small mammals 6 pt 2

Question 1

Dilated Cardiomyopathy in ferrets

Answer 1

• Idiopathic
• Middle-aged+
• →CHF

Question 2

Acquired Valvular Disease or Endocardiosis in ferrets

Answer 2

• Idiopathic
• Middle-aged+
• Valvulardysfunction→ regurgitation → CHF

Question 3

Hyperestrogenism etiology

Answer 3

• Intact, unbred female or
  ovarian remnant
• If prolonged, causes bone marrow hypoplasia

Question 4

Hyperestrogenism clinical signs

Answer 4

• Lethargic, weak
• Swollen vulva
• Sparse coat on the sides
• Pale mucous membranes

Question 5

Hyperestrogenism diagnosis

Answer 5

• CBC and biochemistries
• US for ovarian remnant

Question 6

Hyperestrogenism prognosis

Answer 6

• IfPCV>25%-good
• If15%<PCV<25%-reserved
• If PCV < 15% - poor, requires transfusion

Question 7

Hyperestrogenism Tx

Answer 7

• hCG to ovulate
• Supportive care
• Surgery (ovariohysterectomy), once CBC normal

Question 8

Gastrointestinal
Foreign Body in ferrets etiology

Answer 8

Common
* Young – foreign objects
* Older – trichobezoars

Question 9

Chronic Renal
Failure in ferrets Etiology

Answer 9

• Variable degrees of chronic interstitial nephritis common in geriatric ferrets
• May result in nephrotic syndrome

Question 10

chrnoic renal disease in ferrets

Answer 10

• Variable degrees of chronic interstitial nephritis common in geriatric ferrets.
• Advanced interstitial nephritis, as well as pyelonephritis, glomerulonephritis, and immune complex-mediated glomerulonephropathy, can cause renal failure.
• Renal tumours uncommon.
• Chronic kidney disease may result in nephrotic syndrome, in which
  proteinuria and hypoalbuminemia lead to peripheral edema,
  ascites, or both.

Question 11

acute renal disease in ferrets

Answer 11

• Common causes of acute kidney injury (AKI) are postrenal and intrinsic renal insults; postoperative renal failure with severe anesthetic hypotension.
• Ureteral stenosis, prostatic enlargement, and urolithiasis may result in obstruction of urine flow.
• Infectious disease and toxin exposure (e.g., ibuprofen) may result in acute disruption of the renal parenchyma.
• Clinical signs of renal failure may be nonspecific (e.g., anorexia, weight loss, and lethargy); may also include ulcers, GI abnormalities (melena, rare vomiting), ataxia, ascites, and peripheral edema.
• Physical examination - can include dehydration, pallor, irregularities or asymmetry in the size and shape of the kidneys, and increased blood pressure; polyuria or polydipsia if chronic; oliguria or anuria if acute.
• Diagnosis
• Abnormal serum biochemical results - increased blood urea
  nitrogen (BUN) and creatinine (usually lower than in dogs and cats); may include hyperphosphatemia, hyperkalemia, or hypokalemia and reduced total carbon dioxide levels; azotemia must be interpreted with care, because gastric ulcerations and meat-based diet consumption may artificially increase BUN levels.
• Decreased urine specific gravity; mean endogenous creatinine, exogenous creatinine, and inulin clearance rates have been established; urine protein/creatinine ratios (UP:C) may help rule out the presence of proteinuria.
• Symmetric dimethylarginine (SDMA), could be an interesting tool.
• Ultrasound examination - loss of corticomedullary distinction, focal
  and multifocal alterations in the parenchyma, renal pelvic dilation, and hydronephrosis; ultimately, renal atrophy; ultrasound-guided renal aspiration or biopsy may be performed.
• Necropsy.

Question 12

acute renal failure in ferrets treatment

Answer 12

• aimed at the underlying cause, nonspecific therapy of renal
  failure includes supportive care, such as fluid therapy, vitamin and iron supplementation, omega-3 fatty acid supplementation, and nutritional support; also may include dietary phosphorus restriction, intestinal phosphate binders, antioxidant supplementation, antihypertensive drugs, angiotensin-converting enzyme inhibitors, and erythropoietin in case of anemia; antibiotics if clinically indicated and use culture and sensitivity results; discontinue any potentially nephrotoxic drugs and administer diuretics as needed.

Question 13

acute renal failure in ferrets prognosis

Answer 13

• depends on the cause and severity of the primary disease and response to therapy.

Question 14

Renal Cysts and Polycystic Kidney Disease

Answer 14

• Renal cysts of various sizes are a common incidental finding.
• No specific treatment; ultrasound-guided paracentesis may be palliative, but fluid reaccumulates rapidly.
• Monitor with periodic ultrasound examination, biochemical analysis, and
  urinalysis.

Question 15

General Gastritis and Ulceration

Answer 15

• Often Helicobacter mustelae
• Almost all NA ferrets persistently infected at weaning
• Lifelong, if untreated
• Clinical, if stressed
• Can cause lymphoma, gastric adenocarcinoma
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• Gastric and duodenal ulcers are common.
• Causes - foreign body or toxin ingestion, Helicobacter mustelae infection,
  neoplasia of the intestinal tract, treatment with NSAIDs, and azotemia; rare
  with corticosteroids, even at high doses.
• Signs - melena, anorexia, lethargy, and weight loss; if nausea or abdominal
  pain, often hypersalivate, paw at roof of mouth, or display teeth-grinding;
  coughing or gagging (vomiting uncommon).
• Diagnostic tests - whole-body radiographs (fast for 4-6 hours to visualize
  foreign body or hairball, should be empty), blood tests.
• Left untreated, ferrets with melena may die from blood loss or intestinal
  perforation.
• Hospitalize for fluid therapy and parenteral treatment.
• Antiemetic, such as maropitant citrate, metoclopramide, or ondansetron.
• Antibiotic combination that targets Helicobacter.
• Multiple small feedings of a bland, moist diet (if not vomiting), 400 kcal/kg
  body weight per day; if vomiting, withhold food for 4 to 6 hours and
  monitor for hypoglycemia (subclinical insulinomas), then introduce food.
• Bismuth compounds may prevent peptic ulcers.
• H2-receptor antagonists, such as ranitidine or famotidine, to reduce gastric
  acid secretion; superior acid suppression using proton pump inhibitors like omeprazole.

Question 16

Helicobacter Gastritis

Answer 16

• Helicobacter mustelae, a gram-negative bacterial rod.
• Virtually all North American ferrets are likely to become persistently
  infected at weaning unless they are treated or hand-reared in isolation.
• Infection is lifelong if untreated.

Question 16

Gastritis Dx

Answer 16

• Histopathology
• Fecal PCR

Question 16

Gastritis clinical signs, development

Answer 16

• Melena, anorexia, lethargy,
  and weight loss
• If nausea or abdominal pain, hypersalivate,
  paw at roof of the mouth, or teeth-grinding
• Coughing or gagging (vomiting uncommon)
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• Clinical if stressed; severity increases with age.
• Helicobacter colonizes the antral area of the stomach and the pyloric area
  of the duodenum.
• Chronic infections can result in mucosa-associated lymphoid tissue (MALT)
  lymphoma; possibly gastric adenocarcinoma.

Question 17

Gastritis
treatment

Answer 17

• .Antibiotic – amoxicillin, metronidazole, clarithromycin, enrofloxacin
• .+ Antacid – ranitidine, famotidine, omeprazole, bismuth, etc.
• .+/- Antiemetic – maropitant citrate, metoclopramide, or ondansetron
• .+ Supportive care
  <><><><>
• Treatment - amoxicillin, metronidazole, and bismuth subsalicylate; clarithromycin and either ranitidine bismuth citrate or omeprazole more effective; enrofloxacin plus colloidal bismuth subcitrate is also effective; antacids to reduce discomfort.

Question 18

Diarrhea etiology

Answer 18

• Simple GIT
• Bacteria
• Salmonellosis
• Mycobacteriosis
• Campylobacteriosis
• Proliferative Bowel Disease
  > Lawsonia intracellularis
  > 4-6 months old
  > Chronic, often bright green

Question 19

ferret GI transit, anorexia, gut flora

Answer 19

• Normal ferrets nibble on food all day; GI transit time is 3 hours, so defecation is frequent; normal stool is slightly soft and formed.
• Anorexic ferrets may pass a very dark green (bile) stool that can resemble melena; diarrhea is difficult to classify by origin.
• Gut flora of ferrets is simple and long-term administration of broad-spectrum antibiotics does not cause dysbiosis and diarrhea.

Question 20

Bacterial Disease causing diarrhea

Answer 20

Salmonellosis
* A contagious disease characterized by fever, bloody diarrhea, and lethargy; conjunctivitis and anemia may also be present.
* Low incidence, raw diet.
* Therapy - aggressive supportive care and antimicrobial therapy.
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Mycobacteriosis
* Mycobacterium bovis and Mycobacterium avium infections recognised; raw diet.
* M. avium, M. genavense, M. abscessus, and M. celatum also reported
* Diarrhea, weight loss, lymph node enlargement, conjunctival lesions, splenomegaly, and pneumonia.
* Histopathology of tissue samples, acid-fast staining, PCR testing, and culture.
* Treatment regimens, including rifampicin monotherapy or in combination with enrofloxacin and azithromycin, variable success.
* Zoonotic?
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Campylobacteriosis
* Campylobacter jejuni as a primary pathogen unknown.
<><><><><
Proliferative Bowel Disease
* Rare bacterial disease that causes intestinal thickening and diarrhea
in ferrets 4-6 months of age.
* Due to Lawsonia intracellularis; primarily involves the colon and less
commonly the small intestine.
* Chronic diarrhea, varies from dark liquid feces streaked with bright
red blood to scant stool, often with bright green mucus.
* Painful to defecate, rectal tissue may prolapse; lose weight; may die
if untreated.
* Diagnosis - clinical signs, gross or histopathologic lesions, and PCR
performed on a rectal swab, feces, or intestinal biopsy sample.
* Treatment - chloramphenicol.

Question 21

viral diarrhea in ferrets

Answer 21

• Ferret enteric coronavirus
• epizootic catarrhal enteritis (ECE) – “green slime diarrhea” disease
• Adults, from asymptomatic carrier, incubation 2-3 days
• Morbidity high, mortality low with treatment
• Can lead to persistent, intermittent malabsorption

<><><><>

• Rotavirus – 2-6 weeks old
• Canine Distemper – usually fatal if unvaccinated

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Question 22

Coronavirus in ferrets

Answer 22

• Ferret coronavirus is an important cause of enteric disease.
• Two closely related but genetically distinct forms of this RNA virus
  are an enteric coronavirus and a systemic coronavirus resembling
  feline infectious peritonitis (FIP).
• Ferret enteric coronavirus
• Causes epizootic catarrhal enteritis (ECE), a highly transmissible diarrheal disease of ferrets that was initially called “green slime diarrhea” disease.
• Adults most susceptible, usually from young asymptomatic carrier
• Incubation period is 48 to 72 hours, after which affected ferrets are anorexic and lethargic and develop profuse green diarrhea that can persist for several days and longer.
• Morbidity rate high, but the mortality rate is low if treated.
• Diagnosis - PCR of fecal or small intestinal tissue samples;
  new ELISA-based serologic test.
• Treatment - debilitated ferrets with aggressive fluid therapy,
  antibiotics, and supportive care, and isolate them from
  asymptomatic or unexposed ferrets.
• After recovering, some adults develop a persistent, intermittent malabsorption syndrome with tan, seed-like
  diarrhea.
• The clinical course can last weeks to months; prednisone,
  easily absorbed diet, and Tylosin powder may help. * Ferret systemic coronavirus (FSCV) - see below.

Question 23

Rotavirus in ferrets

Answer 23

• Farm outbreaks of diarrhea associated with high morbidity and
  mortality rates in neonatal kits from 2 to 6 weeks of age; morbidity
  low in adults, but transient, green, mucoid diarrhea.
• Diagnosis is by PCR testing of fecal or tissue samples (jejunum or
  ileum),
• Treatment - supportive.

Question 24

canine distemper in ferrets

Answer 24

• Highly contagious paramyxovirus, usually fatal in unvaccinated
  ferrets.
• Clinical signs - include diarrhea, nasal and ocular discharges, and a
  generalized orange-tinged dermatitis.
• Vaccination has greatly limited its incidence.

Question 25

Parasitic Disease in ferrets

Answer 25

• Outbreaks of Eimeria furonis in groups of densely populated ferrets; all
  ages; acute diarrhea and dehydration.
• Giardia is rarely isolated, and clinical significance is unknown.
• Cryptosporidiosis is described, but may not result in clinical disease. Young
  ferrets can have subclinical infections of Cryptosporidium parvum, and coccidial oocysts can be shed by clinically normal ferrets; zoonotic potential unknown but warn the owner.

Question 26

Inflammatory Bowel Disease

Answer 26

• Inflammatory bowel disease (IBD) is a relatively common cause of gastroenteritis in ferrets; young or middle-aged; one ferret in multiple-ferret household.
• Pathogenesis unknown; lymphoplasmacytic inflammation in the stomach and small intestine, varied severity; commonly overlooked.
• Distinguish from eosinophilic gastroenteritis (see below), which often involves multiple tissues and eosinophilia.
• Can have loose, seed-like stools, intermittent nausea, occasional vomiting, and weight loss.
• Clinical signs can be subtle and chronic, or some can have acute vomiting and lethargy.
• Blood tests may reveal an increase in liver enzymes and plasma globulins, and lymphocytosis is occasionally present; laboratory
  tests may be unremarkable.
• Diagnosis - clinical signs; a detailed clinical history that eliminates
  the possibility of exposure to ECE; and results of diagnostic tests; intestinal lymphoma is the primary differential diagnosis; histologic examination of multiple gastric and intestinal biopsy samples.
• Empirical treatment is common - prednisone, azathioprine; hypoallergenic diets (avoid grain-free formulations - cysteine uroliths).

Question 27

Eosinophilic Gastroenteritis

Answer 27

• Eosinophilic gastroenteritis is uncommon in ferrets.
• Chronic diarrhea, with or without mucus and blood, and severe
  weight loss.
• Granulomas and a thickened bowel may be palpable.
• Clinical signs - may be indistinguishable from persistent ECE, but
  animals are older than 6 months; peripheral eosinophilia is
  common and highly suggestive.
• No pathogens found, food allergy?
• Treatment - remission possible with prednisone.