Bon Bon first visited my surgery eighteen months ago with a well defined 
soft tissue mass to the right of her throat area. It was non painful and had
apparently appeared fairly recently, she was well in herself with no other
clinical signs or other abnormal swellings. The mass was in the area of a 
lymph node, part of the bodies immune defense mechanisms. It was 
possible that the node may be enlarged because it was fighting infection
but no wound or obvious cause could be found, given her general clinical
condition it was decided we would try a short course of antibiotics knowing
that if infection was present then the swelling should go away. We knew
however that it was important to monitor the swelling and agreed another
appointment should be made as further investigations would be needed 
should the swelling not respond to treatment.

Bon Bon returned to the surgery a week later and whilst some 
improvement had occurred a swelling still persisted. It was essential that
we found the cause. After some discussion it was decided that the most 
appropriate way to diagnose her condition was to investigate the area 
under general anesthesia. This would enable us to obtain a biopsy, if
thought necessary, or, perhaps lance an abscess or remove a possible 
foreign body. One concern was the proximity of the area to vital structures 
in her neck. We needed a perfectly still patient and although Bon Bon was 
a very amenable ferret we knew the least stressful and safest procedure for
her would be to undergo these investigations under a brief anesthetic. 
During surgical exploration we found the tissue was solid and uniform in 
appearance, unfortunately our fears regarding the presence of cancer were
raised.

We were faced with a major decision, what was the best thing to do for Bon
Bon. The mass was inoperable as it penetrated deep into her neck area and 
clear surgical margins could not be obtained, there was also too much of a 
risk for such a small patient to undergo such invasive surgery.

To make any decision it was important to confirm a diagnosis, this would 
be based on taking some tissue from the area and sending it to a special 
laboratory for a pathologist to look at the cells and architecture of the 
tissue.

Anxiously we awaited the results but sadly when the report came through 
we learnt that Bon Bon had a malignancy, lymphoma. Lymphoma is a form
of cancer of the lymph nodes tissue that normally fights infection in the 
body and which is linked in the body by a specialized network of vessels. It 
is encountered as eithera mult-centric form whereby all or many of the 
glands or nodes are affected or localized as initially appeared in this case. I 
began researching any treatment options but found there was not a lot
published in terms of protocols for treating ferrets with lymphoma. 
However with the help of the oncology unit at the animal health trust, 
newmarket we decided to use chemotherapy.

Chemotherapy is the giving of drugs that are toxic to cancer cells, because 
cancer cells generally multiple and grow very rapidly most of the drugs 
work by damaging  these cells when they divide and subsequently die. 
Whilst we know that cats and dogs generally tolerate chemotherapy better 
than human patients there was the possibility of some side effects because 
of how the drugs kill cancer cells, but we did not really know how ferrets 
would react to such drugs. What we did know was that our patient was 
bright in herself  and that if we did nothing Bon Bon's quality of life would 
slip away and the inevitable would follow.

Bon Bon began her treatment which was based on the administration of 
tablets; prednisolone and chlorambucil. The dose of prednisolone, a steroid,
is 1mg per kilogram bodyweight daily and empirically chlorambucil 
(leukeran) at 2mg twice weekly. The owner carefully disguises her drug in
the head of a chick, with ice cream and more latterly yogurt being 
favorable alternatives. It is important that the owner watches carefully 
that these drugs are consumed before any other food is given to make sure 
they are all taken and also that these drugs are used responsibly. The drugs 
are  dispensed to be given at home, with regular re checks made at the 
practice. It is essential that owners of pets undergoing chemotherapy follow
all instructions carefully and under no circumstances are these drugs to be
crushed, split or sprinkled. Gloves should be worn at all times when 
handling these drugs. Whilst we briefly looked at alternative treatment 
options these involved the administration of drugs through a vein which we 
knew our small patient could not tolerate, we were fortunate that the 
dosage needed approximated to the size of tablet available and the weight 
of our patient. 

Within one month of commencing treatment Bon Bon's lymph node was 
much reduced in size, by three months the difference in size between the  
initially affected gland and the normal gland on the other side of her neck 
was negligible. Bon Bon was in remission. I followed Bon Bon carefully 
clinically and whilst a neighboring gland started to increase in size as 
we continued with treatment all glands returned to normal. Whilst we 
were seeing Bon Bon monthly we now see her every 8 weeks with her 
owners knowing we are here if she needs us. Perhaps we have been 
fortunate but the side effects reported in other species including vomiting, 
diarrhea coat changes and detrimental effects on the immune system 
leading to infection have not been seen.

The cost of the drugs chosen for chemotherapy may vary and obviously the 
cost of treating any side effects are an unknown quantity until encountered, 
however in many circumstances the cost of the above protocol would not be 
prohibitively expensive.

To summarize, Bon Bon is living a full and active life , and, still making her 
guest of honor appearances at the regional ferret displays, long may this 
continue.