Hemangiomas are a type of tumor of the blood vessels or the skin. They are benign, but the related hemangiosarcomas are a malignant cancer that also target the blood vessels. They come from the same type of cells and the only difference is that one is malignant.

Hemangiomas arise from a mutation in the cells and the cause is unknown. Research suggests that solar radiation through UV light may play a role when these tumors occur in the skin. Both dogs and cats can get hemangiomas. Depending on where the disease is and its progression, clinical signs can vary. There may be no clinical signs, dark purple blisters on the skin, or internal bleeding causing weakness and anorexia. Treatment and long-term outcome for animals vary depending on the type of tumor.

Who gets hemangiomas?

Both dogs and cats can get hemangioma.

Subcutaneous (under the skin) tumors tend to occur as a single mass. The masses may bleed and bruise easily, contain areas with ulcers and dead tissue, and be painful when touched. Approximately one-third of dogs with subcutaneous form have a history of tumor-associated illness that may include lack of appetite, lethargy, lameness, neurologic abnormalities, cough, voice change, and hemorrhages and/or bruises involving the mass.

Cats and dogs with the skin-related form typically have one or more red to purple skin bumps that are located in areas of sparsely haired, lightly pigmented skin. In dogs, these tumors most commonly occur on the chest and belly, sometimes because they like to sunbathe on their backs. In cats, lesions are most common on lightly colored pinnae (ear flaps) and other areas of the head. Lesions are usually small and nonpainful.

Dogs:

Breeds: American Pitbull Terrier, basset hound, Beagle, Boxer, Dalmatian, English Bulldog, English Pointer, Greyhound, Italian greyhound, Staffordshire terrier, Whippet . These breeds are mostly predisposed to the solar-induced form because they are light-skinned dogs with short hair, especially over the chest and belly – at least in those that like to sunbathe on their backs. However, any breed can get hemangiomas, especially the kind that are not related to the sun.

Sex: Both males and females are equally affected.

Age: Middle aged to older.

Cats:

Breeds: No breeds are predisposed.

Sex: Both males and female cats are equally affected.

Age: Middle aged to older.

Diagnosis

Definitive diagnosis usually requires surgical removal of all or part of a mass and its analysis at a laboratory. Blood tests, clinical signs, and predispositions (age, breed, hair coat color/type, sun exposure history) may suggest that your animal has hemangioma or hemangiosarcoma. Routine blood tests may show anemia. A fluid sample may show cancer cells, although many times these samples only show blood. Your veterinarian may suggest an ultrasound if they suspect hemangioma or hemangiosarcoma before surgery to look for more of an internal mass.

Treatment and Prognosis

The treatment options and long-term prognosis of your pet depends on the type of tumor they have. Once a benign hemangioma is removed surgically, your pet usually requires no additional treatment and is back to normal health. Dogs and cats with solar-induced hemangiomas may develop new hemangiomas (or other solar-induced tumors) at other sites of sun-damaged skin, potentially requiring additional surgeries to remove them.

Signs of DIM in Ferrets

The signs of DIM appear suddenly and can worsen rapidly. A ferret can behave perfectly normally one day and show severe signs of DIM the next. Signs are variable, but they commonly include a lack of energy and appetite, weight loss, nausea and vomiting, fever, depression, and/or weakness that can impair their ability to walk. Other signs commonly seen that are not specific to just DIM include excess mucus around their eyes and nose, increased heart rate breathing rate, and changes to the skin. Ferrets with DIM are often found lying down, are reluctant to move and react painfully to touch, especially around their back.

Diagnostics

Diagnosing DIM can be challenging because the signs are commonly seen with many other diseases and we do not fully understand what causes it. There is no definitive diagnosis for DIM, which means there is no test to determine with 100% certainty whether or not your pet has this disease. If your ferret shows a combination of these signs, your veterinarian will most likely complete blood and urine tests, radiographs, and possibly an ultrasound to assess the severity of the disease progression and try to rule out other potential causes. DIM is a diagnosis of exclusion, which means your veterinarian will run many tests to rule out other potential causes before concluding that your pet has DIM. The primary tool used for diagnosing DIM is a muscle biopsy where a small piece of muscle will be removed while the animal is sedated to look for signs of inflammation or infection within the tissue. However, the small section of muscle removed may not be representative of the entire muscle tissue, so a biopsy that is negative for inflammation does not guarantee that other muscles are not being affected by the disease.

Treatment and Prognosis

Unfortunately, due to the complexity of the disease, a general lack of response to treatment is one of the ways that DIM is diagnosed. Some veterinarians have had success treating this.  Due to suspicion that DIM could be an immune-mediated disease, recent recommendations include treating suspected DIM ferrets with corticosteroids (such as prednisolone) and other immune system suppressants.  A treatment protocol of prednisolone, chloramphenicol, and cyclophosphamide may suppress overall inflammation and auto-immune activity, and potentially, further progression of the disease. This protocol is recommended by the American Ferret Association, and continued research needs to be done to determine overall treatment effectiveness.

Supportive care is also very important and involves things like hand feeding, fluid therapy, pain medicine, and general antibiotics. Supportive care is meant to help relieve some of the patient’s symptoms and suffering, but it has not been shown to effectively stop the progression of the disease.

DIM, unfortunately, still has a poor prognosis in ferrets. Since it was first described in 2003, DIM has been considered a fatal disease, as most of the cases confirmed by muscle biopsy resulted in death within several weeks. However, more ferrets are now surviving this condition with improved treatment. Veterinarians and researchers are actively studying these cases and the treatments used to help develop the most effective treatment possible for improving the prognosis of patients with DIM.