Myeloma or MM: Cases Studies from Japan, part00

EVAC Pack for your Ferret
Fleeing Japan with your Fuzz

Ferrets and their endless array of cancers.
Apparently, MM is rather rare in the USA.  And a search of pubmed does not do anything to alter that impression as only one documented and published case shows up and even that was from the 1980s.
In Japan, however, not so unheard of.  As the most frequent ferrant poster put it "My vet reports that it is rare but there are several new cases every year.  Including my own ferrets, I personally know of 5-6 cases ."

Given the vast lack of information on MM in ferrets, we have decided to present a new mini-series of all the MM information we could collect from Japan.

The following is all the carefully collected, extracted, and arranged (for ease of reading) case studies available at this time.   Veterinary and actual owner observations and accounts are included.

:*・☆・*:☆.。.:*・☆・*:.。.☆:*・☆・*:

CASE 1:

Summary:

?? Farms

? (N?, unknown but likely given Japanese regulations and ferret population sources)

approx. 2 years of age when finally diagnosed.

Confirmed MM case.

MM was diagnosed previous to decease. However, the ferret died soon after diagnosis.

Necroposy findings showed bone fractures and also hinted at Bence-Jones proteinuria.

Pathology results after death also confirmed MM.

Progression:

The blood test 2 months prior to final diagnosis showed no irregularities.

Then one day the owner found their ferret was suddenly unstable and wavering, and rushed to the vet. The result of that vet visit was a final diagnosis of MM. The ferret died one week post-diagnosis.

Chemotherapy was used in the interval between diagnosis and death. (Owner feels the chemo administered at the time was too powerful and resulted in an earlier death)

Diagnostic Methods:

XRAY – a veterinarian or xray tech familiar with MM will be able to identify the small round holes in the bone as this is particular to MM

Bone fractures also common.

Bone Marrow Biopsy – considered to give a near definitive result as to whether MM or "other".

**Owner notes that another ferret that s/he owned followed a similar path with similar symptoms but was later diagnosed with CLL (chronic lymphocytic leukemia).

(Time - Other postings and time line references point to this case occurring around 2000.)

original discussions can be found here: 多発性骨髄腫の疑い and 多発性骨髄腫

CASE 2:

Summary:

Canadian Farms

M (N?, unknown but likely given Japanese regulations and ferret population sources)

1 year 4 months at time of original posting in 06/2008

Tested with regular blood screening, xray, ultrsound, and finally a bone marrow biopsy.

Directly from the posting:

"Originally, when he had a health exam last October and since the ALP was somewhat high (152) growth process so we decided to monitor for 3 months then retest.

At the retest, the ALP had fallen to 109 but the TP value had risen.

The following are the test values to date:

	10/22/2007	1/7/2008	2/16	3/17	6/14
TP	6.6	8.8	9.2	8.4	9.4
ALB	-	-	2.9	2.8	3.O
PCV	54	50	45	38	43
HB	19.3	18.4	16.3	14.4	15.8
RBC	1143	1104	986	869	959
WBC	8600	7900	8000	8695	10200

We also tested for ADV in Feb and June and it was always less than “3 times” .

However, there is still the possibility so I can not say right off that ADV is not unlikely. The urinalysis had a value of 30(1＋) for the albumin. "

Other symptoms include eyes a little white and seems to not be able to see well. It is said this symptom is probably a result of the hyperproteinemia. Other than that, acts lively and well.

Diagnostic methods: blood screening, xray, ultrasound, and finally a bone marrow biopsy.

The results from the bone marrow biopsy in July 2008 removed MM as a potential candidate.

MM diagnosis refuted. Given the diagnosis of ADV.

**Note CAGEMATE (New Zealand Farms, M(/N?), 1 year 11 months) present with chronic hepatitis.

original discussions can be found here: 多発性骨髄腫の疑い

CASE 3:

Summary:

?? Farms

M (N?, unknown but likely given Japanese regulations and ferret population sources)

4 years old at original posting in 11/2006

Confirmed MM case. Died one week post-diagnosis.

Owner was told that even IF it is found early, there is no hope of saving the patient so the owner left everything in the hands of the vet.

Any treatments administered during the one week interval between diagnosis of MM and death were not listed.

original discussion can be found here: 多発性骨髄腫

CASE 4:

Summary:

Marshall Farms

M/N

4 years, 11 months

Confirmed MM case.

Symptoms: Lethargy and suppressed appetite. Weakness in posterior limbs.

Xrays showed an enlarged spleen and a fractured rib cage

However, aside from mild swelling palpitated at the mesenteric lymph nodes, fecal and blood tests showed no significant irregularities.

Symptoms improved temporarily with the use of medical therapies including Predisone and Interferon. However, on day 11 symptoms returned and on day 18 both posterior limbs showed partial paralysis.

Another Xray was taken and showed dislocation of the 6th-7th dorsal vertebrae along with multiple instances of "punch-outs" (Japanese word refering to the numerous missing black shadows seen in bones in Xrays) and osteolysis. Plasmacytes were not seen in the peripheral blood and there was no atypism of the lymphocytes.

In accordance with the owner's wishes, no bone marrow biopsy was performed.

We continued with the identical appropriate treatment but the patient died on the day 31.

Examination after death confirmed instances of "punch-outs" in the bones throughout the entire body and osteolysis. Monoclonal gammopathy was not found, hence ADV was not diagnosed. Multiple instances of miliary nodular masses were seen in autopsy as were masses suggesting insulinoma. Histopathology showed widearea spread of atypical cells similar to plasmocytes throughout the bone marrow, spleen, and abdominal cavity, organs and mesentery.

The final comprehensive diagnosis is believed to be MM.

(published 2006)

Index DB Link

Abstract Link

CASE 5:

Summary:

posting at a later date since MM was only suspected but not confirmed. However because it was suspected the vet followed through with one typical therapy regiment for treating MM in a ferret. That information is of use.

UNconfirmed MM case.

No final diagnosis noted.

:*・☆・*:☆.。.:*・☆・*:.。.☆:*・☆・*:

Cheers and see you again! (^_-)-♪

Disclaimer: I am not a DVM. Advice is offered after my own extensive research and/or experience and should be undertaken at your own risk. Consult with your licensed DVM before undertaking any treatment!

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