>...> It was initially felt a stress result from the illness and death of
>her cagemate however she did not respond to amoxy & carafate regimen.
>She was having wobbly episodes which the vet was not sure were caused by
>insulinoma or lack of digestive processing so Ashlee went to the vets for
>exploratory.  Her adrenals at age 5 1/2 looked perfect, her pancreas
>seemed okay too!  Her intestines were off and a section was taken and
>forwarded to Northwest Zoopath.  the diagnosis read: 1.  Marked
>proliferative ileitis/ colitis 2.  Marked reactive lymphoid hyperplasia
>with mild architectural and cellular atypia and with marked edema, lymph
>node.
>
>Comments: Histologic changes in the alimentary tract are severe and vary
>somewhat from the more typical inflammatory bowel disease processes that
>we see.  I suspect there may be an infectious agent associated with this
>condition in the ferret, and a special stain is pending in this regard.
>Changes in the lymph node are reactive and attributed to antigenic
>stimulation associated with the gut lesion.  There is some mild atypia in
>the lymph node suggesting potential for future transformation to lymphoma
>provided the stimulus cannot be removed.
>
>Addendum, 10/16/01: A Warthin-Starry stain reveals large numbers of
>filamentous bacteria in the apical spects of the hyperplastic mucosal
>epithelium.  Morpholgical features of the lesion and the microorganisms
>within the lesion are classic for awsonia infection.  This condition has
>been referred to as "proliferative ileitis"...
 
To start with, Mike made a typo - Lawsonia (also known as Ileobacter,
Desufovibrio, and previously Campylobacter-like organism.) is the
causative agent for proliferative colitis (not ileitis.) Actually, Mike
just asked me for some gross pictures of proliferative colitis and sent`
me a set of his histo images - I presume it was from this case.
 
This is somewhat unusual, as PC is usually seen in young ferrets less than
2 years of age, and predominantly male.  It usually causes clinical signs
of frequent painful defecation which contains mucus and blood.  However,
regardless of her signs, the lesion is very characteristic, and the
diagnosis is not in doubt.
 
Carafate and amoxi won't touch this.  This calls for chloramphenicol
(a somewhat tough antibiotic to get these days) at 50 mg/kg twice a
day.  It is the only antibiotic that touches this bug.  However, this
should bring it under control.  PC is a disease that tends to wax and
wane, especially in periods of stress, so don't expect to eradicate
it - but you can really improve quality of life as well as establish
a long interval of health between attacks.
 
While the possibility of development of lymphoma is always there in
lymph nodes which are chronically inflamed, I don't think that it is
something to be overly concerned about at this point.
 
With kindest regards,
Bruce Williams, dVM
[Sukie note: long, so see rest at website]
[Posted in FML issue 3584]