I have a 6 year, 11 month old male Marshall ferret which is believed to be have mild insulinoma, some gastrointestinal distress/bleeding, and aggressive malignant lymphoma. I do not question the first two things. I want to be as sure as reasonable that he actually has malignant lymphoma. Key vets and other being out of town this week, combined with limited tests, is making clarification difficult. I think some here, particularly Dr. Williams if he is still on list, may be able to provide valuable insight. I'll keep this as short as possible, thanks in advance for any comments (email is welcome). Test Results ------------ The abdominal ultrasound showed four (substantially, IIRC) enlarged mixed echogenic lymph nodes (one vet said mesenteric), splenomegaly (note: an enlarged spleen was noticed prior to removal of left adrenal in Sept 2007), cyst in pancreas and right kidney, fine suspended sludge in gall bladder: http://www.geocities.com/grapeferret/FerretReports/Ultrasound.jpg Cytology Report: Masses, possible lymph nodes, consistent with lymph node aspirate... predominance of immature intermediate-sized to large lymphoid cells occurring singly or in monomorphic aggregates... points to malignant lymphoma: http://www.geocities.com/grapeferret/FerretReports/Cytology.jpg Note: lab says it appears pretty aggressive but they say they can't identify the type or grade unless they receive an actual biopsy sample. A recent blood test and urine cysto: http://www.geocities.com/grapeferret/FerretReports/BloodTest.jpg http://www.geocities.com/grapeferret/FerretReports/UrineTest.jpg Full body and thoracic xrays taken to check for other lymph node involvement or problems... none seen. Recent History -------------- 05/21/2008: Early checkup with exotic vet due to mild hind leg weakness after outdoor walks. Blood work (probably four hours after his last meal) reveals low blood glucose level (65 I believe). Insulinoma suspected, no treatment for now, follow up in three months unless something changes. Note: outdoor walks cut back. 06/XX/2008: Lethargy and hind leg weakness somewhat worse, wobbly when he first wakes up. Touched base with vet, no change in plan unless symptoms worsen. Note: outdoor walks eliminated. 07/27/2008: Lack of energy/strength and wobbling raising more concern. Mild teeth gnashing while eating. Mild hiccups. Eating, but may not be eating enough. 07/30/2008: Largely unresponsive ferret laying in his own urine episode. An hour after Nutrical he was up and wandering around relatively well. All food (Marshall Senior + Totally Ferret Older + Ferretone) immediately replaced, chicken baby food added, treats (bandit treats, and infrequently a few licks of milk) eliminated, major effort to assure adequate food intake. Note: For whatever reason, his energy/strength not only improved immediately but continued to improve going forward. 08/01/2008: Exam, blood test (probably 3 hours after eating), and urine cysto. Some off-nominal values spurred additional testing: http://www.geocities.com/grapeferret/FerretReports/BloodTest.jpg http://www.geocities.com/grapeferret/FerretReports/UrineTest.jpg 08/05/2008: Fasting blood glucose test (confusion over duration, figure 8 hours but it might have been 10 hours) was low (62 I believe). 08/06/2008: Abdominal ultrasound performed. Summary: four (substantially, IIRC) enlarged mixed echogenic lymph nodes (one vet said mesenteric), splenomegaly (note: an enlarged spleen was noticed prior to removal of left adrenal in Sept 2007), cyst in pancreas and right kidney, fine suspended sludge in gall bladder: http://www.geocities.com/grapeferret/FerretReports/Ultrasound.jpg 08/07/2008: Put on Clavamox to cover bases (not sure of dose, just following directions) 08/08/2008: Cytology Report: Masses, possible lymph nodes, consistent with lymph node aspirate... predominance of immature intermediate-sized to large lymphoid cells occurring singly or in monomorphic aggregates... points to malignant lymphoma: http://www.geocities.com/grapeferret/FerretReports/Cytology.jpg Note: lab says it appears pretty aggressive but they say they can't identify the type or grade unless they receive an actual biopsy sample. 08/10/2008: His energy, strength, and food intake have been rather good since 07/30 episode. However, black tarry stools just cropped up and there has been ongoing mild teeth gnashing when eating and one or two recent episodes of hiccupping. Food intake just dropped off too... voluntarily eating soft foods from finger, but not eating enough. 08/11/2008: Exam (with fill-in vet), full body and thoracic xrays performed, said to show no issues other than those previously mentioned (no evidence of thoracic or peripheral lymph node involvement). Weight at 996 grams, down from 1009 on 08/01/2008. Both vet and tech agree that he looks and acts surprisingly well and normal. Started on carafate (not sure of dose, just following directions). Note: later that night he was rather active but getting wobbly again. Given a little Nutrical just in case. 08/12/2008: In PM started on Pepcid AC (1/4 of 10mg tablet once a day) and Pediapred generic (0.5 mls twice a day of "Prednisolone 5mg/5ml solnhit"). Still taking soft foods off finger, but probably not eating enough. Black tarry stools starting to clear up. 08/13/2008: Back to hitting food bowls on his own, wandering around a little bit. All stools from today look normal. [Posted in FML 6062]