From:
Bruce Williams, DVM
Date: 2001-11-15 23:09:00 UTC
Subject: Re: Question: GI Dz in ferrets
--- In Ferret-Health-list@y..., toucanvet@a... wrote:
> Hi there fellow ferret listers + DVMS, and VMDs,
>
> I have a procedure question to pose to the vets,
>
> At what point do you opt for exploratory sx VS medical therapy
> with ferret GI dz?
>
> OK case in point:
>
> 5 yr. m/c ferret. has previous history as a young ferret of
multiple FB
> ingestion
> has not done that in over 2 years though.
> Owners don't always closely monitor ferret (they work)
>
> started with GI signs 5 days ago:
> vomiting, bruxism, diarrhea, inappatince, minimal fecal
production occ
> straining to deficate.
>
> +/- Weight loss T = 101.5 deg F Blood glucose = 95 PCV
= 45%
> TS = 5.5 mg/dl WBC = WNL No alopecia, 1 episode seasonal
loss 2 yrs
> ago.
>
> Palpation revels: small spleen, unremarkable liver, kidneys,
bladder,
> prostate, intestines, Questionable unusual feel to stomach. NON
PAINFUL
>
> RADS: normal chest / normal heart. Unusual charateristic to
stomach -
> R/O pyloric obstruction - Possible loss of serosal detail in
cranial abdomen
> with possible free fluid ? Radiologist R/O Perferation. NO obvious
> visualization of Radiodense FB.
>
> OK HERES THE QUESTION: Chem panel norm. its Sat afternoon. - no E
clinics in
> area cut ferrets (illegal animals to own) - your day off.
>
> DO YOU come in and cut the ferret or Do YOU put it on helicobacter
therapy,
> force feedings and wait the weekend.
>
> You elect for medical mgmnt since you could not talk any techs to
come in
> with you.
> Owner does not have money for Biaxin + Omeprazole so you
choose.....
> 1. Amoxi BID
> 2. Pepto QID
> 3. Flagyl BID
> 4. Pepcid AC SID since you don't have chem yet about kidneys
> 5. Sucrulfate QID 20 min before pepcid (sucralfate binds to H ions
if you
> give h2 blocker first no H ions left to bind to - drug does not
work)
> 6. A/d syringe feeding 60 cc BID
> and are relieved that its the owners giving it and not your
hospital !!!
>
> NOW its Wednesday - owners have not called - no news is GOOD NEWS
ferret is
> eating like a champ !!! and passing normal stool.
>
> WHAT NOW ????
>
> CUT or NOT and if so why ?
>
Ben - I think I would have advocated cutting over the weekend, for a
number of reasons. To start, this animal has a history of FB
ingestion - two years doesn't mean much - I had a ferret who went
years between plastic bag FB - 1st a 1 year, 2nd at 2, and 3rd at 4.
History can be very telling.
All of the symptoms are compatible with a foregin body - Helicobacter
is not going to cause minimal fecal output or straining, and only
rarely vomiting - if he is vomiting several times, or dry heaving, it
doesn't look good for Helicobacter.
Now, he may have passed the fb - these don't sound like people who
would pick through the stool in a bowl of water to see if it was
passed - and now he would e eating and pooping normally.
I guess if there is any backslide, I'd go to surgery with him.
It's often in how it is presented to the owner. I actually have one
of my own that is doing some of the same stuff - dry heaves, poor
stool, some straining - not eating well, not putting out much. No
grinding, though. I cuttig him on Saturday. Here's why: if I come
up empty on a foreign body or hairball or God forbid a mass, then I
can take a couple of biopsies of the intestine, and I'm out, I've
done the most sophisticated diagnostic test available, and I've
collected the most diagnostic evidence. People get unnecessarily
bummed out when an exploratory fails to find a foreign body - it
would be nice to in every case, but it doesn't make the surgery a
failure if there isn't one there.
As I've said many times, I'd much rather go in early on a good
surgical candidate than wait to try multiple empiric therapies until
the surgery becomes an emergency!
With kindest regards,
bruce williams