Dear Diane:
 
>The vet had suspected Juvenile Lymphosarcoma but all testing proved
>inconclusive so he wanted to 'crack' his chest open which I flat out
>refused.  I just wanted to let everyone out there who wrote to me about
>him to know that he is in FANTASTIC shape and no more health problems have
>manifested.
 
Ouch!  In the vast majority of cases of juvenile lymphoma, in which
neoplastic cells affect the organs of the body themselves rather than the
peripheral lymph nodes, the spleen and the liver are as commonly affected
as the thymus (which sits in front of the heart in the chest.) Generally,
X-rays show enlargement of the liver and spleen at the same time that a
thymic mass is seen.  If a biopsy is needed, we look first to the spleen
and liver which are much more easily biopsied.  Other possibilities in
cases in which a thymic mass is suspected would often revolve around needle
aspirates in the chest - fluid first, if it is available, and if not, then
you can do an ultrasound-guided biopsy into the suspected mass in the
chest.  Either of these is generally more available to practitioners and
far safer for the ferret than opening up the chest ("cracking the chest").
 
Diagnosis of an aspirate from a thymic lymphoma is not difficult - allthe
cells are lymphocytes, and all look the same.  In most ferrets over 8
months or so, the thymus has atrophied, and the lymphocytes are fairly
sparse.
 
What does "cracking the chest" mean?  It means surgically opening the
chest.  We generally only do that for true thoracic surgeries, but not for
biopsies, in which with the help of ultrasound we can do very specifically.
(Yes, that's an excellent use for ultrasound, although I don't like it for
many imaging purposes in ferrets.)  When you open the chest, the natural
vacuum that keeps the lungs inflated escapes, and the lungs collapse.  This
is not the end of the ferret, as you can inflate the lungs in and out with
a respirator, or even manually, but it is a much more risky enterprise, and
not something to be entered into lightly.
 
Good to here it all worked out for the Count.
 
With kindest regards,
Bruce Williams, dVM
[Posted in FML issue 3230]