140.JavaMail.root@thallium.smartgroups.com>
http://www.smartgroups.com/message/readmessage.cfm?
gid=1423922&messageid=7143&startid=7144
was catching up on the fml and read this post forwarded
by Sukie in december. I just want to post this info to the
FHL so that owners of ferrets with hemolyptic anemia will
have another option to try.
a little bit of background. Sand was my ferret with severe
anemia. a PCV as low as 5% at one point. he had also been
an adrenal ferret for a couple of years before his anemia
started, and he had a form "sick sinus syndrome", a condition
that causes his heart rate to slow or quicken, in his case
only under aneasthesia (sevo as welll as iso). so not a real
good surgical candidate.
when his PCV first started dropping about a year ago (we noticed
he was a little less active, getting skinny and got an ultrasound
and blood work PCV 19), my vet thought it may be adrenal related, so we
increased his Lupron dose. when we rechecked his blood work next,
his PCV has gone to 13, and he got a transfusion right away, and a
bone marrow aspirate, which indicated his white blood cells were
eating his red blood cells (hemolyptic anemia) and possibly lymphoma,
which we started treating with lspar, vincristine (later stopped because
no more signs of lymphoma, and my vet suspected the vincristine made
him worst). often with hemolyptic anemia, removing the spleen helps
fixed the problem, but Sand's not a good surgical candidate, so he was
started on high doeses of Pred 2cc 2x a day for 3 days, and then 2cc
1x a day). his kidney values were also elevated so he was started on
hill's k/d as well.
a couple months after we first checked, his PCV has gone to 5%, and
we gave him a concentrated transfusion, and try erythropoietin.
I wasn't going to put him through more transfusions, and we were
discussing letting him go. the erythropoeitin made him generate new
red cells. we also put him on filgrastim to bring back white blood
cells that were killed off after his chemo. he was noticeably better
with the erythropoeitin at ~18%. for a few months after that, he hovered
around 18% or so, but then started dropping again, down to 8%.
one of the options available was to remove his spleen, which had done
miracles for hemolyptic anemia ferrets before, and my vets did the
surgery (stitch up and all) in an unheard of 12 minutes (because of
Sand's heart condition). his PCV went up to around 22% a couple weeks
after the surgery, but started going down again (this was late august).
the last resort we started late september was Cyclosporin, a drug
for auto immuno deficiency. his PCV was 20% when we started, and
a month later, it was 35%, and 2 weeks after that it was 43%, which
was within normal ranges.
around december, his kidney values started getting worse. his PCV
was also dropping because of that. we let him go about a month ago
and the post mortem indicated complete kidney failure. we miss the
little fellow so much. he had the best attitude through out the whole
ordeal, and while I'm really grateful he lived another 9 months longer
than we thought, it never seems enough.
a couple of points I want to emphasize for Sand's treatment
- filgrastim and erythropoeitin worked really well together,
for Sand
- Cyclosporin worked wonders for him
don't know if any vet will want to comment on this. I don't know
if the drugs have another name, I found one negative instance of
filgrastim in the archives, and none of cyclosporin.
if anybody needs more details, feel free to email me, and I can
answer more questions or forward your queries to my vet. I don't
really read the FHL (still catching up the FML), so please
reply to me as well as to the list.
thanx.
Selina, Sprite, Bear, Dart & Clef
missing Birch, Dief, Storm & Sand
http://www.cgl.uwaterloo.ca/~ssiu/