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Liver Problems in 9 Year Old Fennec Fox

For species less common than reds and arctics.

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Re: Liver Problems in 9 Year Old Fennec Fox

Postby TamanduaGirl » Thu Apr 28, 2016 6:59 pm

hecate wrote:It appears the physiologic data can be ordered by non-members on CD for $75:

http://www2.isis.org/membership/Documen ... ldlife.pdf

If it prevented even one misdiagnosis it would have paid for itself.


I'm sure it's much better formatted than trying to use the zip. The originals I have of certain species have it color coded between the count and chem also but that didn't copy when I put it in my sheet.

I think I'll write them and see if they'll give more info, specifically if they did only use visible healthy animals or not. I've just been going by the fact the exotic vet I used to see said they didn't and just collected all submitted results. Honestly though even if it's a bit faulty in it's collection it's still a million times better than comparing to the wrong species. Personally I think the ideal would be a study collecting values on both captive and wild, only using visibly healthy, this would ensure that something like the high GGT of tamandua is not due to a faulty captive diet but if wishes were horses and all that. Got to settle for the best of current options.

Ranger wrote:We aren't thinking cancer at the moment. Cancer of the liver usually causes a blockage of the bile duct, in which case his stool would turn grey. He never developed a grey stool. Since he's begun treatment, he has responded very well, bouncing back as if nothing had ever happened to him at all! All I'm doing is giving him B-vitamins every other day and one fourth of a Denamarin pill daily. Actually, he seems to have energy levels that he hasn't had in years! In fact, after his injections, he turns into a little bullet! Not as fast as a year old fennec, but certainly not elderly, either.


Glad he's feeling okay. The b vitamins almost always help a critter feel better no matter the issue. It's often the first thing most owners try for a under the weather exotic before seeking out a vet, at least those who have a lot of them, especially if it's not eating. Hopefully it's just an infection and the antibiotics will have him all fixed up.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby pat » Thu Apr 28, 2016 10:21 pm

so very glad to hear your fox is doing better. sounds like what you were giving helped... :happyfox:
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ash » Fri Apr 29, 2016 12:15 am

So are you going to show the averages to your vet? Not to be rude, but it seems narrow-minded not to. That's the info that AZA zoos go off of. This is an international collection of data on species that conservation facilities of the highest caliber use. It's the closest thing you're ever going to get to peer-reviewed-anything for fennecs.

Looking at the values for a completely separate SPECIES is going to be completely off. In this case, "peer-reviewed" or not, using the ISIS database is going to be infinitely better than comparing apples to oranges.

In the veterinary world there isn't much that is medically peer-reviewed or published when it comes to exotics. So you need to use the most reliable data available to you.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby TamanduaGirl » Sat Apr 30, 2016 11:22 pm

They answered and seems I got bad info from my old vet and feel bad for spreading it around. I guess not too surprising as I parted from him as a client for a reason. Still I had mistakenly accepted that info from him as valid, shame on me. The last half, bolded, is most like the Materilas and methods you are looking for. The middle kind of only applies if you have the Cd, which I may just get since it sounds like it's got a bit more to it than I have.

Here is the information we publish along with our physiological reference intervals:

The ISIS Physiological Data Project

Disclaimer:

At ISIS we take reasonable precautions to ensure that the reference intervals provided on this disk are of the highest possible quality. We remove extreme outlying values and test the validity of the submitted information in several ways. However, with more than 6.41 million test results from 342,000 samples, it is not possible to manually review all the test values submitted by member institutions. The reference intervals are provided to you on an AS IS basis. Some unlikely test values may have inadvertently been included in the calculations, leading to reference intervals for some individual tests and species that experienced clinicians will recognize as implausible. Even so, we are confident that the vast majority of reference values provided on this disk will provide useful diagnostic assistance for interpretation of test results obtained at your institution. Clinicians should always be aware that these are reference intervals, not diagnostic criteria. Any test result falling outside the appropriate reference range should result in a clinical evaluation of that result and a determination of the clinical significance of that result, but should not be taken as an absolute indicator of disease or even of an abnormal health status.

The ISIS Physiological Values database:
Test results for blood samples, along with associated body temperature and weight information, have been submitted to the ISIS database by member institutions for almost 40 years. Originally, paper forms were used to submit results to the database, but starting in 1992, member institutions using the MedARKS software gained the ability to submit records electronically. Database growth over the past 20 years has averaged over 15,000 blood sample records annually and the number of participating institutions continues to increase. The 342,000 sample records in the database represent 2788 species and provides a unique collection of physiological information from captive wildlife. This publication provides reference intervals for the 913 species with at least 50 samples in the database.

How to view the physiological reference intervals on this CD-ROM:
This CD-ROM actually contains two publications of reference intervals that differ only in the units of measurement. One set is in Standard International units used by most of the world, while the second is in the units commonly used by laboratories in the USA (conventional American units). There is an index page for each version of the reference intervals. Select the appropriate index page and double-click on the file name to open the index page in your browser. The scientific name of the species usually provides the easiest means to get to the appropriate page of reference intervals, but all pages are also cross-referenced by common name. Click on any letter in the quick navigation section at the top of the index page to jump you to the start of that alphabetic section on the index page. Click on a species name to get to the appropriate reference interval page.

Organization of the reference pages:
A reference intervals page starts with a header section that identifies the species, any age or gender partitioning of the samples used for the calculations, and the type of units, followed by a table that contains the calculated reference intervals. Each row in the table contains the test name, the units of measurement, the mean and median of test result values, the calculated central 95% reference interval (when the sample size is sufficient), the minimum and maximum data values used to calculate the reference interval, the number of samples used in the calculations and, finally, the number of individual animals that were sampled.

Hematology tests are at the top of the table, followed by blood chemistry tests and body temperature at the bottom of the table. The number of rows in this table varies greatly between species and this is entirely a reflection of the information submitted to the ISIS database by member institutions. In general, there is an inverse relationship between average body size for a species and the number of tests on a reference page for that species (smaller animals yield smaller samples, which allows for fewer tests).

How the reference intervals are calculated:
There are several potential problems associated with calculating physiological reference intervals from a database assembled from multiple sources. Member institutions can use different methods to collect and handle the blood samples and different laboratories to process the samples. The health status assessment recorded at the time of sample collection is based on medical history and the experience and expertise of the clinician, but never-the-less, can be incorrect. Data entry errors can also degrade the quality of the available information. However, few institutions will ever have the resources or the number of values needed to calculate "de novo" reference intervals for even a fraction of the species held at their institution. So, despite these potential limitations, the reference intervals calculated from the ISIS database remain a unique and valuable resource.

Steps have been taken to minimize the impact of potential problems and maximize the quality of the reference intervals. Prior to starting the calculations, the global database was processed with the following filters applied at the sample level:

All samples where the indicated health status was abnormal (at the time of collection) were excluded from further analysis
Samples where the animal was only identified to the genus level were excluded from further analysis
Serum samples where the sample was frozen and stored before analysis were excluded from further analysis
Samples marked as deteriorated were excluded from further analysis
Species with less than 50 samples in the database were excluded from further analysis
The remaining samples were then processed and individual result values were examined. Clinical experience was used to identify individual result values that were judged to be incompatible with normal health (e.g., a serum calcium result of zero) and these individual results were excluded from future calculations as probable data entry errors. This process was designed to remove only the most egregious data errors.

Finally, all retained samples were examined for the presence of three or more excluded test results within a single sample. All samples meeting this criterion were considered to be significantly compromised and were excluded from further analysis.

After all the preliminary filtering and processing, the remaining numeric entry results in the database were used to calculate the reference interval pages for each species; non-numeric test result entries such as "NR", "ND" and "QNS" were ignored.

The list of species with at least 50 samples in the database was compiled and used as the basis for the reference interval pages in this publication.
A set of result values was extracted from the database, filtering by the selected species and test, and this set of data points was tested for outlier values using Tukey's inter-quartile range method. Fences were set at 3 times the IQ range to favor retention of values. All identified outlier values were excluded from the calculation for that reference interval
Note: Tukey's outlier detection method is relatively insensitive to the shape of the distribution curve and is normally an excellent method to detect multiple outlier values. However, some very highly skewed distributions will result in an excessive number of values being classified as outlier values when this detection method is used. Specifically, when given a results set with a large number of zero values and a relatively small number of positive values, such as is common for a set of basophil count results, Tukey's method will often classify all or almost all the positive values as outliers. Excluding all these results from the reference interval calculation is not appropriate. These highly skewed distributions are characterized by a Median Absolute Deviation (MAD) on the lower quantile of zero (or very close to zero), with a positive MAD for the upper quantile. To improve retention of results for highly skewed distributions, when the software detected a lower quantile MAD of zero combined with a positive upper quantile MAD, then Tukey's method was applied only to the results in the upper quantile and only the results greater than the upper fence value were classified as outliers; all other result values were retained for the calculations. This modification to Tukey's method resulted in increased retention of result values with only the very highest values (true outliers) being excluded for these highly skewed distributions. When highly skewed distributions were detected, the next step was skipped and the remaining results in the set were not retested for outliers prior to calculating a reference interval.
If outliers were present, the remaining results in the set were tested for outliers again (same method) and any additional outliers values were also excluded from the calculation for that reference interval (as recommended in ASVCP Guidelines for the Determination of Reference Intervals in Veterinary Species)
Reference intervals were calculated using a non-parametric, 500-count, resampling bootstrap method when the final results set (after discarding outlier values) was over 119 data points. For data sets with between 40 and 119 remaining result values, the reference interval was calculated using the Robust method with tuning constants of 3.7 and 205.6 (Clinical and Laboratory Standards Institute recommendation). When the final results set for a test fell below 40 results, a reference interval was not calculated, but the mean, median, and lowest and highest remaining test result values are reported as long as more than 30 data points remained. If there were less than 30 remaining data points for a test, nothing is reported.
As always, clinicians need to exercise their own judgement and use their clinical experience when using these reference intervals to interpret test results from captive wildlife.

International Species Information System
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Bloomington, MN 55425
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http://www.isis.org
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ranger » Sun May 01, 2016 10:40 pm

It is a little moot at this point since treatment is working superbly. That manic fox has even more energy now than before he got sick!
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ranger » Sun May 01, 2016 10:41 pm

And thanks for the above information. I'll pass it along to my vet.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby TamanduaGirl » Sun May 01, 2016 11:29 pm

Glad he's doing so well now.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ash » Mon May 02, 2016 1:52 am

I'm happy to hear that he's getting better! Keep us updated. It's nice to hear about peoples' experiences with older fennecs. :) I've wanted a fennec for a long time (almost got one...), but the state I currently live in bans them because they could be "invasive." psshh...

What do you feed your fennec? One of the topics we have going on here is about fennec diet in regards to longevity. It would be interesting to know what you've been feeding your little guy. Is he showing signs of age? If "that manic fox has even more energy now than before he got sick!" then I assume he's still going strong. :))
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ranger » Sun May 08, 2016 3:11 pm

Cody isn't just getting better. He's doing better then before he got sick! He's gaining weight and his fur coat is getting super fluffy. And when I say he's gaining weight, I don't mean he's getting fat. He looks like he's bulking up, if that makes any sense. Its probably all the extra fluff, because he looks trim around the middle.

I keep things cool in my house, so he's acclimatized to the cooler climate of my home, so he's always been extra fluffy, but now he's really filling out.

Its so nice having a happy fox again!
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ash » Tue May 10, 2016 3:37 am

Awesome. :)))
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby dmarksvr » Fri Nov 25, 2016 10:49 am

How's your fox doing?


...I was wondering if you could go into more detail on the diet: If I missed it sorry.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby TamanduaGirl » Fri Nov 25, 2016 3:04 pm

I saw on YT he crashed again and it was suspected to be liver cancer but later he said it was just end stage renal failure. Either way his YT is gone now(I can't find it anyway) so he likely is now dead. I don't expect him back, that's why I'm answering for him.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby dmarksvr » Sun Nov 27, 2016 4:10 am

Aw I hope not, but sounds like you're probably right icon-sad
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby Ranger » Sat Dec 10, 2016 4:28 pm

Just giving a quick rambling update for everyone. Cody's liver problems returned twice since his first incident, and the third and hopefully final time the vet and I decided to put him on some very aggressive antibiotics for two and a half months. Every day he got an oral broad spectrum, and every two weeks he got an convenia injection. He's still with us, and is stable and happy, but a few weeks after concluding his treatment, he went blind in one eye and had a very hard time seeing in the other. Turns out, it was a retinal detachment, and their is nothing that can be done. Part of the retina is still attached, but he may as well not be able to see at all in that eye.

Eyesight in the "good" eye has been poor, but has improved with treatment. I took him to an opthamologist who said that the retinal detachment was due to an inflammatory process, possibly from bacterial infiltration during the infection, or from vasculitis that developed from the chronic inflammation that were caused by the liver infection. The veterinary opthamologist called up some university vets as well as a zoo vet, and the recommendation was to prescribe an NSAID called meloxicam for off label use. Fennecs, apparently, tolerate this drug well. Funny side note, we were both prescribed this drug in the same month, though for me it was for a mechanical back injury. I had a tablet, and he has a liquid.

Until I saw the new guide on this forum, I had no idea that retinol was implicated in so many health problems, some of which are similar to what my fox has been experiencing, such as an inflamed optic nerve and liver problems. Not all of his symptoms are consistent with what humans are known to get when they have chronically high levels of retinol in their diets, but we are talking about a difference species.

So, I will be changing my fennec's diet, per recommendations of the guide. The high quality dog kibble will be gone, as this has about four times the retinol content of rabbit. The frozen vegetables are also gone, save for maybe once per week. I also have some 100% dehydrated rabbit (with bone meal), and some cricket flour shipping to my home. I figured that if bugs are good for fennecs, then cricket flour might be a convenient alternative to actual crickets. Crickets are rich in iron and calcium, which he probably needs more of. Best of all, this will be low in retinol. I'm keeping my fingers crossed that it won't cause him any digestive issues. Taurine powder has already been added to his diet, and will continue to be given. I may also add some peanut butter, since he loves the stuff. Sugar free, of course.

This new diet is intended to be highly ketogenic, since he's also having poor glucose tolerance issues. This may have been contributing to a brand new problem, "Simple Partial Seizures". So far, I've only noticed one incident, and it didn't last very long. Clearly, he's having a lot of inflammatory issues that not even the meloxicam can remedy. Hopefully, this will be a far less inflammatory diet.
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Re: Liver Problems in 9 Year Old Fennec Fox

Postby TamanduaGirl » Sat Dec 10, 2016 5:01 pm

I'm glad I was wrong and he's still with you. Sorry about his eyesight though.

Crickets are great protein and good source of iron they are usually low in Calcium though. I don't know the run down on the flour you bought though. Maybe they were gut loaded to fix the calcium issue or they add some to the meal.

I use silkworm puape for my anteaters. They are high quality protein and high iron as well but are also low calcium. One plus though is they actually have something in them that helps lower glucose. They are really stinky though so don't know if a fennec would like them. My anteaters don't really like them but I mix them in their food anyway but anteaters have much different needs than foxes, like their lower calcium needs.

Hope you see some improvements with the diet.

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