From:
Jen Phillips
Date: 2007-02-11 10:01:49 UTC
Subject: [ferrethealth] Chronic Diarrhea
To: ferrethealth@yahoogroups.com
Hello,
I'm writing in hopes of finding some help for my mom's male ferret Kodo,
who is 6 years old. This is a bit long, but I'll try my best to keep it
well organized and easier to read. Kodo is the only ferret in the group
of 4 with these symptoms.
Kodo's Symptoms:
-Chronic diarrhea off and on for over 2 months now (started off just
soft & sometimes seedy, but has progressed to unformed blobs)
-Significant Weight Loss
-Teeth Grinding, Face Rubbing
He's been seen by his vet several times, and been on a few treatments
which I'll describe in detail below. It seems that everything we've
tried so far has either helped for awhile (only to have the diarrhea
return shortly thereafter) or not helped at all. Here's his medical
history since this all started:
11/20/06
-1st trip to the vet after noticing the diarrhea.
-Physical exam normal.
-Stool sample showed nothing abnormal.
-An ultrasound revealed a large right Adrenal (2cm)
-Everything else appears normal.
Kodo was prescribed Metronidazole (50mg/ml) 0.16ml 2x/Day for 10 Days.
11/28/06
-Kodo's diarrhea continues, so back to the vet.
-Kodo had a BG of 52 on 11/23/06, so Pred was started (5mg/ml) 0.15
2x/day X 1 Week.
-He was also put on Amoxidrops (don't have the dose handy) for 10 Days.
-We also continued the Metronidazole (for a total of 20 days, I think).
There was some slight improvement from something done here, my guess is
the Pred, but the diarrhea was back soon after.
12/09/06
It had been 4 weeks since we first saw diarrhea. After the slight
improvement it seemed to come back a bit worse, sometimes green, and
thinner. His weight was really starting to drop. Back to the vet
again. IBD is suspected, but lymphoma was also mentioned as a possibility.
Exam:
-Heart & Lungs Normal
-No palpable masses
-Did CBC & Chem (results below)
-An ultrasound was done again. The head of his spleen appeared to be
slightly mottled, so the vet got aspirates of that as well as his large
right adrenal gland, which he kept in case we decided to have them biopsied.
-Vet recommended increasing the Pred (6.7mg/5ml) to 0.55ml 2x/day to see
if this helps.
-------------------------
CBC & CHEM
-------------------------
ALB 2.3 g/dL *(L)*
ALKP 58. U/L
ALT 100. U/L
AMYL 25. U/L
BUN 24. mg/dL
CA 8.9 mg/dL
CHOL 144. mg/dL
CREA 0.7 mg/dL
GLOB 3.5 g/dL *(H)*
PHOS 6.8 mg/dL
TBIL 0.1 mg/dL
TP 5.8 g/dL
GLU 61. mg/dL *(L)*
NA 160. mmol/L
K 4.7 mmol/L
Cl 124. mmol/L
** WBC 3.45 K/uL
LYM 0.81 K/uL
MONO 0.25 K/uL
NEU 2.29 K/uL
EOS 0.10 K/uL
BASO 0.01 K/uL
%LYM 23.4%
%MONO 7.3%
%NEU 66.3%
%EOS 2.8%
%BASO 0.2%
HCT 43.4%
RBC 9.04 M/uL
HGB 14.7 g/dL
RETIC 28.6 K/uL
%RETIC 0.3%
MCV 48.0 fL
RDW 16.8%
MCHC 33.9 g/dL
MCH 16.29 pg
PLT 217. K/uL
MPV 8.78 fL
PCT 0.2%
PDW 15.6%
**WBC incubation time too long. (WI 8)
-------------------------
We did noticed quite a nice improvement in Kodo after this increase in
Pred for awhile. His poop was back to normal and he gained most of the
weight he lost back. But after several weeks we started seeing
ocassional slightly abnormal poops again (less formed and sometimes a
little seedy but fairly normal color). Sometimes we'd only see 1 nasty
one and then a week might go by before we'd see another. But it became
more abnormal and more frequent again.
By 1/29/07 he was no longer having any normal poos. Things quickly went
downhill for him until there was no form at all to his stools, it was
just liquidy. We started giving him A/D after doing some reading in the
FHL archives, in hopes that he might improve or at least keep things
from getting worse until he could be seen by the vet. It didn't seem to
do much although he was grinding his teeth a little less after it was
introduced.
2/3/07
It was decided at this visit to do biopsies in order to get a definite
diagnosis and to hopefully begin the proper treatment since his problems
have come back full force. Exploratory surgery was done and here's what
he made note of on his report of the surgery:
-GI Tract had no masses
-No enlarged Mesenteric Lymph Nodes
-Mild adhesions on the pancreas, but no palpable pancreatic nodules
-Spleen & Liver appear normal
-Left adrenal gland, which was removed awhile back, has regrown
-Took a piece of intestine and stomach to send out for biopsy
-BG taken while he was there was 45
Food was held for a few hours after surgery, but then he was given an
A/D slurry every 2 hours.
He suggested that while we wait for the results of the biopsy we should
continue the A/D at home for at least 2 days. Then we were to slowly
wean him back to kibble. He recommended a novel protein diet such as
Z/D, Innovative Vet Diet(IVD) (Duck or Venison) that could could help if
Kodo is having trouble with his regular food (Iams Kitten).
He also put him on some new meds. The pred and Melatonin are both
ongoing meds now. So, here's his daily cocktail:
1PM
Metronidazole, 2x/Day (30 days) - 0.15ml
Amoxicillan, 2x/Day (10 days) - 0.3ml
Carafate, Every 8 hours (14 days) - 0.3ml
Melatonin (1x/Day, ongoing) - 1ml
Pred (2x/Day, ongoing) - 0.55ml (on
2/10/07
We got the biopsy results. There's no cancer present, which was
certainly a relief to all of us. The only thing found was mild
inflammation, so he said if it is IBD, it's a mild case. So, this
doesn't really tell us much.
He still has the diarrhea, it's barely improved (pudding like puddles
rather than so watery, usually brown, but sometimes green), even with
all these meds that are meant to help with diarrhea and upset tummy. We
tried Z/D with him starting 2 days after he came home, making it
slighlty soft as recommended. He ate some of it the 1st day we offered
it, but by the following day he would not touch it and seemed agitated
if the Z/D was even offered to him. He hasn't touched it since, and
won't eat anything that he normally likes with Z/D mixed in. He'll
still eat the A/D just fine though, but he's waiting to be hand fed most
of the time rather than eating on his own since the surgery.
He's also losing weight again. He never even made back to his normal
weight. It seems that no matter what's been tried, Kodo either gets
better short term, or not at all. And the flare ups in his symptoms
seems worse each time, and last longer. It feels like we're just
watching him slowly wither away. Our vet is great, but I think even he
is feeling a little perplexed by now.
We really don't know what to do at this point, aside from continuing his
meds until the course is over and trying the special diet of A/D and
whatever easily tolerated kibble he'll eat.
Wow, that was alot to tell, but I think I've covered everything by now,
which just leaves some questions. I'm sure I'll think of other
questions after I send this, but it's a good start.
What else could this be if not IBD or intestinal Lymphoma?
Is there anything else left to give us answers when bloodwork and the
biopsy haven't told us much?
And are there other meds that might be useful in this situation?
What is the best possible diet for a ferret with mystery diarrhea?
Any help with this would be great. We want to do everything we can to
stop this. I don't know how much more of this his little body can
handle, and we're running out of ideas.
Thank you,
Jen
--
Happy Dookin',
The Hidey Hole Gang - http://www.hideyhole.org/
Jen, Mike & The Critters
The Ferrets - Loki & Vivi
The Rats - Ruby, Selphie, Rikku & Trillian
Missing Jamocha, Fria & Duke (ferrets)
Algernon, Plato, Mystique & Boo(rats)
Punk (hedgehog) & Dixie (chicken)
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