Igor

Igor

I got Mr Puss at the end of May '97. His owner, Mr Stevens, saw my ad for the ferret club that I had tried to start and saw the thing about the ferret rescue I also planned to organise and said that he had a male ferret to give away. I understood that the previous owner of his farm had asked him to look after his 2 ferrets or let them go wild. It was winter so Mr Stevens didn't want to release the ferrets into the wild- they lived in a bin. So he built a cage and kept them in a shed. But he also had terriers and other hunting dogs and one day one of the ferrets got out and got killed by the dogs. Mr Stevens didn't want that to happen again so he phoned me to see if I'd take the leftover ferret. I thought that was the answer to my wish for a friend for Jack, so of course I wanted him. So I met Mr Stevens, had a quick chat and took the ferret. Back home it was straight into the bathroom and I washed Mr Puss as he was absolutely filthy. Then Mr Puss went into the ferrets' travel cage which I had prepared for him. Also immediately phoned the vets to book him in for neutering- for the next day.

Mr Puss- soon renamed Igor- was so amazing! He dooked non-stop, like a wound up toy that won't stop, he was very hyper, friendly and so happy, it was so cool! I let him have the run of the house, he ran along all walls of all the rooms, I think he had never encountered stairs before because he had problems going down and couldn't get up very well- but after running up and down several times, he got the hang of it. He wouldn't stop running and he wouldn't stop dooking, so I also took him for a walk. He was a natural, he loved running so much that he didn't mind where we went, he wasn't scared of anything, wanted to run to the horses (girls from the village were passing on their horses) and to our neighbours' dog, and he was so happy to be out, I think he spent a lot of time being locked up.

The next day I took him for a walk in the morning, he walked like a dog and just ran, ran, ran. And then he went to the vets and I picked him up in the afternoon. He was fine by then as if they hadn't done anything to him. He ran all over the car while I was driving and going shopping, no pain, no discomfort, he was so weird.

After about 2 weeks his hormones had gone and I could finally keep him with the other ferrets. Jack bullied him in the beginning but I think that was just to make sure that Igor knew that he was boss. But Jack was still not his old happy self, maybe he wanted an albino friend???

Igor

Igor

17/09/00

Igor isn't very well. During July 00 we noticed that his tummy was getting bigger. He also seemed to be a bit more tired and had less energy so I thought he may have heart disease and took him to the vets on 10th August. We saw Louise and took Jack to compare to Igor, Jack has got a big tummy but his is full of fat. Louise felt Jack's tummy and then Igor's tummy and was sure that Igor had fluid in his tummy and did an aspirate. She got fluid out of Igor's tummy but there was also blood in the fluid which isn't good news. She gave me diuretics to give to Igor and we talked about possibly doing an exploratory on him if the fluid went down.

I soon decided against doing an exploratory. It would've shown us what exactly was wrong but it wouldn't have cured Igor and probably made his life shorter and just caused unnecessary pain. The fluid also didn't go down, he's just getting more and more fluid even though he's on diuretics.

On 18th August we took Igor back to the vets and saw Mr Jones, he had a good feel around his abdomen and said the liver felt a lot bigger than it should. Apart from that he agreed to leave Igor on diuretics as they may be helping his fluid. Igor weighed around 900-950g, at the beginning of August he was 1.2kg so he's got around 250g of fluid in his tummy which is a lot... But he's doing okay, he's running around, playing and looking alright. I'm feeding him mush as well as he likes it and I want him to enjoy whatever time he has left...

He reminds me a lot of Angel as Angel had a lot of fluid with blood in her abdomen. Angel had pancreatic cancer (not insulinoma) so I sort of feel like Igor has cancer as well. The only thing that is different is that Igor is still eating well. Angel went downhill fast and soon stopped eating. She died 1 1/2 months after I first noticed that her tummy was swollen. She went really thin really fast. Igor is eating fine and is not going as skinny as Angel was. But his tummy is getting really big and sometimes he seems to have trouble breathing after he's had his mush. But a little while later he's okay again. I've increased his diuretics, he's getting 1/8th of a 20mg frusemide tablet twice a day and I have increased it to three times a day and he's doing well on it.

Igor on 17/09/00
Igor 17/09/00

16/10/00

Well, I've had one nightmarish week, we went to the vets with Igor on Monday 09/10/00, I took Jack along as well because he'd been wobbly and unstable on his feet... Mr Jones felt Igor's tummy and listened to his heart but couldn't find anything wrong. He examined Jack as well but couldn't find anything. I asked him to do an x-ray anyway. And then I asked if he could put Jack on the x-ray table with Igor and he laughed but said okay. Well, both x-rays were okay, the hearts were fine and it didn't show anything else on Igor's x-ray. Both had some gas and while Igor was still anaesthetised, they did a scan on him and took some of the fluid out of his tummy to be sent to the lab. Igor's fluid was red and if I hadn't known any better I would have thought that it was a blood sample. The worst thing was when Igor woke up. They put the needle in 2 places in his tummy and the holes kept leaking! We sat at the vets for probably over an hour trying to stop the leaks... In the end they put a bandage (like an elasticated sock) all over him with leg holes cut in. And some cotton wool over the holes. On the way home, Igor kept struggling and the pressure from inside the tummy just made everything worse. At home it didn't take Igor long to get out of the bandage. And then the bloody fluid just kept dripping. But once he went to sleep and his tummy relaxed and the pressure inside stopped, it also stopped leaking. His tummy was really bruised but a few days later it looked a lot better.

We got the lab report Thursday, the other vet Louise said that the blood protein is low and the blood is leaking out of the vessels... That could be due to liver or kidney disease... So Friday Igor had a blood test... But everything was normal, liver and kidney functions and the blood protein was normal so that didn't cause the blood to leak. To put it simply, 4 tests later there was no diagnosis... Though Louise thinks that the most likely cause now would be cancer, of the pancreas or liver... Louise would like to drain him and do another scan or open him but no way! He could die from shock if he is drained. Plus he'll be feeling bad after surgery if he survives. He's doing sooo fine right now, I don't want to risk making him worse or loosing him. His tummy has also gone down a lot, maybe he did leak quite a bit, his tummy is softer and he's feeling better.

This is what the lab report said:


Cytopathology

Ascitic fluid
Description of fluid: Dark bloodstained yellow fluid
Red cells: 440,000/ul
Nucleated cells: 22,000/ul
Specific gravity: 1.033
Protein (fluid): 52g/l

Cytological examination

Prepared smears showed large numbers of red blood cells with an increased cellularity. The cell count may have been affected by the blood presence however. Small mature lymphocytes appeared to predominate. An accurate differential was precluded by the presence of disrupted cells. Fewer neutrophils seen. Neoplastic criteria not detected.

COMMENT

This fluid could be classified as a modified transudate if the effect of blood contamination is taken into account or possibly exudate. Observation at the time of collection may help differentiate between prior haemorrhage and sample induced bleeding. The underlying cause is not determined cytologically though differentials for a modified transudate would include non exfoliating neoplasia, other forms of tissue inflammation and possibly hepatic disease. If this is an exudate then sepsis and neoplasia would be the most likely differentials. Cytological evidence for which was not detected.

Full blood profile and re-radiography after abdominal drainage or ultrasonography if available may help further investigate the case. Alternatively if you are able to obtain a further fluid sample we would be pleased to process this FOC.


I've been writing with an American ferret vet, he replied to my ascites question that I asked on the FML and we've been e-mailing since. He suggested the x-ray so I said I'd go and then I told him what happened Monday, how his heart is okay but the ascites was so bad, well, he asked me to have a full post mortem done on Igor when his time comes and then asked if I could have the tissue samples sent to him and he'll do the analysis. He's interested in Igor's case and wants to do the pathology work... Free of charge...

20/11/00

Igor has been doing well on the meat as well. After his tests he actually lost some of the fluid in his tummy. During October his weight went down 150g and his tummy felt a lot softer, not hard and full of water. But over the last 2 weeks he put on 150g again. I don't know if some of that actually is body weight but his tummy has got bigger again as well. He is eating fine but has had a bad mouth again, he suddenly started salivating and his mouth smelt bad so I put him on antibiotics again and he soon got better, he's still on antibiotics now until his mouth has cleared.

10/12/00

Igor died on Wednesday 06/12/00. Monday and Tuesday I noticed that Igor was going downhill, he didn't go potty in the toilet, he couldn't manage to walk over to the toilet so he went potty next to his bed. Every few steps he'd collapse and be totally exhausted. He was breathing so fast and shallow. Tuesday he kept gagging and sometimes bringing food up. He had a lot of fluid in his abdomen so I thought the fluid was making him feel ill. So Wednesday we took him to the vets so they could take some of the fluid out, I thought it would make him more comfortable... But the vets brought him to me after he'd had it done and he came round while he was on my lap and looked even worse, still breathing fast and shallow and he looked in pain, he was coughing and looked like he was suffering so we made the decision to let him go... :-( The vets did a post mortem and found that on his pancreas was one big tumour, the size of a big walnut or a small satsuma. Some parts in it had calcified and were like bone... There were tumours in the liver, too... Louise is 95% certain that it's pancreatic primary with secondary tumours in the liver. I was so afraid that she'd open Igor up and then phone me and tell me that she couldn't find anything... But after she said that I was glad we let him go there and then and not let him go on suffering, I think we caught it at a good time. But still very sad when you make the decision and loose a ferret (or any pet) that you love... I was so hoping that he'd die in his sleep...

I lost my last guinea pig Sammy as well Friday the 8th so it's making this really hard. I had Sammy for 7 years and 7 months and it was the longest I'd ever had a pet. I'm still very upset about Igor and Sammy, I'm pretty good now at pushing it to the back of my mind and I cope by pretending nothing happened, my mind just blanks it out. But I do think about it every so often and then I get pretty upset. I've had Igor 3 1/2 years... He was about 3 years old at the time I got him.

11/01/01

Just before Christmas I went in to the vets yet again to ask like for the 3rd time whether Igor's lab results are back. I was finally told that the vets hadn't sent anything off... I was sooo angry again and started crying on the way back... It's like now I'll never know what exactly was wrong with Igor. Yes, the primary tumour was probably in the pancreas but what cells did it stem off? Were any other organs involved even though they looked okay? I'd asked Louise to do a full post mortem like Dr Williams had told me to ask and I thought that meant that vets take tissue samples of all organs and everything and send it off to the lab! I asked on the FML to see what Dr Williams would say and this is his reply (including some of my mail that I posted to the FML):

Dear Ulrike:

I'd been asking at the vets for over 2 weeks whether Igor's lab results had come back and then last Friday I was finally told that the vets hadn't sent anything off! I was really upset about that, I thought they'd automatically send tissue samples off...

When Louise had done the post mortem, she phoned me and said that on the pancreas there was one big tumour (size of a big walnut or small satsuma) and parts of it had calcified and there were also tumours on the liver. She was 95% certain that the primary tumour was the pancreas.

My question is: should the vets have sent tissue samples off when I asked for a full post mortem? Or do you have to tell the vets to send samples off if you want it doing? Are there different kinds of tumours that can happen in the pancreas? I mean stemming from different cells? Or was it okay for my vets to just have a look inside and not do anything else?

When you ask for an autopsy, it is usually a given that tissues are sent off to a pathologist, who is the expert in determining the cause of death and the origin of any neoplasms that may be found. There are a number of possibilities for a tumor in the pancreas - could it be from the exocrine pancreas - the digestive part, which is usually very malignant, or could it be an insulinoma, from the endocrine (hormonal) part of the pancreas. There is a large parapancreatic lymph node, which could be replaced by lymphoma (which I think is most likely as a result of the description here, but I wouldn't bet the farm on it. (That's why the microscopic examination is so important - we'll never know which one it was.)

No, when you ask for an autopsy, you should get the answers - that's what you are paying for. Not a non-answer like "some tumor on the pancreas, or maybe the liver". The liver in older ferrets commonly has small accumulations of fat within it that may be interpreted as metastatic tumors - is that what happened here, or was there true metastasis?

Igor had significant symptoms and we had discussed him for some time on the FML. It would have been nice to know what happened to him. I would suggest in future dealings, be very explicit about getting a microscopic exam by a pathologist.

With kindest regards,
Bruce Williams, dVM

I've been meaning to talk to Louise about Dr Williams' letter and to see whether she knows whether it was cancer of the exocrine part or whether the lymph node was affected. And if it was the lymph node, would that mean that Igor had lymphoma??? But I am sooo forgetful, I think I've seen Louise 3 times in the last few weeks and I always tried to remember to ask her but then as soon as I saw her- I forgot... I'll have to go and ask her...

Update 2007- I think it would have been a lymphoma and now wish I had tried the operation. Over the years I've come to believe that in most cases an operation is worth a try. All I'm interested in is that the ferrets get enough pain replief after and I ask that they get Vetergesic and Rimadyl for a few days and then maybe just Rimadyl for another few days.

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