From:
sukiec@optonline.net
Date: 2006-01-06 17:00:31 UTC
Subject: [ferrethealth] RE: hard belly//waiting for cbc results
To: ferrethealth@smartgroups.com
Oh, somehow I missed or forgot that she is only 2 and 1/2 years old.
Okay, first off if a CBC with Chemistry Panel was done your vet will have the glucose number BUT the glucose number on sent-out blood is ALWAYS lower than an immediate in-house due to the time factor. If only a CBC was done then you would want to do the complete thing, anyway, because you need the info in the rest of the test before you do surgery because if some things are off then surgery could be too tricky, or stabilization may be needed. Also, since insulinomae are hard to see, testing the blood glucose first lets a vet know before surgery if pancreatic surgery should be done at the same time.
Removing insulinomae is harder than a left adrenal, but a vet who is used to ferrets can do it.
Sometimes ultrasound images of adrenals can't be trusted so your vet is probably worried that opening the ferret up could pose a problem.
One thing you and your vet could try that is short of surgery until you know more is to try a Lupron DEPOT shot (not 24 hour Lupron) and melatonin if in North America. (If you are in Australia, Europe, or South America it may be easier to get Suprelorin which is less costly but less studied, though several studies do exist where it is useful medication for treating adrenal disease in ferrets. I do not know if Suprelorin is available in Canada. Nor do I know which is most available in pasts of Asia.)
Anemia with adrenal disease tends to be severe and can be fatal, not mild.
Another possible cause of an enlarged spleen and mild anemia is that the ferret could be having a helicobacter flare-up, and this would be more typical for that age bracket. In this case the ferret could be more vulnerable to forming ulcers and surgery would be an added strain, so your vet might consider checking the feces for blood traces, or even just starting some of the liquid form of Carafate which is available from any pharmacy and now from some vet hospitals, and then after a while trying a combo of Biaxin and Amoxi to bring down the helicobacter. Remember that Carafate works best if given at least 10 minutes before food (longer after), and that there must be at least a half hour between the Carafate and the other meds so that the Carafate does not diminish their effect.
Here is some adrenal complications info garnered from past posts of Dr. Jerry Murray:
Approaches for ferrets with adrenal disease: surgery (usually best); Core meds: Suprelorin/deslorilin in countries which have it, Lupron, and melatonin. Approaches when there is anemia from bone marrow toxicosis: if safe enough get that diseased adrenal out pronto; bone marrow transplant can be done (See FHL Archives) but it takes a few days to kick in; blood transfusion preferably from a large ferret (Ferrets do not have blood types.). Meds: Lupron and melatonin to stop stimulation of adrenal by pituitary, Arimidex to inhibit estrogens (Both genders have both androgens and estrogens; estrogens are the usual culprits for marrow toxicosis and for prostate swelling secondary to adrenal disease.), Epogen and Procrit to stimulate the bone marrow to make more marrow cells, supplementary iron and B vitamins. Those are NOT either/or. A ferret with bone marrow toxicosis should be expected to need all stops pulled out to get the ferret well enough to undergo surgery. (If the ferret is among the less common ones who have excess androgens then Casodex can be considered, but that is more commonly useful in male ferrets with enlarged prostates or aggressiveness, or both. Other things to do, besides Casodex, when a swollen prostate from adrenal disease results in urinary blockage: have vet remove urine with a needle and do emergency adrenal surgery. Left too long if it is not blocking fully, the prostate may form a cyst and those require much more tricky surgery so that they can drain constantly. Meds: Propecia/Proscar, Lupron and melatonin. Sometimes Flomax may be tried (I think that this is not an established use (?) but Dr. Murray has mentioned trying it once for when the situation was dire.)
Here are some excellent adrenal write-ups:
http://www.miamiferret.org/fhc/basics.htm
http://www.miamiferret.org/fhc/adrenal.htm
http://www.miamiferret.org/fhc/melatonin.htm
http://www.miamiferret.org/fhc/24hr_lupron.htm
It sound like right now what is going on with your little one is not completely clear so your vet doesn't want to leap precipitously without knowing more what is going on, and if it is even at a point where anything should be done.
What I think that you should do is to pursue further testing through this vet and perhaps treatment for a splenic infection immediately following the testing, and talk with the vet whether you might or might not want to try medical approaches for the possible adrenal enlargement now. Stick with the same person for while during this info gathering because the person has said accurate things.
Later, if you are still worried, just ask your vet for a photocopy of the test results and what has been done so far, so that you can seek a second opinion. It may be that what concerns you is within the norm but you just had not noticed it before.
A question: does the hard aspect come and go? There is the transverse colon up near the edge of a normal to slightly enlarged spleen, and I have run into people feeling feces in the that part of the colon and not knowing the difference between that and the edge of the spleen. If it comes and goes, that is what you are feeling.
I think that right now is too early to settle on an adrenal being a problem. It MIGHT be, given that ultrasound image, but ultrasounds can at times false make an adrenal look larger than it is. That seems to be far less of an occurrence than it used to be a decade or more ago, but just within the last few weeks I read a post from someone whose ferret had this happen again, so it is still a possibility. Another option for you, one which we use when we have a questionable case is the TN Panel. You can info on that in the FHL Files, the FHL Archives, and in Miamiferret.
====================================================================<<<
Whatever you Wanadoo, click below:
http://ads.smartgroups.com/adclick/CID=000000b7c79a99a500000000
====================================================================>>>
--
If you want to share pictures, use the calendar, or start a vote
visit http://www.smartgroups.com/groups/ferrethealth
To leave the group, email: ferrethealth-unsubscribe@smartgroups.com
Report abuse http://www.smartgroups.com/text/abusereport.cfm?gid%3D1423922&mid%3D16325