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Alright, so I'm guessing there might be some of you wondering why I haven't been posting on my animal thread all week, especially to update about Pancake's vet visit on Monday. Two reasons - it wasn't good news & I couldn't handle having to post the bad update, and I wanted to wait until we had a little more information to share. So bear with me, we all know I type a lot!! I'll summarize at the end if anyone doesn't have time to read through. Just figure I might as well describe the step-by-step process in case anyone else runs into a similar situation sometime. If you want to skip to the summary, it's the section between the lines below. 
We went to the vet on Monday to make sure Pancake didn't have any mouth issues causing her to not eat. The vet palpated her abdomen, didn't feel anything, got a pretty good look into her mouth, still didn't see anything. We decided to go ahead & sedate her to get some x-rays, both full-body & jaw. This was to make sure there wasn't anything hiding under the surface that we couldn't see. After a bit, the vet came back in to take me to the back & see what they found. At this point, they were doing an ultrasound on her. The full-body x-rays had shown that her liver was much bigger than it should've been, so they wanted a closer look.
Results from that - liver was definitely enlarged and they also suspected there was a mass on/attached to the liver making it look even bigger. This was pushing on her other organs, including her stomach, which is making it hard for her to eat much at once. Her uterus is also slightly enlarged, but that's not high on our list of concerns right now. We decided the next step was to get some samples from the mass to send for cytology & see if that gave us some answers on what we're dealing with. Cytology is a good first step as it's not very invasive - sedation is needed & they used the ultrasound to guide on where to put the needle to draw out cells from the area they want to test. However, there is a chance that if none of the problem cells are in the sample, that the test won't give you any results. The vet took four samples to try & prevent that from happening.
Today we got the results back from the cytology. There are three main findings:
1) Hepatic lipidosis - fatty liver disease. This is most likely from not eating enough, especially lately. This is why we stress so often that a hedgehog needs to be syringe-fed, even if it's only been 1-2 days without food. Without getting food in them, hedgehogs (and cats and ferrets) start to use fat for energy, but their liver has trouble processing it & it causes issues. With Pancake, it's also possible that the 19% fat food she was on for most of her life so far, plus her high weight when she came to Jackie in January were contributing factors. Basically the main thing to do for this right now is liver support (milk thistle & some other supplements, I'll find out more later) & make sure I'm getting as much food into her as I can to support her body.
2) Bacterial infection - Not surprising as her immune system is currently impacted by the next finding. T
3) Cells that point to one of two types of cancer - hepatocellular carcinoma (liver cancer) or cholangiocarcinoma (bile duct cancer). This only tells us that the cells indicative of these cancers are present. What we still don't know - which cancer it is, whether it's malignant or benign, and whether it's all one mass (which would be more easily removable via surgery) or numerous nodules on the liver (which is what the case was with my Lily) or not really a defined mass at all, but spread throughout the liver.
So now the next step will be taking place next Wednesday. Pancake will be going in for exploratory surgery, where the vet will be checking to see whether there's a clearly defined mass that can be removed, and will be taking a larger sample to send for a biopsy. They'll also do a culture & sensitivity test to see what bacteria is present so we can treat that with antibiotics. The vet also has supplements that I can give to her for liver support, and I think appetite stimulants as well.
Culture & sensitivity test will take 2-4 days to come back, if I remember right. Biopsy results will be 3-5 days. We'll start antibiotics once we know which ones to use for the bacterial infection, and then once we get the biopsy results, we'll know what we're really dealing with cancer-wise and what further steps to take for that. Action for that part will really depend on what type of cancer, whether it's malignant or benign, and how aggressive it is.
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TLDR: Pancake has an enlarged liver along with a probable mass in/around/on her liver. Results today showed that she has fatty liver disease due to not eating (and possibly previous diet & weight), a bacterial infection, and some type of liver cancer. Next step is exploratory surgery and a biopsy to see what cancer we're dealing with, and a culture & sensitivity test for the bacterial infection. This will happen on Wednesday (April 20th). Results should all be in by the following Wednesday (April 27th).
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Also, if anyone's wondering on the cost for everything...The Monday appointment came out to around $550 (exam, x-rays, ultrasound, & cytology), and the estimate for the surgery next week is $900-1000. The tests are around $400 of that, the rest is the surgery/recovery cost. By the end of next week, Pancake's total vet bills with me will be somewhere around $1800, I think - when you take in a rescue, make sure you're prepared for what you're getting into! This can happen with any hedgehog, but with a rescue with unknown health history, possible less-than-ideal care, and likely further along in their lifespan, these kinds of things are more likely to come up faster than in other situations. Just something to keep in mind if you're looking at getting a rescue/rehome hedgehog or adopting one from Craigslist. They may have a cheaper initial cost than a baby from a reputable breeder, but they can quickly outstrip that in vet bills.
I'll try to keep you guys updated as things happen now. I'll be keeping Pancake's health updates to this thread & my pet thread will return to it's usual updates.
We went to the vet on Monday to make sure Pancake didn't have any mouth issues causing her to not eat. The vet palpated her abdomen, didn't feel anything, got a pretty good look into her mouth, still didn't see anything. We decided to go ahead & sedate her to get some x-rays, both full-body & jaw. This was to make sure there wasn't anything hiding under the surface that we couldn't see. After a bit, the vet came back in to take me to the back & see what they found. At this point, they were doing an ultrasound on her. The full-body x-rays had shown that her liver was much bigger than it should've been, so they wanted a closer look.
Results from that - liver was definitely enlarged and they also suspected there was a mass on/attached to the liver making it look even bigger. This was pushing on her other organs, including her stomach, which is making it hard for her to eat much at once. Her uterus is also slightly enlarged, but that's not high on our list of concerns right now. We decided the next step was to get some samples from the mass to send for cytology & see if that gave us some answers on what we're dealing with. Cytology is a good first step as it's not very invasive - sedation is needed & they used the ultrasound to guide on where to put the needle to draw out cells from the area they want to test. However, there is a chance that if none of the problem cells are in the sample, that the test won't give you any results. The vet took four samples to try & prevent that from happening.
Today we got the results back from the cytology. There are three main findings:
1) Hepatic lipidosis - fatty liver disease. This is most likely from not eating enough, especially lately. This is why we stress so often that a hedgehog needs to be syringe-fed, even if it's only been 1-2 days without food. Without getting food in them, hedgehogs (and cats and ferrets) start to use fat for energy, but their liver has trouble processing it & it causes issues. With Pancake, it's also possible that the 19% fat food she was on for most of her life so far, plus her high weight when she came to Jackie in January were contributing factors. Basically the main thing to do for this right now is liver support (milk thistle & some other supplements, I'll find out more later) & make sure I'm getting as much food into her as I can to support her body.
2) Bacterial infection - Not surprising as her immune system is currently impacted by the next finding. T
3) Cells that point to one of two types of cancer - hepatocellular carcinoma (liver cancer) or cholangiocarcinoma (bile duct cancer). This only tells us that the cells indicative of these cancers are present. What we still don't know - which cancer it is, whether it's malignant or benign, and whether it's all one mass (which would be more easily removable via surgery) or numerous nodules on the liver (which is what the case was with my Lily) or not really a defined mass at all, but spread throughout the liver.
So now the next step will be taking place next Wednesday. Pancake will be going in for exploratory surgery, where the vet will be checking to see whether there's a clearly defined mass that can be removed, and will be taking a larger sample to send for a biopsy. They'll also do a culture & sensitivity test to see what bacteria is present so we can treat that with antibiotics. The vet also has supplements that I can give to her for liver support, and I think appetite stimulants as well.
Culture & sensitivity test will take 2-4 days to come back, if I remember right. Biopsy results will be 3-5 days. We'll start antibiotics once we know which ones to use for the bacterial infection, and then once we get the biopsy results, we'll know what we're really dealing with cancer-wise and what further steps to take for that. Action for that part will really depend on what type of cancer, whether it's malignant or benign, and how aggressive it is.
__________________________________________________________________________________________________________________________________
TLDR: Pancake has an enlarged liver along with a probable mass in/around/on her liver. Results today showed that she has fatty liver disease due to not eating (and possibly previous diet & weight), a bacterial infection, and some type of liver cancer. Next step is exploratory surgery and a biopsy to see what cancer we're dealing with, and a culture & sensitivity test for the bacterial infection. This will happen on Wednesday (April 20th). Results should all be in by the following Wednesday (April 27th).
____________________________________________________________________________________________________________________________________
Also, if anyone's wondering on the cost for everything...The Monday appointment came out to around $550 (exam, x-rays, ultrasound, & cytology), and the estimate for the surgery next week is $900-1000. The tests are around $400 of that, the rest is the surgery/recovery cost. By the end of next week, Pancake's total vet bills with me will be somewhere around $1800, I think - when you take in a rescue, make sure you're prepared for what you're getting into! This can happen with any hedgehog, but with a rescue with unknown health history, possible less-than-ideal care, and likely further along in their lifespan, these kinds of things are more likely to come up faster than in other situations. Just something to keep in mind if you're looking at getting a rescue/rehome hedgehog or adopting one from Craigslist. They may have a cheaper initial cost than a baby from a reputable breeder, but they can quickly outstrip that in vet bills.
I'll try to keep you guys updated as things happen now. I'll be keeping Pancake's health updates to this thread & my pet thread will return to it's usual updates.
