From:
"Sukie Crandall"
Date: 2007-06-24 22:43:02 UTC
Subject: [ferrethealth] Re: Digoxin possibly for Molly?
To: ferrethealth@yahoogroups.com
Consultations with a vet cardiologist who is used to
ferrets will give an idea if the heart disease is far enough
advanced to add Digoxin or an alternative med.
Your ferret needs less strenuous times now and that need
will increase due to the poor heart function.
If you can stick to food that is not softened that will be
better. Poor heart function appears to decrease peripheral
circulation enough that it is hypothesized as being a route
to gum disease (as well as gum disease being strongly
hypothesized to be a route to vascular and heart disease
through certain specific bacteria -- one of which has been
found in ferrets -- getting into human blood streams, partially
through vulnerability from pre-existing heart conditions (in
humans) and partly from inflammation causing more plague
to lay down in blood vessels (again human and not something
that has been seen at all in ferrets the last time I checked)).
Softened foods are very well demonstrated to lead to gum
problems in ferrets, so until they can't be avoided it is best to
wait on the softened foods as much as possible, and if you
need to use them then do brush your ferret's teeth daily with a
***veterinary*** toothpaste. (A good habit, anyway.) Do NOT
use human toothpaste to avoid fluoride toxicity in the ferret.
Here are some sources of information for you:
In
http://pets.groups.yahoo.com/group/ferrethealth/files/
open the file on specific diseases for compilations, including
one on cardiomyopathy. They are a bit on the old side but
can be useful.
Some more recent posts in the FHL Complete Archives (an
absolutely WONDERFUL TREASURE AND EASY TO USE):
http://ferrethealth.org/archive/YPG1467
BEGIN QUOTE
There are 2 medications that can be used to
help strengthen the contraction of the heart muscles.
Digoxin and Pimobendan are the 2 choices. Both of these
drugs should be used along with other cardiac drugs such
as an ACE inhibitors and furosemide (Lasix).
Digoxin has some safety concerns. Digoxin toxicity is
a real problem that can cause real side effects. Monitoring
of blood levels of digoxin is often recommended to avoid
toxicity problems.
Pimobendan on the other hand is much safer than digoxin.
Side effects are uncommon but can include: increased drinking,
increased urination (PU/PD), vomiting, diarrhea, and inappetence.
Higher doses can induce sinus tachycardia (fast heart rate), and
ventricular arrhythmias. In an article on Pimobendan use in more
than 100 dogs (U of Georgia), found Pimobendan to be "virtually
free of overt adverse effects in dogs..." One dog did develop mild
diarrhea. Thus less than 1% developed mild diarrhea. That is a lot
safer than digoxin!
When Pimobendan becomes approved here in the US, it will be
become the drug of choice to use with an ACE inhibitor and lasix
for those moderate to severe dilated cardiomyopathy cases.
Jerry Murray, DVM
PS No, I do not work for the manufacturer (Boehringer Ingelheim),
and No, I do not own stock in that company.
END QUOTE
http://ferrethealth.org/archive/YPG1341
BEGIN THE HEART PORTION OF JM, DVM QUOTE:
You asked 2 good questions: how to medically
treat an adrenal female ferret and how to medically
treat heart disease in ferrets.
The x-ray showing an enlarged heart is step one. Now
step two is to ultrasound the heart to find out exactly what
type of heart disease is causing her heart to be enlarged.
Dilated cardiomyopathy is the most common problem, but
ferrets can also have hypertrophic cardiomyopathy, heart valve
disease, and heartworm disease. All 4 problems can cause the
heart to be enlarged! Thus it is really important to have the heart
ultrasounded. Then the correct diagnosis can be made, and the
correct treatment plan can be chosen. If it is dilated cardiomyopathy
causing her heart to be enlarged, then there are 3 types of medicines
that can be used to help her.
1) an ACE inhibitor such as benazepril (Lotensin) or enalapril (Enacard).
2) a diuretic such as furosemide or spironolactone and
3) a medicine to strengthen the heart contraction such as digoxin or
the new drug pimobendan.
END QUOTE
http://ferrethealth.org/archive/YPG1093
BEGIN QUOTE
Yes, Dr Williams did answer this question in digest 97.
For dilated cardiomyopathy (the most common type of
heart disease in ferrets) there are 3 medications that are
recommended. 1) an ACE inhibitor (benazepril=Lotensin
or enalapril=Enacard and Vasotec) with 2) a diuretic
(furosemide=Lasix) and 3) a medication to help strengthen
the muscle contraction of the heart (digoxin or the new drug
pimobendan=Vetmedin).
Pred should be avoided when possible because it can cause
fluid retention and make the heart disease worse.
Hopefully that will help clear up the confusion,
Jerry Murray, DVM
END QUOTATION
More cardiomyopathy info can be found by using some
of the vet references in my page of links. I do NOT recommend
my exceedingly old and jumbled write-up at Miamiferret
because except for the most basic stuff like safe toys it is very
out of date, and cobbled together. Plus, the salt reduction in
diet hypothesis that they had us trying out with one did not
work at all.
See:
http://homepage.mac.com/sukie/sukiesferretlinks.html
Sukie (not a vet)
Recommended ferret health links:
http://pets.groups.yahoo.com/group/ferrethealth/
http://ferrethealth.org/archive/
http://www.afip.org/ferrets/index.html
http://www.miamiferret.org/fhc/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
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