Do not forget that ferrets with large tumors on the right side adrenal disease (as with some other problems close to the liver) can have liver inflammation just from mechanical causes due to crowding even when the tumor does not invade the liver. SUPRELORIN (deslorlin implants) often are a better approach for these ferrets than Lupron Depot. Your vet can get it from Virbac USA if you are here and other Virbac branches in many of their other locations. Do NOT use short acting deslorelin or short acting Lupron variants since they have the potential to worsen the disease. See: http://www.miamiferret.org/24hr_lupron.htm ALT levels are not as important as others. They are often naturally high in ferrets, so what is the bilirubin like? Also, Doctor Sue has written in the FHL, the Ferret Health List, about gallbladder disease in ferrets so check at that website using the search box in about the middle of the page as well as the separate archives. Also in the FML Archives, I think, and certainly in the separate FHL Archives is info I carried w permission of author from ferret veterinary pathology expert Dr. Bruce Williams on ALT levls in ferrets and I know that info is also in the materials of the Ferret Health Advancement Group of the Veterinary School of Michigan State. Use these for a start but you can probably find even better fits with a little searching at those locations and maybe at PubMed, though not all studies appear there: http://ferrethealth.org/archive/FHL3606 includes this expert info that the author who is a ferret veterinary pathology expert permitted me to carry over from a now defunct site since the AFIP went away: QUOTE From Dr. Bruce Williams, who is one of the world's top ferret veterinary pathologists: http://www.afip.org/ferrets/Clin_Path/ClinPath.html Liver from an anorexic ferret. Note that this is a physiologic change rather than a pathologic one. (Photo courtesy of Dr. Richard Montali, National Zoological Park). Probably the most common misinterpretation that I see on a routine basis is in the area of hepatic enzymes. Remember, that the ferret, being by nature an obligate carnivore, has an extremely short digestive tract, and requires meals as often as every four to six hours. Should food not be available, it possesses the ability to quickly mobilize peripheral fat stores in order to meet energy requirements. When this physiologic mechanism is activated, the liver is literally flooded with fat, which results in hepatocellular swelling which may be marked. The result of this swelling is the leakage of membrane enzymes such as alanine aminotransferase, and as the hepatocellular swelling increases, occlusion of bile canaliculi occurs, resulting, over time, in elevation of alkaline phosphatase. In conjunction with this physiologic change, elevations of ALT up to 800 mg/dl can be seen, and alkaline phosphatase up to approximately 100 mg/dl. This often causes confusion to practitioners, who render an erroneous diagnosis of unspecified hepatic disease. However, hepatic disease is quite uncommon in this species; the most common cause of true hepatic disease in the ferret is neoplasia, with lymphosarcoma causing 95% of cases. Rarely bacterial infections of the liver or biliary tree may be seen. The diagnosis of hepatic disease in the ferret must be based not only on ALT and alkaline phosphatase, but other clinical indicators in the CBC and chem panel. Clinical elevation of icterus or an elevated bilirubin is an excellent indicatior of primary hepatic disease, or concomitant leukocytosis or pyrexia may lend additional credence to a diagnosis of primary hepatic disease. Decreased total protein and mild hypoalbuminemia is a common finding in both ill and older ferrets. Most commonly, hypoalbuminemia indicates prolonged anorexia in the ferret, but it is also a common feature in long-standing inflammatory disease of the gastrointestinal tract. In older animals, gastroduodenal infection by Helicobacter mustelae is a common cause of mild hypoalbuminemia, and in young animals, any inflammatory bowel disease may cause this sign. END QUOTE The common high but normal for ferrets ALT readings are touched upon in this ferret introduction presentation: <http://www.ferrethealth.msu.edu/Diseases/Introduction_And_Neuropathology.pdf> http://ferrethealth.org/archive/FHL12244 http://ferrethealth.org/archive/FHL11775 http://ferrethealth.org/archive/FHL9359 Sukie (not a vet) Ferrets make the world a game. Recommended ferret health links: http://pets.groups.yahoo.com/group/ferrethealth/ http://ferrethealth.org/archive/ http://www.miamiferret.org/ http://www.ferrethealth.msu.edu/ 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) A nation is as free as the least within it. [Posted in FML 7833]