From:
"merylfaulkner"
Date: 2010-05-22 20:10:25 UTC
Subject: [ferrethealth] =?iso-8859-1?q?Update_=96_sad_-_on_Foster_who_died_Tuesday_(May_4)_afternoon?=
To: ferrethealth@yahoogroups.com
Update on Foster =96 sad, hard to post, but sometimes outcomes help others =
with ferrets that may have similar courses after surgery. We are still not =
certain about the exact cause (no histology done)
I remind myself that ferrets withstand surgery well, but ongoing underlying=
conditions may not be obvious or solved. Foster died May 4. The veterinari=
an and I were both puzzled at his turn downhill. Her best first guess was t=
he spread of lymphoma, but it may have been gastric ulceration.
Some history for those who missed my previous posts (starts at 11106 if you=
search the archives for Foster and sent by Meryl Faulkner). His early sign=
s in early March were a lack of appetite and low blood glucose. We assumed =
a return of insulinoma. He was started on pred. He had surgery March 23rd a=
fter an ultrasound to make sure nothing untoward showed up. One part of the=
ultrasound report had a finding that may have had some bearing on his illn=
ess (thickening of stomach wall).
Post surgery he developed high bg and needed two nights on iv emergency car=
e on--after a bad response to the insulin (lowest dose but made him crash).=
April 12 he was started on amoxi and carafate for continuing poor appetite=
. On April 26 when I took him in because of continuing refusal to eat well =
(since surgery) and a continuing downhill reduction in food/fluid intake an=
d activity), my veterinarian thought that his continuing reluctance to eat =
might be a sign he had lymphoma, or be partly due to kidney disease, or per=
haps stomach problems. He was already on carafate Amoxi and pepcid, but th=
ey seemed to make his appetite worse despite mixing them with various treat=
s/food. In Dr Williams' writings it says client compliance is a problem bec=
ause ferrets hate the taste of the meds.
On April 26 (on the vets equipment) His BUN was high 70,his hemoglobin was =
12.5 (normal 12.4-18.7)his hematocrit 33.9 (norm range 36-56) and his potas=
sium (7.0)was elevated. I'd been subcuing him, but his BUN was not as high =
as that of a previous ferret who continued to eat while being given sc flui=
ds.
I had tried every kind of food - chicken with various additives which sever=
al kind list members suggested I try. At first they worked, and then he wou=
ld regress. He never made it on to dry food.
On April 27 we also started prednisolone. And he ate a little more readily =
for a day or two. Unfortunately then he once more ate very little, (no toot=
h grinding, just gagged) and I got desperate enough to scruff him and drip =
food onto his tongue. However this became (over the following days) a battl=
e, where he would gag and spit, and if he swallowed even a few ccs would lo=
ok thoroughly miserable. So by April 30 I quit hand feeding more than a few=
ccs, just tried more frequently. I also (feel bad now) cut back on the Amo=
xi and carafate since it seemed to make him even more ill. I tried various =
tempting things (he would eat a little warm vanilla ice cream =96 I know ba=
d stuff for ferrets), a few ccs of Welactin, Linatone, but most things just=
got a sniff and a pass. He still moved around and was drinking water and u=
rinating, but very small amts of feces. I gave up on the carafate, Amoxi an=
d pepcid on Saturday May 1 since it seemed to make things worse. He was pre=
tty much out of it over the weekend =96 just sleeping/comatose, but still o=
ccasionally woke and walked a little and got held. I called the vet early T=
uesday the 4th of May to make an appointment to have him euthanized, but wh=
en I checked on him after the call he was already comatose, and felt cool. =
Put him on a heating pad on low and made him comfortable, stroked him, and =
checked on him every 15 minutes. He died in the early afternoon.
Since our local lab no longer does necropsies at a subsidized rate, I froze=
his body temporarily since a biologist who does some wildlife necropsies o=
ffered to "take a look" if nothing else worked out. My vet when I called sa=
id she would be glad to do a necropsy (despite freezing make it impossible =
for histology) if I transferred the body to her. She has gotten out of the =
habit of offering to do it since some clients found the offer upsetting. Sh=
e now will make sure she offers to do them in future.
When the veterinarian opened his GI tract post mortem (she noted her surgic=
al work looked fine =96 and I had noticed his incision had healed perfectly=
) to check for obstructions, his gi tract was clear, but she found gastric =
hemorrhaging. The whole of his stomach lining was bloody with small clots o=
ver the entire surface. Since his tissues had been frozen, histology was no=
t possible. Since he had some loss of appetite (no tooth grinding though) p=
rior to the surgery for insulinoma, it's difficult to know how one could ha=
ve determined a possible gastric issue when his insulinoma seemed the cause=
of his lethargy/lack of appetite. He had no obviously tarry stools. There =
was one ferret introduction to our household prior to his illness, and he d=
id chase her, but she was submissive mostly. The other ferrets are fine. I =
also wonder (if it was ulceration)why the helicobacter mustelae seems benig=
n/asymptomatic in some animals and not in others. Guess like us humans, fer=
rets have varying and individual immune systems. Dr Williams article on hel=
icobacter makes for interesting but depressing reading. He really is a wond=
erful resource.
http://miamiferret.org/helicobacter.htm
A picture of stomachs with gastric ulcers =96 again Dr Williams (don't look=
at this if you're squeamish) but great pics-
http://www.afip.org/consultation/vetpath/ferrets/ulcers.html
The vet's description of Foster's stomach was small pinpoint hemorrhages wi=
th a bloody look to the whole interior of the stomach. In hindsight I wish =
we had started the Amoxi and carafate earlier than April 12, but that presu=
pposes that there was no other cause of the stomach issue, or that the stom=
ach issue started late in the process with some other thing being the trigg=
er. And why the heck didn't I see tarry stools =96 maybe once I saw some da=
rk stools, but most of the time they were baby food color. Very very frustr=
ating.
Meryl
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