Message Number: YG1685 | New FHL Archives Search
From: Bruce Williams, DVM
Date: 2001-03-24 22:30:00 UTC
Subject: Re: Help! ECE/Ulcer/Low blood sugar

--- In Ferret-Health-list@y..., cjbandit@a... wrote:
> Dr. Williams:
> I need you're advice desperately and am at my wits end trying to
provide the
> proper treatment for my ferret Bandit. I will try to make this
short and
> concise.
> Bandit has had symptoms of ECE for the last month: the onset
started within
> 24 hours of introduction to new kit, thought I heard him upchuck
and then
> couldn't which end it came from. As the days progressed Bandit had
> (in all shades of yellow/gold and sometimes green). My vet
originally was
> treating him for Heliobacter with flagyl, antibiotics and pepto -
well as you
> know this treatment is almost impossible to follow, Bandit would
paw at his
> mouth till it bled. I read and reread you're FAQ's on ECE and
decided to
> follow you're treatment-which was to treat Bandit's questionable
ulcer with
> carafate 10 minutes before feeding and stick to a bland diet of
babyfood- I
> did this for a while and did not see a great improvement, he
continued to
> chew at the air during feedings and fought with me not to eat. His
stools at
> this point were more formed but still very seedy a sign of
malabsorption. I
> had recently read to help form the stools to add baby rice cereal
to the
> babyfood and that what I did and it seemed to help some. As I grew
> about Bandit's condition I had remember reading in the FAQ's that
> could help the inflammation in the intestines and stimulate
appetite, I
> decided to try it-I started Bandit with .30 cc 1x a day (the bottle
> 1mg/ml)for seven days and then the following seven days weaned him
off to
> every other day. During this time I noticed his energy was up and
> appetite a little too. Approximately two weeks later Bandit had
> again and at times it was greenish and very loose and seedy. His
eyes looked
> glassy and he looked dehydrated. It was hard to know what was
going on cause
> I had recently added Dyne to his babyfood to increase his caloric
intake and
> tried adding 1/4 capsule of acidophilus to his food. I took Bandit
to the
> vet and insisted on sub-q-fluids although my vet did not think he
> them. She ran a CBC and a complete chemistry-the results showed
low BG of 62
> (in house) and his red blood count was high suggestive of
dehydration. I was
> wondering if I could post the values when I get the report and get
> feedback??
> My questions are:
> 1) Could Bandits blood sugar be affected if he was dehydrated?

No - dehydration affects a number of values in the bloodwork, but
glucose is not one of them. Those glassy eyes may be the result of
transient hypoglycemia due to an insulinoma. A blood glucose of 62
and clinical signs of hypoglycemia is generally enough for me to want
to go to surgery, but at this point, I would suggest a recheck of the
blood in a couple of days to see if the low BG is consistent.

> 2) Bandit had bilateral adrenal surgery-one surgically removed and
the right
> with cryosurgery. He has not needed hormone replacements his
> always seem to be good. Is it possible that whatever adrenal
tissue Bandit
> has left is not putting out enough hormones and is leaving him
dehydrated and
> in turn affecting his blood sugar?

Not likely. Although I don't know when he had his adrenalectomy
done, most cases of adrenal insufficiency occur within 1 month. In
his case, you can always look at the electrolyte values when the
report comes back.
> 3) What else is a high red blood count indicative of?

An elevated PCV is 99.9% dehydration. Neoplastic conditions that
cause elevated production of red blood, such as polycythemia vera or
erythroleukemia have not been documented in ferrets.

> 4) Should I discontinue the rice baby cereal in his babyfood if his
> sugar is low?

No, I don't see any need. The rice cereal if anything should
increase the BG, not lower it.

> 5) Is it okay to give peppermint flavor pepcid a/c chewable tablet
to my
> ferret-and how much ?? the pill is 10mg and Bandit weighs 2lbs

The dose of Pepcid (famotidine) is 0.25-0.5 mg/kg once daily, so one
20th of a tablet will suffice. (another reason I'm not a big fan of

> 6) Is it okay to give the pepcid while giving the pred??

Yes, there is no adverse reaction between the two.
7) I know you suggest avoiding pepcid if the ferret has ECE because
> further complicates absorption of food-but I don't necessarily
believe Bandit
> still suffers from ECE. Yes, his stool continues to be seedy but
from what I
> read that can stay with him along time.

When I talk about ECE, I am talking about the entire process. While
he may or may not have infectious virus in his system, the seedy
stools indicate that his intestine is still not functioning properly
from the ECE. Ulcers don't cause seedy stools - only the villar
shortening resulting from coronavirus infection does that.
> My vet decided to put Bandit back on pred but to raise the dose
to .50 cc/ml
> (bottle reads 1mg/ml) twice a day for 14 days and then then 3rd
> everyother day and to call her at that point to inquire how to wean
him off
> the fourth week.

The dosage that I have recommended is 0.5 mg/lb once daily (still a
low dose.) The first dose that Bandit got was 0.1 mg/lb once daily.
Now we have bumped it to 0.22 mg/lb. I guess I am not convinced that
that prednisone has been given at a high enough dosase to work to
this point.
> I am concerned because I really am not convinced Bandit has
insulinoma or if
> with everything else going on it's affected his BG. I would like
to continue
> with the pred but do not want him to grow dependent nor irritate or
> more ulcers.

Ferrets are steroid resistant species. He will not grow dependent on
the steroid, nor is a dose of 0.5 mg ulcerogenic. I would have to be
concerned, though if the BG is 62 - you are only two points from
where I recommend surgery without even needing clinical signs (below

In all honesty, there is a lot of playing around with diet and
medication here, and your feeling that he does not have ECE or
insulinoma is running contrary to the clinical evidence. It is not
uncommon for ferrets to have both ECE, ulcers, and if they are in the
golden age of 4-6 years, other concurrent disease as well.

With kindest regards,

Bruce H. Williams, DVM, DACVP
Join the Ferret Health List at

> Can you please offer you're advice and suggestive treatment.
> Thank you so very much,
> (I am sorry this is so long-so much information to convey)
> Christina