Baby was a bit ill at the end of June and in July ('01). When Jilly had her mouth abscess at the end of June, Baby came down with an infected mouth as well on the same day... She looked like she was in terrible pain and also had yucky stuff around her mouth but I couldn't see what it was. I took her to see Louise and she was put on antibiotics and her mouth cleared up. For a week, then it flared up again. This time I could see that it was her lower right canine tooth, she'd broken it off early in the year and it hadn't caused any problems until now. I read that teeth sometimes can get infected when they break off and the root is left in... So it was back to the vets for her and Louise anaesthetised her to see what she could do and whether she could remove the leftovers of the tooth... Well, the infection must have loosened it all, the tooth came out easily so Louise removed it. Baby was back on antibiotics and the wound healed quickly and she's been alright since.
Baby had an "emergency" operation Thursday 4th December. Wednesday night I noticed a big lump under her last left nipple. It hadn’t been there Wednesday morning and when I let her out at night she was staggering and falling over and then I saw the lump when I fed her a bit later. Thursday morning it had almost doubled in size. So she was operated on, Michaela said they like to remove fast growing tumours ASAP because they tend to be malignant and aggressive. I observed the operation. She actually had two operations. First we did an abdominal exploratory, we were so sure she had adrenal disease. She had progressive hair loss which got a lot worse over the last 2 weeks. She also lost a lot of muscle mass. But her adrenal glands were small and felt healthy so Michaela didn’t remove any (even though one of them (or both) could theoretically be bad). All her organs were healthy, all she had were 2 fluid filled cysts adhered to her stomach. Michaela drew most of the liquid out of both cysts and sent it off for pathology. Then Baby was stitched up. Then Michaela cut where the lump was, she thinks it was a lymph node, she removed it. When Baby was again stitched up, she cut the tumour open and there was already necrotic tissue. It’s being sent off to pathology. Baby was looking bright when she came round and she’s over 7 years old. Pain relief is such a wonderful thing!
But at home she didn't want to eat. She'd been off her food Wednesday night and only ate 20g when she usually eats 30-35g. Thursday morning she only ate 5g. After the operation she didn't want to eat anything, neither her chicken nor the A/D. She acted like she was feeling sick, when she sniffed food or tasted any, she started gagging. So I left her alone. Friday she still didn't want to eat and of course didn't want to take medication so I took her to the vets and Michaela gave her metocloperamide for the nausea, cimetidine to reduce stomach acid and she had vetergesic for pain relief as Michaela doesn't like giving rimadyl for pain relief if the animal doesn't eat. And she had her synulox antibiotic. I also bought some Waltham convalescent diet, it's a powder that you mix with water, it is energy dense and easy to digest. I syringe fed it to Baby when we got home- and she ate!!! :-) The anti sickness drug must have worked wonders. I fed her every few hours and she ate more and more, up to 15ml in one sitting. At night I injected her with more metocloperamide and she also had a rimadyl injection as the vetergesic isn't long acting (only 8 hours).
Saturday Baby looked very bright, ate her liquid convalescent diet greedily and she wanted to exercise a little but could only walk a few steps at a time. She must feel pretty weak and having been cut open between her hind legs it must feel horrible. From Sunday on, she had her ground chicken again and was getting better and better. Monday I put her back with her group and so far she is looking good.
I had her histopathology report back, she didn't have a tumour but some infection...
1. Sudden appearance tumour L inguinal, ? lymph node. Off food, lost weight. Cut surface necrosed. 2. Ex lap – all internal organs NAD. Cystic tumour small curvature of stomach, aspirated fluid.
Cellulitis and Purulent Lymphadenitis
Prognosis: Uncertain – Aetiology Not Clarified In This Submission
The submission consists of a biopsy sample of skin and subcutis, including mass, from the inguinal area, plus a fluid sample from which two smears were made, for cytology.
HISTOPATHOLOGY: the sections reveal the mass is a lymph node embedded in subcutaneous adipose tissue. The latter is heavily infiltrated by mixed inflammatory cells, with a high proportion of neutrophils, and the inflammation extends into the lymph node, which is also rather haemorrhagic, but shows little cortical follicular activity. There is no overt evidence of neoplasia in the sections examined. There is mild hyperplasia of mammary gland elements in the dermis overlying the inflamed node, and although there is some inflammation within the gland, the pattern is not that of a true mastitis, more of a bystander effect.
The appearances are consistent with focally severe, sub-acute cellulites with associated purulent lymphadenitis. The cause could not be identified in the sections, but is presumed to be bacterial infection.
CYTOLOGY: the smears are about 50% erythrocytes and 50% nucleated cells, but unfortunately, for some reason, the latter are poorly preserved and the majority difficult to identify. Most are small, round cells about 1-1.5x the diameter of an erythrocyte and I suspect they are lymphoid. This would suggest the mass is either a hyperplastic lymph node, or a lymphoma. The lack of cellular detail in the smears, however, means I am unfortunately unable to make a firm diagnosis.
Monday 17/05/04, Baby had a dental. We almost lost her (age 7-8) under anaesthetic. She had her teeth cleaned (and the root of a canine, that had broken off, drilled out) and Michaela was almost finished when Baby's heart stopped and she stopped breathing... Michaela injected adrenaline into her heart and got it started again, Baby also got some other injection for circulation or something. She took a long time to come round from the anaesthetic, luckily she was well enough to eat at night and seemed very bright Tuesday morning. Michaela is very good and researched ferrets and anaesthesia and does everything right, she gives the ferrets pre med, something to keep the heart going and a painkiller and then they get another painkiller after an operation or tooth extraction. And yet Baby still almost died... And yet she'd had such a big operation last December and didn't have a problem with the anaesthetic then...
Baby had been unwell since her dental in May. Two lymph nodes by her jaw (submandibular lymph nodes) were big and hard, all the other lymph nodes seemed enlarged (but during the autopsy we found out that they were just packed in a lot of fat). Baby's tummy also got big while the rest of her body went thin so we thought she had fluid in her abdomen. So by the middle of June we came to the conclusion that she had lymphoma and abdominal ascites. (I know, bad, bad, bad to make a diagnosis- and a wrong one- without tests, we're not doing that anymore, not assume but diagnose with tests...) We put Baby on antibiotics to see whether an infection was causing her lymph nodes to go up but it had no effect and then Baby went off her food. She would usually eat 30-35g of minced chicken morning and night but towards the end of June she would only eat 20g of chicken once a day in the morning. So I tried her on goats milk and she would drink some of that at night so at least she got some nourishment. I also started her on prednisolone and dissolved that in goats milk. She soon got her appetite back and ate well again.
Another strange thing was that she became very thirsty, I can't remember if it started in May or June but she acted like Bella had acted the months before she was put to sleep. When I got up in the morning, Baby was up, waiting to be let out of the cage. Then first thing she would go to the water bowl and have a drink, then go and find a bed to sleep, then get up every now and again to drink out of the bowl. Bella had been exactly the same. Also, Baby refused to drink out of the water bottle they had on the cage. Bella had never drank out of the bottle in the end. So I made sure I let Baby have a drink out of the bowl a few times during the day. She loved her goats milk that she got morning and night during the last month. It didn't give her diarrhoea.
She slowly went downhill. She became very thin around her head, neck, ribs (like she had lost all muscle mass) and put on a lot of weight around her tummy. I don't think she was suffering, all she did was drink much and sleep. She didn't have much quality of life, wasn't playing at all but she had a quick run around and didn't seem to be in pain so I couldn't have her put to sleep. But on 26/07/04 she looked worse. On 27/07/04 she definitely didn't look good, it was my birthday but I couldn't have let her go on another day so I went to my vets at the end of morning surgery and Michaela put her to sleep. I asked for Baby to be anaesthetised with a gas mask and not the gas chamber which had distressed Bella (and me) so much. Baby didn't fight the gas at all, drifted off quickly and peacefully and then got the heart stick. She was gone very quickly. I'd had Dana with me as well to keep Baby company so that Baby would hopefully be more relaxed.
I was expecting to see Baby riddled with cancer but there was nothing obviously wrong. In her chest cavity she had a cyst or lymph node filled with fluid, parts of her lungs had stopped working, her chest cavity and abdominal cavity were full of fat like we’d seen in Jack. Back then Dr Williams said that usually they only see this with adrenal disease so I made sure Michaela would look for the adrenal glands. The kidneys were packed in tons of fat so it was hard to find them. Michaela couldn’t find the right adrenal gland, the left one was tiny but we sent it in for pathology anyway. There was a growth on the pancreas, the liver looked dodgy, as did the spleen. The kidneys looked bad so maybe she was in renal failure. One kidney looked like it had stopped working and the other looked like it wasn’t fully working.
2 photos of Baby, taken July 04:
Baby's histopathology report:
Lethargy, inappetence, PD, abdominal distension, Splenomegaly not verified on post mortem.
Chronic Renal Failure
Prognosis Not Applicable
Kidney (slide 1, 2 sections): Several wdge-shaped areas in the renal cortex with a depressed capsular surface contain interstitial fibrosis, the tubules are either lost or distended and with attenuated epithelium, sometimes filled with hypereosinophilic material (protein casts). In one area, the tubular epithelium is completely lost and replaced by basophilic mineralized material. Glomeruli in these areas are absent or have a very thickened mesangium and shrunken tuft with variable degrees of fibrosis (glomerular sclerosis). Similar changes, i.e. thickened mesangium and some increase in cellularity are present in many other glomeruli across the sections examined. In some glomeruli, the epithelium of Bowman’s capsule is separated from the basement membrane by accumulation of palely eosinophilic amorphous material (Congo Red negative-not amyloid). The interstitium of the renal medulla has multifocal to coalescent fibroplasias (fibrosis) and compression or loss of collecting ducts.
Lymph node (slide 1, 1 section): There is a uniform population of medium size lymphocytes without clear germinal centers in the cortex and paracortex. The medullary sinuses are greatly distended by clear edema fluid. Several clusters of plasma cells are present in the septa. Within the sinuses, many macrophages are completely surrounded by erythrocytes that have attached to the outer surface of their cellular membrane.
Adrenal gland (slide 1, 1 section): A focal proliferation of cortical cells is present outside the adrenal capsule.
Liver (slide 2, 1 section): The surface contour is irregularly pitted. There are several clusters of oval cell proliferation with frequent differentiation towards small bile ducts present in the lobular parenchyma and, less often, in portal zones. Several small arterioles are also present within the lobular parenchyma (microvascular proliferation). Minimal areas of hepatocellular necrosis with some neutrophils are present.
No significant lesions are present in the pancreas.
The changes in the kidneys of this ferret are marked to severe and characteristic of chronic renal failure (CRF). CRF very possibly caused the clinical signs as glomerular injury is accompanied by protein loss and polyuria, which would have resulted in polydipsia. The cause of CRF is often difficult to pinpoint. Chronic inflammation with deposition of antigen-antibody complexes in the glomerular basement membranes is often associated with CRF development.
The liver had a mild bile duct hyperplasia and a multifocal microvascular proliferation. Microvascular proliferation in adult animals generally indicates some form of portal hypertension that stimulates the formation of alternative vessels to relief the pressure.
The appearance of the lymph node examined suggests an early stage of lymphosarcoma. There is cortical adrenal hyperplasia, not uncommon in ferrets.