FerretDz 2023-3.ppsx

DOMESTIC FERRETS Common Diseases  Ferret Diseases Gastrointestinal Hematopoietic Endocrine Neoplastic Respiratory Cardiovascular Urogenital Musculoskeletal Gastrointestinal Diseases Dental Dz GI Foreign Body (GI FB) Gastritis / GI Ulce...

DOMESTIC FERRETS Common Diseases  Ferret Diseases Gastrointestinal Hematopoietic Endocrine Neoplastic Respiratory Cardiovascular Urogenital Musculoskeletal Gastrointestinal Diseases Dental Dz GI Foreign Body (GI FB) Gastritis / GI Ulceration Viral Gastritis / Gastroenteritis GI Parasitism (kits - see previous handout)  Dental Disease Fractured Canine Teeth - very common  If fx not into the pulp cavity, sharp edges can be smoothed off with Dremel tool  If pulp cavity is involved -> root canal or extraction needed  Dental Dz Dental Calculus (tartar) build up leading to Gingivitis & Periodontitis  most > 1 yr have tartar - > dental prophy  inc incidence if fed soft or canned foods  Dental Dz Tooth Root Abscess – occasionally  check for if have chronic tearing  +/- draining tract or swelling over zygomatic arch area  if no tract -> anesthetize & probe More Ferret Dental Disease  GI Foreign Body GI Foreign Body - very common  if < 2 yrs old - > ingested FB (most commonly is rubber)  shoe soles & insoles, foam rubber, rubber cat & dog toys, rubber bands, erasers  also stuffing from furniture & mattresses, sponges, cotton, towels, plastic & metal  if 3 yrs + - > often gastric trichobezoar (hair ball)  GI FB – Clinical Signs Variable - > acute onset - severe depression, anorexia, dehydration, absence of stools +/- signs of nausea (ptyalism, face rubbing, bruxism = teeth grinding) & vomiting (not w/ chronic) - > chronic – gradual weight loss w/ intermittent melena (dark , tarry stools = blood) & variable appetite +/- GI ulceration - > GI bleeding -> anemia W/ trichobezoar - > as w/ chronic plus anemia if duodenal ulcer present  GI FB - Diagnosis W/ acute -> palpation of gas and fluid in stomach and/or intestines Often have palpable abdominal mass +/- localized pain (usually have w/ intestinal obstruction) W/ chronic -> may need barium series or exploratory sx Rads -> gastric distention, segmental ileus (no motility), gas and fluid; occas reveals the FB Bushed Tail (piloerection) in a ferret secondary to severe pain GI FB – Treatment (Tx) SURGER Y! Supportive care w/ fluids & antibiotics then Sx right away Supportive care post-op as above Return to soft foods in 24 hrs GI FB  Gastroenteritis / GI Ulcers Causes  FB/trichobezoar (may be most common cause in pets)  Helicobacter mustelae infection* (over 3-4 yrs old)  Viral - > CDV, Rotavirus, Coronavirus  Ulcerogenic drugs (NSAIDS), toxin ingestion  GI neoplasia *  Inflammatory Bowel Dz  Diseases other than primary GI dz (renal dz, insulinoma, toxicity, etc.)  Psychologic stress (diarrhea) * H. mustelae also assoc w/ gastric adenocarcinoma & some lymphomas  Gastritis - Clinical Signs Pytalism Bruxism Vomiting Diarrhea (w/ H. mustelae gastritis, proliferative bowel disease, lymphoma) Weight loss GI Ulceration - Clinical Signs Vomiting / nausea Melena (w/ H. mustelae, NSAID toxicity (espec ibuprofen), FB) Halitosis Anorexia Lethargy Sudden death  GI Viral Diseases “Ferret Kit Disease” = Rotavirus infection  high morbidity & mortality in kits 2-6 wks old (pet ferrets typically older than this when acquired so this is a problem w/ commercial breeding or lab facilities)  Dx = Electron Microscopy (EM); serology is unreliable Tx = supportive / Treat secondary bacterial infections  GI Viral Dz Epizootic Catarrhal Enteritis (ECE) = Coronavirus infection = “Green Slime Disease” May be carried by juveniles w/ mild to no signs  May shed virus for 6 mos or more Adults not previously exposed exhibit most severe signs (espec if have concurrent illness)  often see signs in older ferrets 2-3 days after new kit introduced to household  ECE – Clinical Signs Watery, dark green, foul smelling diarrhea w/ abundant mucus initially – may become gold to yellow & have a “birdseed”* like appearance during recovery phase Anorexia, vomiting, weight loss, dehydration, death Damage to GI tract can lead to chronic maldigestion, *malabsorption & possibly predisposition to other dz  ECE – Dx & Tx Dx - culture of feces during first 3 days after see green diarrhea Tx - supportive (fluids, broad spectrum antibiotics for 7 days) CLIN BRIEF 9-2013  Hematopoietic Dz Aplastic Anemia secondary to hyperestrogenism Splenomegaly Lymphosarcoma (see Neoplasia section) Hematopoietic Disease Estrogen – Induced Toxicity of Hematopoietic Tissue - > Aplastic Anemia Hyperestrogenism caused by prolonged estrus (> 1 mos) secondary to failure to ovulate (i.e. if not bred, since ovulation is induced by copulation) Hyperestrogenism caused by ovarian remnant in sprite (spayed female)  Hyperestrogenism – Signs Hyperestrogenism -> Bone Marrow Suppression ->> Aplastic Anemia (RBCs, WBC & PLTs are not produced) Clinical Signs swollen vulva +/- vaginal discharge pale mucous memb (anemia) subcutaneous hemorrhages (petechia – no PLTs!) +/- bilaterally symmetrical alopecia Later - > depression, lethargy, weakness (posterior limb paresis), anorexia, +/- melena, heart murmur, death Hyperestrogenism Aplastic Anemia - CBC Nonregenerative, normocytic, normochromic anemia +/- NRBCs Thrombocytopenia Granulocytopenia (neutropenia, eosinopenia) Aplastic Anemia - Prognosis PCV > 20% = good prognosis (Px) PCV 14 - 20% = guarded Px PCV < 14% = very poor Px (euthanasia often recommended @ 12% or lower due to poor response to Tx) Aplastic Anemia - Tx Sx - > Ovariohysterectomy (OVH) / Ovariectomy (w/ ovarian remnant) Tx w/ hormones inducing ovulation (hCG, GnRH) then spay when in anestrus and blood work is normal (done in animals to be bred at later date also (the hormones not the spay!)) Can try blood transfusions (no blood types in ferrets so can do multiple transfusions) Supportive care  Splenomegaly Splenomegaly = enlarged spleen Very common! most = marked congestion & extramedullary hematopoiesis (EMH) of unknown cause (not true hypersplenism)  Diffusely enlarged, nonpainful w/ smooth round borders  Prone to ruptures & can cause discomfort due to size - > Sx removal (splenectomy)  Splenomegaly  often see with insulinoma & adrenal dz but may not be associated w/ any disease 5 % = splenic lymphosarcoma Other neoplasia (HSA, hemangioma, metastatic tumors) & hematomas Congestion secondary to heart disease Endocrine Diseases Insulinoma Adrenal Gland Disease Both very common in middle aged & older in US, Japan & parts of Europe (AAE); Australia & New Zealand do not report these as major problems in ferrets Insulinoma Tumors of beta cells in pancreatic islets (most = beta cell carcinoma)  tumors produce excessive amounts of insulin resulting in hypoglycemia  glucose deprivation of nerve cells - > mental dullness, confusion, seizures &/or coma, severe muscular weakness  rapid decrease in glucose also causes release of catecholamines - > increase in sympathetic tone - >> ptyalism/nausea, tachycardia, tremors, hypothermia, nervousness & irritability Insulinoma – Clinical Signs Common presentation = acute episode of collapse - > depressed or minimally responsive, may be recumbent, drooling or pawing at face (nausea), “glazed” eyes Episodes are intermittent, can last several minutes to several hours & may increase in frequency & severity - > eventually seizures, coma, death Insulinoma – Clinical Signs Other presentation = gradual onset of weakness & lethargy over wks or mos w/ signs of nausea, gradual decrease in appetite & weight and intermittent hind limb ataxia May not have signs or may show signs of other concurrent dz  Insulinoma - Diagnosis Fasting blood glucose level < 70 mg/dl = insulinoma Fast for 4 to no more than 6 hrs (longer cause serious hypoglycemic episode) Normal fasting glucose reported as 90 – 125 mg/dl (non fasting may be as high as 200 mg/dl)  Insulinoma – Dx If glucose level = 66 – 85 mg/dl can do serum insulin level also > 350 pmol/L (most labs) = suggestive of insulinoma  normal insulin w/ hypoglycemia supports insulinoma, espec if blood glucose = 65 mg/dl or lower (as usually is w/ insulinoma in the dog)  Elevated insulin w/ hypoglycemia confirms dx of insulinoma  Insulinoma - Tx Surgery!! (ferrets < 5-6 yrs old)  Usually see/feel single or multiple, small, firm, tan to reddish- brown nodules within pancreatic parenchyma +/- pancreatic mesentery  Can have metastasis to spleen, liver or regional lymph nodes  Occas no masses are identified  Nonfunctional masses may be found incidentally at necropsy (Nx) Insulinoma  Insulinoma - Sx Fast for 4-5 hrs pre-op Slow drip LR S during Sx (2.5% or 5% dextrose in saline if patient was having mod to severe hypoglycemic episodes) Check glucose level immed post-op & 2-3 x / day Continue fluids IV or SC (not 5% dextrose!) for 24 hrs, then switch to LR S for another 24 hrs No food for 24 hrs post-op then small, frequent meals (bland food) for 2 days – normal diet at 3 days post-op Release 2-3 days post-op; re-check glucose in 2 wks then Q 1-3 mos to check for recurrence  Insulinoma - Tx Medical Management  Prednisolone - > inhibits glucose uptake by peripheral tissues & increases hepatic gluconeogenesis (formation of glucose) thus increasing blood glucose  Diazoxide (Proglycem®) - > inhibits insulin release and stimulates epinephrine release promoting hepatic glycogenolyis (breakdown of glycogen) and gluconeogenesis and decreases glucose uptake by tissues  frequent high protein (meat based) meals; no simple sugars!  Insulinoma – Medical Tx Emergency Tx of hypoglycemic episode  slow IV bolus of 50% dextrose until response observed  if no response (seizures persist or remains comatose), place IV catheter - > 5% dextrose fluids, Tx for shock (corticosteroids)  mild episodes - > high quality protein best if will eat & can swallow; if not rub small amount of honey, corn syrup or other liquid sugar product on gums  Insulinoma - Px Depends on age, whether metastasis is present and method of Tx Can be managed but ultimately is fatal Complete recovery achieved w/ Sx in young w/out mets (~ 60% cure rate, ~ 40% recur in 10 mos) If extensive at Sx, debulking can decrease signs & need for meds (buys time) With medical management of older, often eventually euthanized due to increased frequency & severity of signs W/ combo Tx can live for up to 5 yrs  Insulinoma Adrenal Disease & Cutaneous Mast Cell Tumor are often present in ferrets with insulinoma Adrenal–Associated Endocrinopathy (AAE) Adrenocortical Dz Hyperplasia Adenoma (benign tumor) Adenocortical carcinoma Unlike in dogs & cats, these proliferative lesions produce excessive amounts of estrogen precursors and androgens (sex hormones not cortisol) Cause is not known, but early neutering (< 6 wks old), exposure to unnatural photoperiods & artificial lighting & genetic predisposition are suspected  AAE – Clinical Signs / PE Signs usually seen in ferrets 3 yrs + Most common - > bilat symmetrical alopecia usually starting at hind end & progressing forward  may have Hx of seasonal hair loss & re-growth for 2-3 yrs before remaining bald  may have thin, dry, coarse coat or yellow discoloration of coat w/ increased body odor (in sprite/gib, as if sexually intact) Alopecia due to Adrenal Dz  AAE – Signs / PE  may be pruritic (itchy) w/ or w/out hair loss & have scabs & excoriations secondary to scratching (this may be the only sign!) Atrophy of skin (thin & soft) & abdominal & hind limb musculature - > hind limb weakness & pot-bellied appearance Vulvar swelling in spayed female +/- alopecia (unresponsive to hCG or GnRH) Vulvar Enlargement  AAE – Signs / PE Dysuria associated w/ enlarged prostate or sexual behavior in neutered male (gib) Enlarged spleen  AAE – Dx Diagnosis usually based on clinical signs & confirmed at Sx Blood hormone levels (estradiol, 17-hydroxyprogesterone, androstenedione & others) – lab needs 0.3 ml serum to perform Tests for hypercortisolism (ACTH stimulation, high & low dose dexamethasone tests) are not helpful Ultrasonography (US)/CAT scan – may detect larger masses Rads – not useful for adrenal lesion but good for Dx of concurrent dz CBC / Chemistries – usually normal; rarely anemia  AAE - Tx Sx - > Adrenalectomy  75% left (becoming more common to see on right)  10% bilateral (left removed, subtotal Sx right)  Right gland difficult to remove – adherent to vena cava – can have spread into w/ carcinomas  Px usually good if no mets (CA slow to met), but can recur in other adrenal in 1-2 yrs  Dz is slowly progressive & some ferrets may live quality lives Abnormally Large Adrenal Gland  AAE – Sx / Post-op Insulinoma & lymphosarcoma (less often) occur w/ adrenocortical dz commonly Post-op - > Dexamethasone injection then oral prednisone in 24 hours for a few days (no steroids if pancreatic Sx or infectious dz) Normal diet in 6-12 hrs (unless pancreatic Sx also) Release in 1-2 days Normal size vulva in 2-4 wks; hair re-growth starts in 1-4 mos  AAE – Medical Tx Only if adrenal lesion is inoperable or if patient cannot undergo anes/Sx for another reason Mitotane / op’-DDD (Lysodren®) – effectiveness is equivocal – maybe useful w/ adenomas, but CA is unresponsive  low toxicity potential in ferrets but reduces corticosteroid levels resulting in hypoglycemic shock / coma if insulinoma also present Lupron® (GnRH analog -> estrogen blocker) alleviates signs but does not stop tumor progression  Neoplasia Lymphosarcoma Cutaneous Neoplasia Insulinoma (see Endocrine Dz above) Adrenocortical Adenoma & CA (see above)  Lymphosarcoma (LSA) LSA – very common tumor of ferrets  most often arise spontaneously but has been speculated (not proven) to be caused by a retrovirus  Wide range of clinical presentations; can involve any organ, multiple organs, one or more lymph nodes and/or blood and bone marrow (commonly involves lymph nodes, spleen & liver)  LSA Multicentric — may be no signs in early stages; generalized, painless enlarged lymph nodes most commonly; +/- distended abdomen; anorexia, weight loss and depression with progression of dz Gastrointestinal — anorexia, weight loss, lethargy, vomiting, diarrhea, abdominal discomfort, tarry stools, urgent need to defecate Mediastinal — seen most often in younger ferrets — anorexia, weight loss, drooling, difficulty swallowing and regurgitation; thymic mass often causes compression of lungs, dyspnea (respiratory distress) and pleural effusion, coughing, exercise intolerance (can be misdiagnosed as pneumonia or heart dz)  LSA Solitary form — depends on location; spleen or liver: distended abdomen with discomfort; single area lymph node enlargement; eyes: facial deformity, protrusion of the eyeball; spinal cord: quickly progressing posterior partial paralysis may be seen; kidney: signs of kidney failure Cutaneous (skin) epitheliotropic — solitary or multiple (more common) masses; lesions may be ulcerative or pustular with thickening and crusting; here may be diffuse erythema and/or swelling of the feet  LSA May have no clinical signs for months to years; reports of up to 25% of ferrets diagnosed with lymphoma that have been asymptomatic Clin Path Mild to severe nonregenerative anemia is the most common hematologic abnormality; may be severe w/ leukemia +/- Neutropenia (more common than lymphocytosis) and thrombocytopenia Chemistry abnormalities reflect the organ system affected; elevations in ALT & ALP are common; hypercalcemia (may be seen with lymphoma in other species) is uncommon  LSA – CBC +/- Persistent leukocytosis (total WBC > 10,000) w/ lymphocytosis (absolute lymphocyte count > 3,500) or +/- Lower total WBC count w/ lymphocytes persisting at 60% or more Can have one of the above w/out other signs  LSA More recent studies show that neither lymphopenia nor lymphocytosis are as common as once thought and are not reliable indicators of lymphoma in ferrets; many cases of “lymphocytosis” have been determined to have abnormal or neoplastic cells (leukemia)  LSA – Dx Cytology of FNA, effusion or bone marrow Histopathology  Lymph node Bx - w/ peripheral lymphadenomegaly or clinically normal w/ lymphocytosis  Core Bone Marrow Bx Skin Bx  LSA – Tx & Px Tx  Chemotherapy  W/ generalized peripheral involvement, thymic, splenic, cutaneous  Poor response w/ gastrointestinal LSA, multi-organ involvement or if only 1 lymph node is affected  Px – guarded; often not curative - relapse is common; reports of only 60 to 70% remission rate w/ chemo. and reports of remission lasting 3 mos to 5 yrs  LSA – Tx Focal masses in lymph nodes or other organs typically are removed before chemotherapy. +/- Splenectomy (if affected or enlarged & causing discomfort) Prednisone – palliative (only use if not going to use chemoTx – reduces effectiveness of) Nutritional support, antioxidants (Vit C, pycnogenol), immune- stimulants  Cutaneous Neoplasia Skin tumors = most common skin problem occurring in ferrets Most common  Cutaneous Mast Cell Tumor  Sebaceous Epitheliomas Other  Squamous Cell Carcinoma (SCC) Apocrine gland cystadenoma & carcinoma Basal Cell Tumor  Mast Cell Tumor (MCT) Cutaneous MCT = very common (usually > 3 yrs old)  alopecic, flat, hyperkeratotic (scaly) plaques or smooth & raised / often have black exudate  2 mm to 1 cm diameter  +/- pruritis Cutaneous Mast Cell Tumor  Sebaceous Epithelioma = benign tumor of sebaceous glands  verrucous (wart-like) masses +/- ulceration  can occur anywhere but have predilection for head & neck  R/O Apocrine cyst (very common) or tumor Sebaceous Epithelioma/Adenoma  Skin Tumors - Tx All skin tumors should be removed & submitted for histopathologic evaluation!  MCT occasionally metastasize  MCT often occur in ferrets with insulinoma  Respiratory Diseases Canine Distemper Virus (CDV) Influenza Virus Aspiration Pneumonia  Canine Distemper Virus (CDV) Family Paramyxoviridae, Genus Morbillivirus Commonly affects members of terrestrial carnivore families including Canidae, Felidae, Hyaenidae, Mustelidae, Procyonidae, Ursidae, and Viverridae In the U. S., free-ranging raccoons (Procyon lotor) are the main species affected by CDV in wildlife, serving as a potential disease reservoir  CDV Accelerated syndrome in ferrets w/ clinical signs very similar to those in dogs & other canids ~ 100 % fatal in ferrets!  CDV - Transmission Virus shed in all body excretions ~3-6 days post exposure Most commonly spread via aerosols (infection via inhalation)  also via direct contact w/ ocular or nasal discharge, urine, feces, saliva, skin lesions  contact w/ contaminated fomites  CDV – Signs / PE Anorexia, depression, pyrexia (105-106 F), mucopurulent oculonasal dischg w/ photophobia & blepharospasm Papular rash w/ swelling then crusting starting on chin, lips & eyelids then inguinal area or generalized Skin often turns orange just before see hyperkeratosis of nasal planum & footpads (often w/ swelling) +/- vom/diar (not as commonly seen as w/ dogs) CDV – Chin rash, footpad hyperkeratosis, dermatitis CDV – Blepharospasm, mucopurulent ocular discharge  CDV – Signs / PE CDV causes Immunosuppression - > secondary bacterial infections!  Causes suppurative Bronchopneumonia Often become moribund and die or must be euthanized within 16 days of infection; rarely will survive this stage of dz but if do - > usually sucumb to neurologic infection (acute myeloencephalitis) w/in a few wks  Ataxia, torticollis, nystagmus, tremors, seizures, coma  CDV - Dx Characteristic clinical signs / suspect w/ suppurative bronchopneumonia in young ferret Fluorescent Antibody Test (Immunohistochemistry) Samples should contain cells from the conjunctival, tonsillar, genital and/or respiratory epithelia; can also be used on cells in cerebrospinal fluid, blood (buffy coat), urine sediment and bone marrow Can have false negatives in early stage  CDV - Dx Clinical Pathology – regenerative anemia, lymphopenia, thrombocytopenia In early stages may see distemper inclusions in circulating blood cells Histopathology – characteristic lesions; classic acidophilic inclusion bodies in the cytoplasm of epithelial cells of the mucous membranes, reticular cells, leukocytes, glial cells and neurons  Immunohistochemistry of biopsies of upper respiratory tract and associated lymphatic system, as well as of skin biopsies are diagnostic  CDV – Tx Tx – Not Recommended!  usually will die anyway  few animals that may survive will remain a source of infection for nonvaccinated animals CDV - Prevention VACCINATION!!!! (See previous handout)  Influenza Virus Family Orthomyxoviridae Ferrets susceptible to human influenza!  usually infected by owners Mild disease w/ very low mortality rate in adults  Influenza - Transmission Febrile ferrets shed for 3-4 days Transmission occurs via inhalation of aerosol droplets  Influenza – Clinical Signs Similar to dz in people - > upper respiratory tract affected, pneumonia is uncommon  Often lasts longer in ferrets (up to ~ 2 wks) Sneezing, watery eyes, coughing, mucoid nasal discharge Fever (2 spikes ~ 3 days apart), anorexia, malaise, listlessness Neonates develop more severe form; can be fatal  Influenza - Tx Supportive  nutritional support  supplemental heat  pediatric antitussives (no alcohol)  antihistamines (Benadryl®) No Acetaminaphen (Tylenol®)!!!  Antibiotics may be useful in neonates w/ secondary bacterial infections  Influenza - Prevention Vaccines not efficacious because of antigenic variants (strains) of virus Limit exposure to infected humans or ferrets  Aspiration Pneumonia Most common cause of pneumonia in the ferret Due to aspiration (involuntary inhalation) of oral medications or of vomitus into the lungs Be very careful when administering liquid oral meds - > If a patient is resisting by fighting or squirming – STOP!!  Cardiovascular Diseases Cardiomyopathy Heartworm Disease  Cardiomyopathy Cardiomyopathy – common in American lines of ferrets w/ presumed genetic basis 3 Forms (similar to in domestic cats)  Dilatative – most commonly  Hypertrophic  Restrictive - uncommon Cardiomyopathy – Signs / PE Usually see at 5 & 7 yrs old but can see as early as 1 yr in severely affected ferrets Decreased activity, exercise intolerance (need to rest in middle of play sessions), weak in hind end, difficulty waking from sleep As progresses - > dyspnea, ascites (+/- abdominal distention & large liver), loss of body condition, +/- coughing Cardiomyopathy – Signs / PE +/- cyanosis, prolonged capillary refill time (CRT), tachypnea, tachycardia +/- irregular heart beat, irregular or weak femoral pulses +/- pulse deficits, holosystolic heart murmur  Cardiomyopathy - Dx Suspect based on signs - > work up Rads - > Enlarged heart, ascites &/or pleural effusion (in advanced cases); pulmonary & liver congestion (common) Ultrasound (US) = Echocardiography Electrocardiography (ECG)  Cardiomyopathy – Dx & Tx Do heartworm test!!! – signs & radiograph findings are very similar Tx – meds variable - > based on form of cardiomyopathy & physical findings  Heartworm Disease Ferret susceptible to infection & disease caused by canine heartworm, Dirofilaria immitis Most cases have occurred in Florida  Heartworm Disease Signs / PE Signs & physical findings of heart failure as w/ cardiomyopathy Sudden death, w/ out premonitory signs, can occur due to occlusion of pulmonary arteries Aberrant migration of worms into the brain (cerebrum) has been reported in ferrets  Heartworm Dz - Dx Small number of worms usually, so often with very low level or no microfilaremia, therefore need to run occult (antigen) tests and take radiographs  CITE® Test noted to be relatively accurate in ferrets IDEXX Feline Test may be more sensitive for low levels of antigen  Heartworm Dz – Tx & Prevention Adulticide Tx w/ Thiacetarsemide (Carparsolate®) – reportedly well tolerated but it is no longer available Melarsomine dihydrochloride (Immiticide®) – high risk of serious adverse effects Prevention  Advantage MultiR (moxidectin & imidacloprid) for cats (0.4 ml size) every 30 days– recently approved for use in ferrets for heartworm prevention and killing adult fleas  Prophylaxis w/ ivermectin or selamectin recommended in endemic areas (SE) espec if housed outside! (See previous ferret handout)  Urogenital Diseases Chronic Interstitial Nephritis - common Urinary Tract Infection / Pyelonephritis – common in jill Dysuria & Urethral Obstruction Secondary to Prostatic Enlargement & Cysts - common Urolithiasis (Renal / Bladder Stones) – uncommon  Renal Disease Chronic Interstitial Nephritis (CIN) Early lesions sometimes as young as 2 yrs old resulting in renal failure at 4.5 yrs old Progression is most like that seen w/ older cats  Chronic Interstitial Nephritis May not see changes in renal function tests until advanced dz  proteinuria may be first abnormal Most advocate decreasing protein in diet after 3 yrs old to slow progression  Urinary Tract Infection Bacterial infection common in females / uncommon in males Cause = E. coli - most commonly Staphylococcus aureus – significant # of cases  Bacterial Urinary Tract Infection Bacterial cystitis (urinary bladder infection) – often subclinical in female Ascending infection into the kidneys (pyelonephritis) are not uncommon & may result in renal failure in ferrets  Prostatic Dz Common due to adrenal dz (See AAE, above) - > estrogenic cmpds produced - > squamous metaplasia of lining epithelium of prostate gland - > accumulation of secretory material & keratin & prostatic cyst formation - > Prostatic Dz – Clinical Signs enlarged prostate gland & multiple cysts impinge upon prostatic portion of urethra causing partial or complete obstruction of urine flow Straining to urinate, +/- hematuria, stranguria, dribbling urine to no urine flow w/ complete obstruction (same signs as w/ bladder stones) Prostatomegaly & Prostatic Cyst Dysuria due to Prostatic Dz - Dx Rads – may see enlarged prostate or cysts (could see stones if due to urolithiasis) Urinalysis - +/- RBCs or WBCs, +/- bacteria if infection also  Prostatic Dz - Tx Relieve urinary obstruction first if present Tx adrenal dz! - > adrenalectomy -> prostrate shrinks w/in a few days Infected prostates (uncommon) or w/ large cysts - > drainage or Sx  Fatal Muscle Disease Myofasciitis (Disseminated Idiopathic Myositis – DIM) Emerging disease Affects primarily young (6-18 mos) Progressive inflammatory disease Noncontagious – thought to be immune-mediated; similar syndrome reported in humans assoc w/ vaccine adjuvant-related macrophagic myofasciitis Currently no successful tx  Clinical Signs Clinical Pathology Acute onset of pain & reluctance to move with fever & failure to respond to meds +/- Inappetance, vomiting or diarrhea Leukocytosis (12,000–100, 000 WBC/ml) w/ mature neutrophilia Commonly mild hypoalbuminemia & mild hyperglycemia Occasionally mildly elevated ALT or AST & bilirubin Rarely elevations in creatine kinase  Gross Lesions White streaking in muscles with marked muscle atrophy Adequate fat stores Mottling and dilation of esophageal Splenomegaly +/- Enlarged lymph nodes  Diagnosis Presumptive based on HX, signs, labs & failure to respond to treatment Definitive Dx requires muscle bx: Moderate to severe suppurative to pyogranulomatous inflammation in all muscle groups incl esophagus and the heart +/- extension into SC or cavity adipose Myeloid hyperplasia of spleen and/or bone marrow