Dear Dr. Williams.  It is so nice to see you posting again!  Just like the
old days :) And you do so look handsome in your pics on the web (tell your
wife I said so!) ;) Indeed, when I was green as a ferreteer it was being
able to call you and Dr. Weiss and Dr. Kawasaki that kept me sane.
 
Thank you for answering my question about gentamicin eye drops.  Though you
probably rightly say there is likely no danger of systemic damage, I do
still worry that if systemic treatment with an ingestable or injectable
gentamicin antibiotic causes such extreme problems as deafness and kidney
problems that absorption in eye tissue could be harmful.  It is probably a
coincidence but my Claudette is losing weight, after two rounds with the
drops.  I will ask for other eye drops if needed in the future, as you
suggest, and monitor Claudette and get her to a vet if needed.  No need to
take risks if other antibiotic eye drops are available.
 
I read your post "Lymphoma and adrenal" with one of those "sinking
feelings" in my heart.  You wrote:
 
"When abdominal lymph nodes are submitted for analysis, there is a large
margin for error.  The chronic inflammatory diseases we often see in
middle aged and older ferrets (Helicobacter in the stomach and ECE in the
intestine) cause such reactive changes in local lymph nodes that even
experienced pathologists may often be swayed to a diagnosis of lymphoma."
 
My truly amazing fur kid Tarzan received chemo based on a biopsy of
abdominal nodes.  His other nodes were never enlarged, which my vet said
was unusual, though not unheard of.  Additionally, during exploratory my
vet could barely recognize his pancreas, it looked so terrible.  Pathology
revealed insulimomas but he'd never exhibited low blood sugar, had had a
good blood panel before surgery (albeit not fasting) and was only three.
Our regular pathologist, your colleague Dr. Garner, wasn't available,
though my vet was going to make sure he saw the biopsy, too, which didn't
occur.  Lymphoma was diagnosed by the unknown pathologist.  Tarzan's
symptoms had been vomiting and weight loss.  We'd had ECE in our household
a year or so before he was the only one of eight ferrets who *didn't* show
symptoms.  He'd always been so incredibly healthy and strapping and full
of life it was so hard to believe he had lympho!  Though I know this can
happen.  Before the exploratory we'd found and successfully treated
giardia, hoping that was the root problem, but his vomiting and weight
loss had continued.
 
During exploratory the vet saw many "tumors" along the intestines, on the
nodes.  She removed a large growth (the one used for the biopsy) that was
blocking the duodenom, I believe.  The "tumors" on the intestines didn't
seem to be blocking anything (she ran her fingers along the intestines) so
we had some hope.  And Tarzan did well following surgery in terms of weight
gain and good energy.  But once chemo commenced Tarzee passed away after
the fourth treatment, though up to the week before he passed he'd been
doing very well.  I've since learned that CBC's should be done with each
intravenous treatment, which they weren't (causing much guilt and grief,
but I didn't know nor did the oncologist vet, who'd mostly treated cats,
though she'd worked with Dr. Susan Brown some time ago on a chemo protocol
for ferrets, so I had faith).
 
Now I'm wondering if Tarz might have NOT had lympho.  I've heard there's
a mesentery (sp?) node that can get enlarged due to helicobacter.  Now...
could my amazing Tarzee have had a raging helicobactor infection?  I've
often wondered about that trashed pancreas, which perhaps will clue you
in to something.  My vet is on medical leave but I know she would want to
discuss this with you if you think we may have been off base.  She is very
dedicated and one of the hardest working women in vet business.
 
I ask this on the FML because I've read at least a few times of abdominal
lymphoma.  It may be too late for Tarzee, and we probably can't ascertain
now whether he was misdiagnosed, but another ferret who could be
misdiagnosed might be saved.  Thank you Dr. Williams.  I think your
perspective as a pathologist is invaluable to the ferret community and
that your making yourself available is wonderful and commendable.
 
Lynn and the Five Sweet Fur Kids, Antique Cat Wellington (and two porch
squirrels who are breaking my peanut budget)
[Posted in FML issue 3191]