From:
sukiec@optonline.net
Date: 2006-03-17 18:39:46 UTC
Subject: [ferrethealth] RE: Elevated liver enzymes--a different twist
To: ferrethealth@smartgroups.com
In case it is useful here is a portion of
http://www.afip.org/ferrets/Clin_Path/ClinPath.html
for which I have author's permission to carry here:
START QUOTE
Probably the most common misinterpretation that I see on a routine basis is in the area of hepatic enzymes. Remember, that the ferret, being by nature an obligate carnivore, has an extremely short digestive tract, and requires meals as often as every four to six hours. Should food not be available, it possesses the ability to quickly mobilize peripheral fat stores in order to meet energy requirements. When this physiologic mechanism is activated, the liver is literally flooded with fat, which results in hepatocellular swelling which may be marked. The result of this swelling is the leakage of membrane enzymes such as alanine aminotransferase, and as the hepatocellular swelling increases, occlusion of bile canaliculi occurs, resulting, over time, in elevation of alkaline phosphatase.
In conjunction with this physiologic change, elevations of ALT up to 800 mg/dl can be seen, and alkaline phosphatase up to approximately 100 mg/dl. This often causes confusion to practitioners, who render an erroneous diagnosis of unspecified hepatic disease. However, hepatic disease is quite uncommon in this species; the most common cause of true hepatic disease in the ferret is neoplasia, with lymphosarcoma causing 95% of cases. Rarely bacterial infections of the liver or biliary tree may be seen.
The diagnosis of hepatic disease in the ferret must be based not only on ALT and alkaline phosphatase, but other clinical indicators in the CBC and chem panel. Clinical elevation of icterus or an elevated bilirubin is an excellent indicatior of primary hepatic disease, or concomitant leukocytosis or pyrexia may lend additional credence to a diagnosis of primary hepatic disease.
Decreased total protein and mild hypoalbuminemia is a common finding in both ill and older ferrets. Most commonly, hypoalbuminemia indicates prolonged anorexia in the ferret, but it is also a common feature in long-standing inflammatory disease of the gastrointestinal tract. In older animals, gastroduodenal infection by Helicobacter mustelae is a common cause of mild hypoalbuminemia, and in young animals, any inflammatory bowel disease may cause this sign.
END QUOTE
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