Message Number: SG15513 | New FHL Archives Search
Date: 2005-09-26 13:39:46 UTC
Subject: question on helicobacter eradiciation protocol (was:Adrenal and renal cyst)
Message-ID: <>

Hi all,

Fortunately I have good news about our ferret: the biopsy of the pylorus, s=
howed a lymphocytic gastritis (nothing tumoral after all!) =

We are going to try helicobacter-therapy with omeprazole, clarithromycine =
and amoxicilline now, but vets over here are not very acquainted with this =
in ferrets, so I have been searching myself and I think I'd prefer this pro=
tocol. =

I do wonder about the doses though, I can only find doses for omepra +clari=
thro+metronidazole, or for omepra+amoxi(+metronidazole). Can anyone help?

I found in the archives a post from Dr. Murray saying =

"The "new option" is to use Biaxin (clarithromycin 25mg/kg, =

three times a day), amoxicillin, and an antacid for atleast =

2 weeks. This study was done back in 1997. Some cases =

may need biaxin and amoxicillin for 3-4 weeks to clear the =

Helicobacter infection."

-But what about the dose for amoxicillin then? 20mg/kg BID? or 35/kg SID? o=
r 30mg/kg TID? (all of these are listed in my exotic animal forumulary)

-And what about omeprazole? I can't find anything about then and the new fo=
rmulary again lists several... (0,7mg/kg; 4mg/kg; 1/2 capsule)??

(can't find which 1997 study it was unfortunately)

Then another thing: has anyone heard of carafate being contraindicated in f=
errets with renal failure (this particular ferret has high BUN, one shrivel=
ed kidney, and a cyst in the other kidney)? Several (human) websites list =
that it is contraindicated then...? The liver biopsy showed a hamartoma (b=
enign) and hepatitis btw. =

Author wrote:
> Hi Dr. Murray and everyone else,
> Unfortunately, the operation had been postponed to today, and I'm afraid =
I don't have very much good news...
> The left adrenal has been removed and she came through surgery just "fine=
" BUT...
> We found several other things, besides the adrenal tumour...:
> -her right kidney had a cyst, as we already knew from the ultrasound, but=
didn't look particularly bad. Her left kidney though, was shriveled. =

> --> I guess this explains the high BUN...
> BUN 106mg/dl definitely TOO HIGH
> Creatinin 0,44 mg/dl
> -her liver showed a huge cyst, which was drained. There were also severa=
l very small hard nodules, with a lot of pigment in them
> --> Could this explain the AST? Although this isn't VERY high, is it?
> ALT/GPT 118U/L
> Gamma-GT 7U/L
> ALK PHOS 29U/L normal but on the high side
> -her pancreas showed a group of several white nodules, too many to take t=
hem away, as she wouldn't keep enough pancreas left...
> --> They didn't think these were insulinoma's per se, they thought it cou=
ld just be hyperplastic nodules. =

> Her GLUCOSE was 68mg/dl after a 4 =E0 4,5 hour fasting period, they thoug=
ht this wasn't indicative for insulinoma. But I AM worried that this might =
be a bit too low after all...?
> -the pylorus of her stomach was severely thickened, they were thinking of=
an adenocarcinoma. The gastric (?) lymph node was also very much swollen.=

> --> Is there anything in the bloodwork that can point us to this? They we=
re talking about a surgery procedure, used in cats and dogs, in which the d=
iseased part is removed and the remaining part of the stomach is connected =
to the duodenum, but they didn't know immediately if this had been done in =
ferrets before, or even if this would be feasible...? Does anyone know what=
to think of this? =

> Could helicobacter play a role in this? =

> So the left adrenal has been removed, and they have taken a biopsy from t=
he stomach and the liver. But I'm quite taken by surprise right now and do=
n't really know what to do... I had hoped she would've been fine with remov=
ing the adrenal and supporting the kidneys in the way Dr. Murray indicated =
(maybe even in combination with enalapril or benazepril?). But they even s=
eemed reluctant to treat the kidney right now, when I asked them about it(m=
aybe in order to not put too much stress on the liver?) =

> All help/insights are and will be very much appreciated!
> thanks in advance, once again
> Wendy
> PS: I have included the entire bloodwork below, in order to make it more =
easy to maybe check things out
> -Hemoglobin 11,4 g/dl TOO LOW (but not as low as a month ago)
> -PCV 39,0% slightly TOO LOW according to some references, normal accoring=
to others)
> -erythrocytes 6,72 10^12/l (slightly?) TOO LOW
> MCV 58,1 fl
> MCH 16,9pg
> MCHC 29,1g/dl
> RDW 13,1%
> -WBC 3,2 10^9/l normal
> -neuthrophils 0,0% (these are the ones with the non-segemented nucleus, I=
don't know how to translate it)
> -neutrophils (segmented) 60,7% TOO HIGH according to some??
> -lymphocytes 33,7%
> -Monocytes 2,1%
> -Basophils 0,2%
> -Eosinophils 3,3%
> -Morphology RBC/WBC/PLT normal
> (the different WBC's are also listed in 10^6/l and /cmm instead of as%, i=
f you need to see those also, please ask)
> -Reticulocytes 2,5%
> -Sodium 151mEq/l
> -Potassium 4,8mEq/l
> -Chloride 116mEq/l
> -BUN 106mg/dl definitely TOO HIGH
> -Creatinin 0,44mg/dl normal
> -Tot. Protein 6,0g/dl or 60g/l normal this time, although on the high sid=
> -Albumin 2,64g/dl or 26,4g/l normal or TOO LOW???
> -ALT/GPT 118U/L
> -Gamma-GT 7U/L
> -ALK PHOS 29U/L normal but on the high side
> -Glucose 68mg/dl normal according to the refs, but maybe TOO LOW accordin=
g to me... ?? She doesn't have symptoms though, she fasted for 4 hours befo=
re the bloodwork was done)
> Estradiol 920pmol/l or 250pg/ml DEFINITELY MUCH TOO HIGH
> =

> =



End of ferrethealth Digest