Message Number: FHL3062 | New FHL Archives Search
From: "Sukie Crandall"
Date: 2007-11-17 17:34:24 UTC
Subject: [ferrethealth] Re: current ECE protocol?

Well, there are a number of other things that cause diarrhea
which people call ECE which are not ECE. ECE is a specific
disease; it is not a general term for any diarrhea in ferrets
though on many sites a person will find it used that way. That
misuse upsets me because it leads people down paths which
are appropriate for other diseases but not for actual ECE.

In an older ferret ECE is an extremely serious, often dehydrating
coronavirus which can last for months and can wind up with
secondary infections involved. It can be fatal in an already
compromised ferret. (So can some other causes of GI illness
such as E. coli infection, one of the nastier and less looked for
genera of coccidia, etc.)

Suggestion: read all related materials, including FHL past posts in
from Dr. Bruce Williams since he was the pathologist who first
found the ECE virus.

Begin here and look at dates because in recent years the coronavirus
has been isolated and its molecular identity patented for the development
of testing, prevention, or treatment approaches:

Actually, coronaviruses aren't know for their
predilection to mutate, such as we see with
influenza viruses (of a different family, the
Pramyxoviridae). There are many variables
that determine whether a particular animal
will become clinically ill, subclinically infected,
or fight off infection. Age, previous infection,
maternal antibody, and concurrent disease are
some of them.

It is well known that young animals are rarely
clinically infected with the coronavirus that causes
ECE, but can be carriers for up to 6-8 months.
Coronaviruses appear to infect more readily in animals
with a higher gastric pH, and the prevlaence of
H. mustelae infection in older ferrets supports the
higher frequency of clinical infection in this
demographic. Additionally, many kits have maternal
antibody, as quite a few breeders have endemic
ongoing infections (facilities in which clinical animals
become extremely rare over time.) So it is of no
surprise that the young animal is perfectly fine while
the three older ferrets are experiencing ECE firsthand.

Currently, there appear to be a number of ongoing ECE
outbreaks, far more than we have seen in recent years.
It is likley that this may become the status quo - seeing
hotbeds of infection every couple of yers as immunity in
the animals of a particular area begins to wane.

With kindest regards,

Bruce Williams, DVM

> Our Vet diagnosed their condition as:
> 1. Virus of the immune system
> 2. Symptoms of Corona virus =96 ECE
> 3. Clostridia bacteria
> 4. He took a bacteria culture which came back today and showed indication=
s of a Proteus Mirabilis bacteria
> 5. He believes Savannah to be the carrier of the virus

I would take issue on the diagnosis of Clostridium if the examination of a =
fecal smaple was how it was made - there are many robust bacilli that look =
like Clostridia in ferret feces and this is not the way to diagnose this ra=
re condition. Also, Proteus mirabilis is not significant in a fecal cultur=

I also don't see evidence for a "virus of the immune system". The outbreak=
is very consistent with ECE, though.

> He prescribed the following:
> 1. During their stay, he administered sub-cu fluids to the 3
> 2. Metronidozale and Amoxicillin for all 4 (twice daily for 7 days)
> 3. Recommended Pepto for the 3 with diarrhea (three times a day)
> 4. Scrub all litter boxes and food dishes
> 5. Keep Savannah separated for the next 3 months.
> 6. Do not let the others share Savanna=92s litter boxes or food dishes
> 7. Always thoroughly wash hands after handling.

Pepto is a poor choice for diarrhea. In cases of ECE, we do much better by=
adjusting the diet to an easily digestible food and get prepared for 3-4 w=
eeks (or longer) of bad stools. I see no reason to be giving Flagyl in thi=
s case.

There is no need to quarantine Savannah - ECE is such an contagious virus, =
the other animals have already been exposed. In fact, you are a possible s=
ource of exposure to other naive ferrets, so you have to watch your interac=
tion with any other ferrets.

> 1. By keeping Savannah are we increasing the risk to the other three? =

No, they are already exposed.

> 2. Since all are now exposed, should Savannah be strictly quarantined in =
a closed off room or is a separate cage sufficient?

If everyone is showing sign, there is no reason to separate her at all. =

> 3. Assuming a strict quarantine is not necessary=85 Once the three are we=
ll enough to get out-and-about, should they be allowed to play in the same =
room that Savannah has played in?

Sure - they're already infected.

> 4. Once we are past this illness (God willing), is it foolish to attempt =
introducing a kit to our seniors?

The biggest risk with a pet store kit these days is ECE - you already have =
the infection in the house.

> 5. The Metronidozale REALLY stresses them out (gagging, etc.). Could it =
be doing more harm than good?

In the case of ECE, I think yes, you probably should discontinue it. The =
older ferrets are at risk for the development of ulcers from the stress, wh=
ich would significantly worsen their prospects for a quick recovery.

> 6. We did have a weeklong trip planned for next week (the ferrets always =
travel with us). That has now been rescheduled for the week of 10/20. Is =
it unrealistic to think that they may be well enough to travel (by car) by =

I think that a trip is proably a bit precipitous - too much stress involved=
. =

> 7. Is there anything we are missing that might help to ensure the recover=
y of our babies?

What exactly are you feeding - are you continuing to try to feed kibble - i=
n ECE cases we generally go baby food only, and slowly reintroduce kibble. =
Pedialyt is generally not necessary by now, if they are eating the baby fo=
od well.

With kindest regards,

Bruce Williams, DVM

Here are two studies since the original discovery by Dr. Bruce Williams:


Virology. 2006 May 25;349(1):164-74. Epub 2006 Feb 24.

Molecular characterization of a novel coronavirus associated
with epizootic catarrhal enteritis (ECE) in ferrets.

Wise AG, Kiupel M, Maes RK.
Diagnostic Center for Population and Animal Health, Lansing, MI 48909, USA.
A novel coronavirus, designated as ferret enteric coronavirus (FECV), was identified in
feces of domestic ferrets clinically diagnosed with epizootic catarrhal enteritis (ECE).
Initially, partial sequences of the polymerase, spike, membrane protein, and nucleocapsid
genes were generated using coronavirus consensus PCR assays. Subsequently, the
complete sequences of the nucleocapsid gene and the last two open reading frames at the
3' terminus of the FECV genome were obtained. Phylogenetic analyses based on predicted
partial amino acid sequences of the polymerase, spike, and membrane proteins, and full
sequence of the nucleocapsid protein showed that FECV is genetically most closely related
to group 1 coronaviruses. FECV is more similar to feline coronavirus, porcine transmissible
gastroenteritis virus, and canine coronavirus than to porcine epidemic diarrhea virus and
human coronavirus 229E. Molecular data presented in this study provide the first genetic
evidence for a new coronavirus associated with clinical cases of ECE.
PMID: 16499943 [PubMed - indexed for MEDLINE]

J Am Vet Med Assoc. 2000 Aug 15;217(4):526-30.
Coronavirus-associated epizootic catarrhal enteritis in ferrets.

Williams BH, Kiupel M, West KH, Raymond JT, Grant CK, Glickman LT.
Department of Veterinary Pathology, Armed Forces Institute of Pathology, Washington, DC
20306-6000, USA.
OBJECTIVE: To characterize clinical signs and lesions and identify the etiologic agent
associated with epizootic catarrhal enteritis in domestic ferrets. DESIGN: Cross-sectional
study. ANIMALS: 119 ferrets with epizootic diarrhea of presumed viral cause and 5 control
ferrets. PROCEDURE: Clinical records and biopsy or necropsy specimens of ferrets with
presumed epizootic catarrhal enteritis were reviewed. Immunohistochemical staining for
coronavirus antigen was performed on paraffin-embedded tissues from approximately
10% of affected ferrets to identify viral antigen and determine its distribution.
Transmission electron microscopy was performed on fecal samples and sections of
jejunum. Virus isolation studies as well as immunofluorescent tests for other similar
viruses were performed. RESULTS: Characteristic microscopic lesions consistent with
intestinal coronavirus infection (vacuolar degeneration and necrosis of villus enterocytes;
villus atrophy, fusion, and blunting; and lymphocytic enteritis) were consistently detected
in affected ferrets. Coronavirus particles were identified in feces and jejunal enterocytes
use of transmission electron microscopy. Immunohistochemical staining of jejunal
sections revealed coronavirus antigens. Antigen staining was not detected in healthy
ferrets or ferrets with other gastrointestinal tract diseases. Virus isolation was
unsuccessful, and other similar viruses were not detected. CONCLUSIONS AND CLINICAL
RELEVANCE: Results strongly implicate a coronavirus as the causative agent of epizootic
catarrhal enteritis in ferrets. Diagnosis may be made on the basis of a combination of
historical, clinical, and microscopic findings.
PMID: 10953717 [PubMed - indexed for MEDLINE]


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