From:
Sukie Crandall
Date: 2004-05-05 02:36:48 UTC
Subject: Sherman: possible infection complicating things (kidney problems? ulcer? myeloma? lymphoma? IBD)
To: ferrethealth@smartgroups.com
Message-Id: <0F0A65AE-9E3D-11D8-82E2-000A95CD182C@mac.com>
IDEAS?
Yet more testing is being done on Sherman. He survived a very hard
time with what appears to have maybe been an infection over the
weekend, and saw his vet today, having more blood letting, more x-rays,
sub-cu fluids, injected steroid and injected Florinef.
His palate sore is gone but we are assuming that the way he hates to
swallow now may indicate esophageal sores and perhaps stomach ulcers.
Concern for his kidneys exists, as a result also, of course. It does
not look like MegaE though very early MegaE can't be completely ruled
out this early. His over-all picture makes a person think ADV in many
ways but he tests negative for it. Another thing his over-all pictures
looks like is multiple myeloma so his sets of x-rays need to be seen by
some others just in case they can spot anything which doesn't jump out
at a person. Lymphoma is certainly in the list of possibles.
He is still very active though he is having some tired spells and
others of being downright aggitated; when he's like that he acts
active, and nervous but not aggressive though he will occasionally nip
another ferret when in that state.
With the problems he had over the weekend he is skin and bones (but
actually a tad heavier than he was two days ago) and weighs under 2
pounds. He's a small male but this is very thin for him even. You can
count ribs visually.
An ultrasound may be in his near future.
Idexx snap test was negative for all in that, and the tick people in NC
are talking with out vet to see if there is was to test him with less
serum than usual. The chances of it being something from that
infestation 4 years ago when he was a kid are considered slim.
History: 4 year old altered male from a petstore supplying farm; found
wandering as a kit emaciated, covered in ticks, and with gangrene which
resulted in amputation of most of his tail
Has had IBD for years. The only thing which ever worked well on it for
him was injectible Pred but that caused extreme obesity and had to be
stopped some time before his R adrenal surgery to allow of some weight
loss.
L adrenal lost to vascular abnormalities; early adrenal hyperplasia was
expected (diffusely found) but the big thing then was he turned out to
have rampant vascularization of the L adrenal: several large and leaky
vessels so he's a mine of hemoclips. R adrenal lost 5 weeks ago to
adrenal hyperplasia. Path at time of L adrenal was also done on
intestine and stomach. Intestine " The intestine has moderate to
marked infiltrates and plasma cells with rare eosinophils. Crypts are
mildly hyperplastic and focally eroded." Stomach: "The stomach has a
mild infiltrate and plasma cells." with notes: " 1. Diffuse cortical
hyperplasia, adrenal; 2. Moderate to marked lymphoplasmacytic
enteritis; 3. Mild lymphocyctic gastritis. "
Blood results confusing. It's intersting seeing path reports; so much
gets lost or confused in conversation is learned from them. Sadly, the
new receptionist didn't photostat his latest path report for me from
surgery 5 weeks ago.
Here are some testing results for him from February and March. Note
that in-house glucose was fine and some blood shipped a distance so
that time reduces glucose levels.
2/15
Superchem
Glucose 57 low (norm 80-120)
Urea Nitrogen 21
Creatine 0.3
Total Protein 12.0 high (norm 5.5-7.6)
Albumin 2.7
Total Bilirubin 0.3
Alkaline Phosphatase 90 high (norm 15-45)
ALT (SGPT) 263
AST (SGOT) 60
Cholesterol 129
Calcium 9.4
Phosphorus 3.7 low (norm 4.2-8.5)
Sodium 159
Potassium 4.8
Chloride 120 high (90-110 norm)
Albumin/Globulin Ratio 0.3 low (1.0-2.3 norm)
BUN/Creatine Ratio 70
Globulin 9.3 high (2.9-4.9)
Lipase 470
Amylase 23
Triglycerides 128 high (31-101)
CPK 277
GGTP 7 Magnesium 2.2
Calculated Osmolality 315
Complete Blood Count
Hemoglobin 12,7 low (13.0-18.0 norm)
Hematocrit 36.3 low (43.0-55.0 norm)
WBC 6.7
RBC 6,92
MCV 52
MCH 18.4
MCHC 35.0
Platelet Count 326
Platlet Estimate Adequate
Differential (Absolute then %)
Neutrophils 5628 84
Bands 0 0
Lymphocytes 737 11
Monocytes 201 3
Eosinophils 134 2
Basophils 0 0
3/04
---
Aleutians Test Neg
---
3/04
Chemistry
Albumin 2.6
BUN 12
Calcium 15.2 high (8.0-12.0 norm)
Cholesterol 119
Creatine 0.8
Glucose 131
Phosphorus 2.4
SGOT (AST) 82
SGPT (ALT) 92
T. Bilirubin 0.6
Total Protein 8.4 high (5.0-7.0 norm)
serum cond. normal condition
Electrophoresis
Alpha1 Globulin 1.02
Alpha2 Globulin 0.66
Beta Globulin 1.41
Gamma Globulin 3.78
Albumin% 31.3
Alpha1 Globulin% 10.2
Alpha2 Globulin% 6.6
Beta Globulin% 14.1
Gamma Globulin%37.8
A/G Ratio 0.46
Albumin EPH 3.13
TP EPH 10.0
Decreased a/g ratio values. Very increased gamma glubulin.
-Consider acurte or chronic inflammation, infection, chronic hepatitis,
and immune mediated disorders
Ion. Ca++/Electrolyte Module
Ca++ 1.00
Adjusted Ca++ 1.30
pH 7.885
Na 153.5
k+ 4.35
---
3/04
Hematology
WBC 6
RBC 4.69 low (7-12 norm)
PL Protein 8.4
PCV % 50
Buffy Coat 0MCV 107
HGB 13.0
MCHC 26
NRBC 0
Thrombos/Plat Pres
Azuroplils% 0
Bands% 0
HETS/NEUTS% 67
Lymphocytes% 32
Monocytes 0
Eosinophils% 1
Basophils% 0
React Lymphs% 0
Poly normal
Aniso normal
hemoparasites N/S
Hemoparasite TYP N/A
peripheral blood looks okay
--
3/05
Electrophoresis Graph
Albumin Rel% 31.3 G/dL 3.13
Alpha 1 Rel% 10.2 G/dL 1.02
Alpha 2 Rel % 6.6 G/dL 0.66
Beta Rel % 14.1 G/dL 3.78
Gamma Rel % 37.8 G/dL 3.78
Total G/dl 10.00
A/G 0.46
Magnification 130%
There are hand written notes: Aleutians (but you know that tested
negative though maybe we should test and test again), something that
looks like Poly clor and then some letters I can't make out, multiple
My and then some letters I can't make out
Supplementary:
In August of 2003 the following blood levels were unusual but I did not
ask for earlier levels:
Glucose 127 high (80-120 norm)
Total Protein 12.8 high (5.5-7.6 norm)
Alkaline Phosphatase 79 high (15-45 norm)
Potassium 4.2 low (4.3-5.8 norm)
Chloride 116 high (90-110 norm)
Albumin/Globulin ratio 0.2 low (1.0-2.3 norm)
WBC 8.5 high (2.5-8.0 norm)
RBC 11.80 high (6.5-11.00 norm)
MCV 42 low (46-65 norm)
MCH 14.4 low (15.5-19.0 norm)
Platelet Count 763 (high) (300-700)
and because I don't know enough to know what means what in late August
he also read:
Differential Absolute %
Neutrophils 7395 87
Bands 0 0
Lymphocytess 765 9
Monocytes 255 3
Eosinophils 85 1
Basophils 0 0