I'm not an expert on lympho nor am I a vet.  However, I have one ferret with
lympho and at various times others have been 'diagnosed' with lympho
inconclusively and wrongly BY VETS.  So, I'm listing things that you should
know and do when your vet discusses lympho as a possibility.
 
First, read the Ferret Medical FAQ on lympho.  Nothing I'm saying here is
news if you've read that FAQ.  The address is
 
http://www.optics.rochester.edu:8080/users/pgreene/faq/med/lymph.html
or
http://pw1.netcom.com/%7Echris_ni/FAQ/med/lymph.html
 
The symptoms of lympho can be:
- Swollen lymph nodes
- High lymphocyte count in the blood
- Lethargy
- Weight loss
- Diarrhea
- Congestion & breathing problems
- Partial paralysis
- Enlarged spleen
There are certainly others.
 
Also note, there are two forms of lympho - juvenile and 'classic' lympho.
Juvenile strikes ferrets younger than 2 years of age.  Classic lympho
strikes 4-5 yr old and older ferrets, although there are exceptions.
 
FIRST, I must note that many vets may diagnose lympho based on two things:
swollen lymph nodes (found on a physical exam) and a high lymphocyte count
(found when doing bloodwork/CBC).  Dr. Bruce Williams, a noted ferret
pathologist, has stated that there can be other causes of an elevated
lymphocyte count and that the diagnosis of lympho should not be made based
on that alone (as was done with one of my ferrets).  I have seen ferrets
with visibly and palpably swollen lymph nodes that DO NOT have lympho.  So,
you ask, what other problems can cause those two symptoms?  Dr. Williams
names heliobacter infections - a common chronic problem in ferrets.  I have
seen ulcers (caused by heliobacter) and respiratory viruses cause swollen
lymph nodes and high lymphocyte counts.
 
The best way to be sure is to take a needle aspirate or a lymph node biopsy
and examine the sample for signs of lympho.  These exams should be done by
pathologists familiar with ferrets, as they can be inconclusive.  However,
physical symptoms alone may not be sufficient for a diagnosis, particularly
since a heliobacter infection can cause swollen nodes, high lymphocyte
counts, lethargy, weight loss, and diarrhea.
 
So what do you do when your ferret has these symptoms and the vet wants to
put them on a high dose of prednisone to control the disease?  You should
note that prednisone can AGGRAVATE certain ailments.  Assuming that you've
had the ferret examined and bloodwork done, my next recommendation would be
to have the vet perform a needle aspirate of some lymph glands.  The vet I
see performs these for approx.  $35/sample.  This is a fair price for a
certain diagnosis.  If the aspirate is conclusive, you have your answer.  If
it is inconclusive, you need to think about other possibilities based on the
symptoms of the ferret.  You can test and treat for heliobacter infection,
eosinphilic gastritis, pneumonia, bad teeth, blockages, etc.
 
Things that may NOT help:
- Assuming lympho on the basis of swollen nodes & high lymphocytes, and
  treating with prednisone
- Running through a gamut of tests (tracheal wash, heartworm test, xrays)
  without doing an aspirate first, although these may be necessary later
- Only seeing one vet and getting one opinion
 
I've found out the hard way that if the vet hasn't seen the problem my
ferret is having before, the ferret may not get treated properly.  Obscure
symptoms and test results warrant a trip to a more experienced ferret vet if
it can be afforded.  Try to find someone who attends small mammal veterinary
conferences and who is willing to let you ask questions like, "Why do you
think it isn't a general infection" or "How can we know for certain about
this diagnosis?" Good vets will understand that you don't want to
inappropriately treat your ferret.
 
So, important things that WILL help:
 
- Read the medical FAQs!
- Ask your vet what else can cause these symptoms, especially if an
  aspirate biopsy comes out inconclusive
- Talk to other vets and solicit suggestions from the FML.  A hands-on
  exam is always the best, but someone may have seen something similar
  before and may be able to provide advice
 
Last, DO NOT leave your vet's without finding out EXACTLY what the medicines
she's prescribed are for, what they do, what their side effects can be, and
making sure YOU feel they are appropriate.
 
As far as lympho being communicable, as far as I know Dr. Susan Erdman was
the vet doing most of the research into that.  She may have isolated a
retroviral agent that could be the cause, but nothing has been proven yet.
Jeff Johnston has stated that if it IS, the mode of transmission is almost
certainly body fluid-to-body fluid, but unlikely to be any method
involving less direct contact (ie, through you).
 
If I have cited or stated anything incorrectly, please correct me.  I know
some people feel a tissue biopsy is unnecessary when certain symptoms are
present, but I feel that I'd rather be 100% sure before putting an animal on
prednisone, which can do more harm than good when wrongly prescribed.
 
Melissa
[Posted in FML issue 2144]