Exotics: Ferret Medicine

Question 1

1. What type of virus is distemper?
2. How is it transmitted?

Answer 1

1. Morbillivirus
2. Aerosols, Direct contact with urine, faeces, skin and other secretions, fomites

Unvaccinated ferrets
Almost always fatal

Question 2

What are the clinical signs of distemper in ferrets?

Answer 2

1. Non-specific- lethargy, anorexia, fever
2. Cutaneous- erythema, hyperkeratosis and crusts
3. Respiratory- dyspnea, tachypnoea, cough
4. Ocular- muco-purulent conjunctivitis
5. Neurological- paresis, ataxia, seizures

Question 3

1. How is distemper in ferrets diagnosed?
2. How is it treated?

Answer 3

1. Unvaccinated ferrets, combinations of signs, swabs for PCR/Ag detection, PM and Histo
2. Most require euthanasia, Supportive

Question 4

When can ferrets be first vaccinated against distemper?
When are they boosted?

Answer 4

12 weeks, yearly boosters
Avoid contact with non-vaccinated
Routine cleaning/hygiene

Question 5

What is the most common source of infection of influenza in ferrets?

Answer 5

Owners are most common source
Aerosols

Question 6

How is influenza diagnosed in ferrets?

Answer 6

Clinical signs
* Fever
* URT signs
* Conjunctitivitis
* Occasionally othoer organs

Exposure to humans with flu

Question 7

How is influenza in ferrets managed?

Answer 7

Most cases are self-limiting
General supportive care- fluids/feeding
NSAIDs?
Antiviral: have been tested in ferrets with positive results, risk of resistance

Question 8

1. What type of disease is Aleutian disease?
2. What ferrets are usually affected?
3. What are the signs?

Answer 8

1. Parvovirus- immunocomplex mediated disease
2. Older ferrets 2-4 years
3. Death without any clinincal signs, chronic wasting disease, neuro (tremors, paresis/paralysis), organ enlargment, anaemia, melena

Question 9

How is aleutian disease diagnosed and managed?

Answer 9

Diagnosis
* Plasma electrophoresis- low albumin, high gamma-globulin
* Haematology: low PCV
* Biochem: depends on affected organ
* PCR
* Positive serum ab
Treatment
* Supportive care
* No effective treatment
* Immunosuppressive?
* Melatonin implants?

Question 10

What lymphomas can commonly occur in ferrets?

Answer 10

• T cell lymphoma
• B cell lympoma
• Cutaneous epitheliotropic lymphoma
• Gastric lymphoma

Question 11

How should a ferret lymphoma diagnostic workup work?

Answer 11

• Haematology- anaemia
• Biochemistry- hypoalbumin, hyperprotein, hyperglobin, hypercalcaemia uncommon
• Ultrasound
• Cytology- almost fully diagnostic
• Biopsy samples- allow grading and phenotyping

Question 12

What treatment options are there for lymphoma?

Answer 12

Chemotherapy- several protocols
* Prednisolone as single agent
* Combination oral (prednisolone and chlorambucil)
* Oral and SC (L-asparaginase)
* SC venous access port
* Modified COP
* Modified CHOP
Radiation therapy

Question 13

1. What cells cause the neoplasm insulinoma?
2. What does it cause?
3. What are clinical signs?
4. How is it diagnosed?
5. How is it treated?

Answer 13

1. Pancreatic B cells- benign
2. Hypoglycaemia
3. Nausea, lethargy, ataxia, seizures
4. Blood glucose <3.3mmol/l after starving, insulin conc, US, imaging
5. Surgery: nodulectomy, partial pancreactomy, suvivial time 1 year

Question 14

How can insulinoma be medically managed acutely and chronically?

Answer 14

Acute/emergency
* IV bolus dextrose
* Maintenance fluids w/ 5% glucose
* Midazolam
Chronic
* Prednisolone- 0.5mg/kg BID then adjust to effect
* Diazoxide- 5mg/kg BID

Question 15

What are the three types of hyperadrenocorticism?
What causes it?

Answer 15

Hyperadrenocorticism
* Hyperaldoseronism- mineralocorticoids
* Hyperadrenocorticism- endogenous steroids
* Hyperandrogenism- androgens
Causes
* Surgical neuter
* Abnormal photoperiod/circadian rhythm
* Genetics

Question 16

What are the clinical signs of hyperadrenocorticism in ferrets?

Answer 16

• Progressive symetrical alopecia
• Pruritis
• Vulvular enlargment in spayed females
• Males- sexual behaviou (odour), urinary blockage (prostate enlargment)

Question 17

How is hyperadrenocorticism diagnosed in ferrets?

Answer 17

Abdominal ultrasound scan
* Adrenal gland enlargment
* Other organs (prostate)
Advanced imaging
Serum/plasma hormones: androstenedione, estradiol
ACTH not diagnostic

Question 18

How can hyperadrenocortisim be treated surgically and medically?

Answer 18

Surgical
* Adrenalectomy

Question 18

How can hyperadrenocortisim be treated surgically and medically?

Answer 18

Surgical
* Adrenalectomy

Question 19

How can hyperadrenocortisim be treated surgically and medically?

Answer 19

Surgical
* Adrenalectomy- L easy, R close to caudal Vena Cava
* Risks- anaesthesia, bleeding, addison’s
Medical managment
* GnRH-agonist
* Supress released of gonadotrophins and adrenal gland stimulation
* Applied every 12-18 months

Question 20

What is the clinical approach for a ferret with gastritis?

Common reason for consult- vomiting, anorexia, lethargy, melena

Answer 20

1. Complete history
2. Full clinical exam
3. Some cases- supportive only
4. Initial investigations- imaging and blood
5. Further investigations- GIT biopsies, C&S

Question 21

What are possible causes of gastritis in ferrets?

Answer 21

• Foreign bodies
• Toxic ingestion
  * NSAID treatment
• Helicobacter mustelae infections
• Neoplasia
• Renal disease

Question 22

What initial supportive disease can be given to ferret with gastritis?

Answer 22

• Fluids
• Anti-emetics- maropitant, ranitidine
• Feeding- frequent/small meals, highly digestable/high protein
• Heat

Question 23

What is helicobacter mustelae?

Answer 23

• Chronic gastritis and mucosal ulceration
• Clinical signs triggered by stress
• Ulceration- melena, anaemia, shock

Diagnosis: gastric wall biopsies

Question 24

How is helicobacter mustelae managed?

Answer 24

* ABs: amoxicillin, metronidazole, claritomycine- 21 days * Bysmuth citrate * Sucralphate * Famotidine * Omeprazole * Fluids and supportive

Question 25

What are common causes of diarrhoea in ferrets?

Answer 25

* Bacterial infections- salmonella, campylobacter * Viral- ferret coronavirus, rota virus (kits), distemper and flu occasionally * Inflammatory bowel disease * Neoplasia

Question 26

What are the two forms of viral enteropathies?

Answer 26

Enteric form * green profuse diarrhoea * Can become chronic * Supportive care ± prednisolone * Tylosin Systemic form * Progressive, pyogranulomatous inflammation * Weight loss, abdominal masses, diarrhoea Confirm w/PCR

Question 27

1. What age of ferrets are affected by rotavirus? 2. How is it treated?

Answer 27

1. Young <6 weeks 2. Supportive care

Question 28

1. What is the pathogenesis of IBD in ferrets? 2. How is it diagnosed? 3. How is it managed? 4. What other disease is managed the same?

Answer 28

1. Lymphoplasmocytic infiltration of intestinal wall 2. Abdominal US- only shows increased thickness and reactive lymphnodes 3. Diet, prednisolone, Azathioprine 4. Eosinophilic gastroenteritis

Question 29

1. What causes proliferative bowl disease? 2. What age of ferrets are more affected? 3. How is it diagnosed? 4. How is it treated?

Answer 29

1. Lawsonia intracellularis 2. Young ferrets and colon 3. Intestinal wall biopsies for histology ± PCR 4. Chloramphenicol- not licensed in the UK and potentially severe side effects

Question 30

When would cardiac disease be suspected?

Answer 30

* >3 yo * Lethargy, excercise intollerance, weight loss * Coughing dyspnoea * Ascites * Organmegaly * Heart murmur, muffled sounds, arrhythmias * Hindlimb weakness * Pulse deficits * Hypothermia * HR 180-250, sinus arrythmia

Question 31

How is acute and chronic cardiac disease approached in ferrets?

Answer 31

Acute/Emergency * Supplement O2 * Sedation * Furosemide Chronic * Full bloods ± urinalysis * Radiography * Heart scan * ECG * Heartworm testing * Cardiac troponin

Question 32

What are the main heart disease presentations?

Answer 32

1. Dilated cardiomyopathy 2. Hypertrophic cardiomyopathy 3. Valvular heart disease (aortic most common) 4. Myocarditis 5. Neoplasia 6. Heartworm

Question 33

What are the treatment optons for cardiac disease?

Answer 33

* Stable and diagnosed patients * Furosemide * ACE-inhibitors * Pimobendan