Dear Judy:
 
>The lady who surrendered her said that she also had been diagnosed with
>lymphoma.  But Smokey is bouncy, playing, eating and pooping just fine.
>Her energy level continues to be through the roof!
 
If there are no clinical signs, and the diagnosis was made 7 months ago,
probably we are not dealing with lymphoma at this point.  When abdominal
lymph nodes are submitted for analysis, there is a large margin for error.
The chronic inflammatory diseases we often see in middle aged and older
ferrets (Helicobacter in the stomach and ECE in the intestine) cause such
reactive changes in local lymph nodes that even experienced pathologists
may often be swayed to a diagnosis of lymphoma.
 
I generally recommend biopsy of non-abdominal nodes, such as those in the
armpit or behind the knee when lymphoma is a possibility, and only rarely
have I actually made a diagnosis of lymphoma on abdominal nodes (but lots
and lots of reactive changes.)
 
Let's just keep this diagnosis in the back of our mind, but I think at this
point I would ascribe it to a mis-diagnosis on a complicated slide.  And to
think that the vet thought he was removing the adrenal glands - ouch!
 
>So poor little Smokey may have a double-whammy going against her.  I want
>to do surgery for the adrenal disease 'cause I'm pretty sure that the
>first vet may have missed one or both of the adrenals.  But I'm concerned
>that if she really does have lymphoma brewing then her chances of recovery
>are going to be very slim (energy level notwithstanding.)
 
Once again, with no clinical signs of lymphoma, good activity, no enlarged
nodes - I think I would consider going ahead with the adrenal surgery.
While there is always a possibility that Smokey isn't listening to my
lecture on lymphoma, I don't see any reason why the percentages are not
strongly in our favor....
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3187]