GI Disease in Ferrets

Profile

• 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).

Types of GI Disease in Ferrets

• 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

|

• 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

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.

Resources for Specialized Diagnostic Tests

| Cryptosporidium sppHelicobacter sppMycobacterium spp  | Research Associates Laboratory | | FRECV/FRSCVCanine distemper virus  | Michigan State University | | FRECVCryptosporidium sppMycobacterium sppH mustelaeCampylobacter jejuniLawsonia 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).

*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.

• Ideal products include high-protein, easily digestible foods that can be fed by syringe (Oxbow Carnivore Care, Hill’s Prescription Diet a/d ).

• 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.

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