From:
Ulrike
Date: 2008-10-11 20:48:30 UTC
Subject: [ferrethealth] Re: Distressing last moments of ferret, what happened, please?
To: FHL <ferrethealth@yahoogroups.com>
I got Nipper's histopathology report. (He developed acute respiratory
failure (?) 1 1/2 weeks ago and died at the vets, possibly due to a
blood clot in his lungs?) I don't understand some things and haven't
had a chance to speak to my vet, yet. There was a lot of inflammation
and fibrosis? It says that Nipper had diabetes even though he was
diagnosed with insulinoma, I repeatedly measured his blood glucose and
it was low. So he was put on pred which was also prescribed for his
chronic lung disease. I admit I didn't check the BG again in the last
half year or so as it seemed stable. Am I right thinking there were
blood clots found in the gall bladder? If so, can we assume that one
of those clots probably went to the lungs? He was diagnosed with
adrenal disease even though he didn't show any symptoms... With all
the inflammation, could he have had ADV? 1 1/2 yrs ago he had
neurologic problems where he could barely walk. I had him for a while
when his owners went on holiday and he got worse, when I put him on
the floor, he would just lie on his side, then crawl awkwardly to the
nearest bed. Pred back then at 1 mg/kg fixed his problem and he
recovered fully. And a year ago his owners surrendered him and his
daughter to me.
Would the mild pancreatitis have caused his anorexia? Or the gall
bladder/ bile duct inflammation?
Ulrike
Report:
Sections from necropsy samples of various tissues from a Polecat
Ferret, age and sex not specified, were examined microscopically.
[Nipper was an albino, 8 1/2 yrs, male]
LIVER: 3 samples received; 3 sections examined. One of these sections
is largely unremarkable apart from a very small, single focus of
hepatocytic vacuolar change. One section includes a large, cystic
structure lined by a single layer of cuboidal epithelium, which I
think is probably the distended gall bladder, but it is filled with
blood and fibrinous clot material. The parenchyma surrounding this is
markedly congested, the hepatocytes swollen and vacuolated and the
portal areas inflamed and fibrosed, with moderate dilatation of bile
ducts. In the third section, there is marked bile duct proliferation
and marked peribillary, lymphoplasmacytic inflammation. The majority
of the proliferated bile ducts are mildly distended with more or less
amorphous debris, often admixed with a few neutrophils.
KIDNEY: 1 sample received; 1 section examined. A single area of
interstitial fibrosis extends from the capsule down into the medulla
and is associated with moderate tubular atrophy and dilatation and a
minimal infiltrate of mononuclear inflammatory cells. The remainder of
the section is histologically unremarkable.
SPLEEN: 1 sample received; 1 section examined. The splenic pulp is
expanded by a combination of congestion and extramedullary
haemopoiesis.
LUNG: 2 samples received; 2 sections examined. Microscopy reveals
fairly marked congestion accompanied by slightly increased cellularity
of the alveolar walls and slightly increased numbers of alveolar
macrophages. A large plug of mucoid material admixed with a few
neutrophils is present in one of the mainstem bronchi.
HEART: 1 sample received; 2 sections examined. Grossly, this appeared
abnormally globose in shape and the lumen of the left ventricle was
markedly dilated. Microscopy reveals patchy vacuolar degeneration of
myocytes in the left ventricular wall, often accompanied by mild to
moderate anisokaryosis and associated with mild interstitial fibrosis.
There is minimal inflammation.
ADRENAL GLAND: 1 sample received; 1 section examined. The normal
architecture of the gland is largely effaced by a cellular
proliferation forming a mass that occupies almost the entire cortex in
the section examined, expanding the gland markedly, crossing the
capsule and growing into the adjoining adipose connective tissue. It
consists of a mixture of cell types, including very large, ballooned
cells with clear cytoplasm; medium-sized to large cells with fairly
abundant, variably vacuolated, eosinophilic cytoplasm; and smaller
cells with a small amount of amphophilic cytoplasm. There are also
some interconnecting bands of spindloid cells coursing through the
mass. There is little nuclear atypia and only occasional mitoses can
be found.
PANCREAS: 1 sample received; 1 section examined. In this section there
is patchy, mild interstitial inflammation and fibrosis of the exocrine
portion of the gland and there is marked vacuolation of the Islet
cells.
DIAGNOSIS: Various pathological changes - see "Discussion" below.
DISCUSSION: There is evidence of fairly severe, chronic cholecystitis
and cholangitis, which was probably sufficient to have been causing
biochemical changes consistent with hepatic dysfunction. The cause is
uncertain, but as there is also mild pancreatitis the possibility of
infection ascending the biliary system from the intestine should be
considered. Vacuolation of islet cells is often seen in animals with
diabetes mellitus.
The heart showed gross and histological changes compatible with
dilated cardiomyopathy and the congestion and mild interstitial
pneumonia in the lungs may have been associated with this, although
few pigmented macrophages ("heart-failure cells") were seen in the
sections examined. Cardiomyopathy is fairly common in ferrets, but a
definitive cause has not been identified, as far as I am aware. It is
particularly common in some American lines, suggesting a possible
genetic basis. Cardiomyopathy may also occur secondary to some
myocardial infections, especially viruses, and some workers have
suggested a dietary deficiency may be to blame. Clinical signs may be
seen In animals as young as 1 year of age, but are more common between
about 5 and 7 years.
Adrenal tumours of the type seen in this animal, comprising a
pleomorphic population of cells, effacing the normal structure of the
gland, have traditionally been diagnosed as carcinomas, but there is
little published material correlating histological criteria used in
diagnosis with clinical outcome and I suspect many such tumours are
behaviourally benign and may be better classified as adenoma.
The combination of extramedullary haemopoiesis and congestion, as seen
in the spleen of this animal, is a common cause of splenomegaly in
ferrets but the cause remains uncertain, although there are many
hypotheses.
There is also evidence of mild, patchy, chronic interstitial
nephritis, which is unlikely to have been of any clinical significance
at this level.
2008/9/30 Ulrike <ferretlove.uk@googlemail.com>:
> Nipper, 8 1/2, last year he was diagnosed with chronic lung disease and
> cardiomyopathy. He got Fortekor (Benazepril) and a few months ago we
> started Theophylline. He was already on Prednisolone because of insulinoma
> and the pred was needed for the lung condition, too. And 4-5 or so months
> ago we started Furosemide because he started coughing with fluid in his
> lungs. He did quite well until recently.
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