From: "Sukie Crandall"
Date: 2001-03-17 13:25:00 UTC
Subject: Re: [Ferret-Health-list] RE: more on corn
The reason protein is often reduced w chronic kidney damage is to get
down the phosphorous levels, but with a ferret like this who needs an
animal source protein increase it would pay to tackle phosphorous
more directly by feeding a good quality food with reduced
phosphorous levels. I suspect.
Struvite stones are usually from a ferret having been fed a cheap
food with a high plant content and often correcting the diet is
what makes the most change. You rescue probably had someone
who didn't know better before you.
Ask the vet about adding a very high quality accessible protein like
egg (if that is low enough in phosphorous --which I honestly don't
recall), and about adding a urine acidifier.
Liquid intake is very important w kidney damage and also Omega 3
fatty acids can be useful.
One aim will be to have high quality protein to avoid further uroliths
BUT lowered phosphorous levels.
With a lot of vet care Steve and I got a ferret past cystine stones and
a bladder diverticulum, and then plugged urethra (which his vet got
him past w cystos,emptying bladder w a needle, so that he managed
to avoid a PU surgery, a rerouting of the urethra, that way) with
bilateral hydronephrosis thrown in but it was a long haul. He
required not only his meds, hydration, and dietary control (different
for that type of stone compared to the struvite you encountered),
After he was out of the woods it took a year before he could regain
his lost weight and another half year before he even had normal
energy. Now he is doing great. So, it can be done, but if it gets
really bad then it will be a long haul which is entirely worth it.
SOME QUOTED EXPERT THINGS:
You referenced an article from Dr Scott Brown,
VMD, PhD, ACVIM from the University of Georgia.
He has written many on this topic. Yes, the fish oils
have the omega 3 fatty acids (EPA and DHA) that help
to reduce inflammation. In the kidneys, fish oils lower
the amount of the eicosanoids (prostaglandin E2 and
thromboxane A2), which reduces glomerular pressure
and slows the progression of chronic kidney disease.
Omega 6 fatty acids (vegetable oils) increase the production
of the eicosanoids, increase glomerular hypertension, and
speed up the progression to end-stage kidney failure (death).
That is one of the reasons Iams/Eukanuba kitten, Totally
Ferret, and Marshall's ferret food all have fish oil in them.
Hope that helps,
Jerry Murray, DVM
As far as surgery goes, I would recommend using
just a gas for anesthesia (ie Iso or preferably SEVO)
instead of the injectables (domitor+ketamine, etc).
Removing the left adrenal gland is usually easy to do,
so that part of the surgery should go just fine.
The elevated BUN is also a concern. I would recommend
slow drip IV fluids (LRS,.NACL, or Normosol) during the
surgery. It may be a good thing to add Dextrose to the IV
fluids also. Cysts on the kidneys do not usually cause
kidney failure (CRF), so removing the kidney may not
help with the BUN/kidney problem. Draining the cyst may
be an option also. After the surgery reducing the protein
level of the diet may help, adding omega-3 oils (ie fish oil),
reducing the phosphorous level and adding potassium citrate
may also help the kidney problem. Using Hill's feline K/D or
Eukanuba feline renal diet mixed 50/50 with Totally Ferrets
Senior food or Marshall's senior food would be my suggestion.
Hope that helps and everything goes well,
Jerry Murray, DVM
A bladder infection with sediment that shows up on
an x-ray is interesting. It is time to do an urinalysis.
This will tell us what kind of crystals are causing the sediment,
the ph of the urine, and if there is a bacterial infection. If there
is bacteria found then a culture/sensitivity test can be done
to find out what bacteria it is and what antibiotic to use. I would
speculate that the ph is elevated, this is struvite crystals causing
sediment, and it is urease producing bacteria. Treatment would be
to acidify the urine (dl-methionine or a better diet) and use
drops, or Cefa drops, or Baytril, or Amoxi drops. On the other hand
if the ph is too low then it could be calcium oxalate crystals and
a totally different problem.Thus the urine test is the first step.
With adrenal gland disease, one can find prostate problems
with prostate and secondary bladder infections, so yes it could be
to adrenal gland disease. Are there other signs (like itchy skin,
thinning haircoat, bald areas, hair that epilates easy, increased
body odor, return of sexual behavior, etc) that would suggest
adrenal gland disease in this ferret?
If so then you would have to treat the adrenal gland disease
(i.e., surgery, Lupron depot, or melatonin) too.
Hope that helps,
Jerry Murray, DVM
Looks like I caused some confusion about corn/plant
proteins, and urinary ph. Corn and plant based protein
contains amino acids that the ferret can use, but the problem
with corn and most plant based protein is simple. When the
protein is metabolized it will make the urinary ph alkaline.
When the protein from meat based protein is metabolized
it will make the urinary ph acidic. When the urinary ph is alkaline
(i.e., plant based protein) struvite crystals form and urinary
(crystals, infections, bladder stones, blockages, etc) happen.
Why does this happen? Corn and most cereal grains have low levels of
the essential amino acid methionine. Meat based protein has a lot of
methionine. When the essential amino acid methionine
is metabolized it produces a sulfate (SO4-2) that is excreted in
the urine as sulfuric acid (H2SO4), which acidifies the urine!
The good news is most cat and ferret foods have dl-methionine
as an ingredient. This is added to acidify the urine. That is why
we do not commonly see urinary problems in ferrets.
Thus corn as a carbohydrate source will not cause urinary problems.
Jerry Murray, DVM
Maybe useful, maybe not:
> J Pineal Res. 2007 Mar;42(2):203-9.
> Melatonin is more effective than taurine and 5-hydroxytryptophan
> against hyperglycemia-induced kidney-cortex tubules injury.
> Derlacz RA, Sliwinska M, Piekutowska A, Winiarska K, Drozak J,
> Bryla J.
> Department of Metabolic Regulation, Institute of Biochemistry,
> Faculty of Biology, Warsaw University, Warsaw, Poland.
> The antioxidative effects of melatonin (Mel), 5-hydroxytryptophan
> (5-HTP) and taurine (TAU) on hyperglycemia-induced oxidative stress
> was investigated in primary cultures of kidney-cortex tubule cells
> grown in metabolically and hormonally defined medium. In the
> presence of 30 mm glucose (hyperglycemic conditions), cell
> viability was decreased by about 35% in comparison with that
> estimated in the glucose-depleted medium probably as a result of
> induction of apoptosis, as concluded from: (i) chromatin
> condensation and DNA fragmentation assays, (ii) a significant
> enhancement of reactive oxygen species (ROS) production, (iii) 8-
> hydroxydeoxyguanosine (8-OHdG) generation, (iv) an increased
> protein peroxidation and (v) a decline of reduced glutathione (GSH)
> levels leading to a disturbed glutathione redox state. The addition
> of 100 microm Mel to the hyperglycemic medium resulted in a twofold
> decrease in both 8-OHdG accumulation and protein peroxidation as
> well as restoration of the control intracellular ROS levels
> accompanied by a substantial increase in GSH/oxidized glutathione
> (GSSG) ratio due to a decline in GSSG content. ROS elimination was
> also achieved in the presence of 1 mm TAU which diminished protein
> and DNA injuries by about 25% and 30%, respectively. On the
> contrary, the action of 100 microm 5-HTP on ROS level, 8-OHdG
> generation, protein peroxidation and GSH/GSSG ratio was negligible.
> Thus, in contrast to 5-HTP and TAU, Mel might be considered as
> beneficial for diabetes therapy, particularly in terms of reduction
> of hyperglycemia-induced kidney injury.
> PMID: 17286753 [PubMed - indexed for MEDLINE]
Sukie (not a vet)
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