From:
Dr. Bruce Williams
Date: 2001-02-24 18:43:00 UTC
Subject: Re: AutoImmune Disease in my ferret
--- In Ferret-Health-list@y..., "Mildred Moore" <ferretmom@m...>
wrote:
> I really hate to bother you, but my Suzy seems to have
pemphigus. A biopsy
> was not performed until after she had had a long and short term
cortizone
> shot. The biopsy only showed that there was no bacteria in the
sores.
>
>The sores are located around, between, top and bottom of her paws,
all
> around her mouth, one ear, eyes, some near her vulva and anus, plus
a couple
> on her tail. She has gotten this bad over a period of 3 months. >
> I recently changed vets because she kept getting worse.
Every time she
> would show some improvemnet, he cut her Prednisolone back, then it
would get
> worse than before.
>
> We are at a loss as to where to go from here. Do you have
any ideas on
> what we can do to help her? She is close to 5 years of age, and I
can tell
> that she is very unhappy about her problems. I almost feel like
she wants
> to give up.
>
> She is on .5ml of Cefa Drops each morning to keep out any
secondary
> infections. She has stopped eating solid food, but does eat duck
soup after
> each dose of pred (which I mix with Ferretvite). And yes, she has
gained
> weight, up from normal weight of 1 lb 12 oz to 2 lb 6 oz.
Dear Millie:
Pemphigus is not as uncommon in ferrets as one might think.
However, it is rarely diagnosed in ferrets for a number of reasons.
first, very few vets consider the diagnosis - it is not currently
written in the literature, so aside from the few vets that read lists
such as this one, there aren't going to be a lot of biopsies taken
and sent in for diagnosis. Another problem with the diagnosis of
pemphigus is that very, very few biopsies are diagnostic. I've seen
many bipsies that hinted at the diagnosis, but only one that
confirmed it.
Let me explain. Pemphigus is a disease in which the bodies own
immune system attacks substances in the epidermis. Autoantibodies are
produced against components of the cells f the epidermis, literally
digesting the structures that holds the epidermis to the underlying
dermis, resulting in the formation of blisters. If the intact
blister is biopsied, the diagnosis is very clear. However, because
these animals are scratching and rubbing, the blisters often rupture,
leaving an ulcer, which eventually becomes a scab. Once the blister
is gone, the biopsy becomes virtually useless, unless the pathologist
knows exactly what he/she is looking for and knows about pemphigus in
ferrets.
Steroids are commonly used to treat pemphigus, as they inactivate the
inflammatory response generated against the skin. There is no set
dose, as everycase is different. The key is to find the lowest dose
that controls the signs - there is no cure, because as you decrease
the pred below the critical threshold, the lesions recur. Your first
vet was actually trying to do the right thing - find that lowest
dose, but was not having good success.
If 2.25 mg twice a day controls the signs, then we go at that dose
until everything is cleared up. Then I would try for a maintenance
of 2 mg twice a day for 30 days, and if that worked, we might try
1.75 twice a day, etc. The key is no fast decreases, and realize
from the start that you will never be able to remove the steroids for
the rest of this ferret's life.
There are other more expensive and potentially risky drugs that we
can use in very severe cases which are not touched by prednisone, but
since it is working here - there is no need to go to explore that at
this point.
In the case of generalized scabbing, it is always a good idea to at
least ask your vet about this possibility.
If you have any photos of your ferret with this condition, or anyone
else in this thread has some, I would really appreciate them. Non-
or poorly haired skin (or if the animal has been shaved prior to
biopsy would make for the best photos!
With kindest regards,
Bruce H. Williams, DVM
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