From:
Shelley Knudsen
Date: 2002-04-24 18:04:00 UTC
Subject: Gastric ulcers
Hello,
I have seen several posts regarding gastric ulcers or symptoms
that could fit gastric ulcers in here lately, so I thought I
would just write up a brief description of gastric ulcers in
ferrets, and the treatment. (Amazing what I can find to do to
procrastinate studying :-). I am writing this off of the top
of my head (not looking it up), so vets, if you see an error,
please correct it.
Almost all ferrets (probably about 80-90%) have the bacteria
Helicobacter mustelae living normally in their stomach and
intestines. However, when ferrets undergo stress, which can
be anywhere from minor such as a different routine or new
animal in the home, to severe such as illness or being dumped
at a shelter or new home, they will tend to increase
secretions of their gastric acids, which in combination with
the urease produced by Helicobacter, predisposes them to an
ulcer in the stomach mucosa. Once an ulcer has formed, this
gives the bacteria an opportunity to take hold, producing more
urease which further damages the lining, which basically
results in a vicious cycle, that can end with the ferret
bleeding severely into the intestines, and death if not
treated.
Symptoms of gastric ulcers can be grinding of the teeth
(bruxism) and a decrease or lack of appetite (anorexia).
Stools may initially may be "liquidy" in appearance, and may
or may not have a greenish or mucuousy look to them. Once
these stools dry, they may look kind of like dried tar. Once
the ulcer has started bleeding quite a bit, the stools may
develop a black tarry appearance while fresh. Ferrets may be
less active, and act depressed. They may lay flat but with
their abdomen hunched up, which is a sign of abdominal
discomfort. Probably the most identifying symptom is the
grinding of teeth in conjunction with the abnormal stools,
without evidence of other diseases. However, all of these
symptoms can also indicate other things, so a history of a
stressful event can also be helpful in diagnosing an ulcer.
The average ferret owner may never see a gastric ulcer,
however, ferret shelter operators may be very experienced at
identifying the symptoms, as ferrets in shelters, due to
stress from missing their former homes, tend to be more likely
to develop an ulcer. There is no good clinical test that can
be done for an ulcer, since most ferrets normally harbor the
bacteria anyway. (Other than maybe endoscopy or biopsy)
The good news is that ulcers are almost always treatable, and
the sooner treatment is initiated, the better. The best
treatment for a gastric ulcer is unlikely to cause any other
problems, and if the ferret responds to the treatment, it also
pretty much confirms that it was an ulcer. The old standard
of treatment was metronidazole, amoxicillin, and sucralfate
(carafate) for 6 weeks. However, there is a better, faster
treatment that is much better received by the ferret, and will
have almost complete resolution of symptoms usually within the
first week of treatment. That treatment is clarithromycin
(Biaxin) dosed at 50mg/kg once daily, and amoxicillin dosed at
25-50 mg/kg twice daily, with sucralfate (carafate) given
about every 6-8 hours, although it should be given at least 3
hours separately from the antibiotics. This treatment is
given for a period of two weeks. Sucralfate is not necessary
for the treatment, but it will make the ferret feel better,
and speed healing of the uclerated area in the
gastrointestinal tract. Pepto bismol can also be given
instead of sucralfate, but most ferrets hate the taste. I am
not aware of any other successful treatment for gastric ulcers
that does not utilize amoxicillin and either clarithromycin or
metronidazole, although there may be some. Most vets do not
carry clarithromycin on hand, but it can be obtained from any
human pharmacy in the pediatric liquid suspension at 50mg/ml.
If symptoms do not resolve within the two weeks of the
clarithro/amoxi combo, there is a very strong likelihood that
it is not an ulcer, and further diagnostic tests should be
performed.
Clavamox may be given in place of regular amoxicillin -
clavamox is basically just a more potent form of amoxicillin,
so the dosage would be different. Please note that I am not a
vet (yet), I am a second year vet student. However, when I
ran a ferret shelter for 3 1/2 years, I dealt with gastic
ulcers in ferrets fairly often. Again, most ferret owners
will never see a gastic ulcer, it usually requires a stressful
event, and it is also dependent on the ferrets themselves -
some will be more affected by stressful events than others.
Hope that is beneficial.
Dooks to your fuzzies,
Shelley Knudsen
Class of 2004 KSU Veterinary College
ferrets@kansas.net sknudsen@vet.ksu.edu
http://www.tcgcs.com/~ferrets
785-565-9041 cel402-984-4217
"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