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Common diseases of ferrets (Proceedings)
While insulinomas are rarely cured, most affected ferrets can be reasonably controlled and will often live months to years following diagnosis.
• Insulinoma
- Very common in ferrets
- Tumor of the beta cells in the pancreas that secrete excessive levels of insulin
- Results in hypoglycemic episodes
• Weakness
• Lethargy
• Salivation
• Pawing at mouth
• Seizures
• Difficult to awaken from naps*
- Generally malignant with metastasis to the liver, spleen, and other tissues
- Presumptive diagnosis based on blood glucose level (<70mg/dl)
More than 1 test: non-fasted and then 4-6 hours fasted
- Insulin levels can help to distinguish insulinoma from other causes of hypoglycemia
- Definitive diagnosis based on histopathology of biopsy samples taken at exploratory laporatomy
- Treatment
♦ Surgical
• Debulk extensive tumor
• "shell-out" suspicious nodules
• Pancreatic lobectomy
• Post-op pancreatitis is rare
♦ Medical
• Dietary management
o High protein
o High fat
o Frequent feedings
o High sugar material on hand and to only be used in a hypoglycemic crisis
• Chromium Picolinate may help in regulating glucose levels
o Found in Brewer's yeast
o 1/8 – 1/4 tsp per ferret 1-2 times per day
• Prednisolone
o Promotes gluconeogenesis by inhibiting glucose uptake by tissues
o Raspberry flavored
o Dose ranges: 0.1mg/kg – 4 mg/kg SID to BID
o Start low then raise as needed to maintain adequate glucose levels
• Diazoxide
o Inhibits insulin release and reduces cellular uptake of glucose
o Used alone or in conjunction with Prednisolone
o Dose : 5-10 mg/kg BID
While insulinomas are rarely cured, most affected ferrets can be reasonably controlled and will often live months to years following diagnosis
• Adrenal Endocrinopathy (key points)
o Very common in ferrets
o Represented by adrenal hyperplasia, adenomas, and adenocarcinomas
o Usually >3 years of age
o Left more commonly affected than right
o Estrogen is most commonly secreted hormone NOT cortisol
o Carcinomas slow to metastasize
o Diagnosis not easy to confirm
♦ Endocrinopathy can be useful if the correct tests are performed
• Measure estrogen precursors NOT cortisol
♦ Ultrasound has been useful but only 50% successful
• Size greater than 3mm wide consistent with enlargement
o Clinical Signs
♦ Hair loss
♦ Pruritus
♦ Enlargement of vulva in females
♦ Loss of muscle mass/ weight loss
♦ Skin can appear thin or almost translucent
♦ Pot-bellied appearance
♦ Aggressive or mating behavior
♦ Urination difficulties in males
♦ Enlargement of mammary tissue in either sex
♦ Sometimes anemia &/or decreased platelets
o Abdominal palpation – can palpate an enlarged adrenal in approx. 1/3 of cases
o CBC, Chemistry panel, Radiographs, and Urinalysis can all be normal – but useful to look at concurrent disease
o Sometimes will see estrogenic bone marrow suppression (anemia – normocytic/normochromic) (leukopenia) (thrombocytopenia)
o Recommend adrenal endocrine panel from Univ. of Tennessee
♦ Need 0.5cc of serum, frozen, by next day delivery
♦ Measures cortisol, 17 OH Progesterone, Estradiol, Androstenadione, and DHEAS.
♦ Cost = $60 + S/H
o Treatment
• SURGICAL REMOVAL! #1
• Left much easier to remove
• Right adrenal is close to the vena cava and can encompass this large abdominal vein
• If both removed have to think about steroid supplement
• * Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy is effective with a low rate of complications and post-operative recurrence rate.
• Cryosurgery**- benefits include dec. bleeding, less intraoperative time, a quicker recovery & technically easier procedure
• Medical
• Lupron* (leuprolide acetate)– a long acting GnRH analog that stops the stimulation to the adrenal glands therefore decreasing the levels of both sex steroids & androgens
o injectable drug available in 24 hr, 1 mo. depot, 3 mo. depot, and 4 mo. depot.
o No clinical research done on the 24hr, 3mo. or 4 mo. Depot
o *Only research available on the 1 month depot
o Dose: 100mcg/kg IM of the 1 mo. depot diluted
o comes in 3.75mg formulation: dilute to concentration of 500mcg/ml
o can be stored indefinitely at –70C serum freezer or a liquid nitrogen storage.
o possible using regular freezer but drug stability unknown – suspected to be 6 mo.
o 1 vial costs $400 & will treat approx. 35 ferrets
• Melatonin* – a natural hormone secreted by the pineal gland.
o o ; "terminating" (in the fall) the ferret's hypothalmic-pituitary-gonadal axis in response to the seasonal changes in the photoperiod.
o Melatonin inhibits GnRH release, decreases LH and FSH, and ultimately decreases the sex hormone concentrations.
o Dose: 1mg/kg given 8-9 hours after sunrise or 0.5mg PO q 24 hrs
o Implants
• Estrogen Toxicity
o Rarely encountered now due to early spaying
o Jills are induced ovulators so remain in heat until bred
o These extended periods of estrus lead to bone marrow suppression & pancytopenia
o Weak, pale, and sometimes shocky, vulva can be swollen and turgid
o Anemia, leukopenia, and thrombocytopenia present
o Treatment: OVH
♦ Human chorionic gonadotropic (HCG) 100 IU once and repeated in 2 week can be given to stimulate ovulation
♦ Transfusion may be necessary
♦ All ferrets have the same blood type
♦ Use whole blood
• Lymphosarcoma
o Third most common neoplasia
o Affects ferrets of any age
o Lymphadenopathy is the hallmark of the disease
o Peripheral lymphocytosis may be seen on CBC
o Diagnose with histopathology or cytology
o Treatment
♦ Vincristine
♦ Cyclophosphamide
♦ Prednisolone
♦ Doxorubicin
o Prognosis is guarded although remissions of 3 months to 5 years are reported
♦ Proliferative Bowel Disease
o Same disease that swine and hamsters develop
o Caused by the organism – Lawsonia intracellularis
o Chronic diarrhea is the primary clinical sign
o Partial rectal prolapse is sometimes seen
o Weight loss due to malabsorption
o Young ferrets most commonly affected
♦ 10-16 weeks of age
♦ Nutritional and environmental stressors play a role
o Difficult to culture
o PCR for swine available
o Indirect FA to ID omega antigen in swine, hamsters and ferrets
o Presumptive diagnosis based on signalment & clinical signs and even histopath lesions
o Treatment: Chloramphenicol 50mg/kg BID
♦ Fluids and nutritional support also needed
♦ Helicobacter Gastritis
o Spiral shaped gram – rod bacteria
o Causes gastritis and gastric ulceration
o Clinical signs
♦ Vomiting
♦ Anorexia
♦ Weight loss
♦ Diarrhea
♦ Melena
o Definitive diagnosis based on surgical or endoscopic examination of gastric lining
o Treatment
♦ Amoxicillin 20mg/kg BID
♦ Metronidazole 20mg/kg BID
♦ Gastrointestinal protectants
♦ Bismuth subsalicylate 1cc/kg BID
♦ Cimetidine 10mg/kg TID
♦ Sucralfate 25mg/kg BID
♦ Omeprazole
♦ Ranitidine
♦ Epizootic Catarrhal Enteritis
o Unknown viral etiology (coronavirus)
o Affects ferrets of any age but most will have a history of recent exposure to other ferrets
o Often seen following shows, fairs, or in shelter ferrets
o Clinical sign
* Green, mucoid diarrhea = "green slime disease"
♦ Voluminous and sometimes explosive
♦ Can progress to GI ulceration>melena>anemia
o Diagnose based on history and clinical signs
o Histopath shows lymphoplasmocytic enteritis with villar atrophy and blunting
o Treatment = supportive care
o High morbidity, low mortality
o Most recover in a matter of 2-4 weeks
♦ More severe in older ferrets with concurrent disease
♦ Influenza
o Ferrets are susceptible to human influenza viruses
o Mild to moderate upper resp. signs seen 48 hours post exposure
♦ Sneezing, nasal discharge, lethargy, anorexia
♦ Biphasic fever spike documented, but usually missed
♦ +/- enteritis
o Disease is usually self limiting and treat symptomatically
♦ 5-14 days duration
♦ Diphenhydramine 0.5-2mg/kg BID
♦ Fluids and Nutritional support as necessary
♦ Myofasciitis = Disseminated idiopathic myositis (DIM)
o New emerging fatal disease
o Noncontagious
o Progressive and ultimately fatal
o 1 WEEK – MONTHS
o Young adult ferrets (6-18 months)
o Clinical signs
♦ Acute onset of pain
♦ Reluctance to move
♦ Fever
♦ Leukocytosis with mature neutrophilia
♦ Failure to respond to antibiotics & anti-inflammatory meds
♦ Mild non-regenerative anemia
♦ Mild hypoalbuminemia
♦ Mild hyperglycemia
o Necropsy Findings
♦ Gross
• Atrophy of leg & rib muscles with thin diaphragm
• White streaks in muscle
• White splotches in heart
• Red/white mottling of esophagus*
• Entire length
• Check tongue
• Reddened and inc. friability of adipose tissue
• Reddened lungs
• Splenomegaly
• Reddened bone marrow
♦ Histopath
♦ Necrosis & loss or atrophy of myofibers
♦ Suppurative to pyogranulomatous inflammation in muscles
♦ Suppurative to pyogranulomatous inflammation in heart
♦ Full length, circumferential, full thickness suppurative inflammation in all tunics but mucosa*
♦ Suppurative inflammation in adipose tissue adjacent to muscle, lungs, mediastinum
♦ Myeloid hyperplasia in spleen and bone marrow
o Cause undetermined
♦ Bacterial and viral cultures negative
♦ PCR and immunohistochemistry negative
♦ Immune mediated?
o Treatment
♦ Many drugs used – unsuccessful
♦ Combo ?
♦ Chloramphenicol, prednisone, cyclophosphamide
