From:
"M. Michaela Maurice, DVM"
Date: 2007-09-26 01:04:11 UTC
Subject: [ferrethealth] Re: Lymph fluid in the abdomen
To: ferrethealth@yahoogroups.com
Dear Paty,
Hi. I hope little Leela is continuing to do well.
To answer your questions:
(NB: I didn't plan to write such a long or detailed answer, but in the end,
I hope more information is better than less - if anything is still unclear,
feel free to email me)
The kinds of ferret behaviour you mentioned was not the kind of 'trauma'
to which I was referring. When
I referred to traumatic injury, I was
referring to serious trauma - the
kind of trauma where you would have
seen other signs (at minimal,
bruising of some sort). In fact, even
with severe trauma, like a 'hit
by car', rupture of the thoracic duct
(a large lymph vessel) is
extremely rare.
If some sort of trauma did occur while you were out of town, the good
news is that studies
show that thoracic duct healing is very rapid,
with effusions resolving within 1-2 weeks. In
addition, the majority of
"spontaneous" cases of chylous effusions heal
spontaneously, or
with conservative medical management.
In
dogs and cats, conservative medical management consists of:
paracentesis/abdominocentesis (ultrasound-guided removal of the fluid
with a needle), a low-fat diet (to decrease the amount of chyle
produced
to help the body absorb the fluid more easily), and
benzopyrone
drugs (rutin) . The efficacy and potential side effects of
benzopyrone
drugs have not been determined in cats or dogs (never mind
ferrets).
They are used with caution.
With repeated paracentesis, one would monitor for electrolyte
imbalances (hyponatremia and hyperkalemia being most common)
and
protein losses.
Surgery
is considered when the cause is unknown, or when conservative
medical
management is either impractical, or fails to resolve the effusion.
(note: full resolution can take upwards of two months).
Unfortunately, in the majority of cases of chylous effusions,
the cause remains undetermined.
I still think that, despite the lack of other findings, the most
likely
cause that should be ruled-in/out, is a neoplasm (lymphoma),
either
directly obstructing the lymphatic system, or, as is often the
case
with carcinomas, causing inflammation of the visceral organs,
and/
abdominal lining, leading to leakage of the lymphatic vessels.
Given
that the cause of the effusion remains unknown, I would view
her weight
loss with diuretics with cautious optimism. It would be
especially important to confirm that the weight loss is coming from
a decrease in
the abdominal fluid, and not simply a decrease in
blood volume. This is easily done with a follow-up ultrasound.
(The idea is that
diuretics will decrease blood volume, "helping"
to mobilize fluids from
abnormal areas (e.g. ascitic fluid),
back into the vascular system.
With Chylous fluids, the fat and
protein levels can interfere with this
movement. In human medicine,
diuretics are used in cases of chylous
ascites, with mixed results.)
I
truly hope that this turns out to be one of those enigmatic
(a.k.a
idiopathic (unknown)) cases, and that both of you have
many years to
come.
(And, keep us updated! :))
Best wishes,
Dr. Meesh
a.k.a. meesh, meeshmeesh, M. Michaela Maurice, D.V.M.
If one advances confidently in the direction of their dreams,
and endeavors to lead a life which they have imagined,
They will meet with a success unexpected in common hours.
Henry David Thoreau
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