Vomiting in Ferrets

Vomiting is the forceful expulsion of stomach contents through the mouth. Vomiting may be triggered by irritation of the intestinal tract or by irritation of receptors in the nervous system. Vomiting can be seen with disease of the intestinal tract, organ system diseases such as liver or kidney disease, toxins, or neurologic disorders. In ferrets, vomiting is not a common symptom when compared to similar diseases in dogs and cats. For example, vomiting is the most common symptom of gastric foreign bodies in dogs. Although ferrets with gastric foreign bodies may occasionally vomit, they rarely do so.

There are many causes of vomiting in ferrets. A few of the more common causes include:

• Bacterial infections, especially Helicobacter mustelae gastritis
• Viral infections
• Neoplasia – cancer of the intestinal tract or liver
• Dietary changes
• Foreign bodies (objects lodged in the intestinal tract)
• Toxins
• Parasites

If your ferret vomits only once and has no other symptoms, veterinary attention may not be immediately required. If, however, the vomiting continues, if he vomits more than once, the vomiting lasts more than a day, returns frequently or other symptoms occur, medical attention is needed. Vomiting in ferrets usually is a sign of serious disease. Continued vomiting can cause a loss of fluid and electrolytes, leading to dehydration.

What to Watch For

• Drooling
• Pawing at the mouth
• Lethargy
• Loss of appetite
• Diarrhea
• Straining to defecate
• Fresh blood or mucus in the feces
• Dark, brown-black tarry stool

Diagnosis

Your veterinarian may recommend specific diagnostic tests depending on the severity and duration of the vomiting. Chronic vomiting – vomiting lasting for several days to weeks – or vomiting along with other symptoms usually requires extensive diagnostic testing.

A complete history is extremely helpful in reaching a diagnosis. Be prepared to tell your veterinarian when the vomiting began, if the feces have changed or have been varied in consistency or color, the type of diet your ferret is on, and of any potential exposure to other ferrets.

Diagnostic testing your veterinarian may perform include:

• A thorough physical examination
• Sampling the feces to look for parasites
• Sampling the feces for bacterial culture and cytology
• A complete blood count (CBC) and serum biochemistry panel
• Radiography (X-rays) to look for evidence of intestinal disease, size and density of the liver, kidneys or other organs
• Endoscopy

Treatment

Treatment for vomiting may include any combination of:

• Hospitalization for intravenous fluids and injectable medications for critically ill or dehydrated ferrets
• Dietary change or forced-feeding
• Antibiotics or antiparasitic medications
• Medications to protect the intestinal tract or alter the motility of the intestinal tract

Home Care

Your veterinarian should be contacted if your ferret vomits or has an abrupt decrease in appetite. Give all medication as directed, for as long as directed, even after the symptoms appear to be gone.

Watch for a change in the stools, and report any changes to your veterinarian. If improvement is not seen, if the vomiting returns, or the ferret develops other symptoms, alert your veterinarian immediately.

Vomiting is a complex reflex in which the stomach contents are forcibly expelled through the mouth. Vomiting in ferrets is usually preceded by symptoms of nausea such as salivating excessively, pawing at the mouth, licking the lips and walking backwards. Vomiting can be triggered by irritation of the lining of the stomach or intestinal tract because of inflammation, infection or foreign bodies.

Vomiting receptors are located in nerves supplying the intestinal tract and in the central nervous system. Irritation of these receptors by chemical mediators like toxins or drugs will also trigger vomiting. Disorders that affect your ferret’s balance center (vestibular system) located in the brainstem and inner ear, such as motion sickness or inner ear infections, may trigger violent episodes of vomiting.

Vomiting is seen less frequently in ferrets with gastrointestinal disease as compared to other pet mammals. Many conditions, such as gastric ulcers or foreign bodies, readily cause vomiting in dogs and cats. Ferrets with these conditions usually show other symptoms, such as decreased appetite and weight loss, and will only occasionally vomit.

The appearance of the vomitus can be helpful in discovering which disease process is causing the vomiting. Foreign objects, tumors or other masses in the stomach often obstruct the opening from the stomach to the intestines. This prevents food from emptying from the stomach and often causes vomiting. In these cases, the vomitus will appear as undigested or partially digested food. Food that is liquid in consistency, digested and stained with bile suggests vomiting caused by diseases of the intestinal tract, toxins or metabolic diseases. Fresh blood in the vomitus, or digested blood that has the appearance of coffee grounds is seen with ulceration of the lining of the stomach or intestines.

Causes

There are many causes of vomiting in ferrets. The cause may be very simple, such as a dietary change, or may be due to a number of complex disease processes. There are many contagious diseases that cause diarrhea, so it is important to inform your veterinarian of any potential contact – direct or indirect – with other ferrets. Possible causes of vomiting in ferrets include:

• Bacterial infection. Bacterial infections are among the most common causes of vomiting in ferrets and may infect the stomach, small intestine or large intestine. Helicobacter mustelae is an extremely common cause of stomach ulcers, causing melena (digested blood in the feces) and sometimes vomiting. Campylobacter spp., Salmonella sp., Clostridium spp, and Desulfovibiro are other common bacteria that cause disease in the intestines.
• Obstruction. Tumors or foreign objects may block the intestinal tract. Ferrets are extremely fond of chewing, and will often swallow toys. Most ferrets with intestinal obstruction will have vague symptoms such as weight loss, lack of appetite and diarrhea. Occasionally, an intestinal intussusception (telescoping of one part of the intestinal tract into another) may cause diarrhea initially, then a lack of feces later in the course of disease.
• Viral infection. Epizootic Catarrhal Enteritis (ECE) is commonly known as “green slime disease” because of the characteristic green, mucous covered diarrhea produced by affected ferrets. Vomiting occurs alone or in combination with diarrhea in ferrets with ECE. The specific virus causing this disease has not yet been isolated. The disease appears to be highly contagious, and is usually spread by young ferrets that shed the virus without showing any symptoms (asymptomatic carriers). Other, less common causes of vomiting include rotavirus and parvovirus (Aleutian disease virus, not canine parvovirus).
• Parasitic causes. Intestinal worms are rare. However, microscopic parasites, such as Giardia, coccidia, and Cryptosporidium may cause vomiting in ferrets. These parasites are more likely to contribute to diarrhea when a bacterial or viral infection is also present.
• Neoplasia. Cancer, especially lymphoma, is extremely common in ferrets of all ages. Lymphoma may cause vomiting by invading the intestinal tract or liver. Primary cancers of the gastrointestinal tract, such as adenocarcinoma, are less common neoplastic causes of vomiting.
• Metabolic disorders. Liver disease, renal disease, pancreatic disease may all cause vomiting.
• Infiltrative Disease. Eosinophilic gastroenteritis is a condition in which a eosinophils (a type of white blood cell whose normal function is to fight infection) invades the intestinal tract. The cause of this disorder is unknown. Proliferative bowel disease is a condition in which lymphocytes and plasmacytes invade the large intestine. This disease is cause by a bacteria (Desulfovibiro).
• Drugs and toxins. These include plant toxins, heavy metal toxicity, bacterial toxins from spoiled food.
• Vaccine reaction. Ferrets often begin vomiting within one hour following administration of vaccines when an allergic reaction occurs. These ferrets should be taken to the veterinarian immediately.
• Dietary. These include diet changes, eating spoiled food and dietary intolerance.
• Vestibular disease. This includes motion sickness or diseases of the inner ear.
• Stress induced. This would include sudden change in environment.

Diagnosis In-depth

A thorough history is extremely important in the diagnosis of vomiting. Be prepared to answer the following questions:

• When did the problem begin and how frequently is your ferret is vomiting?
• Is the vomitus digested or undigested food? Liquid or solid? Does it appear frothy and bile-stained (yellow or green)?
• Is there an increase (or decrease) in the amount and frequency of stools?
• Does the ferret strain to defecate?
• Is there fresh blood or mucous in the feces?
• Has the diet changed? Does the ferret tend to eat table foods or get into the garbage?
• Is the ferret still eating a normal amount of food?
• What are the ferrets chewing habits? Does he have access to metal objects or plants? Does the ferret chew apart toys?
• Are any other symptoms, such as lethargy or weight loss present?
• Has the ferret been exposed to other ferrets?

The veterinarian will recommend specific diagnostic tests depending on how severe the vomiting is, if other symptoms are present, or how long the problem has been going on. Ferrets that have other symptoms or have had chronic or recurrent vomiting may require extensive diagnostic testing. Any combination of the following may be recommended:

• A thorough physical examination.
• Sampling the feces for bacterial culture and cytology to look at cell types for evidence of infection or inflammation
• Sampling of the feces to look for intestinal parasites
• A complete blood count (CBC). The number of circulating white blood cells may be helpful in distinguishing between infectious and non-infectious causes of vomiting. The number of red blood cells may be diminished if bleeding in the intestinal tract is present.
• Serum biochemistry panel to look for evidence of metabolic problems, such as diseases of the liver, kidney or pancreas
• Radiography (X-rays) to look for evidence of intestinal disease, tumors, size and density of the liver, kidneys or other organs.
• Contrast radiographs, such as barium studies, to look for tumors or foreign bodies, ulcerations or thickening of the lining of the intestinal tract. This test will also determine how quickly ingested material is moved through the intestinal tract.
• Abdominal ultrasound. To visualize the intestinal tract for evidence of intestinal wall thickening, gastrointestinal masses, and foreign bodies. This is also useful in identifying tumors. A small sample may be obtained by using the ultrasound to guide a needle into any mass found in the abdomen. A specialist usually performs this test.
• Endoscopy. To view the intestinal tract directly with a flexible endoscope to collect samples for biopsy or culture. A specialist usually performs this test.
• Exploratory laparotomy. Often, surgery must be performed to obtain segments of the intestinal tract for biopsy in order to determine the cause of vomiting.

Therapy In-depth

Your veterinarian may recommend one or more of the diagnostic tests described above. In the meantime, treatment of the symptoms might be needed, especially of the problem is severe. The following treatments may be applicable to some, but not all ferrets that are vomiting. Theses treatments may reduce the severity of symptoms, or provide relief for your ferret. However, nonspecific therapy is not a substitute for definite treatment of the underlying disease responsible for your ferret’s condition.

Ferrets with moderate to severe vomiting and other symptoms such as lethargy and anorexia usually require hospitalization and 24-hour care.

• Fluid therapy. Ferrets that are vomiting often become dehydrated and require fluids, which may be given by an intravenous catheter or subcutaneously (under the skin). The route of administration depends on how severe the level of dehydration is.
• Dietary change. Ferrets that are still willing to eat will often benefit from a diet that is easy to digest.
• Forced feeding. Ferrets that refuse food may require forced-feeding of an easily digestible, high protein food.
• Antibiotics or antiparasitic medications may be needed to treat or prevent an overgrowth of bacteria or parasites.
• Intestinal protectants such as sucralfate (Carafate), cimetidine (Tagamet), or pepto bismol.