Newsgroups: alt.pets.ferrets,rec.pets,rec.answers,alt.answers,news.answers
Subject: Ferret FAQ [5/5] - Medical Overview
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Summary: Answers to Frequently Asked Questions and general information
         about pet domestic ferrets.  Should be helpful to both
         prospective and current ferret owners.
	 Part V - overview of medical tests and problems, recovery, references
Keywords: faq pet ferrets medical overview recovery disease sick cancer
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Archive-name: pets/ferret-faq/part5
Last-modified: 19 Jan 1998
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FERRET FAQ (part 5 of 5) -- MEDICAL OVERVIEW
Compiled and edited by Pamela Greene <pgreene@optics.rochester.edu>
Additions, corrections, and suggestions for this file are welcomed!

This document is copyright 1994-1998 by Pamela L. Greene.  See section
0.5 (in Part 1, About Ferrets and This FAQ) for authorship information
and redistribution rights.  In short, you can give it away, but you
can't charge for it or include it in any for-profit work without
permission.

The basic Ferret FAQ has five parts, all of which should be available
wherever you obtained this one.  Most people will want to look at
parts 1 through 4, and perhaps skim part 5.  A complete table of
contents for all five files is given in Part 1.  Please at least read
section 0 in Part 1, About this FAQ.  In addition, there are separate
FAQ's for several common ferret diseases.  Information about those is
given in section [1.1].

Please note: I am not a ferret expert, and I did not write, nor did I
independently verify, all the information in this file.  I have done
my best to include only accurate and useful information, but I cannot
guarantee that what is contained in this file, whether written by me
or by one of the contributors, is correct, or even that following the
advice herein won't be harmful to you or your ferret in some way.  For
advice from an expert, you may wish to consult one of several books
available, or, especially in the case of a suspected medical problem,
a veterinarian who is familiar with the treatment of ferrets.

------------------------------

Subject: CONTENTS OF THIS FILE

Part 5: MEDICAL OVERVIEW

11. *** Common health problems ***

   (11.1) Common diseases in ferrets
   (11.2) Overview of common health problems
   (11.2.1) Noninfectious
   (11.2.2) Parasitic health problems
   (11.2.3) Infectious diseases
   (11.2.4) Neoplasia (Cancer)

12. *** General medical information ***

   (12.1) Do I need to worry about toxoplasmosis?
   (12.2) How can I get my ferret to take this medication?
   (12.3) Where can I get medications at a discount?
   (12.4) Can ferrets have transfusions?
   (12.5) What anesthetic should my vet be using?
   (12.6) How do I care for my sick or recovering ferret?
   (12.7) My ferret won't eat.  What should I do?
   (12.8) What's Duck Soup?  Anyone have a recipe?
   (12.9) What are normal body temperature, blood test results, etc.?
   (12.10) What tests might my vet want to run, and why?

13. *** Medical reference material ***

   (13.1) Who makes this product or medication?
   (13.2) What books can I get or recommend to my vet?
   (13.3) Are there any other useful references?

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

11. *** Common health problems ***

------------------------------

Subject: (11.1) Common diseases in ferrets

Once again, I'm not a vet or even a ferret expert, but here's a list
of several of the most common medical problems in ferrets.

Intestinal blockages
   Caused by eating something indigestible, such as an eraser, a
   rubber band, some fabrics, or even a good-sized hairball
   (accumulated from grooming), which gets stuck.  Symptoms may
   include (one or more of) lack of bowel movement, constipation,
   bloating, vomiting or heaving, drooling, and others.  Blockages may
   occur at any point in the digestive tract, from the throat through
   the lower intestine, even in the stomach where the object may move
   around and produce only intermittent symptoms.  Blockages are
   serious and occasionally fatal; the most important immediate
   concern is to keep your ferret hydrated, which you can do by giving
   him 5 cc of water every 4 hours from a baby feeding syringe.  You
   can try giving your ferret large doses of hairball remedy every 30
   minutes for an hour or two to see if the blockage passes, but if
   not, take him to a vet right away for an X-ray, barium study,
   and/or surgery to remove it.  Laxatone or a similar hairball
   remedy/laxative can help prevent this [6.2].

Tumors or lesions of the adrenal glands
   Symptoms vary, including hair loss spreading from the base of the
   tail forward [10.6], lethargy, loss of appetite, and loss of
   coordination in the hindquarters.  In females, often the most
   prominent sign is an enlarged vulva as in heat.  Often, however, a
   tumor will be present without showing any signs at all, so if your
   ferret is going in for any surgery, the vet should take a look at
   the adrenal glands as well (if time permits -- ferrets lose body
   heat very quickly in surgery).  The left gland seems to be affected
   more often than the right.  More information is available in the
   Ferret Medical FAQ on Adrenal Disease [1.1].

Islet cell tumors (insulinoma)
   These are tumors of insulin-secreting cells in the pancreas.  Their
   main effect is a drop in the blood sugar level, and they are also
   common enough in older ferrets, even without symptoms, that if your
   pet is having surgery for something else, a quick check is
   worthwhile.  Symptoms include lethargy, loss of appetite, wobbly
   gait, and pawing at the mouth; in more severe cases attention
   lapses (staring into space) or seizures may also occur.  If you're
   more than a minute from your vet and your ferret has a low enough
   blood sugar level to be having seizures, call the vet and ask if
   you should rub Karo (corn sugar) syrup or honey on your pet's gums
   to raise it just enough to bring him out of the seizure.  More
   information is available in the Ferret Medical FAQ on Insulinoma
   [1.1].

Lymphoma or lymphosarcoma
   This is a cancer of the lymphatic system.  There are two main
   types, "classic" and juvenile.  Classic lymphoma occurs in older
   ferrets and causes enlarged lymph nodes and irregularities in the
   blood cell count, but often the ferret doesn't show any outward
   signs until the disease has progressed pretty far, at which point
   the ferret suddenly gets very sick.  Conclusive diagnosis is by
   aspiration or biopsy of a lymph node, and treatment is
   chemotherapy.  Juvenile lymphoma is completely different. It
   affects ferrets under 14 months, doesn't generally cause
   enlarged lymph nodes, and hits very hard and fast.  Also see
   the Ferret Medical FAQ on Lymphosarcoma [1.1].

Splenomegaly [enlarged spleen, usually a swelling in the upper abdomen]
   In situations where a neoplasm is not present [this is a common
   symptom of lymphosarcoma], the pros and cons of splenectomy should
   be discussed with your veterinarian.  If an animal simply has a
   large spleen, but shows no signs of illness or discomfort, it is
   safer for the animal to leave it in.  However, if the animal shows
   signs of discomfort, such as lethargy and a poor appetite, or a
   decrease in activity, the spleen should probably be removed.  These
   animals also need good nursing care [12.6] care to get them back on
   their food.  Often caused by H. mustelae infection (see below).
   With proper care - recovery rates are over 90%.  Also see the
   Ferret Medical FAQ on Splenomegaly [1.1].

Helicobacter mustelae infection
   A bacterial infection of the stomach lining, Helicobacter
   mustelae is extremely common in ferrets.  Animals with
   long-standing infections (generally older animals), may develop
   gastric problems due to the bacteria's ability to decrease acid
   production in the stomach.  Signs of a problem include repetitive
   vomiting, lack of appetite, and signs of gastric ulcers (see
   above).  Helicobacter infection and gastric ulcers often go hand in
   hand - the relationship between infection and gastric ulcer
   formation has not been totally worked out, although there is
   currently a lot of research in this area.  Also see the
   Ferret Medical FAQ on Gastric Ulcers / Helicobacter mustelae [1.1].

Cutaneous vaccine reactions
   Subcutaneous vaccination with rabies or other vaccines may, over
   a period of weeks, cause a hard lump [10.1] at the site of
   vaccination.  The lump simply consists of a large area of
   inflammation and most commonly are seen around the neck.  The lumps
   can be removed, and generally do not cause a major problem for your
   pet.  Similar lesions may be seen in vaccinated dogs and cats.

Urinary tract infections and prostate trouble
   Signs include frequent urination, straining to urinate, and
   possibly funny-looking or smelly urine.  Un-spayed females in heat,
   and spayed females with swollen vulvas due to adrenal disease
   [1.1], are particularly prone to UTIs.  Treatment generally
   consists of a course of antibiotic (usually Amoxicillin); if the
   ferret doesn't respond to that, the possibility of bladder stones
   [11.2.1] should be considered.

   In males, what looks like a UTI may be (or be aggravated by) an
   inflamed prostate, also generally caused by adrenal disease.  In
   this case the prostate, which is normally tiny, can be palpated,
   and a greenish goo can often be expressed from it.  Taking care of
   the adrenal problem should clear up the prostate trouble too.

------------------------------

Subject: (11.2) Overview of common health problems

All of this section was written by Susan A. Brown, DVM.

Most common health problems of the pet ferret

------------------------------

Subject: (11.2.1) Noninfectious

by Dr. Susan Brown, DVM

A. GI Foreign Bodies [11.1]

       This is the MOST COMMON cause of wasting and acute abdominal
   disease in the ferret under 1 year of age.  It occurs with less
   frequency in older ferrets.
       Ferrets love to chew and eat rubber and "sweaty" objects.  The
   most common foreign bodies we remove are latex rubber pet toys,
   foam rubber, insoles and soles of shoes, pipe insulation, chair
   foot protectors, along with towels, cotton balls, plastic, metal,
   and wood.
       Hair balls are VERY COMMON particularly in the ferret 2 years
   of age and older.
       Most foreign bodies remain in the stomach if they are too large
   to pass and cause a slow wasting disease that may last for months.
   (This is the way that most hairballs present.)  However, if the
   foreign material passes out of the stomach and lodges in the small
   intestine, then the pet becomes acutely ill, severely depressed,
   dehydrated, in extreme abdominal pain and finally coma and death
   within 24 to 48 hours if surgery is not performed.
       Other signs that your pet may have a foreign body are pawing at
   the mouth frequently, vomiting (although remember that many pets
   with foreign bodies do not vomit), appetite that goes on and off,
   black tarry stools that come and go.
       Prevention is by use of a cat hairball laxative [6.2] either every
   day or every other day (about 1") and ferret proofing [5.1] your
   house on hands and knees for potential foreign body items.
       Treatment is generally surgery, because if it is too large to
   leave the stomach, it has to come out somehow!

B. Aplastic Anemia

       A common cause of death of unspayed breeding females.
       The cause is a condition caused by high levels of the hormone
   estrogen that is produced during the heat period which in turn
   suppresses the production of vital red and white blood cells in the
   bone marrow.  This suppression is irreversible as the disease
   advances and death occurs from severe anemia, bleeding (because the
   blood can't clot properly), and secondary bacterial infections
   because there aren't enough white blood cells to fight.
       Signs are seen in animals in heat 1 month or longer (they can
   stay in heat up to 180 days if unbred), and include general
   depression and hind limb weakness that seems to occur suddenly and
   sudden loss of appetite.  Additionally there may be marked hair
   loss and baldness on the body.
       Upon closer exam the gums appear light pink or white, and there
   may be small hemorrhages under the skin.  A complete blood count
   should be done to determine the severity of the damage to the bone
   marrow.
       If the condition is advanced, there is no treatment as it is
   irreversible, and euthanasia is recommended.  If the disease is
   caught early, treatment may include a spay, multiple transfusions
   [12.4] and other supportive care.
       Prevention is by having animals not designated for breeding
   spayed by 6 months of age.  Those to be used for breeding should
   use the hormone HCG for taking them out of heat during cycles when
   they will not be bred.  The use of vasectomized males can sometimes
   be unreliable, and we do not recommend it.

C. Anal Gland Impaction

       Caused when the animal has a blockage to the outflow of anal
   gland secretion or abnormally thick anal gland material.
       Signs are few, doesn't seem to cause them much pain.  If the
   gland ruptures, a draining hole will be seen near the anus, and the
   pet may lick at the area frequently.
       Treatment is by surgical removal of the anal glands.  Even if
   only one is affected now, remove both as the other may become
   affected later.
       There is no prevention, and this disease does not occur with
   sufficient frequency to warrant routine anal gland removal in all
   ferrets.

D. Cataracts

       Caused when the lens of the eye becomes opaque.  Light can no
   longer reach the retina and the animal becomes blind.  In ferrets
   it is primarily seen in animals under one year of age and is
   considered to be hereditary.  In other cases it may be caused by
   aging of the eye in very old animals or as a result of injury to
   the eye.
       Signs are almost nonexistent.  Ferrets have very poor eyesight
   and do not depend on it for much.  Many people are surprised to
   find that their ferrets are blind.  They eyes will have a whitish
   blue cast to the area of the pupil.
       Treatment is unnecessary.
       Prevention of hereditary cataracts is by not repeating the
   breeding.

E. Cardiomyopathy
There is a separate FAQ devoted to cardiomyopathy; see section [1.1].

       Seen generally in animals over 3 years of age, rare in young.
   Caused by an abnormal thinning or thickening of the heart muscle
   which interferes with blood flow through the heart.
       Signs include a marked decrease in activity, the need to rest
   in the middle of the play periods, great difficulty in awakening
   from sleep, and as the disease progresses one may see coughing,
   difficulty breathing, fluid build-up in the abdomen and a general
   loss of condition.
       Diagnosis is by x-ray and EKG.
       Treatment is dependent on which type of heart muscle
   abnormality is present.  There is no cure for this disease,
   treatment helps to alleviate symptoms and reduce he work load on
   the heart and attempt to prolong life.

F. Urolithiasis (Bladder Stones)

       The cause is not completely understood.  A high ash content of
   the diet and possible underlying bacterial or viral infections, and
   even some genetic predisposition may all play a part. This
   condition is rarely seen in animals on a low ash cat food.
       Signs include blood in the urine, difficulty in urinating (may
   be accompanied by crying when urinating), "sandy" material being
   passed in the urine, and in the most severe cases there may be a
   complete blockage leading to no urine being passed and eventual
   depression, coma and death.
       Treatment depends on the size of the stones.  Surgery may be
   indicated or a change to a special diet may solve the problem.
       Prevention is by feeding a low ash diet.

------------------------------

Subject: (11.2.2) Parasitic health problems

by Dr. Susan Brown, DVM

A. Ear Mites [10.10]

       Caused by a small mite that lives in the ear and sucks blood
   and is picked up from other animals with mites (including dogs and
   cats).
       Signs are very minimal to none.  Ferrets seem to tolerate mites
   very well.  Occasionally there may be an excessive amount of ear
   wax produced, extensive scratching of the ears, and small black
   pigmented areas that appear on the ear.
       Treatment is with Ivermectin at 1 mg/kg divided into two doses
   with each dose dropped into each ear.  This is repeated in two
   weeks.  All the animals in the house should be treated.  Wash
   bedding the same day as treatment and a bath for the pet wouldn't
   hurt, either.  They also may be treated with Tresaderm daily for 14
   days.

B. Fleas [10.9]

       Caused by an insect that spends a small portion of its life on
   the animal and lives in the surrounding environment laying eggs the
   rest of the time.
       Prevented by spraying or powdering your animals 2 times a week
   with a pyrethrin product if they go outside. If you already have
   them, the house must be treated also.

------------------------------

Subject: (11.2.3) Infectious diseases

by Dr. Susan Brown, DVM

A. Influenza virus

       Caused by the same complex of viruses that cause disease in
   humans.  They can catch it from humans or other ferrets.
       Signs include a runny nose (clear discharge), runny eyes,
   sneezing, coughing, decrease but not total loss in appetite,
   lethargy and occasionally diarrhea.  In newborns it may be fatal.
       Treatments is generally nothing specific except rest and loving
   care.  They generally get over it in 3 to 7 days (recall how long
   your flu lasted, and they will generally be the same), The
   antihistamine product Chlor Trimeton may be used at 1/4 tablet 2
   times daily for sneezing that may interfere with sleeping or
   eating.  If the appetite is totally lost or if any green or yellow
   discharges appear or if there is extreme lethargy, these animals
   should be seen by a veterinarian.
       Prevention is washing hands and no kissing when you are dealing
   with a cold.  Also remember, they can give the flu right back to
   you!

B. Canine Distemper

       A 100% fatal disease that is still very much out there!  It is
   caused by a virus that attacks many organs in the body.  The virus
   can stay alive for a long time on shoes and clothes that have come
   in contact with infected material.  (Such as from walks in parks or
   other areas where animals roam).
       Signs range from acute [quick] death to a slow progressive
   disease which usually starts as an eye infection and progresses to
   a rash on the chin and lips and abdomen, and thickened hard pads on
   the feet.  Diarrhea, vomiting, severe lethargy are other possible
   signs.  The disease may be very drawn out with seizures and coma at
   the end.
       There is no treatment for distemper.  Euthanasia is the kindest
   solution as it is a long and painful way to go.
       Prevention is by vaccination with the Fromm-D [or Fervac-D]
   distemper vaccine [9.2].  Use of [some] other vaccines have
   occasionally caused cases of distemper in ferrets.  The schedule
   would be the first shot at 6 weeks of age then 8 weeks, 11 weeks,
   14 weeks and annually thereafter.  The vaccine WILL NOT last for 3
   years in the face of an outbreak.  Ferrets do not need vaccines
   containing leptospirosis, hepatitis, parainfluenza or any other dog
   virus.

------------------------------

Subject: (11.2.4) Neoplasia (Cancer)

by Dr. Susan Brown, DVM

Each of these four cancers has its own FAQ; see section [1.1].

A. Lymphosarcoma

       This is a disease of the lymphatic system of the body which is
   an important part of the immune system.  The cause is unknown but
   investigation is being done to determine if there is a virus
   involved.  It can occur in ferrets of any age.
       Signs are very variable, and many animals show no outward signs
   until they are very ill, or changes are picked up on a routine
   veterinary exam.  Changes may include enlarged lymph nodes anywhere
   in or on the body, a greatly enlarged spleen, wasting, difficulty
   breathing, and extreme lethargy.  A complete blood cell count may
   indicate abnormal (cancerous) cells present, although this occurs
   in a very small percentage of cases.
       Diagnosis is generally by biopsy of a lymph node, spleen or
   fluid from the chest.
       Treatment is by chemotherapy of the animal fulfills certain
   criteria that would make it a good candidate, Chemotherapy has been
   successful in about 75% of our cases, allowing life to be prolonged
   in a quality way for 6 months to 2 years.

B. Insulinoma

       This is a tumor of the pancreas leading to a high insulin
   production and a low blood sugar.

C. Adrenal Adenoma or Adenocarcinoma

       This is a tumor of the adrenal gland.

D. Skin tumors

       There are a variety of skin tumors occurring in the pet ferret.
   The most common are sebaceous gland adenomas, and mast cell tumors.
   Most of these should be removed particularly if they are ulcerated,
   bleeding, or have a rough surface.
        Chondromas occur with some frequency on the tip of the tail as
   a hard round lump.  They are generally benign, but may become large
   and bothersome and can easily be removed.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

12. *** General medical information ***

------------------------------

Subject: (12.1) Do I need to worry about toxoplasmosis?

Toxoplasmosis is a disease which is sometimes spread through animal
feces, especially cats'.  It's nothing to worry about, unless you're
pregnant, have a very young child, or have a weakened immune system --
it's very dangerous to a human fetus in the first stages of
development, it may be dangerous to infants and toddlers, and it's a
concern for those who are HIV+.  Ask your doctor if you think you
might be susceptible.

Dr. Bruce Williams, DVM, says:

     Toxoplasmosis has been reported twice in ferrets.  Ferrets will
     not shed the toxoplasma organism to the extent that cats do, but
     if they are exposed to cat feces, they may contract the disease
     and shed very low amounts of oocysts.

     Here's the bottom line.  Because of the devastating effects that
     Toxoplasma can have on a developing human fetus in the first
     trimester - you don't want to take ANY chance at all on exposing
     [a pregnant woman] to Toxo.  So [someone in the household who
     isn't pregnant] inherits all litterbox duties for the next
     nine months.  Actually, she probably stands a higher chance of
     getting Toxo from poorly cooked beef.  The doctor says - if she's
     a carnivore - better get used to well-done steaks....

------------------------------

Subject: (12.2) How can I get my ferret to take this medication?

If your ferret is just starting long-term medications and you're not
looking forward to an hour-long struggle twice a day forever, take
heart.  Most of them resign themselves to the routine after a couple
of weeks.  If you only have to give your ferret medication for a week
or two, at least there's an end in sight!

The method Rick Beveridge has used, with pictures, can be found at
<http://www.seaside.net/homepage/rbever/medication/medicate.html>.

If you're really lucky, your ferret will like the taste of the
medication.  In that case, either hold the dropper in front of the
ferret or empty it into a spoon and let him lick it.  If you squeeze
the medication into his mouth, be sure not to squirt it down his
throat, since he may inhale some and get pneumonia.  Putting the
dropper behind his back teeth and aiming in from the side helps.

If he doesn't like the medication, you'll want to mix it with
something that tastes better, such as Ferretone, Petromalt, Pedialyte,
or apple juice.  Check with your vet to find out what won't interfere
with the medication or its absorption.  Some can't be given with oils,
others with sugary foods, others with dairy products, and so on.  You
might be able to just mix the medication and the bribe on a spoon and
get your ferret to lick it that way.

If not, suck the medication into a small feeding syringe, the kind
without a needle, draw in a few cc's of the bribe, and shake it to mix
them.  Put a big old towel on a table or the floor, put the ferret on
it, and see if he'll lick the mixture willingly.  Be warned, ferrets
can spit several feet.  Don't wear your nice clothes.

If you have to force the mixture in, hold the ferret's head and
shoulders with one hand so he can't back away.  Put the syringe tip in
on the side of his mouth and slowly squirt the stuff in, being careful
not to aim it down his throat (or he might inhale some) and making
sure to give the ferret enough time to swallow.  You may need to hold
the ferret's head up and his mouth closed, and rub his throat so he
swallows.  Once the medication is gone, give the ferret another small
treat and tell him what a good ferret he was.

Some people have good luck with crushing a pill or pill piece and
mixing it with a liquid treat, after checking with a vet to see which
ones are all right.  Otherwise, try completely covering it with
something gooey such as Petromalt or peanut butter, then holding it on
the tip of one finger.  Gently pry the ferret's mouth open with a
finger on one side, and scrape the goo and treat onto the ferret's
tongue.  Get it pretty far back if you can, but don't gag him.  Hold
his mouth closed so he can't push the pill out with his tongue, and
rub his throat to get him to swallow.  If he manages to spit out the
pill, just keep trying.

------------------------------

Subject: (12.3) Where can I get medications at a discount?

A fairly new company called PetMed Express offers common veterinary
medications at a discount.  Flea treatments, prednisone, and so on are
available.  The require a faxed prescription or the phone number of
your vet's office so they can call for the prescription information.
Call 1-888-233-PETS for information.

------------------------------

Subject: (12.4) Can ferrets have transfusions?

Yes.  Ferrets have no apparent blood types, so if your ferret needs a
transfusion any other ferret can be a donor -- the bigger, the better.
Dr. Susan Brown writes, "Approximately 20 ml of whole blood can be
removed by cardiac puncture from a healthy male ferret weighing 1 kg
[2.2 lb] with no side effects; it can then be used immediately for
transfusing.  12 cc may be removed from a female weighing .75 kg [1.6
lb]."

If your ferret is going in for extensive surgery, ask your vet whether
it might be a good idea to also bring along a big, healthy ferret as a
potential blood donor, just in case it's needed.

------------------------------

Subject: (12.5) What anesthetic should my vet be using?

Isoflurane, an inhalant.  Dr. Bruce Williams, DVM, says:

    The only acceptable type of anesthetic agent for general
    anesthesia in the ferret is gas, and preferably a gas anesthetic
    called isoflurane.  Most vets use it, but other types of gas
    anesthetics, such as halothane are still in use.  Isoflurane
    currently is the safest, with the least chance of generating a
    life-threatening cardiac arrhythmia or causing liver disease, both
    of which may be seen (rarely) with halothane.  Most
    ferrets, even with severe disease, will go down quickly with
    isoflurane, and come up within 5-10 minutes.  No other
    premedications are necessary [unlike for the injectable ketamine].

    I would not use a vet who used injectable anesthetic for surgery -
    chances are much higher for overdosing.  The effects of injectable
    anesthetics are extremely unpredictable in the ferret, and older
    ferrets are at risk for arrhythmia and cardiovascular shock.

------------------------------

Subject: (12.6) How do I care for my sick or recovering ferret?

The following information comes from Sukie Crandall, who generously
sent an account of her experiences with Meltdown and Ruffle, two of
her ferrets with heart disease.

At first, your sick or recovering ferret will be a big drain on your
time, energy, and humor.  It's amazing how stubborn a sick ferret can
be.  If you're unfortunate enough to have a chronically ill ferret,
you may find that she becomes easier to deal with after a while, as
you both get used to her new routine and limitations.

You may have an assortment of medications for your ferret, whose
schedule and doses might change according to her health.  It's very
important to keep a complete and accurate chart.  Note how and when
medicines must be given, and whenever you give medicines write them
down and note the time.  Keep information on side effects, when to
skip doses, how to deal with missed doses or accidently doubled doses,
which medicines should not be given close together, which must be
shielded form light, and all other related information. Do not keep
medications in a room which gets too hot, too cold, or too humid.
Never give a laxative close to when you give a medicine.  Be aware of
side-effects and interactions; for instance, some medicines increase
the chance of sunburn.

Pill cutters work much better than scalpels or other things, and a
tweezers will also be handy.  Keep in mind how different medicines
must be given, and find the best way for each to minimize the stress
to you and your ferret.  Some must be given in ways which minimize the
exposure to water or saliva.  They are most easily given with a narrow
pill gun such as your vet will probably carry, or mixed with a fatty
gel like Nutrical.  Liquids are pretty straight forward, but some
ferrets get good at bring those up or spitting them out.  If your vet
or the manufacturer's research pharmacists say they may be given with
fats try putting some Linatone or Nutrical on the ferret's nose and
while she is licking that off squirting in the dose at the posterior
side of the mouth.  (Do not use a laxative such as Petromalt for
these.)

You may need to cut down the sides of a litter pan for easy access,
and folded towels can be used to make gentle ramps.  For recovering
ferret who is ready for play but isn't quite up to speed yet, put
extra ramps, pillows, and climbing boxes around the room she'll be
playing in, to make it easier for her to get into and out of boxes and
jump down from furniture.  (Be careful not to let her be more active
than is safe, and always supervise her in play.)

Weak ferrets can't play normally, but they still enjoy encountering
new things.  Ruffle loved being carried for walks, being given herbs
to smell (especially mints and basil), having the sun on her belly
for short periods, listening to music (especially songs with her
name), hugs and kisses, and other peaceful entertainments.

If your ferret has a reduction in smell try moistening a cotton puff
or swab with a bit of perfume and putting it on the lower back above
the tail, and behind the ears.  That will keep it from sensitive areas
but let the ferret enjoy the comforting status of having a
ferret-proper level of smell.

If at all possible cancel your trips away.  If not possible have a
familiar, friendly, knowledgeable pet sitter such as a vet tech.  Have
a schedule, with some minor variations for interest, so that your pet
knows what to expect.  When your ferret has to be at the vet's office
bring along a favorite toy or blanket which smells like home.

------------------------------

Subject: (12.7) My ferret won't eat.  What should I do?

If your ferret gets sick, chances are your vet will tell you to feed
him softened food for a time while he recovers.  Even so, sometimes an
upset or recovering ferret will simply refuse to eat on his own.  If
that happens, a good thing to try is Gerber's Second Meals chicken baby
food.  It's full of nutrients and water (though it's not a good
full-time food [6.1]) and most ferrets love it.  Put a little on your
finger and let your ferret lick it; if he won't try it, carefully
smear a little on his nose.  He should lick it off and eat the rest
from your fingers eagerly.  In general, ferrets like attention, and
they love to be hand-fed.  For a stubborn case, try letting another
ferret "raid" the sick one's food bowl in front of him.  Sometimes
there's nothing like competition to get a ferret to eat.

You can add Nutri-Cal, Pedialyte, medications, and so forth to the
baby food if your vet recommends them, and as your ferret's recovery
progresses, you can mix in portions of his regular food, moistened
somewhat, to gradually work him back to eating dry food on his own.

Sustacal and Ensure are sometimes recommended as short-term diets for
very sick ferrets, possibly in a mixture such as "Duck Soup" [12.8]
but they aren't nutritionally complete and should never be used as the
only long-term food for a non-terminal ferret.  According to one
report, Ensure has the preferred flavors, but is also more likely to
cause diarrhea.  The best solution seemed to be combinations of the
two.

------------------------------

Subject: (12.8) What's Duck Soup?  Anyone have a recipe?

Duck Soup, also called Ferret Soup and similar things, is a
high-calorie, high-protein concoction meant to be fed to old or sick
ferrets in order to fatten them up and help them regain their health.

To really get the weight back on a sick ferret, some people have
suggested giving him whipping cream.  It doesn't have much nutrition,
but it is full of calories and can help an underweight ferret gain
some back.

The following comes from Ann Davis:

ACME Ferret Company --- The Original  DUCK SOUP

For years, we have been trying to find a super formula to fatten up
sick ferrets, oldsters and ferrets with ulcers.  We have been looking
for something high in calories and protein, with added vitamins. After
trying just about everything on the market for pets, we had just about
given up, and were making do with some things that were not quite
perfect for the little guys, because everything made for cats that we
could find had a condensed milk base.

[If your ferret is really sick, you may have to work your way through]
all the steps, from full Sustacal to Duck Soup in caring for a sick
ferret.

We have heard of many miraculous recoveries attributed to Duck Soup.
It has helped old ferrets, ferrets with insulinoma, ferrets with hair
loss, and ferrets who are just plain too sick to eat.

DUCK SOUP

1 can Sustacal (8 oz., or about 230 ml; it comes in a larger size too)
1 can water    (8 oz., or about 230 ml)
2 scoops puppy or kitten weaning formula -- OPTIONAL
4 oz. (110 g? or ml?) dry kitten or ferret food, soaked in enough water to
               cover and soften it completely

[Sustacal is meant for humans; look for it by baby formulas or in the
pharmacy section of your supermarket.  Debbie Riccio says you can also
use Ensure, Discover 2.0, or Just Born (puppy/kitten milk replacer).]

Mix thoroughly.  We always nuke it for them to the temperature of baby
formula.  We serve about 4 fluid ounces at a time twice a day for
maintenance; if your little guys eat too much and you feel they are
getting fat, you can increase the amount of water.  We have tried
increasing the amount of dry food, but if it gets too thick some of
them won't eat it. This formula also freezes well -- the Sustacal must
be used within 48 hours if left only in the fridge.

------------------------------

Subject: (12.9) What are normal body temperature, blood test results, etc.?

Rectal temperature   100-103 F (37.8 - 39.4 C), 101.9 average
Heart rate           216-250/min (225 average)
Respiration          33-36/min
Urine pH             6.5-7.5; mild to moderate proteinura is common and normal
Blood volume         60-80 ml/kg

The following information comes from "Normal Parameters and Laboratory
Interpretation of Disease States in the Domestic Ferret," an article
written by Dr. Tom Kawasaki around 1994.  Your veterinarian might find
this information helpful.

                            mean    acceptable range
sodium (mmol/L)             153     143-163
potassium (mmol/L)          4.47    3.2-5.77
chloride (mmol/L)           116     105-127
calcium (mg/dl)             8.8     7.5-10.1
inorganic phosphorus (mg/dl) 5.5     3.7-7.4
glucose (fasted) (mg/dl)    110     65-164
BUN (mg/dl)                 21      8-37
creatinine (mg/dl)          0.5     0.16-0.84
BUN/creatinine              42
total protein (g/dl)        5.8     4.4-7.3
albumin (g/dl)              3.3     2.5-4.1
globulin (g/dl)             2.2     1.8-2.9
total bilirubin (mg/dl)     0.2     0.1-0.5
cholesterol (mg/dl)         174     76-272
alkaline phosphatase (IU/L) 37      15-75
ALT (IU/L)                  95      13-176
AST (IU/L)                  61      23-99
CO2                         22      14-30
A/G (g/dl)                  1.3     1.0-2.3
LDH                         274     101-498
triglycerides               98      31-101
GGT                         4.8     1-13
uric acid                   2.2     1.4-3.3
PCV (%)                     45.4    38-54
hemoglobin (g/dl)                   13-18
RBC (X10^6/mm3)             9.0     7.0-11.0
platelets (X10^3)           400     350-600
reticulocytes (%)           N/A
WBC (x10^3/mm3)             5.22    2.8-8.0
neutrophils                 3017    2329-5700
                            (59%)   (39-85%)
lymphocytes                 1157    525-3500
                            (35%)   (11-55%)
monocytes                   119     52-177
                            (2.6%)  (0.76-4.4%)
eosinophils                 133     29-432
                            (2.8%)  (1-8%)
basophils                   0       0
MCV (um3)                   51      46-65
MCH (pg)                    17.7    15.5-19.0
MCHC                        33      29-36 *

Dr. Susan Brown also notes that the normal insulin level is 0-20, but
that insulin may appear normal even in animals with insulinoma [1.1].

There are, of course, dozens of components in your ferret's blood
which can help your vet determine what's wrong.  Here are some of the
ones people ask about most often, and normal ranges.  If you want to
know more about what your ferret's tests mean, don't hesitate to ask
your vet.

The following information is extracted from an article in
The FAIR [Ferret Adoption, Information & Rescue Society] Report,
Vol. II, No. 2, by Mary Van Dahm, with a few additions.

Blood glucose
  Glucose is a sugar, the main energy source for the body.  Its level
  varies through the day, higher just after a meal, lower when the
  ferret is hungry, but the body keeps it fairly constant mainly by
  controlling the amount of insulin in the blood.  A non-fasted blood
  glucose test might give values up to 207 mg/dl, depending on when
  the ferret last ate.  Testing the blood glucose after withholding
  food from the ferret for 6 hours (fasting blood glucose) eliminates
  the variation and gives you a more definite number to judge it by.
  A low reading (hypoglycemia) may be a sign of insulinoma (see the
  Ferret Insulinoma FAQ [1.1]).  A high reading (hyperglycemia) is
  rare, but might be a sign of diabetes.  However, insulinoma can
  also cause a high glucose reading, and since diabetes is extremely
  rare in ferrets, you should double-check any diabetes diagnosis by
  looking for sugar in the urine as well.

Pack cell volume/hematocrit (PCV/HCT)
  This is the percentage of red blood cells in the blood.  Low
  readings indicate anemia; high readings are usually a sign of
  dehydration.

Red blood cells (RBC)
  Red blood cells carry oxygen to the body's tissues and carbon
  dioxide back to the lungs.  Low readings show anemia.

White blood cells (WBC)
  Part of the immune system.  Readings over about 7000 may mean
  the ferret is fighting off an infection, cold or flu.  Readings over
  10,000 may be early signs of lymphoma (see the Ferret Lymphosarcoma
  FAQ [1.1]) or another cancer.  Unusually low readings indicate anemia
  and a bone marrow problem.

Lymphocytes
  Another type of white blood cell.  High readings can indicate a
  "smoldering" infection, possibly Helicobacter mustelae (see the
  Ferret Gastric Ulcer/ H. mustelae FAQ [1.1]).  Many, but not all,
  cases of lymphosarcoma also show elevated lymphocyte levels (see the
  Ferret Lymphosarcoma FAQ [1.1]).

Eosinophils
  Another type of white blood cell.  Often an indicator of intestinal
  disorders, infection, or cancer.  Other parts of the blood profile
  must also be considered for a diagnosis.

Protein, Albumin and Globulin
  Albumin is a kind of protein, and globulin is a general term for all
  proteins that aren't albumin, so protein - albumin = globulin.  The
  numbers indicate the ferret's general health and nutrition, and
  albumin also helps show how well the liver and kidneys are working.

BUN and Creatinine
  The job of the kidneys is to filter out impurities, so if they
  aren't working well, these levels will be high.

Alkaline phosphatese
  This is an enzyme found in the liver and bone.  When bones are
  growing or the liver is damaged, lots of this is released into the
  blood.

Total bilirubin
  A by-product of the normal breakdown of hemoglobin in red blood
  cells.  Helps diagnose liver disease and bile duct obstruction.

Sodium, Potassium and Chloride
  Controlled by the kidneys, these are commonly called blood
  electrolytes.  They are involved in water balance, acid/base balance,
  and the transmission of nerve impulses, especially to the heart.

Calcium and Phosphorus
  These minerals are controlled by the parathyroid glands and the
  kidneys.  The levels show possible problems with bones, blood
  clotting, and nerve, muscle, and cell activity.

References:
  1. Wellness, Inc. How to Read Your Report,  1993
  2. Finkler, M. Practical Ferret Medicine and Surgery for the Private
          Practitioner, 1993
  3. Brown, S.  Ferret Medicine and Surgery, 1992
  4. Fox, JG.  Biology and Diseases of the Ferret, 1988 *

------------------------------

Subject: (12.10) What tests might my vet want to run, and why?

Dr. Michael Dutton, DVM, writes:

    There is no one test for a general check-up. There are not even
    tests that are specific for some certain diseases. The following
    is a list of some example tests for common ferret diseases, but in
    case of some multi-systemic diseases (such as heart disease), they
    may not show all the abnormalities.

    TESTS THAT ARE SPECIFIC FOR ONE DISEASE

    insulinoma - resting blood glucose and insulin level
        (see the Ferret Insulinoma FAQ [1.1])
    hyper adrenal disease - the Univ. of Tenn. ferret adrenal panel
        (see the Ferret Adrenal Disease FAQ [1.1])
    ovarian remnant - estrogen
    urinary tract infection - urinalysis
    urinary bladder stones - x-ray
    bone fractures - x-ray

    TESTS THAT HELP DETERMINE A PARTICULAR ORGAN FUNCTION
    (may not be specific to cause, prognosis, etc.)

    heart disease  - auscultation, x-ray, ultrasound
        (see the Ferret Cardiomyopathy FAQ)
    malignant lymphoma - physical exam, biopsy
        (see the Ferret Lymphosarcoma FAQ)
    masses - physical exam, biopsy
    spleen masses - physical exam, biopsy
        (see the Ferret Splenomegaly (Enlarged Spleen) FAQ)

    The problem with biopsies is that you need to biopsy the correct
    tissue.  That may not be possible such as some type of spinal cord
    or brain lesion.  Intestinal diseases are easy to biopsy by
    surgical methods but that entails anesthesia (which may be risky
    to an ill ferret) and major abdominal surgery.  So...  you have a
    number of difficulties from the medical side to run a test for
    general health.  Even if you can target a specific area, there may
    not be a definitive test and the owner needs to agree to costs,
    risks, etc.

    THE ADVICE DISPENSED BY MYSELF IS NOT MEANT TO SUPPLANT THE ADVICE
    OF VETERINARIANS WHO ARE IN CHARGE OF THE PATIENT.  IF THE PATIENT
    IS NOT CURRENTLY UNDER THE CARE OF A VETERINARIAN, THE CLIENT IS
    RECOMMENDED TO TAKE THEIR FERRET TO ONE.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

13. *** Medical reference material ***

------------------------------

Subject: (13.1) Who makes this product or medication?

(This list was provided by Dr. Susan Brown.)

Alkeran - Burroughs-Wellcome Co.

Cytoxan - Bristol Meyers

Fervac D vaccine - United Vaccines Madison, Wisc. 53713 (608) 277-3030

Fromm D vaccine - Solvay Animal Health, Inc. Mendota Heights,
Minn. 55120

Keflex Pediatric Suspension 100 mg/cc - Dista Products Co. Division of
Eli Lilly, Inc. Indianapolis, Ind.

Lasix - Taylor Pharmacal Co. Decatur, Illinois 62525

Lysodren - Bristol Meyers

Nutrical - EVSCO Pharmaceuticals Buena, N.J. 08310

PDS II - Ethicon, Inc. Somerville, N.J. 08876-0151

Proglycem - Baker Cummins 800-347-4774

------------------------------

Subject: (13.2) What books can I get or recommend to my vet?

One excellent medical reference is

Ferrets, Rabbits and Rodents - Clinical Medicine and Surgery, by
   Elizabeth Hillyer and Katherine Quesenberry (1997)

Another good reference work, a bit outdated but still worthwhile for
both vets and others, is

Biology and Diseases of the Ferret, by James G. Fox.  Lea and Febiger,
   Philadelphia (1988).  ISBN 0-8121-1139-7.

There is also a series out by the

          American Animal Hospital Association
          12575 West Bayaud Ave.
          Lakewood, CO  80228
          tel. 800-252-2242

for practitioners on exotic pets.  There are five books in the series.
Dr. Jeff Jenkins and Dr. Susan Brown produced the one on Rabbits and
Ferrets (he did the rabbit part).  Many people feel that it is
practical and useful; it has drug dosages, treatments, husbandry,
normal clinical pathology values, and diagnostic techniques that might
be useful for your vet.

------------------------------

Subject: (13.3) Are there any other useful references?

Dr. Bruce Williams, DVM, recommends these references on cancers:

Lawrence HJ et al.  Unilateral adrenalectomy as a treatment for
     adrenocortical tumors in ferrets: Five cases (1990-1992).  JAVMA
     203(2): pp 267-270, 15 July 1993.

Marini, RP et al.  Functional islet cell tumor in six ferrets.  JAVMA
     202(3):430-434, 1 February 1993.

Rosenthal KL et al.  Hyperadrenocorticism associated with
     adrenocortical tumor or nodular hyperplasia of the adrenal gland
     in ferrets: 50 cases (1987-1991).  JAVMA 203(2):pp. 271-275, 15
     July 1993.

Dr. Susan Brown recommends these, on a variety of subjects:

Blancou J, Aubert MFA, Artois M. Experimental rabies in the ferret
     (Mustela [putorius furo] Susceptibility - Symptoms - Excretion of
     the virus. Rev Med Vet 1982; 133(8-9): 553 557. (Translation by
     NIH).

Daoust PY, Hunter DB. Spontaneous aleutian disease in ferrets. Can Vet
     J 1978; 19: 133-135.

Forester, U., The adaptability of two rabies virus strains isolated in
     central Europe to one domesticated and two wild-living species. A
     contribution to the Epidemiology of rabies. Part 4: Transmission
     studies on ferrets with a rodent isolate.  Zbl Vet Med B 1979;
     26: 26-38. (Translation by NIH).

Fox JG, Murphy JC, Ackerman MS, Prostak KS, Gallagher CA, Rambow VJ.
     Proliferative colitis in ferrets. 1982; 43: 858-864.

Garibaldi ME, Goad P, Fox JG, Sylvina TJ, Murray R. Serum cortisol
     radioimmunoassay values in the normal ferret and response to ACTH
     stimulation and dexamethasone suppression tests. Lab An Sci 1988;
     38: 452- 454.

Hoover JP, Baldwin CA, Rupprecht CE. Serologic response of domestic
     ferrets (Mustela putorius furo) to canine distemper and rabies
     virus vaccines. J Am Vet Med Assoc 1989; 194: 234-238.

Johnson-Delaney C, Nelson W. A Rapid procedure for filling fractured
     canine teeth of ferrets. J of Small Exotic Animal Medicine 1992;
     3: 100-102.

Kawasaki, T. Retinal Atrophy in the ferret. J of Small Exotic Animal
     Medicine 1992; 3: 137.

Kociba GJ, Caputo CA. Aplastic anemia associated with estrus in pet
     ferrets. J Am Vet Med Assoc 1981; 178: 1293-1294.

Kreuger KL, Murphy J C Fox J G.  Treatment of proliferative colitis in
     ferrets. J Am Vet Med Assoc 1989; 194: 1435-1436.

Liberson AJ, Newcomer CE, Ackerman JI, Murphy JC, Fox JG. Mastitis
     caused by hemolytic Escherichia coli in the ferret. J Am Vet Med
     Assoc 1983; 183: 1179-1181.

Luttgen PJ, Storts RW, Rogers KS, Morton LD. Insulinoma in a ferret. J
     Am VetMed Assoc 1986; 189: 920-921.

Mainka CH, Heber L, Schneider W. Studies on rabies of ferrets after a
     singleantibodies vaccination, J Vet Med B 1988; 35: 24-28.

Manning D, Bell J. Lack of detectable blood groups in domestic
     ferrets: Implications for transfusion. J Am Vet Med Assoc 1990;
     197: 84-86.

Nguyen HT, Moreland AF, Shields RP. Urolithasis in ferrets (Mustela
     putorius).  Lab An Sci 1979; 29: 243-245.

Rupprecht CE, Gilbert J, Pitts R, Marshall KR, Koprowski H. Evaluation
     of an inactivated rabies vaccine in domestic ferrets. J Am Vet
     Med Assoc 1990; 196: 1614-1616.

Stauber E, Robinette J, Basaraba R, Riggs M, Bishop C. Mast cell
     tumors in three ferrets. J Am Vet Med Assoc 1990; 196: 766-767.

== End of Part 5 ==