Insulinoma in a cat

A 14-year-old domestic shorthair cat was presented with hypoglycaemia and seizures of several weeks duration. Bloodwork revealed hypoglycaemia (1.83 mmol/l; reference range 4.22-8.05 mmol/l) with concurrent normal insulin levels (171 pmol/l; reference range 72-583 pmol/l). An insulinoma was suspected and medical and dietary management were attempted with minimal success. An exploratory laparotomy was performed and a single, well-defined mass was found within the left lobe of the pancreas. The mass was removed and histologically classified as an islet cell carcinoma, consistent with an insulinoma. The cat had an episode of presumed postoperative pancreatitits, but recovered with appropriate treatment. The cat has had no clinical signs of recurrence of greater than 32 months postsurgery. There are only four cases of insulinoma in cats reported in the literature. All prior insulionomas reported were in older cats and were malignant in character, which is similar to the reports in the dog. This case is unique because of the apparent lack of local recurrence and development of metastatic disease, leading to the prolonged survival.     

Insulinoma in dogs: a review

Insulinomas are rare malignant functional pancreatic tumors of the β cells that retain the ability to produce and secrete insulin. Insulinomas are the most common pancreatic neuroendocrine tumor in dogs that can induce a variety of clinical signs that result from hypoglycemia and secondary neuroglycopenic and adrenergic effects. Diagnosis and treatment is considered challenging, and the prognosis can be extremely variable depending on the therapeutic choices. This review aims to summarize and update classic knowledge with current trends in the diagnosis, treatment, and prognosis of insulinomas.     

Blastomycosis in a ferret

An 18-month-old female ferret with an ulcerated metacarpal pad and signs of respiratory illness was diagnosed as having blastomycosis by visualization of organisms on a tissue imprint, an agarose gel immunodiffusion test, and thoracic radiography. The ferret was treated intravenously with amphotercin B at 0.4 to 0.8 mg/kg and orally with ketoconazole at 8 mg/kg for approximately 1 month, during which time clinical and radiographic improvement was noted. A change to SC amphoterocin B therapy resulted in relapse of clinical signs despite continuation of ketoconazole therapy, and necessitated euthanasia. Necropsy revealed granulomatous lesions typical of Blastomyces dermatitidis infection in the lungs, thoracic pleura, spleen, meninges, and brain. Comparisons between this case and canine blastomycosis cases are made and alternative treatment regimes for mustelid blastomycosis are suggested.     

Hyperadrenocorticism in a ferret

A 7-year-old adult male ferret had progressive hair loss that was bilaterally symmetric. Also clinically evident were severe dehydration, polydipsia, muffled heart sounds, weak femoral pulses, hepatomegaly, lethargy, weakness, temporal muscular atrophy, dyspnea, and weakness. The blood profile of the ferret indicated profound leukopenia, eosinopenia, and high phosphorus, BUN, creatinine, and potassium concentrations, as well as high aspartate transaminase activity; the albumin concentration was low. The serum cortisol concentration was 8.1 micrograms/dl. Necropsy and histologic findings confirmed a diagnosis of hyperadrenocorticism, complicated by dilatative cardiomyopathy, chronic active hepatitis, and renal disease.     

Polycystic kidneys in a ferret

Polycystic kidneys were found at necropsy in an adult ferret with a history of seizures and a palpable abdominal mass. Both kidneys contained numerous fluid-filled cysts of various sizes. The ferret may provide an animal model for the study of polycystic disease in man.     

Pregnancy toxemia in a ferret

A late-gestation jill was presented for depression, anorexia, and weakness. The working diagnosis became pregnancy toxemia. Supportive care was initiated and an emergency cesarian section performed. Twelve live kits were delivered; however, all soon perished despite home care. Surgery and recovery are discussed, including information regarding pregnancy toxemia in general.     

Renal adenocarcinoma in a ferret

A spontaneous case of renal tumor was observed in a 7-year-old ovariectomized female pet ferret (Mustela putorius furo). Clinical signs included exhaustion, emaciation, anorexia, and stooping position. At necropsy, a solid and cystic mass replaced the left kidney and adrenal gland. The tumor was composed of pleomorphic epithelial cells with a large number of giant cells. Metastases were recognized in the lung, liver, greater omentum, right renal pelvis, and systemic lymph nodes. Immunohistochemical stains revealed that the tumor cells were positive for CD10, cytokeratin (CAM 5.2), and Ki-67 (MIB-1). On the basis of morphologic and immunohistochemical features, the tumor was diagnosed as a pleomorphic renal adenocarcinoma. This type of neoplasm is very rare in all species and has never been reported in a ferret.     

Recurrent adenocarcinoma in a ferret

A 4.5-year-old, neutered male ferret with a history of recurrent adenocarcinoma in the preputial region was given 2 radiation treatment courses designed to control the rapidly growing neoplasm. The tumor regressed completely after the first 3.5-week course of therapy. The ferret remained clinically disease-free for 4 months, at which time small masses were noticed in the inguinal area and the original tumor site. A second course of therapy was administered, which again resulted in complete clinical regression of the neoplasm. However, the duration of remission was brief. Local recurrence and abdominal metastasis were observed within 2 months of the completion of therapy.     

Acute ibuprofen toxicosis in a ferret

A 20-month-old 1.44-kg (3.2-lb) castrated male ferret was examined because of vomiting, defecating in an abnormal location, dyspnea, and signs of depression. Within 5 minutes of initial evaluation, the ferret became nonresponsive to all stimuli except deep pain. Despite intensive supportive treatment, the ferret died. Toxicologic analyses for ibuprofen were performed on serum, urine, and liver, using gas chromatography and mass spectrophotometry. Serum ibuprofen concentrations were 245 micrograms/g before and 269 micrograms/g after death. Acute ibuprofen toxicosis may cause severe lethargy progressing to coma, apnea, and death in ferrets. Ibuprofen toxicosis should be considered in differential diagnoses for ferrets with signs of depression, with or without clinical signs of gastrointestinal tract dysfunction.     

Suspected pseudohypoparathyroidism in a domestic ferret

A 1.5-year-old ferret examined because of seizures was found to have low serum calcium, high serum phosphorus, and extremely high serum parathyroid hormone concentrations. Common causes of these abnormalities, including nutritional secondary hyperparathyroidism, chronic renal secondary hyperparathyroidism, tumor lysis syndrome, and hypomagnesemia, were ruled out, and a tentative diagnosis of pseudohypoparathyroidism was made. Pseudohypoparathyroidism is a hereditary condition in people that, to our knowledge, has not been identified in ferrets previously and is caused by a lack of response to high serum parathyroid hormone concentrations, rather than a deficiency of this hormone. The ferret improved after treatment with dihydrotachysterol (a vitamin D analog) and calcium carbonate. It was still doing well after 3.5 years of continued treatment.     

Cryptococcus gattii chorioretinitis in a ferret

Bilateral exudative chorioretinitis was diagnosed in an 18‐month‐old male neutered ferret (Mustela putorius furo) with a generalized Cryptococcus gattii infection confirmed by PCR. The animal was referred to the Ophthalmology Service of the Autonomous University of Barcelona (VTH‐UAB) for acute onset blindness. Complete ophthalmic examination revealed absent menace response and dazzle reflex in both eyes (OU), as well as subretinal edema located in the tapetal fundus. At that time, the clinical ophthalmologic diagnosis was bilateral exudative chorioretinitis. Treatment with prednisone (0.5 mg/kg PO q24 h) was instituted in addition to the ongoing treatment with fluconazole (10 mg/kg PO q24 h). The following rechecks revealed secondary cataracts with subsequent lens subluxation and panretinal degeneration OU. Despite being blind and the poor prognosis of disseminate cryptococcosis, the patient remained active and in good body condition during 6 months after the initial diagnosis. At that time, the ferret showed ataxia, incontinence, and generalized pain. A magnetic resonance imaging study revealed a mass affecting the spine. The owners declined further investigations and the ferret was humanely euthanized. The postmortem histopathology confirmed the initial diagnosis of cryptococcosis and the presence of intraretinal Cryptococcus spp. To the authors’ knowledge, this is the first report of Cryptococcus spp. induced exudative chorioretinitis in a ferret.     

Thyroid follicular adenocarcinoma in a ferret

A 5-year-old male castrated ferret was presented to the Washington State University College of Veterinary Medicine for evaluation of progressive hair loss and a large, rapidly growing ventral neck mass. The patient had been diagnosed previously with an insulinoma, which was managed medically. Fine-needle aspirates of the neck mass were performed. The cytologic results were most consistent with epithelial neoplasia, likely a carcinoma; thyroid origin was considered likely based on tumor location and cell morphology. The tumor grew rapidly, and the owners elected euthanasia 1 week after examination. At necropsy, a circumscribed, ovoid mass disrupted the right cervical musculature next to the right lobe of the thyroid gland. Histopathologic evaluation revealed an infiltrative mass consisting of cuboidal cells arranged in solid sheets and irregular follicles enclosing colloid. The cells were large, with prominent nucleoli, and had a high mitotic rate. The histopathologic diagnosis was consistent with thyroid follicular adenocarcinoma. Immunochemical findings confirmed thyroglobulin production by neoplastic cells, but to a lesser extent than in normal ferret thyroid tissue. To our knowledge, this is the first case of thyroid follicular adenocarcinoma to be reported in a ferret, with only 1 other case of thyroid carcinoma, a C-cell carcinoma, described previously.     

Spontaneous Aleutian disease in a ferret

A 3-year-old female ferret died five days after admission to a veterinary clinic for treatment of acute dyspnea and posterior paresis. Blood chemistry showed no hypergammaglobulinemia. Histopathological examination revealed mild to severe inflammatory infiltrates, composed mostly of plasma cells, in multiple organs. Lesions were especially severe in the kidneys, where focal segmental membranous glomerulopathy was also present. In the liver, in addition to lymphocytic and plasmacytic infiltration in periportal areas, dilatation and proliferation of the bile ducts were seen. On analysis of PCR products, using primers directed against the gene encoding Aleutian disease (AD) viral capsid and formalin-fixed kidney samples, we detected a single band of about 400 bp, specific to the AD virus.     

Pyloric adenocarcinoma in a ferret.

Pyloric adenocarcinoma was diagnosed in a ferret with clinical signs of gastric distention. The development of this tumor may be related to Helicobacter mustelae infection in the gastric mucosa of ferrets. Pyloric adenocarcinoma has only recently been reported in ferrets and should be considered as a differential diagnosis for gastric distention in this species.     

Eosinophilic gastroenteritis in a domestic ferret

Eosinophilic gastroenteritis without peripheral eosinophilia was diagnosed histologically in a 5-year-old neutered male ferret showing acute signs of projectile vomiting, dark mucoid diarrhea, and chronic weight loss for 2 mo. The ferret was clinically normal after 4 days of treatment with parenteral fluids, antibiotics, and corticosteroids.