The Vomiting Ferret

Notes from a presentation by Dr. Mark Burgess, Southwest Animal Hospital, Beaverton, Oregon

Vomiting* can range from the occasional "nuisance" to the regular vomiting on an empty or full stomach, and may or may not be accompanied by diarrhea. This presentation addresses vomiting without diarrhea. The main causes of vomiting (without diarrhea) are foreign bodies (the most common cause of vomiting), Inflammatory Bowel Disease, Helicobacter, and liver disease (the least common cause of vomiting).

Not all ferrets with foreign bodies will vomit. Foreign body ingestion is usually caused by rubber or hair balls. These foreign bodies can lodge in the stomach or intestines. Objects remaining in the stomach are free to move about thus not creating as urgent problem as those items that get lodged in the intestines. The foreign bodies in the stomach usually require surgery to remove them. However, the intestines, being about as big around as a pencil, can get blocked easily (a "functional" blockage). If surgery is not performed within 12 hours, the intestines start to die and the ferret will succumb. For this reason, vomiting should always be taken seriously. If a ferret has had previous problems with a hairball, the ferret should remain on a hair ball medicine the rest of its life - as often as needed but may require medicine daily.

There are many foreign-body look alikes. These include gastric ulcers which may be caused inflammatory bowel disease., irritation of foreign bodies, "stress", and drugs. Stress due to moving, introducing new ferrets, owner tension, etc. can produce increased levels of acids which burns through the stomach lining. Drugs such as non-steroidal anti-inflammatory drugs (N.S.A.I.D.'s) excluding cortisone can cause vomiting. The new N.S.A.I.D, Rimadryl, which is prescribed for conditions like arthritis, does not cause stomach upset in dogs. Unfortunately, it does not work the same in ferrets and will cause vomiting, severe bleeding, and ulcers and should not be used on ferrets.

Generally, if the vomiting symptoms are slow to come on, the condition is not caused by a blockage. Always do a blood profile first to rule out liver problems.

This condition is where the immune system attacks the bowel or stomach, without an infection being present. IBD is frequently caused by an allergy to foods. In a blood panel, an increase in lipase is indicative of IBD. If a ferret is allergic to its normal diet, switch to one of the new blends such as duck and potato. It is important not to feed the ferret any specialized diet unless medically required since these foods may be required as the future staple diet. Lamb and rice, which is commonly used in foods today, will not work unless the ferret has not ever received these products in its diet before. The treatment of IBD is diet change and cortisone. There are lots of conditions that mimic IBD so it is difficult to diagnose and requires a biopsy of the bowel.

Helicobacter is caused by an organism in the stomach and results in ulcers. The treatment is easy - Amoxicillin and Flagyl for two weeks but diagnosis requires a biopsy to be certain. Dr. Burgess does not believe this condition is as common as reported.

Liver disease, or hepatitis, is common. Typical signs of liver disease are loss of appetite and lethargy, sometimes occasional non-tarry diarrhea, and less commonly vomiting. (Tarry stools would indicate that ulcers due to IBD., helicobacter, etc.) There are two types; bacterial and lymphocytic. Bacterial is easier to treat but the ferret becomes dramatically sick from this condition caused by bacteria in the liver. Also, the ferret may become jaundiced. Lymphocytic liver disease looks a lot like IBD and is caused by an immune system problem. If not treated, it can progress to full-blown lymphoma. The liver can tolerate a lot of damage before showing signs. However, the liver also has an amazing capacity to heal itself.

New variety of ECE? In response to questions, Dr. Burgess noted that he has seen two cases recently of "cluster" ECE-like illness but without the green diarrhea. The signs are profuse, brown, tarry diarrhea, dehydration, and wasting. Ferrets can't absorb nutrients resulting in diarrhea out the other end of the digestive tract. There has been a high mortality rate among older ferrets if not treated immediately. Because of the highly contagious nature of this illness, several ferrets in the same family have been ill resulting in the "cluster" terminology.

Treatment is the same as for ECE: immediate veterinary care, lots of fluids, warmth, appropriate medicines, and months of follow-up care by the owner to combat the wasting. It is critical to treat this disease quickly because a ferret can literally waste away and die within days whereas other companion pets have the ability to hang on longer before getting critically ill.

Dr. Burgess speculated that there must be some asymptomatic carriers because new ferrets introduced to the household become ill while the other ferrets remain "healthy". This is similar to ECE which stays in the environment for at least six months. He also speculated that it is possible that the increase in popularity of ferrets is resulting in new diseases in their environment.

*Vomiting is different from regurgitation. Vomiting means that the food has entered the stomach whereas in regurgitation, the material does not enter the stomach first. Regurgitation is common in ferrets with megaesophagus, a relatively rare condition. In megaesophagus, the esophagus dilates due to the lack of muscular motility. When the ferret attempts to swallow, the food or liquid cannot be propelled into the stomach causing the esophagus to swell as it fills. As a result, the ferret regurgitates usually within minutes of eating.

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