From:
Shelley Knudsen
Date: 2001-09-25 14:20:00 UTC
Subject: 3rd degree AV block
Hello,
I am looking for any information and advice on 3rd degree AV
block in ferrets. Taz is a 5 1/2 year old male ferret of mine
who first came down with rather sudden onset insulinoma
symptoms (constant shivering) about two months ago. I did a
glucose at home, and got 52, at which time I started him on
0.5 mg/day prednisone that I had on hand. One week ago, I
brought him into the veterinary clinic here at school to be
able to obtain more prednisone for him. During his routine
exam, it was noticed that he had a heart rate of 72, and a
murmur that none of us could quite place. I should also note
that he had an adrenalectomy a year and a half ago, at which
time he was on a heart monitor, which was normal (around 200
average).
The morning that I brought him into the clinic, and then again
that night, he had a hypoglycemic seziure, to the point where
he was screaming and thrashing, and lunging at anything that
came near him. Both times I was able to bring him out of it
to a point over a course of 2-3 hours, first by syrup, then
A/D, then pred. His glucose that afternoon was 46. Since he
was already pretty stressed, the exotic vet suggested I
increase his pred dose, and bring him back in a week so he
could stabilize before anymore tests were done. During the
past week, he has been on 1.2 mg a day, but he still shakes a
lot, and is nowhere near normal, so I was thinking it would
have to be surgery, despite the cost. However, because of his
abnormal heart rate, we needed to discover the cause of that
before he could go under anesthesia.
When I took him in this morning, we first did an ECG. It
revealed 3rd degree AV heart block both times we did an ECG
(about 2 hours apart, the first strip had some problems with
lead II). We then did radiographs (upon the insistence of the
radiologists before they would do an ultrasound). It revealed
a rather enlarged heart with a slight deviation of the
trachea. We then went to ultrasound a few hours later (each
time we did something we waited about 1-2 hours in between to
give him time to recover from stress). The ultrasound
revealed very pronounced 3rd degree AV block, the atria were
firing about 4 times for every beat of the ventricles. I
don't have the numbers here in front of me, but basically his
heart has compensated in overall blood flow (normal 42, he was
at 40), but there was one number extremely low (I don't
remember what, but I can find out).
My questions are these. What are my options? I'm not sure
his insulinoma can be controlled with just pred, but the
surgeons here will not go to surgery unless we can
consistently keep his heart rate up. He has now been bumped
up to 2 mg of pred per day, I don't know yet how well he will
respond to that. What are some drugs that may have some
effect on this that will be okay to use in ferrets, and at
what dose? I know that a pacemaker has been successfully
implanted in a ferret before, but I am pretty sure that it
would not be feasible for me financially (I can't afford the
insulinoma surgery, especially here, but I hate to see him so
out of it, so I can find a way to manage that).
I would appreciate any feedback or help anyone could give me
regarding this.
Thank you,
Shelley Knudsen
Class of 2004 KSU Veterinary College
ferrets@kansas.net sknudsen@vet.ksu.edu
http://www.tcgcs.com/~ferrets
785-565-9041 402-984-4217
"There ain't no limit in this life to how far you can get,
but if you're going all the way, you gotta break a sweat."
- Chad Brock