From:
Pam Sessoms
Date: 2001-11-28 15:26:00 UTC
Subject: Re: [Ferret-Health-list] Frusemide dosage?
On Tue, 27 Nov 2001, Ulrike wrote:
>
> My Jack as a tumour in his chest and also fluid in his chest and/ or
> lungs. We started him on Frusemide in August and he got 5mg twice a
> day to start with. But the fluid is getting worse now and I usually
> half the 20mg tablet and then pinch some off so he gets about 8mg.
> Jack's weight is 2kg so the 8mg are the maximum dose accorning to the
> books. But he's starting to have trouble with the fluid again, this
> morning he sounded bad an was coughing so what do I do when the 8mg
> are not enough anymore?
I haven't seen anyone tackle this one yet, so here goes. The usual "I'm
not a vet" disclaimer applies.
My ferret Sunny was on huge doses of furosemide (lasix) for fluid in her
lungs from cardiomyopathy. So, different problem but the same drug. Not
sure if that'll make things work differently. We topped out at that 4
mg/kg dose you see in the books rather quickly, did some research and
consultations, and found that this is a "dose to effect" drug. That is,
you just give what you need. Sunny was on tremendous amounts of it.
It's not a terribly long-acting drug, and giving it every 8 hours instead
of every 12 helped for awhile. Then we started increasing the amounts.
Eventually we were giving her 8 mg every six hours (she weighed 1 kg).
Others have also reported using big doses of it. One person had much
better luck with injectible lasix than oral; they maintained one for years
on the shots and also used very high doses. If you search the archives
for the word lasix, you'll find that message in a thread on congestive
heart failure. I gave Sunny shots only when she was having a coughing
crisis - it really did help very quickly. Some ferrets don't tolerate the
really high doses and don't compensate by drinking more, so you have to
watch the individual.
> He seems okay with his 8mg, how much can ferrets tolerate? How do I
> know that he's not tolerating his dose?
I'm kinda afraid to say too much because I'm not very qualified, but
mostly we watched Sunny for dehydration (tacky gums, lack of eye buldge,
skin tent, color of urine), lack of thirst and any biggies like even more
lethargy or weakness, stumbling, etc. You have to watch out for
electrolyte imbalances. Lasix will cause the ferret to lose a lot of
potassium, so blood tests are good to see if you need to be supplementing
that. Too much potassium is as bad as too little. And there can be harm
to the kidneys, although when you get to the point of needing large
amounts of lasix, you just kinda have to accept that you're in a mode of
trading risks. Usually when you're needing large doses of diuretics,
there is a very bad problem you're fighting in the shorter term, so you
have to just watch the kidneys and electrolytes and do the best you can.
> What side effects does the Frusemide have?
Lots of drinking, lots of peeing. :) And the associated potential
problems with potassium loss. It also can increase the blood sugar -
Sunny had insulinoma so this was actually helpful. Here is a web page
with general Furosemide info:
http://www.marvistavet.com/html/furosemide.html
If Jack gets to the point where increasing the lasix doesn't help him
anymore, it is possible to add other diuretics for an additional boost.
This doesn't seem to be done very often, but it is something to discuss
with your vet if the time comes. There are some that act on other parts
of the kidney. We had Sunny on a few different diuretics at the end of
her disease and we did see improvements each time we added a new one. We
even got to drop back the lasix a bit.
For the truly curious, there is a really cool web page about the
nitty-gritty of diuretics at the following web page (from a vet school
course web page, not specifically about ferrets, but was very helpful for
me in learning when Sunny was ill):
http://www.vetmed.wsu.edu/boeing/small_animal_medicine/diuretic.htm
I hope that helps a little bit. Keep us posted about Jack.
Best wishes,
-Pam S.