Piper's autopsy pictures


Abdominal cavity with angry looking lymph node.
Piper

Spleen on left, angry looking lymph node (or adrenal gland?) in middle.
Piper

Heart.
Piper

Heart.
Piper

Spleen.
Piper

Heart.
Piper

Heart.
Piper

Heart.
Piper

Heart.
Piper



Piper's blood test results 03/12/08

Haematology

RBC 9.85 x10^12/L (7.5-11.9)
Hb 17.2 g/dl (12-20.8)
HCT 56.2 % (36-68)
MCV 57 fl (42.4-88.4)
MCH 17.5 pg (15-20)
MCHC 30.6 g/dl (26.2-38.6)
Platelets 258 x10^9/L (180-800)
WBC 2.49 x10^9/L (3.5-7) *** LOW ***
Neutrophils 70 % 1.74 x10^9/L (1.9-5.9)
Lymphocytes 30% 0.75 x10^9/L (1.7-2.9) *** LOW ***
Monocytes 0% 0.00 x10^9/L
Eosinophils 0% 0.00 x10^9/L (0-0.35)
Basophils 0% 0.00 x10^9/L

Blood film examination: 2 fresh blood smears and a film made from the submitted EDTA were examined. Red cells appear normocytic and normochromic. Moderate lymphopaenia with no abnormal cells seen. All other leucocytes appear of normal morphology. Platelet count and morphology appear normal with occasional platelet clumps in the tail of the EDTA smear.

Biochemistry

Total protein 41 g/L (53-72) *** LOW ***
Albumin 18 g/L (33-44) *** LOW ***
Globulin 23 g/L
Albumin Globulin ratio 0.8
Sodium 137 mmol/l
Potassium 6.2 mmol/l
Total calcium 1.25 mmol/l (2-2.95) *** LOW***
Phosphate 3.2 mmol/l (1.3-2.9) *** HIGH ***
Urea 25.5 mmol/l (3.6-16) *** HIGH ***
Creatinine 67 umol/l (35-80)
Alk Phos 37 U/L (30-120)
ALT 161 U/L
Bile Acids 19.3 umol/l
Glucose 7.9 mmol/l (3.4-7.4) *** HIGH ***

Clinical comments:
Hypoproteinaemic and hypoalbuminaemic.
May(?) reflect malnutrition/ failure to absorb/ failure to process protein (liver) or(?) excess loss (gut/ kidney).
Hypocalcaemia may be due to malabsorption or just reflect the hypoproteinaemia.
The(?) urea is very high. In the absence of a high creatinine, this could be pre-renal (I would check cardiac function but should also consider gut disease or(?) a generalised catabolic state) but it is high enough not to rule out renal failure.

(The ? are by words that were somewhat cut off on the copy of the report.)


Piper's histopathlogy report

Diagnosis
Lymphoma (Lymphosarcoma)

Prognosis
Not Applicable

Post-mortem tissues from a ferret: multiple samples received; heart evaluated grossly and 23 sections of various tissues including heart evaluated histologically.

GROSS FINDINGS.

Heart. Evaluation of the formalin-fixed heart revealed a focal tan thickening of the base of the left ventricular free wall. The ratio of the ventricular septal diameter to the diameter of the right ventricular free wall was approximately 2.75 : 1.

HISTOLOGICAL FINDINGS.

Tissues generally show moderate autolysis, which has hindered interpretation of some tissues.

Heart. Extensively in the wall of the left ventricle near the atrioventricular junction, extensively in the papillary muscles, and to a lesser extent in the right ventricular free wall and elsewhere in the myocardium, myocardiocytes are disrupted by an interstitial infiltrate of round cells. These vary somewhat in size but tend to have scanty cytoplasm, large oval nuclei and prominent nucleoli. In a few areas where the cells are better preserved, mitotic figures are recognizable at approximately 3 per 400x field. Intervening myocardiocytes are sometimes hypereosinophilic with condensed nuclei and are surrounded by minor haemorrhage (necrosis; possibly infarcts). Rarely, rafts of similar round cells are present in the lumens of myocardial blood vessels.

Lung. Around most interstitial blood vessels and around airways, there are nodular clusters and sheets of round cells similar to those in the heart. These frequently and extensively infiltrate bronchial epithelium (epitheliotropism). In the alveoli, similar cells are present and are sometimes intermingled with bizarre multinucleate giant cells. There is generalized moderate oedema.

Mediastinal Lymph Node. Adjacent to the lung, a node is overrun by similar round cells. There are zones of necrosis, along with some infiltration by spindle cells. Dense rafts of similar round cells plug lymphatic vessels in adjacent adipose tissue.

Unspecified Lymph Nodes. Lesions are similar to those in the mediastinal node, described above.

Spleen. Focally extensively, similar round cells expand the red pulp. Adjacent to these are zones of necrosis and haemorrhage (infarction). Elsewhere, there is prominent extramedullary haematopoiesis.

Stomach and Small Intestine. No lesions are recognized.

Pancreas. Round cells similar to those described above from the presumed pancreatic lymph node spill out into adjacent adipose tissue and locally infiltrate the pancreatic interstitium. Otherwise no lesions are visible.

Liver. Multifocally and apparently randomly, clusters of similar round cells disrupt and replace hepatic parenchyma. There is moderate, generalized congestion.

Kidney. Occasionally, radiating wedges of fibrocollagenous connective tissue with clusters of small mononuclear leucocytes including some recognizable plasma cells extend from the medulla to the cortex. Entrapped glomeruli are sometimes sclerotic and entrapped tubules sometimes contain proteinaceous casts. Elsewhere, renal tubular epithelial cells contain brown pigment (possibly bile).

Adrenal Glands. Both glands are largely replaced by similar round cells, with remnant islands of cortical and medullary tissue. Some zones of necrosis, haemorrhage and fibrosis are also present.

Vulva. In the dermis / lamina propria, there are dense nodular aggregates of round cells similar to those described above. There is mild congestion.

DIAGNOSIS:

Lymphoma, immunoblastic-polymorphous type

COMMENTS:

This ferret had malignant lymphoma (lymphosarcoma), which had infiltrated most organs, including the heart and the vulva. Lymphoma is the cause of death.

Lymphoma is a fairly common malignancy in ferrets. This neoplasm takes several different forms in this species, and the immunoblastic-polymorphous variant is relatively uncommon. All of the systemic forms behave similarly though, and for the most part result in rapid metastasis and death. It is common for clinical signs to arise suddenly, as in this case. Any temporal link to clinical treatment or to the history of dental surgery is coincidental. Lymphoma in ferrets carries a poor prognosis and is rarely responsive to chemotherapy. Earlier diagnosis would almost certainty not have changed the outcome.

This ferret also had mild to moderate, chronic interstitial nephritis, a common lesion in middle-aged ferrets. There is some evidence of renal protein loss, which might account for some of your clinical test results. Nevertheless, this lesion does not appear severe enough to have led to renal failure and is not the primary cause of illness or death.