From:
"Sukie Crandall"
Date: 2008-01-18 20:23:10 UTC
Subject: [ferrethealth] Re: elevated liver functions, blood
To: ferrethealth@yahoogroups.com
Carried w author's standing permission.
>From Dr. Bruce Williams, who is one of the world's top ferret veterinary pathologists:
http://www.afip.org/ferrets/Clin_Path/ClinPath.html
BEGIN QUOTE
Liver from an anorexic ferret. Note that this is a physiologic change rather than a
pathologic one. (Photo courtesy of Dr. Richard Montali, National Zoological Park).
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
and
http://www.afip.org/ferrets/PDF/Ferret_GI_path_reports.pdf
Helicobacter (common in ferrets) treats well with Biaxin and Amoxi, and if ulcers are
present then treat those aswell.
--- In ferrethealth@yahoogroups.com, "Ann" <annh330@...> wrote:
>
> In Sept Rascal, age 3, had blood work in advance to having a dental.
> The blood tests revealed elevated liver functions. ALT 402 (10-280),
> Alkaline Phosphatase 79 (15-45). As a result, when he was under
> anesthesia for the dental my vet also did a liver biopsy. Results of
> this were Mild diffuse lymphoplasmacytic cholangitis and diffuse
> moderate vacuolar hepatopathy. The second one is fatty liver which
> is common change in ferret livers. The first one, according to
> pathologist, suggested a low grade chronic inflammatory lesion that
> may be arising from the GI tract. We treated Rascal with
> metronidizole and amoxi. Repeat blood work showed the Alkaline
> phosphatase came back within normal range but the ALT was still high,
> though it did improve. It was 399 (82-289) The first test was done by
> an outside lab and the second was inhouse. On Wed I took him in for
> a ALT only and the results were 526(10-100). This was also an outside
> lab. Now...Rascal is acting fine, he is eating, drinking, pooping
> etc. Poops look ok. No vomiting. In short he has no signs of anything
> wrong. In fact we were surprised that his blood work was what it was
> in Sept because of this. My question is does anyone on this list have
> any suggestions as to what to do next. My vet is thinking liver
> support supplements such as Sam-E. Perhaps another round of GI
> treatment with metronidazole and amoxi. She is posting on VIN to get
> other vets input and I said I would post here to see if anyone had
> any suggestions. Thanks for any input.
>
> Ann
>
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