Introduction
Ferret's are highly prone to several serious
diseases. In addition to insulinomas and adrenal gland disease, they
are also prone to cancer. This page shows a ferret that has a
liver
cancer.
Symptoms
Some ferrets do not show any
symptoms while others exhibit lethargy and weakness and a distended
abdomen. There might be a decrease in appetite and weight loss.
Symptoms alone are not enough to diagnose liver cancer.
Diagnosis
Like most diseases, the diagnosis of liver cancer
is made based on history,
examination findings, and diagnostic
tests. In this specific case an
exploratory surgery was performed to verify the diagnosis and
determine the extent of the problem. an ultrasound could have been
performed also. Since ferrets are prone to so many internal organ
diseases, and since exploratory surgeries can be performed rapidly
and yield a large amount of information, it is common to perform
surgery instead of ultrasound. Some ferrets are diagnosed as having
cancer when an abdominal surgery is being performed for other reasons
(adrenal gland
disease, spay,
insulinoma).
This is especially true for the ferrets that are not showing any
symptoms of this disease.
Blood
samples are an aid in the diagnosis and can also be helpful
to rule out other important diseases that might be occurring
simultaneously. Our laboratory specializes in working with
ferrets, and has a special blood panel for
them.
We are
commonly asked how the heck do you get blood from a ferret.
They are certainly one of the more difficult patients to
obtain blood from. This is where the expertise of our
nursing
staff comes into play. a very
small needle is used because the veins are so fragile. This
ferret is having its blood taken from a vein on the side of
its rear leg.
This
test tube is filled with fluid that was taken from a ferret
that had a distended abdomen due to liver cancer. analysis
of this fluid in conjunction with other diagnostic tests
gives us a clue as to its cause.
A useful tool as an aid in this diagnosis
is radiography. It gives us a clue as to the presence of
fluid along with abnormalities of the internal organs.This
ferret is laying on its right side, and has a distended
abdomen due to a large liver and fluid in its abdomen. It
also has a large spleen. In addition, there are 3 metallic
clips visible just under the kidney from a prior surgery for
adrenal
gland disease. The clips were
used to stop bleeding when the diseased adrenal gland was
removed. The identified organs are: Liver (L), Stomach (S),
Kidney (K), Spleen (SP) and Bladder (B).
a view of this
same ferret while it is on its back shows the large area of
the liver and the large spleen. Look carefully at the spleen
because it is folded over on itself in this picture and is
larger than it first appears.
Whenever we suspect cancer we take a radiograph
of the chest to look for evidence that the cancer has spread. We
use the chest for this radiograph because the small blood vessels
that are located around the lungs act as a filter to trip cancer
cells that have spread. The black background of the lungs allows
us to visualize these cells that are white in
color.
In this same
ferret as above we are looking at a side view of its chest
with the head to the left. The windpipe (W) goes from left
to right, the Heart (H) is in the very center, and the air
filled Lungs (Lu) are above the heart. To the right of all
of these structures you can see the large white area that
denotes the large liver.
Surgical Treatment
The above information gave us reason to suspect a
high probably of liver cancer, so an exploratory surgery was
performed. The owner was aware of the poor prognosis in this case but
wanted to know for sure what was going on.
Several pecautions must be taken
when this surgery is performed. Ferrets can easily become hypothermic
due to the anesthesia and the fact that their abdomen will be open
during the procedure. They can also become hypoglycemic due to the
stress of the procedure. Special precautions are taken to help
mitigate these problems.
The following area contains
graphic pictures of an actual surgical procedure performed at the
hospital. It may not be suitable for some children (and some adults
also!). If you do not want to view this surgery click
here
and you will be taken to the end of this page.
Brandi
is a high risk anesthetic
patient. In addition to the usual precautions we take for
hypoglycemia and hypothermia, we have to be concerned with
the induction of anesthesia. a special induction chamber is
used for Brandi to breathe in the anesthetic gas and slowly
go to sleep. You can see her doing what ferrets do best when
they fall asleep-curl up.
Once she
is relaxed enough a small tube is put into her windpipe to
allow us to give her 100% oxygen along with precise amounts
of anesthetic. In this view you can see her breathing tube
on the left. She has been clipped for surgery and her final
prep is about to begin. The distended abdomen is obvious.
The pink bandage on her left front leg is where her
intravenous
catheter (IV) is placed so that
we can accurately give her fluids.
We made a rapid entrance
into her abdomen due to her anesthetic risk. What we
encountered was a abdomen filled with blood. In this picture
there are intestines visible on the left with abdominal fat
on the right. Encountering this much hemmorhage at the start
of the surgery is not a good sign.
The tissue was very
delicate and bled easily when touched. In this picture we
are using a laser beam to cauterize bleeding blood
vessels.
When the bleeding was
relatively under control we slowly exteriorized the severely
diseased liver, seen here under Dr.
P's fingers. The
spleen is starting to become visible under the surgeon's
hands (arrow).
A closeup of this liver
lobe shows how
enlarged and hemmorhagic it is. For comparison purposes,
a normal liver is below this picture of a diseased
liver.
Notice
the tremendous difference in color and size in this
normal liver lobe.
The liver was so
delicate (the medical term is friable) that it bled
significantly when touched. We were unable to get an
adequate biopsy due to this problem We are using the
laser beam again to control the bleeding we
caused.
After
we checked the liver we exteriorized the spleen. It is
enlarged and hemmorhagic also. Go back up to the x-ray
and now see if you can visualize the full size of the
spleen.
A very important organ to check
during and exploratory surgery is the adrenal gland since
adrenal
gland disease is common in
ferrets. Brandi had her left adrenal gland removed previously. We
know this because we did it and because of the hemoclips on the x-ray
we showed you above.
Prognosis
Brandi survived the surgery (we are not sure
her mother has recovered yet). Unfortunately, several months after
this surgery we euthanized her because her problem had progressed
significantly.
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