Dear Pam:
 
>Bloodwork showed mild dehydration (corrected) and elevated liver enzymes:
 
>Alkaline phosphatase 130 (15-45)
>ALT 665 (10-280)
>Total bilirunin 1.0 (0.0-1.0) (normal)
 
Yes, these are mild elevations, except for the bilirubin, which although in
the higher side of normal, is still normal.  That's good, though, because
it reaffirms that the liver is not failing.  I consider both the ALT and
alk phos to be in the mild range, and certainly what we can see with
anorexia.  Something else that can be contributing to the elevations,
especially the alk phos is the prednisone administration, which is a
common cause for elevation of alkphos.
 
The theory about the platelets and the ulcer is a fair one, but platelets
can vary markedly from day to day, so I wouldn't go too much on one sample.
 
At this point, there is nothing to worry about with these liver enzymes.
They fit that pattern of an older ferret who is an inconsistent eater.
 
Probably wouldn't hurt to treat for an ulcer at this point with Carafate
and a bland diet.  I think at her age and status I would hold off on the
full-fledged treatment for Helicobacter - amoxi, Flagyl, and PB - the
stress in that treatment may actually worsen an ulcer.  Let's go with the
gentler treatment to start, and if it is ineffective, then we can pull
out all the stops.  Blind, arthritic, and hypoglycemic and 8 years old -
I think I'd tread lightly with treatment here, especially without any
definitive symptomatology (tooth grinding or tarry stools) of an ulcer.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3228]