Dear Karen (and others)
 
Eosinophilic enteritis is a sporadic disease of ferrets which is most often
seen in young male ferrets.  It is a disease that was discovered about ten
yeaars ago, and unfortunately, we know no more about it today that we did
back then.  Eosinophilis are a special type of white blood cell that is
primarily seen in allergic reactions or reactions to parasites.  The lesion
is simply a large accumulation of eosinophils in the abdominal organs
(while the disease is known as eosinophilic enteritis or gastroenteritis,
in truth the lesion can be seen in any organ of the abdomen - I common see
it in liver, mesenteric lymph node, and pancreas as well.)
 
Because eosinophils are most commonly seen in allergic reactions or
parasitic lesions, theories abound that this is a variant of food allergy,
or a type of parasitic reaction.  Now parasties have never been identified
in this lesion (I should know, I've spent fruitless hours looking for them
as well).  The bottom line is that we treat for allergy (with prednisone)
and parasites (with ivermectin), and many animals respond well to the
prednisone - but we are just shooting in the dark.
 
The problem with EE is that eosinophils are filled with some very
destructive compounds with are normally packaged within granules in their
cytoplasm.  When they come in contact with a parasite, hey liberate these
chemicals, causing damage and eventually death to the parasite when the
numbers of eosinophils are high enough.  They really pack a wallop!  When
you get a lot of them together, eventually some will start degranulating,
making others degranulate, and causing tremendous damage in the tissue.
 
Prednisone helps to stabilize the membranes of these cells, keeping them
from degranulating as easily, and decreases their ability to congregate
in large numbers as well.  However, it can't work miracles, and often the
disease is well advanced before we even know an animal has EE, and damage
in the GI tract or other parts of the abdomen is too advanced for a good
prognosis.  If we can get a handle on the disease with prednisone,
treatment is generally life-long - removal of the prednisone results in a
relapse.  The key is to find the lowest dose that controls the signs and
maintain on that.
 
EE is often a diagnosis of exclusion - once everything else is ruled out,
think about EE.  Occasionally, we will see elevated eosinophils in the
peripheral blood on a CBC as part of the workup, which should raise a red
flag in animals with animals with GI complaints.
 
Treatment involves a 2-dose ivermectin protocol, and prednisone, coupled
with a bland diet.  Eventually, if good response is seen, we can slowly
go back to the normal diet.
 
Be advised, though - EE can be a debilitating disease and not every case
ends up happily.  I'm hoping Buckwheat's does.
 
With kindest regards,
Bruce Williams, dVM
[Posted in FML issue 3242]