Posted: February 10, 2014, 4:45 p.m. EST
© Gina Cioli/I-5 Studio
Ferrets with insulinoma must have their blood sugar level monitored and usually are prescribed prednisolone or diazoxide.
Most veterinary medications are quite safe for ferrets, but a few that should be avoided due to side effects and adverse reactions. In addition, most over-the-counter pain products for people are not safe for ferrets, and a few can even be fatal in ferrets.
Pet ferrets should be routinely vaccinated for canine distemper and rabies. Canine distemper is almost 100 percent fatal to unvaccinated ferrets, so vaccinating is necessary to protect against this deadly virus. Currently there is only one USDA-approved vaccine for distemper prevention in ferrets. It is called Purevax Ferret Distemper, and it is manufactured by Merial. This vaccine has a low rate of allergic reactions to it. Most of these allergic reactions are only mild to moderate in severity and can be easily treated with a cortisone injection and subcutaneous fluids. Very rarely a ferret will experience a serious anaphylactic reaction to this vaccine. Such a reaction requires more aggressive treatment with epinephrine, cortisone and intravenous or subcutaneous fluid therapy.
The only USDA-approved rabies vaccine for ferrets is Merial’s Imrab-3. Rabies is an uncommon disease for pet ferrets, but vaccinating against it is important if a bite or scratch incident ever happens. If the ferret is current on its rabies vaccine, most city animal control officers only require a simple quarantine. If the ferret is not vaccinated, then the city or public health official may require the ferret be euthanized and tested for rabies. Many areas have laws requiring ferrets to be vaccinated against rabies. Similar to the distemper vaccine, the rabies vaccine has a very small chance of causing a mild to moderate allergic reaction.
Some veterinarians give Benadryl or cortisone prior to giving vaccines to try to prevent any vaccine reactions. I give a cortisone injection prior to vaccines if a ferret has had a previous vaccine reaction. Also, giving the rabies vaccine and then waiting one or two weeks before giving the distemper vaccine may reduce the risk of reaction slightly, plus if a reaction occurs, the vaccine triggering it is known. I routinely have ferret owners wait for 30 minutes in the clinic after vaccinations to monitor for any reactions.
Several veterinary products are safe to use for parasite control in ferrets, even though they are not specifically labeled for use in ferrets. Advantage for cats and Frontline Plus for cats are both safe and effective for flea control.
Ferrets are very susceptible to heartworms. As few as one or two heartworms can be fatal to ferrets due to the small size of a ferret’s heart. In areas where heartworm disease is common in dogs, ferrets should be on a monthly heartworm preventative year round. Advantage Multi for small cats and Revolution for small cats are both safe and effective at preventing heartworms in ferrets. These feline heartworm medications will also kill fleas and ear mites. Always discuss with your veterinarian before using any type of parasite control product on your ferret.
Most ferrets need to be treated with an antibiotic sometime during their lifetime. No antibiotics are specifically approved for use in ferrets, but most of the commonly used antibiotics are extremely safe; however, a few antibiotics must be used with caution and at least one antibiotic should not be used at all. Gentamicin (Gentocin) is an aminoglycoside antibiotic, and it is used primarily for Gram-negative bacterial infections such as E. coli and Salmonella.
Gentamicin should not be used in ferrets. Gentamicin is well known for its toxicity to the kidneys and the inner ear of dogs and cats. Ferrets may be even more susceptible to the kidney damage from gentamicin. Using a diuretic such as furosemide and/or some antibiotics such as cephalexin with gentamicin may increase the risk of inducing kidney damage from gentamicin. The kidney damage is usually reversible after the drug is stopped, and the ferret is treated for the kidney damage. The damage to the inner ear may be irreversible. This may cause permanent hearing loss, or it may cause more serious problems such as a head tilt, walking in circles, and falling over.
Gentamicin is also in many veterinary ear and eye medications, so these products should be avoided, too. Gentamicin is a danger if used by itself, but the risk for kidney damage increases if it is used with furosemide or cephalexin.
Enrofloxacin (Baytril) is a fluoroquinolone antibiotic, and it is commonly used for Gram-negative bacterial infections such as E. coli, Salmonella and Pseudomonas. It is much safer than gentamicin, but it does have some adverse effects. A potential problem in dogs is cartilage erosion in rapidly growing puppies; therefore, enrofloxacin should be used with caution in growing ferret kits. Gastrointestinal signs such as vomiting and anorexia are also potential problems, but the most common problem with enrofloxacin is its bitter taste. Enrofloxacin is also available as an eardrop product.
Metronidazole (Flagyl) is a nitroimidazole antibiotic and antiprotozoal agent. It is used mainly for anaerobic bacteria such as Clostridium and for protozoa such as Giardia. In ferrets it can be used for intestinal infections (diarrhea) and with other medications to treat for Helicobacter infections (stomach ulcers).
Metronidazole does have some possible adverse effects including anorexia, nausea, vomiting and diarrhea. With chronic use for Helicobacter treatment, neurological toxicity may happen. Clinical signs of neurological toxicity can include ataxia, head tilt, disorientation, muscle twitches and seizures. Fortunately these side effects are very uncommon, but it has an unpleasant taste. Antibiotics that taste good and work as well or even better than metronidazole are amoxicillin (Amoxi drops or Clavamox drops) and clarithromycin (Biaxin).
Trimethoprim-sulfa (Tribrissen) is a combination antibiotic that is used for both Gram-positive and Gram-negative bacterial infections, and it is also an effective treatment for Coccidia. Plus, it is frequently used in ferrets with bladder and prostatic infections. Adverse effects are fairly rare in ferrets, but they may include gastrointestinal distress (such as nausea, vomiting, diarrhea), bone marrow suppression, liver damage, hemolytic anemia and dry eye. The good news about trimethoprim-sulfa is that it is not as bitter tasting as enrofloxacin.
Chloramphenicol (Chloromycetin) is a bacteriostatic antibiotic approved for use in humans that has a wide spectrum of activity against many Gram-positive and Gram-negative bacteria. Chloramphenicol can be toxic to the bone marrow and cause a serious aplastic anemia. Due to the potential for this serious bone marrow toxicity, chloramphenicol should not be used routinely in ferrets. It should only be used to treat proliferative bowel disease in ferret kits.
Insulinoma is probably the most common cancer in ferrets. Insulinomas overproduce insulin, which causes a low blood-sugar level. Prednisolone and diazoxide are commonly used to medically treat ferrets with insulinomas, although this is off-label use.
Prednisolone (Pediapred) is a synthetic steroid used to elevate the blood glucose level. Unfortunately prednisolone has some side effects, especially with long-term use. Prednisolone causes fat to be redistributed to the abdomen and the sides of the neck, so after long-term administration most ferrets will develop a "pred belly.” Prednisolone at high doses can sometimes cause a stomach ulcer. Fortunately stomach ulcers from prednisolone are rare. Even rarer is the development of diabetes from long-term use of prednisolone. One of the common side effects of prednisolone is fluid and sodium retention. This is usually not a problem unless the ferret also has a heart problem. In addition prednisolone may make the ferret resistant to some chemotherapy drugs and cause some immune system suppression.
Diazoxide (Proglycem) is the other medication used to treat insulinomas, and it directly lowers insulin secretion from the pancreas. This helps to elevate the blood glucose level; however, diazoxide does have some side effects. The most common side effects include anorexia, vomiting and diarrhea. Giving this medication with food helps to reduce those problems. Other possible side effects include fluid and sodium retention. Again, this is usually not a problem unless the ferret also has a heart problem.
Adrenal gland disease is the most common problem of middle-aged and older ferrets. Adrenal gland disease of ferrets is very different than adrenal gland disease of dogs (Cushing’s disease). Several of the canine adrenal medications such as mitotane (Lysodren), ketoconazole (Nizoral) and trilostane (Vetoryl) should not be used in ferrets. Instead leuprolide (Lupron), deslorelin (Suprelorin) and melatonin (Ferretonin) should be used to medically treat ferrets with adrenal gland disease. All three medications are considered very safe in ferrets.
Heart disease is common in older ferrets. Several medications are routinely used to manage heart disease. In general all of these drugs are quite safe, but beware of some side effects. Enalapril (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. It is used to dilate the blood vessels (vasodilator) and to lower the blood pressure in order to treat heart disease. Enalapril is quite safe, but it may cause anorexia, vomiting and diarrhea. Other potential problems include hypotension (low blood pressure) and kidney problems. The newer ACE inhibitor benazepril (Lotensin) may be a slightly safer option.
Furosemide (Lasix) is a diuretic that is often used to increase the excretion of fluid, sodium, potassium and chloride in ferrets with heart problems. Furosemide can cause dehydration and low potassium levels if overdosed; however, this rarely happens.
Digoxin (Lanoxin) was a commonly used heart medication. Digoxin helps to strengthen the heart contraction, increase the amount of blood that is pumped out of the heart and reduce the heart rate. Side effects from digoxin are related to the dose. At high doses, digoxin may cause heart arrhythmias and make the heart disease worse.
Pimobendan (Vetmedin) is the newest heart medication. It is safer than digoxin and is better at strengthening the heart contraction than digoxin, so it has replaced digoxin in the heart treatment protocol.
Chemotherapy is a delicate balancing act. Enough medication must be given to kill the cancer cells while doing minimal damage to the normal cells. Chemotherapy is mostly used to treat lymphoma, which is a very common cancer in ferrets of all ages. Many medications and several different treatment options exist for ferrets with lymphoma. Some protocols use multiple agents at different time intervals to try to achieve remission. The most commonly used chemotherapy agents are doxorubicin, streptozocin, cyclophosphamide, vincristine and asparaginase. Prednisolone can be used in combination with these agents or by itself for palliative treatment of lymphoma.
Ferret First-Aid Kit
You can use a few over-the-counter products at home to treat or prevent some ferret problems. A laxative product formulated for ferrets to prevent hairballs can be used during the spring and fall shedding season to prevent hairballs. Styptic powder can be applied to a nail if it gets clipped too short. Neosporin can be safely applied to small wounds and mast cell tumors. Benadryl can be used to treat allergic reactions to insect bites or from vaccines. Karo syrup or pancake syrup can be used at home to treat ferrets that are having low blood glucose problems before quickly bringing the ferret to a veterinarian for treatment. Pedialyte or Rebound can be used to help maintain hydration in a sick ferret. Always check with your veterinarian to see what medications are ferret-safe and what medications need to be avoided.
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