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Special Species > Ferrets > Flashcards

Ferrets Flashcards

1
Q

What family do ferrets come from?

A

Mustelidae

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2
Q

Ferrets are a domesticated form of what other animal?

A

European polecat

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3
Q

Are ferrets closely related to mongoose?

A

No

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4
Q

Are ferrets omnivores, carnivores or herbivores?

A

Strict carnivores like cats

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5
Q

What type of GI tract do ferrets have?

A

Carnivore GI tract with simple stomach.

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6
Q

How long is GI transit time in a ferret?

A

148-219 minutes

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7
Q

Ferrets can be a model for what 5 human diseases?

A
  • Gastric and duodenal ulcers
  • Gastro-esophageal reflux
  • Gastric carcinoma and lymphoma
  • Helicobacter mustelae (H. pylori in humans)
  • Model to test anti-emetics
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8
Q

Since the jejunum and ileum cannot be differentiated in a ferret, what is this section of intestine known as?
Where does it end?

A
  • Jejuno-ileum

- Ends at ascending colon

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9
Q

Do ferrets have a cecum?

A

No

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10
Q

The ferret colon is similar to that of what 2 other species?

A
  • Cats

- Dogs

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11
Q

Overly manipulating a ferret in the cervical region can lead to cervical (mechanical) vagal stimulation which can affect what?

A

Affect intestinal motility

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12
Q

Dental diseases in ferrets are similar to those that can be seen in what other species?

A

Cats

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13
Q

What age range of ferrets tend to be more affected by dental disease?

A

Middle aged and older

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14
Q

What are 3 examples of dental disease that can be seen in ferrets?

A
  • Tartar
  • Gingivitis
  • Periodontal disease
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15
Q

What is a tooth that can be commonly broken in ferrets?

A

Broken canines

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16
Q

What are 2 examples of acute causes of gastric ulceration in ferrets?
2 examples of chronic causes?

A
  • Acute: foreign body, toxins

- Chronic: infectious disease, renal disease

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17
Q

What is a very common cause of gastric ulcers in ferrets?

A

Helicobacter mustelae

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18
Q

What is something that is endemic in most commercially produced ferrets?

A

Helicobacter gastritis

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19
Q

Can ferrets be asymptomatic carriers of Helicobacter?

A

Yes

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20
Q

What can be a factor in triggering helicobacter gastritis?

A

Stress or other disease

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21
Q

What are 5 possible clinical signs of Helicobacter gastritis?

A
  • Bruxism
  • Ptyalism
  • Anorexia
  • Chronic weight loss
  • Melena
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22
Q

What is bruxism?

A

Teeth grinding

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23
Q

What is a clinical sign that may be, but is not normally, seen with Helicobacter gastritis?

A

Vomiting, may be blood-tinged

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24
Q

What are 5 factors for diagnosing Helicobacter gastritis?

A
  • Fecal occult blood (consider carnivorous diet)
  • CBC (regenerative anemia)
  • Difficult to culture, endemic
  • Pyloric or duodenal mucosal biopsy
  • Warthin-starry stain
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25
Q

What are 4 types of drugs that can be combined in the treatment of Helicobacter gastritis?

A
  • Antibiotics
  • Proton pump inhibitors
  • Mucosal protectants
  • H2 receptor agonists
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26
Q

What are 3 examples of antibiotics that can be used in the treatment of Helicobacter gastritis?

A
  • Metronidazole
  • Amoxicillin
  • Clarithromycin
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27
Q

What is an example of a mucosal protectant that can be used in the treatment of Helicobacter gastritis?

A

Sucralfate

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28
Q

What is a drug that should not be used if the ferret has an actively bleeding ulcer since is has an NSAID component?

A

Pepto-Bismol

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29
Q

What are 2 examples of H2 receptor agonists that can be used in the treatment of Helicobacter gastritis?

A
  • Famotidine

- Ranitidine

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30
Q

Since ferrets explore with their mouths, what is something they can get?

A

GI foreign body

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31
Q

Can ferrets get hairballs?

A

Yes

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32
Q

What are 6 possible types of clinical signs that can be seen in ferrets with a GI foreign body?

A
  • Acute or chronic
  • +/- Diarrhea and melena
  • +/- Vomiting
  • lethargic
  • Anorexic
  • Weight loss
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33
Q

What are 3 factors in diagnosing a GI foreign body in ferrets?

A
  • Palpation
  • Radiographs
  • Exploratory
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34
Q

What are 4 possible forms of treatment for GI foreign bodies in ferrets?

A
  • Lubricants
  • Antibiotics
  • fluids
  • Surgery when necessary
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35
Q

If a ferret has diarrhea, a detailed history should be obtained including what 7 factors?

A
  • Source of ferret/breeder
  • Volume, color, consistency, frequency, duration
  • If other pets in household are sick as well
  • Activity level, time of day
  • Environmental factors
  • Toys, treats, bedding, sanitation
  • Tenesmus, vocalization, flatulence, bruxism
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36
Q

What are 6 possible etiologies of diarrhea in ferrets?

A
  • Foreign body
  • Viral
  • Dietary indiscretion
  • Inflammatory bowel disease
  • Proliferative bowel disease
  • Lymphoma
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37
Q

What is a viral disease that can cause diarrhea in a ferret?

What virus causes it?

A
  • Epizootic catarrhal enteritis (ECE)

- Corona virus

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38
Q

What are 2 bacteria that can cause proliferative bowel disease in a ferret?

A
  • Campylobacter

- Lawsonia intracellularis

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39
Q

Inflammatory bowel disease in ferrets is similar to cats in that it is usually what?

A

Usually lymphoblastic

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40
Q

Is there a genetic predisposition in ferrets for inflammatory bowel disease?

A

Yes

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41
Q

What is a possible causative factor of inflammatory bowel disease in ferrets that can be found in foods?

A

Grain carbohydrates in commercial foods.

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42
Q

What drug should be used cautiously in ferrets with inflammatory bowel disease?

A

Prednisone

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43
Q

What are 2 antibiotics that can be used with inflammatory bowel disease in ferrets?
What is a vitamin that can be given?

A
  • Azothiaprine, Metronidazole

- Vitamin B12

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44
Q

Azothiaprine and metronidazole are both what?

A

Both immunosuppressive

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45
Q

What are 3 descriptors for the type of diarrhea caused in ferrets by corona virus?

A
  • Profuse
  • Mucoid
  • Green slime
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46
Q

What age group of ferrets are more susceptible to viral diarrhea caused by ECE?
Which group is more likely to be carriers?

A
  • Older ferrets susceptible

- Younger are carriers

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47
Q

What are 3 possible clinical signs of ECE in ferrets?

A
  • Lethargy
  • Dehydration
  • Anorexia
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48
Q

What is the mortality rate of ECE in ferrets?

A

Low with treatment

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49
Q

What should the treatment of ECE in ferrets mainly focus on?

What can be given for secondary infections?

A
  • Hydration

- Antibiotics

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50
Q

What is an emerging disease in ferrets that came to light in 2004?

A

Ferret systemic corona virus

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51
Q

What feline disease does ferret systemic corona virus resemble?

A

Feline Infectious Peritonitis

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52
Q

Where are 4 locations ferret systemic corona virus can cause pyogranulomatous inflammation?

A
  • Peritoneum
  • Liver
  • Kidneys
  • Pancreas
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53
Q

If a ferret has mucoid stool, what are 4 things that should be on the differentials list?

A
  • Parasites (coccidia)
  • Helicobacter
  • Campylobacter
  • Viral
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54
Q

If a ferret has melena, what are 3 things that should be on the differentials list?

A
  • Foreign body
  • Hairball
  • Ulcers
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55
Q

If a ferret has a form of stool other than mucoid or melena, what are 2 things that should be on the differentials list?

A
  • Metabolic disease

- Inflammatory bowel disease

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56
Q

The larynx in the ferret is similar to what other species?

A

Humans

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57
Q

How does the larynx in a ferret function?

A

Closes airway to raise intra-abdominal pressure and keeps ingesta from being aspirated.

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58
Q

How many ribs does a ferret have?

How many sternebrae?

A
  • 14 ribs

- 9 sternebrae

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59
Q

Where is the lung field in a ferret?

Does ferrets have a small or large lung capacity?

A
  • 1st-10th/11th ICS

- Large lung capacity

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60
Q

Are the lung lobe divisions in a ferret similar to a dog/cat?

A

Yes

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61
Q

Ferrets are the only domestic species susceptible to what?

A

Human influenza

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62
Q

Photophobia, catarrhal nasal discharge, sneezing, coughing, pyrexia, anorexia, malaise, dysphagia and +/- pneumonia are all possible clinical signs that can be seen with what disease in ferrets?

A

Influenza

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63
Q

How long does influenza usually last in ferrets?

A

7-14 days

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64
Q

What are 4 aspects of treating influenza in ferrets?

A
  • Supportive
  • Antihistamines
  • Cough suppressants
  • Prophylactic antibiotics
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65
Q

What is one way to prevent influenza in ferrets?

A

Separate from ill humans.

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66
Q

What are 3 possible causes of pneumonia in ferrets?

A
  • Aspiration of medication/vomit
  • Bordetella bronchiseptica
  • Pasteurella multocida
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67
Q

Which bacteria responds poorly to antibiotics so may develop into penumonia in ferrets?

A

Bordetella

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68
Q

What are 2 possible treatments for pneumonia in ferrets?

A
  • TMS

- Chloramphenicol

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69
Q

What are 2 ways to try to prevent pneumonia in ferrets?

A
  • Separate from sick dogs

- Separate boarding facilities

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70
Q

What respiratory disease is fatal in ferrets?

A

Canine distemper

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71
Q

What is the time frame for the disease progression of canine distemper in ferrets?

A

12-42 days

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72
Q

What are 5 ways canine distemper can be transmitted in ferrets?

A
  • Direct contact
  • Fomites
  • Aerosolization of urine
  • Feces
  • Nasal exudate
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73
Q

Since canine distemper is severely immunosuppressive in ferrets, the ones that survive the respiratory phase tend to succumb to what?

A

Neurologic stage within several weeks.

74
Q

Is there any treatment for canine distemper in ferrets?

A

No

75
Q

When should ferrets be vaccinated for canine distemper?

A

6, 10, 14 weeks old then annually

76
Q

Anorexia, pyrexia, chin dermatitis, photophobia, nasal or ocular discharge, bronchopneumonia, hyperkeratosis of planum nasale and foot pads, CNS signs and brown crusts on the face are clinical signs of what ferret respiratory disease?

A

Canine distemper

77
Q

Histopathology will show what with canine distemper in ferrets?
Where are 3 places these can be found?

A
  • Eosinophilic viral inclusion bodies (intracytoplasmic and intranuclear)
  • Bladder, renal pelvis, biliary epithelium
78
Q

Non-suppurative encephalitis and demyelination can be seen with what ferret respiratory disease?

A

Canine distemper

79
Q

What kind of discharge can be seen with ferret distemper?

A

Mucopurulent ocular discharge

80
Q

Can ferrets get heartworm?

A

Yes

81
Q

Dyspnea, cough, pale MM, lethargy and anorexia are clinical signs for what ferret respiratory disease?

A

Heartworm

82
Q

Muffled heart sounds or low grade murmur, enlarged heart, pulmonary congestion, pleural effusion and ascites are clinical signs that can be seen with what ferret respiratory disease?

A

Heartworm

83
Q

What are 3 ways to diagnose heartworm in a ferret?

A
  • Echocardiogram
  • Worms in right atrium and ventricle
  • SNAP test or Dirocheck
84
Q

What are 2 treatments for heartworm in ferrets?

A
  • Thiacetarcemide

- Ivermectin plus steroids

85
Q

What are 2 forms of heartworm prevention that can be used for ferrets?

A
  • Heartguard

- Revolution (cat doses off label)

86
Q

Chronic sneezing and respiratory irritation can indicate what in ferrets?

A

Allergies

87
Q

What are 4 ways to alleviate the symptoms of allergies in ferrets?

A
  • Symptoms subside
  • Anti-histamines
  • Topical ocular/nasal antibiotics
  • NSAIDs
88
Q

A culture obtained from a ferret with allergies often contains what?

A

Mixed bacteria (normal flora)

89
Q

What should always be a differential for nasal discharge in a ferret?

A

Dental disease

90
Q

What should be looked for when examining the mouth of a ferret?
What is one way to look for this?

A
  • Tooth root abscesses

- Dental/skull radiographs

91
Q

Dust, spider webs, inhaled particulate matter can all lead to what in a ferret?

A

Paroxysmal sneezing

92
Q

What are 3 causes that should be considered if there is nasal bleeding or continuous sneezing in a ferret?

A
  • Foreign body
  • Rhinitis
  • Sinusitis
93
Q

What are 2 reasons catheterization is difficult in ferrets?

A
  • Small urethra

- Crooked os penis

94
Q

What are 2 urogenital issues that can be seen with ferrets?

A
  • Urinary tract obstruction

- Urolithiasis

95
Q

A poor quality diet can lead to what type of urine?

This can lead to what 4 conditions?

A
  • Alkaline urine

- Crystalluria, uroliths, adrenal disease, prostatomegaly

96
Q

Stranguria, dribbling urine, frequent urination, hematuria, vocalization with urination, wet fur or skin irritation, frequent licking of perineum or prepuce, lethargy, inappetance and dehydration can all be clinical signs of what 2 conditions in ferrets?

A
  • Urinary tract obstruction

- Urolithiasis

97
Q

What are 3 forms of treatment for urinary tract obstruction and urolithiasis in ferrets?

A
  • Urinary catheter
  • Fluids
  • Surgery
98
Q

What are 2 surgeries that may be performed in the treatment of urinary tract obstruction and urolithiasis in ferrets?

A
  • Cystotomy

- Perineal urethrotomy

99
Q

What are 2 aftercare changes that should be made after the treatment of urinary obstruction and urolithiasis in ferrets?

A
  • Diet change (don’t feed cat food)

- Antimicrobial therapy to acidify urine

100
Q

What are 5 factors that go into diagnosing urinary tract obstruction and urolithiasis in ferrets?

A
  • Palpation of enlarged bladder
  • Clinical signs
  • Urinalysis with crystalluria
  • Elevated pH
  • Azotemia
101
Q

What position should female ferrets be placed in for urinary catheterization?

A

Ventral recumbency with rear quarters elevated with a rolled towel.

102
Q

Where is the urethral opening found in female ferrets?

A

Floor of urethral vestibule about 1 cm cranial to clitoral fossa.

103
Q

What is a common sequelae of adrenal disease in male ferrets?

A

Urethral blockage

104
Q

Where is the urethral opening located for the male ferret?

A

Very small opening located on ventral surface of penis, proximal to tip of os penis.

105
Q

What position should male ferrets be placed in for urinary catheterization?

A

Dorsal recumbency with penis exteriorized.

106
Q

What is a urogenital disease seen in female ferrets?

A

Hyperestrogenism

107
Q

T/F: Ferrets are seasonally polyestrus and induced ovulators.

A

True

108
Q

When is the estrus season for intact female ferrets?

A

March to September

109
Q

What is the treatment for female ferrets with hyperestrogenism?

A

HCG injection to stop estrus then OHE when stable

110
Q

What are 2 conditions female ferrets can develop if they are left intact and not bred?

A
  • Estrogen toxicity

- Bone marrow suppression

111
Q

What are 3 types of prostatic disease that can be seen with male ferrets?

A
  • Prostatomegaly
  • Prostatic cysts
  • Abscesses
112
Q

Prostatic disease in male ferrets is often secondary to what?

A

Adrenal disease

113
Q

What can prostatic disease lead to?

A

Urethral obstruction

114
Q

What are 4 methods of treatment for prostatic disease in male ferrets?

A
  • Treat adrenal disease
  • Antibiotics
  • Drainage of infected fluid
  • Surgical de-bulking when needed
115
Q

What are 2 types of cutaneous neoplasia that ferrets can get?

A
  • Mast cell tumors

- Basal cell tumors

116
Q

Are cutaneous neoplasia common?

A

Yes, but only in the skin.

117
Q

Do cutaneous neoplasia in ferrets typically metastasize?

A

No

118
Q

What is a skin condition in ferrets that can be itchy, bleed and appear ulcerated?

A

Cutaneous neoplasia

119
Q

What is the prognosis for cutaneous neoplasia in ferrets?

A

Good

120
Q

What are 2 types of neoplasia that ferrets can be that are more likely to metastasize?

A
  • Fibrosarcoma

- Sebaceous gland adenoma

121
Q

What are 2 possible causes of dermatophytosis in ferrets?

A
  • Microsporum canis

- Trichophyton metagrophytes

122
Q

How is dermatophytosis transmitted?
What do the lesions look like?
Clinical signs?

A
  • Transmission: direct contact
  • Lesions: typically self-limiting
  • Clinical signs: like in dogs and cats
123
Q

Dermatophytosis can be secondary to what?

A

Pyoderma

124
Q

What are 3 types of treatment for dermatophytosis?

A
  • Iodine/chlorhexidine shampoos
  • Griseofulvin
  • Disinfect environment
125
Q

What are 3 types of ectoparasites that ferrets can get?

A
  • Ctenocephalides
  • Otodectes cyanotis
  • Sarcoptes scabei
126
Q

Generalized Sarcoptes scabei can be seen in what 3 locations?
Localized in what 3 locations?

A
  • Face, pinna, ventrum

- Paws, nails, toes

127
Q

How are ectoparasites diagnosed in a ferret?

A

Skin scrape

128
Q

What are 2 types of treatment for ectoparasites in a ferret?

A
  • Ivermectin

- Lyme sulfur dips

129
Q

Behavior changes, head tilt, nystagmus, tremors/seizures, paresis/paralysis and ataxia/rolling are clinical signs that can be seen with what type of disease?

A

Neurologic disease

130
Q

What are 6 types of diagnostic techniques that can be used when neurologic disease is suspected in ferrets?

A
  • Physical/neuro exam
  • CBC/serum chemistries
  • CSF tap
  • Culture/sensitivity
  • Imaging
  • Serology
131
Q

What is the most common etiology for otitis media/interna in ferrets?

A

Pasteurella multocida

132
Q

How do you diagnose otitis media/interna in a ferret?

A

Radiology

133
Q

What are 4 possible treatments for otitis media/interna in ferrets?

A
  • Enrofloxacin systemic
  • Topical (Baytril or gentamicin)
  • Chloramphenicol
  • Flush ears with saline under anesthesia
134
Q

What are 2 sources of neurologic disease in ferrets?

A
  • Distemper

- Rabies

135
Q

The end stage of what disease seen in ferrets shows progression to naso-ocular exudate and hyperkeratosis of foot pads

A

Distemper

136
Q

Hyperexcitability, excess salivation, muscle tremors, convulsions and coma can be seen with what phase of what disease?

A

Neurotropic phase of distemper

137
Q

What is the prognosis for Distemper in ferrets?

A

Grave

138
Q

How can distemper be prevented in ferrets?

A

Vaccination

139
Q

Ascending paralysis, ataxia, cachexia, fever, hyperactivity, bladder atony, tremors and paresthesia are clinical signs that can be seen with what disease in ferrets?

A

Rabies

140
Q

What should happen with unvaccinated ferrets that are suspected of having rabies?

A

Euthanized and sent to state lab for testing.

141
Q

How can rabies be prevented in ferrets?

A

Vaccination

142
Q

What are 2 common endocrine diseases that can be seen in ferrets?

A
  • Adrenal disease

- Insulinoma

143
Q

What are 3 potential causes of adrenal disease in ferrets?

A
  • Adenoma
  • Adenocarcinoma
  • Adrenocarcinoma
144
Q

What is NOT seen with adrenal gland disease in ferrets?

A

Hypersecretion of cortisol

145
Q

What IS seen with adrenal gland disease in ferrets?

A

Hypersecretion of SEX hormones: DHEA, estradiol, progesterones

146
Q

Will most ferrets develop adrenal disease?

A

Yes

147
Q

What is something that if done early may lead to adrenal gland disease developing?

A

Spaying/neutering

148
Q

What is elevated in serum with adrenal disease?

What is not?

A
  • Serum concentration of steroids are elevated

- Serum cortisol not elevated

149
Q

Symmetric alopecia, pruritis, erythema, sexual behavior, vulvar enlargement, bone marrow toxicity (females), urinary obstruction (males) and a stronger smell are possible clinical signs seen with what in ferrets?

A

Adrenal gland disease

150
Q

What are 2 types of medical treatment for adrenal disease in ferrets?

A
  • Leuprolide acetate monthly depot injections

- Deslorelin acetate implant

151
Q

If performing an adrenalectomy in a ferret, is this more difficult on the right or left?
Why?

A
  • Right

- Located near vena cava and caudate lobe of liver

152
Q

An insulinoma a a tumor of what type of pancreatic cells?

What is secreted by these cells?

A
  • Beta cells

- Hypersecretion of insulin

153
Q

Decreased activity, weight loss, difficult arousal from sleep, hypothermia, ptyalism, mental dullness, tremors and collapse are all clinical signs for what condition in ferrets?

A

Insulinoma

154
Q

How are insulinomas diagnosed?

A

Blood glucose levels less than 70 mg/dL

155
Q

What are 2 types of treatment for insulinomas in ferrets?

A
  • Prednisone

- Surgical removal

156
Q

Is subsequent pancreatitis from insulinoma treatment common or rare in ferrets?

A

Rare

157
Q

What are 2 age ranges ferret lymphoma can be seen in?

A
  • 6 months to 1 year

- 3 to 5 years

158
Q

What is a condition that can be seen in young ferrets with rapid onset, rapidly progressive, multi-centric distribution involving hematopoietic and lymphatic tissues, lung and kidney?

A

Ferret lymphoma

159
Q

What form a ferret lymphoma is seen in older ferrets?

What is the prognosis?

A
  • Chronic

- Better survival times

160
Q

Where is a common location for ferret lymphoma?

What are 3 clinical signs seen with this location?

A
  • Mediastinal lymphoma

- Dyspnea, coughing, regurgitation

161
Q

Emesis, diarrhea, tenesmus and splenomegaly are clinical signs that can be seen with lymphoma in what location in ferrets?

A

GI or abdominal lymphoma

162
Q

What are 3 forms of treatment for ferret lymphoma?

A
  • Surgery
  • Chemotherapy
  • Steroids
163
Q

Round, smooth, firm masses that develop on the tail tip in ferrets and originate from the original notocord are known as what?

A

Chordomas

164
Q

Do chordomas grow quickly or slowly in ferrets?

Can they metastasize?

A
  • Slowly

- Yes

165
Q

How do you treat chordomas in ferrets?

A

Surgical removal of tail.

166
Q

What is a disease that is seen in ferrets that can lie dormant until times of stress?
What virus causes it?

A
  • Aleutian disease

- Parvovirus

167
Q

What is a disease seen in ferrets that can be transmitted ferret to ferret or mink to ferret through aerosolization of virus particles or contact with urine, feces, saliva or blood?

A

Aleutian disease

168
Q

What is an immune-mediated disorder characterized by hyper-gammaglobulinemia?

A

Aleutian disease

169
Q

Chronic weight loss, cachexia, malaise, melena and posterior paresis can be seen with what disease in ferrets?

A

Aleutian disease

170
Q

What are 3 possible progressions of Aleutian disease in ferrets?

A
  • Vasculitis
  • Multiple organ failure
  • Sudden death
171
Q

Is there any treatment for Aleutian disease in ferrets?

A

No

172
Q

Cyanosis, tachypnea, increased CRT, jugular distension or pulses, abnormal femoral pulses, tachycardia, muffled heart sounds, left or right sided murmurs, gallop rhythm, pulmonary crackles and ascites can be seen with what in ferrets?

A

Cardiac disease

173
Q

What is a normal heart rate in a ferret?

A

180-230 bpm

174
Q

What is the most common cardiac disease seen in ferrets?

What is the cause?

A
  • DCM

- Unknown

175
Q

What are 3 possible treatments for DCM in ferrets?

A
  • Digoxin
  • Nitroglycerin
  • ACE inhibitors
176
Q

What are 2 possible treatments for HCM in ferrets, aimed at improving diastolic function?

A
  • Beta-adrenergic blockers (Propranolol)

- Calcium channel blockers (Diltiazem)

177
Q

What is the prognosis for a ferret with cardiac disease?

A

Poor

178
Q

What are 3 primary causes of splenomegaly in ferrets?

A
  • Lymphoma
  • Splenic neoplasia
  • ADV
179
Q

What are 4 secondary causes of splenomegaly in ferrets?

A
  • Insulinoma
  • Adrenal disease
  • Cardiac disease
  • Dental disease
180
Q

What are 7 indications for splenectomy in a ferret?

A
  • Discomfort
  • Hypersplenism
  • Splenitis
  • Splenic neoplasia
  • Torsion
  • Rupture
  • Abscess
181
Q

Excessive destruction of erythrocytes, leukocytes and/or platelets is known as what?

A

Hypersplenism

182
Q

What are 5 indications for splenic aspiration in ferrets?

A
  • Splenomegaly
  • Irregular spleen
  • Abnormal ultrasound
  • Anemia of unknown origin
  • Lymphoma/sarcoma

Special Species (4 decks)

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