From:
d6n6b6@yahoo.co.uk
Date: 2005-02-15 08:09:31 UTC
Subject: prednisone already? or wait?
To: ferrethealth@smartgroups.com
Message-ID: <4039230.1108454971646.JavaMail.root@thallium.smartgroups.com>
Hi,
one of our ferrets has lymphoma. We found a mass in his abdomen on 9 november 2004, rather by coincidence, whilest doing an ultrasound. An aspirate was taken, the option of lymphoma was already mentioned, but we still had some hopes for it being an abcess of some kind, since the aspirate contained a lot of neutrophils.
One week later he went in for surgery, but unfortenately the mass -which turned out to be in his mesentery- couldn't be removed. A piece of it was sent in for histopathology and came back as a T-cell-rich B-cell-lymphoma on 7 december 2004.
He will be 4 years old this may. His other lymph nodes aren't swollen, it's only that one big mass in his abdomen.
We had bloodwork done around half december, and this too was fine (biochemical values were ok and no pathological lymphocytes were found in his blood).
We have chosen not to try chemo, because of the small number of remissions (10%), and simply because we didn't want to put him through all of that every week. (He already had very much stress when masking him down to take blood and it took him at least a day to recover from it).
He shows no clinical symptoms, other than being a bit more of a sleepy head (but that's quite difficult to judge, since he has always slept more than our other 3 ferrets and I do wake him up 4 times a day too to give him his "meds"-see below- and then he is quite active).
I have him on pycnogenol (twice a day) and essiac (also twice a day, hence I get to wake him up 4 times a day) since "the beginning" (I don't expect miracles from it, but he's doing quite good on them). He gets some of bob's chicken gravy with these, I switched him (and the others) from TF to Innova (which I am more comfortably with, being -IMHO- more meat based and with less grains), and he also gets a commercial raw meat for ferrets available here in Belgium and the Netherlands (carnibest) now and then. His appetite is still very good and his weight remained pretty much the same.
The vet and I (I am a vet-student) decided not to put him on prednison yet, more or less based on what is stated in "Ferrets Rabbits and Rodents" (p100):
"If traditional multi-agent therapy is not an option, palliative therapy often results in a significant decrease in tumor burden for several months. All forms of lymphoma tend to be initally responsive to steroids. Adult onset forms may show a less significant response to the mature lymphocyte's innate steroid resistance; however, ALL NEOPLASMS TEND TO RECUR OVER A PERIOD OF MONTHS. When tumors recur, they are steroid resistant".
So, because he doesn't show actual symptoms yet, and it was actually a coincidence that we discovered the mass in this stage, we chose to wait with prednison. Also because I was afraid that when the tumor then came back, it would be more aggressive than ever...
But now, 2 months later, doubts begin to rise. Would it be better to put him on prednisone already?
And if so, how should we determine the right dose for him?
I quote Quesenberry again:
"A minimum oral dose of prednisone (2,2 mg/kg q24h) should be used an increased as needed to decrease tumor burden and alleviate clinical signs"
And since he shows no real clinical signs...
Any help would be appreciated greatly, I don't want to lose him and I want what's best for him!
Thanks in advance,
Wendy