From:
"Tressie"
Date: 2009-03-06 19:01:09 UTC
Subject: [ferrethealth] Re: Suppurative hepatitis
To: ferrethealth@yahoogroups.com
I recently posted about my 5 =BD year-old sprite Linguini, who was diagnose=
d with EGE in 2007. She had been managed quite well with diet but since he=
r 5th birthday in October she started getting sick again. She was put on a=
low dose of prednisolone in October and did better for a few months but th=
e past few weeks she has started failing again and has developed a fairly l=
arge abdomen.=20
On February 25th X-rays showed an enlarged spleen (not overly enlarged) but=
otherwise inconclusive. Her gums however, were in pretty bad shape even t=
hough in October they had been fine. Her last dental was in 2007.
My vet concluded that the prednisolone exacerbated a gum infection. She wa=
s put on Clavamox for the infection and Tramadol for pain and scheduled for=
a dental on March 3rd.
I got a call from my vet on the 3rd that her pre-surgical panel showed live=
r values off the chart, he did them twice because he couldn't believe the r=
esults. Given the results he was reluctant to put her under general anesth=
esia. After much discussion I felt that her mouth really needed to be deal=
t with because it was further compromising her health, so my vet did manage=
to successfully do the dental under Torbitol sedation.
I brought her home that afternoon. My vet had sent her blood sample out fo=
r a further more in-depth analysis by a professional lab, while we both too=
k a deep breath to decide what next.
Following are the results =96 I have added the normal ranges because these =
are Canadian values:
RBC 6.2 (normal range 7-13 x10E12/L)
Hemoglobin 128 (normal range 140-180 g/L)
Hematocrit 0.33 (normal range 0.40 =96 0.51 L/L)
MCV 53 (normal range 45-49 L/L)
MCH 21 (normal range 16-17 pg)
MCHC 391 (normal range 332-358 g/L)
Platelets 125 (normal range 131-44 x10E9/L)
Lymphocytes 0.8 (normal range 1.0-6.3 x10E9/L)
Total Protein 78 (normal range 49-76 g/L)
Globulin 45 (normal range 22-43 g/L)
ALT 1915 (normal range 39-196 IU/L)
AST 523 (normal range 10-90 IU/L)
Cholesterol 9.9 (normal range 2.94-8.94 mmol/L)
Glucose 9.4 (normal range 3.0-8.5 mmol/L)
Morphologies for WBC, RBC & PLT were normal. It was a good sample. Unfort=
unately, the RCT was not done.
However, if you note the ALT - it is alarmingly high!!=20=20
I contacted a well known and highly respected Ferret GI expert and asked hi=
m to consult with my vet, which he has graciously done. He was sent copies=
of the original pathology report and subsequent blood panels.
The tentative diagnosis, given by the `GI Guru' at this time is suppurative=
hepatitis caused by a bacterial agent. Linguini has been put on a course =
of Enrofloxacin (Baytril) and Amoxicillin for 2 weeks, while slowly being w=
eaned off the prednisolone and eventually switched over to Imuran.=20
However, all depends on whether her ALT goes down with the treatment. Afte=
r 2 weeks she is to have her PCV and ALT rechecked. Both vets are aiming f=
or an ALT in the 200 range. If after the 2 weeks the ALT has not dropped, =
the default differential diagnosis is neoplasia.
Liver disease is not common in ferrets, has anyone had a ferret with suppur=
ative hepatitis? What was your experience? What treatments worked or didn=
't work?
Thank you!
Tressie
[Moderator's Note:
Bilirubin number? That is the most important one to
get for liver figures with ferrets. See:
http://www.afip.org/consultation/vetpath/ferrets/Clin_Path/ClinPath.html
Scroll to Chemistry Panel paragraphs
and
http://www.afip.org/consultation/vetpath/ferrets/PDF/Ferret_GI_path_reports=
.pdf
It would also help to know if she is jaundiced (icterus).]
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