Back in the first half or so of the last century people naively clumped things and thought that one day there would a cure for "cancer" (singular). For quite some time since we have known that there are hundreds of so called "cancers", and those subsets sometimes have their own subsets and some of those subsets have their own subsets. So it is with lymphoma, a malignancy of the lymphocytes. There are multiple types of lymphoma that ferrets can get and of those at least one has subsets that differ greatly in how aggressive they are. For people here I will just mention the basic types of lymphoma that are found in ferrets, but you can look in the FHL and FML archives for further information. Any of the types of lymphoma can present symptoms only near the end, but some give warnings early enough to treat. In fact, even some vets have lost personal ferrets only to find hidden lymphoma that had squirreled away in some place where it did not show up on most tests, for example in the marrow, only to then ravage the animal too rapidly to do anything. Luckily, for most forms that is not the typical presentation (though it is very common for Juvenile Lymphoma). Here is a segment from an article in a past issue of Ferrets Magazine by Dr Bruce Williams who has given me blanket quoting permission that I am careful to not abuse: BEGIN QUOTE Lymphoma is a common occurrence in ferrets. Overall, it is the third most common neoplasm overall in ferrets (following insulinoma and adrenal neoplasms) and the most common of all malignancies. And it doesn't discriminate based on age - while the majority of cases affect animals 5 years and older, animals may be affected as young as 4 months of age. While a few similarities exist, as outlined below, lymphoma is unique in its dissimilarity between cases. Every case is unique and unpredictable -- which organs are affected, how rapidly the diseases progresses, etc. The tumor may choose to infiltrate critical organs such as the brain, kidneys, or heart, or non-critical areas such as the eyes or skin. END QUOTE Lymphoma types can look like a range of illnesses or medical problems (like blockages) in ferrets because they can be present in so many organ systems, and often in more than one at the same time. Another quote from Dr. Williams' article: BEGIN QUOTE Let's look at the basics of lymphoma. In the ferret, three major forms of lymphoma exist, which generally differ from each other in terms of age of animal affected, the organs affected, the average survival time, and the predicted response, if any, to therapy. END QUOTE The lymphocytic form (the adult-onset form) is the most common one in ferrets. When you read about people treating lymphoma in ferrets this is the one that they usually mean, and often in this form the peripheral lymph nodes will be enlarged though sometimes deeply internal nodes are the first to enlarge and you can can not know about that casually. This is the slowest progressing of the lymphoma types, but in the archives you will find work on which markers show how aggressive the subsets of this form will be. Some ferrets with lymphocytic lymphoma can live about a year and the slow growth means that there is the chance that treatment will bring remission. All of us who have had ferrets for any length of time have treated ferrets with this type of lymphoma. Lymphoblastic lymphoma is the juvenile form. Malignancies typically take a decent amount of time to get from the few cell stage to being a pronounced disease. That is true for a number of other neoplasias as well. (Many human lung tumors probably first began growing 30 years before they are pronounced, and some growths in ferrets appear to typically show up about 3 years after the triggering event, with work on that regard in things like adrenal neoplasia and also the third type of lymphoma which will be discussed later.) Juvenile lymphoma/ Lymphoblastic lymphoma usually appears LONG before the 3 year mark in age. Most who die of it are under 2 years of age. Arian was just shy of one year but there have been kits lost at just a few months of age. To manage that there usually needs to be a genetic involvement. I have not had time to keep up on work on this regard so will need to make the time and do so, but genetic problems which could lead to such difficulties could be genetic variants that promote mutations, or the lack of active genes that kill off mutated cells well (useful when working since everyone always has some mutated cells in them), or epigenetic changes that have a critical gene turned on or turned off, or perhaps stem cells are involved so the disease is present even before birth like teratomas are, or... Again quoting Dr. Williams: BEGIN QUOTE In this variant, myriads of immature (blastic) cells infiltrate visceral organs in large numbers, while the lymph nodes remain unaffected until the latest stages of disease. Infiltration by neoplastic cells results in enlargement of major organs and the most commonly affected organs are the liver, spleen and thymus. In most cases, thymic enlargement rapidly becomes a life-threatening issue, as the thymus occupies the thoracic cavity, a space enclosed by the unforgiving cage of the ribs. As the neoplastic cells expand the thymus (as seen in Figure 2), the thymus compresses the adjacent lungs, making it difficult, and eventually impossible, for the animal to breathe. In juvenile lymphoma, labored breathing is often the first clinical sign noticed by the owner, and this form's early compromise of pulmonary function is the reason that it carries the shortest survival time of all variants (only 2 weeks after diagnosis.) END QUOTE Luckily, it is rare disease. In over 30 years with ferrets we have encountered it twice. Helix got a few weeks after symptoms began and in her case it got into her spinal cord which was very horrid; Arian got only a few days because her thoracic growth was filling her chest cavity with blood, but she actually got to play even on her penultimate day but then was actively dying on her final day. I know of only one ferret with JL who somewhat responded to treatment (but died after it went to the spinal cord) and that ferret was one of the unusual adults with JL and had it progress more slowly than it usually does. The immunoblastic-polymorphous variant is the final variant of lymphoma that is well known in ferrets. This is the form that appears in clumps, with multiple ferrets in the same home breaking with it at about the same time. Work at MIT showed that there appears to be a viral trigger an average of about 3 years before the onset of these cases of lymphoma. We have been through that twice, too, with the final bout killing over about a year's time. We are not in the midwest but for some unknown reason that seems to be where this shows up more. Yet another quote from Dr. Williams: BEGIN QUOTE In fact, in 1995, researchers at the Massachusetts Institute of Technology were able to transmit lymphoma between ferrets with cell- free extracts, suggesting a possible viral cause for lymphoma, or at least some forms of it. The development of lymphoma in this experiment took several years in inoculated individuals, and not all inoculated ferrets developed lymphoma, but the results of this study are too intriguing to ignore. To date, however, a virus has yet to be identified or isolated from malignant lymphoma in ferrets. END QUOTE We have also treated ferrets with that form and possibly managed to slow it down and to add to quality of life. So, now you know about the primary forms of lymphoma found in ferrets. Please, use the two archives to learn more about treatment options for the types that can be treated. Arian's death on Monday should help someone. Maybe this information will allow it to do so. Sukie (not a vet) Recommended ferret health links: http://pets.groups.yahoo.com/group/ferrethealth/ http://ferrethealth.org/archive/ http://www.miamiferret.org/ http://www.ferrethealth.msu.edu/ http://www.ferretcongress.org/ http://www.trifl.org/index.shtml http://homepage.mac.com/sukie/sukiesferretlinks.html all ferret topics: http://listserv.ferretmailinglist.org/archives/ferret-search.html "All hail the procrastinators for they shall rule the world tomorrow." (2010, Steve Crandall) On change for its own sake: "You can go really fast if you just jump off the cliff." (2010, Steve Crandall) [Posted in FML 7422]