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GI Disease in Ferrets

Angela M. Lennox, DVM, DABVP, Avian & Exotic Animal Clinic, Indianapolis, Indiana

Small Mammals

|September 2013|Peer Reviewed

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  • The ferret is a laboratory model for research on emesis, Helicobacter mustelae gastritis, and certain GI neoplasms.
  • GI disease, common in pet ferrets, is often multifactorial and can be secondary to other disease processes and stress.
  • The ferret’s relatively short GI tract predisposes it to GI disease.
  • Causes include primary GI disease (eg, infectious, neoplastic, foreign body) and inflammatory conditions (Table: Types of GI Disease in Ferrets).
  • Viruses frequently affecting the GI tract include ferret enteric coronavirus (FRECV) (also known as epizootic catarrhal enteritis [ECE] virus) and ferret systemic coronavirus (FRSCV), a newly recognized virus.
  • In an informal survey at the author’s clinic, owners reported mild to severe diarrhea after a traumatic event (eg, change in social structure, housing, veterinary visit).

Table

Types of GI Disease in Ferrets

Primary  
Differentials for infectious causes
  • Canine distemper virus
  • Salmonellosis
  • Influenza virus
  • Mycobacteriosis
  • Campylobacteriosis
Foreign body
  • Younger ferrets most affected
  • Documented foreign materials include foam, rubber, and plastic
  • Trichobezoars are also seen
Infectious disease
  • Bacterial, including H mustelae
  • Viral, including enteric (FRECV) or systemic coronavirus (FRSCV) or rotavirus in very young animals
  • Parasitic, most commonly coccidia in younger animals
Inflammatory disease
  • Inflammatory bowel disease, eosinophilic gastroenteritis
  • Underlying causes uncertain
Neoplastic disease
  • Primary GI neoplasms, including lymphoma and carcinoma
Secondary  
Physiologic stress
  • Stress from any other disease processes, including non–GI neoplasia, organ failure
Psychological stress
  • Changes in housing or social structure, separation, veterinary visits

Physical examination and historical findings can reveal:

  • Weight loss
  • Decreased appetite to hyporexia or anorexia
  • Lethargy
  • Vomiting and regurgitation
  • Abnormal stool (eg, diarrhea, hematochezia)
  • Palpable masses or bowel thickening
  • Apparent pain on abdominal palpation
  • Dehydration
  • Emaciation and hypovolemia (in severe cases)
  • Rectal or colon prolapse (young ferrets) or straining from sacculectomy complications
Safe restraint of a ferret using scruff technique
Safe restraint of a ferret using scruff technique

Figure 1 Safe restraint of a ferret using scruff technique

Figure 1 Safe restraint of a ferret using scruff technique

Diagnosis

  • Definitive diagnosis requires identifying underlying primary disease, other concurrent disease process(es), and/or stress.
  • Primary pathogen testing includes bacterial culture and sensitivity testing, PCR assay for specific pathogens (eg, viruses), and fecal flotation (Table: Resources for Specialized Diagnostic Tests).
    • Fecal flotation may identify coccidia or other organisms, but GI parasitism is uncommon in pet ferrets.
    • Confirmation of disease from H mustelae requires gastric biopsy with documentation of lesion-associated organisms. Because most pet ferrets are thought to harbor this organism, PCR assay with biopsy is recommended.
    • Occult fecal blood testing can be a useful adjunct test in identifying GI hemorrhage.

Table

Resources for Specialized Diagnostic Tests

Pathogen Resource
Cryptosporidium spp Helicobacter spp Mycobacterium spp   Research Associates Laboratory
FRECV/FRSCV Canine distemper virus   Michigan State University
FRECV Cryptosporidium spp Mycobacterium spp H mustelae Campylobacter jejuni Lawsonia intracellularis   Veterinary Molecular Diagnostics
  • Abdominal radiography is most useful in cases of GI obstruction and can also identify other abnormalities.
  • Abdominal ultrasonography can be useful, especially for investigation of masses potentially related to the GI tract.
  • GI tract biopsy is indicated in patients that are unresponsive to therapy.
  • CBC and serum biochemistry profile analysis can provide useful information on overall clinical condition (eg, hypoproteinemia from albumin loss via the GI tract).
    • CBC can also help identify other underlying disease conditions.

 Treatment

Treatment includes resolution of fluid deficits (eg, shock, anemia, dehydration).

  • Blood transfusion can be relatively easy in ferrets, which have no identifiable blood types.
  • Some GI diseases—particularly gastritis—appear particularly painful.
  • Analgesics or proton pump inhibitors may be useful; the author finds famotidine to be efficacious.
  • Bacterial GI disease is treated with appropriate antimicrobials based on culture and sensitivity test results if available.
  • Good empirical choices include amoxicillin and enrofloxacin.
  • Treatment of viral disease is supportive only.
  • A regimen for FRSCV has been proposed and is based on treatment for feline infectious peritonitis (Suggested Treatment Protocols for FRSCV).

Suggested Treatment Protocols for FRSCV1*

In combination:

  • Doxycycline at 10 mg/kg PO q12h
  • Cimetidine at 10 mg/kg PO q12h
  • Polyprenyl at 3 mg/kg PO 3× weekly
  • Pentoxifylline at 20 mg/kg PO q12h
  • Feline vitamin supplement
  • Prednisolone at 1–2 mg/kg PO q12h, tapering dosage
*Currently proposed for management of ferrets with FRSCV; treatment may be long-term, depending on response to therapy
  • Triple therapy (metronidazole–amoxicillin–bismuth subsalicylate) is often used for suspected Helicobacter spp gastritis; other drug combinations have also been used.
  • Foreign body obstruction requires laparotomy. Ferrets are generally good surgical candidates, excluding those with chronic disease and marked debilitation.
  • A number of protocols have been developed for treatment of GI lymphoma. Success can vary.
  • Many ferrets with GI disease require hand-feeding.
  • Stress, a contributor to enteritis and diarrhea, should be managed.
  • Ferrets that are unresponsive to therapy should be referred for advanced diagnostic testing and therapy.
  • Many owners can aid in treatment by administering medications and providing meals via frequent hand-feeding.
An emaciated, wasted ferret with chronic diarrhea; note dark tarry stool accumulation at the perineum, likely indicating hematochezia.
An emaciated, wasted ferret with chronic diarrhea; note dark tarry stool accumulation at the perineum, likely indicating hematochezia.

Figure 2 An emaciated, wasted ferret with chronic diarrhea; note dark tarry stool accumulation at the perineum, likely indicating hematochezia.

Figure 2 An emaciated, wasted ferret with chronic diarrhea; note dark tarry stool accumulation at the perineum, likely indicating hematochezia.

Follow-up & Prognosis

  • Patients must be monitored carefully for response to therapy; simple bacterial gastroenteritis may resolve promptly.
    • Many conditions, however, may only temporarily respond or not respond at all.
  • Prognosis is good for patients with bacterial or parasitic disease.
    • Chronic inflammatory disease may be difficult to treat.
  • FRECV carries a high morbidity, but most ferrets survive with supportive care.
    • Most deaths are seen in older or already debilitated animals.
  • Prognosis is guarded for ferrets affected with FRSCV.
  • GI neoplasia often carries a guarded prognosis; lymphoma may respond to chemotherapy.
  • Failure to respond is often a result of incomplete diagnosis or failure to manage other concurrent disease or stress.
  • Coronavirus may produce significant damage to the intestinal mucosa; chronic GI dysfunction is common and may be difficult to resolve.

ECE = epizootic catarrhal enteritis, FRECV = ferret enteric coronavirus, FRSCV = ferret systemic coronavirus

References

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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