>The questions... What could cause the intestine to perforate?  If
>exploratory surgery would have been done the first visit or even the
>second one could he have survived?  I'm not asking for a guarantee ...
 
Dear XXXXXXX:
 
Sometimes you see perforations for no apparent reason.  AS you indicated,
foreign material can result in perforation - especially if there has been
a blockage for any significant period of time.
 
Another cause of perforation is neoplasia - certain tumors can weaken the
wall of intestine and result in tearing - lymphoma is probably the most
common of these.
 
Generally , if there are feces in the abdomen, the prognosis is very poor -
at best you have a severe septic process with a mixed bacterial population.
One thing that I have some trouble with is the fact that we have a
perforation and feces in the abdomen, but the bloodwork did not show
any elevation in WBCs?
 
It is always a difficult issue to determine when surgery is appropriate.  I
tend to agree with you - if there is a question, then you go in preferably
earlier than later.  I would rather rule out the possibility of a blockage
by surgery and come up with nothing, than wait until a ferret is a worse
surgical candidate.  But, not being at the original presentation of your
ferret, and with the bloodwork not being markedly abnormal, I am hesitant
to second guess your vet on this one.
 
With kindest regards,
Bruce H. Williams, DVM, DACVP
 
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[Posted in FML issue 3396]