ferret - Articles
Dyspnea
Synonym(s): Difficulty breathing, Labored breathing
Introduction
- Distress associated with difficult or labored breathing which leads to a shortness of breath.
- Cause: respiratory causes including disease of the upper and/or lower respiratory tract; non-respiratory causes include pain, anxiety, fever, heat stroke, obesity, abdominal distension, cardiac disease, metabolic disorders, neuromuscular disease, and anemia.
- Signs: depends on underlying cause. General: anorexia, lethargy, weight loss, poor hair coat. Increased respiratory effort, pyrexia, nasal discharge, sneezing, coughing, wheezing.
- Diagnosis: a complete physical examination with history. CBC/chemistries, microbiology, ELISA and IFA, PCR tests, nasal swab/wash, transtracheal wash or bronchoalveolar lavage, cytology of any exudate, ultrasound-guided lung aspiration, thoracentesis, abdominocentesis, histopathology, radiography, CT or MRI, ultrasonography, respiratory endoscopy.
- Treatment: oxygen administration, fluid therapy, anxiolytics, analgesia.
- Prognosis: poor if the ferret is open-mouth breathing; poor to grave for underlying disease such as neoplasia, cardiac disease; guarded to poor if a severely dyspneic ferret has not improved within 12 hours of intensive care.
Presenting signs
- Vary due to underlying cause.
- General: anorexia, lethargy, weight loss, poor hair coat.
- Pyrexia (may be with bacterial or viral infection).
- Upper airway obstruction:
- Increased respiratory effort.
- Open-mouth breathing.
- Stertor, stridor.
- Facial asymmetry possible especially if chronic cause.
- Upper respiratory tract disease:
- Serous to mucopurulent nasal discharge.
- Ocular discharge.
- May be associated dental disease, including ptyalism, bruxism, facial abscess.
- Sneezing.
- Lower respiratory tract disease:
- Coughing.
- Exercise intolerance.
- Wheezing/labored breathing.
- Dyspnea.
- Decreased or absent breath sounds with abscess, lung consolidation, neoplasia or heart disease (effusion).
Acute presentation
- Dyspnea.
- Often tachypnea.
- Heart rate may be elevated.
- Lethargic: reluctance to move.
- Frequently some degree of dehydration as dyspneic ferrets are often reluctant to drink.
Geographic incidence
- Worldwide.
- In ferrets, fungal diseases are more common in certain areas:
- Blastomyces dermatitidis: central and SE USA, Canada, Africa, and occasionally central America.
- Coccidioides immitis: endemic to SW USA and parts of Latin America.
- Histoplasma capsulatum: mid-west USA.
Age predisposition
- Infectious causes often younger animals.
- Neoplasia: older than 3 years of age.
Gender predisposition
- Hyperestrogenism causing anemia in entire females.
Public health considerations
- Influenza is zoonotic between humans and ferrets.
Cost considerations
- Examination.
- Diagnostics.
- Hospitalization, intensive care.
- Medications.
- Anesthesia.
- Surgery.
- Infection spread to rest of group.
Special risks
- Immunosuppression due to poor diet, stress, age, overcrowding, concurrent disease, corticosteroid use.
- Laryngeal edema or trauma due to traumatic intubation, multiple intubation attempts, or inadvertent laryngeal trauma that occurred during dental procedures.
- Tooth root abscesses.
- Poor husbandry which contributes to irritation of the airways: including use of substrates that contain aromatic oils (such as pine, cedar), disinfectants/cleaning chemicals, poor sanitation that leads to ammonia build-up within the cage, smoke, inadequate/improper ventilation, ambient temperature, and humidity.
- Ferrets are very susceptible to human influenza strains, therefore humans with cold or flu-like symptoms should avoid contact with ferrets or wear a surgical mask to minimize transmission of the influenza virus.
- Vaccination status should be determined as ferrets can get canine distemper.
Pathogenesis
Etiology
Respiratory causes
- Upper respiratory tract:
- Nasal passage obstruction.
- Rhinitis, sinusitis.
- Dental disease Periodontal disease: tooth root abscess Dental abscess.
- Trauma (to face, nose, neck).
- Foreign body (ferrets are very inquisitive).
- Neoplasia (such as nasal adenocarcinoma, lymphoma Lymphoma overview).
- Laryngotracheal obstruction (edema, swelling from trauma): traumatic intubation, multiple intubation attempts, or inadvertent laryngeal trauma that occurred during dental procedures.
- Canine distemper virus Canine distemper.
- Influenza Influenza.
- Contact irritation.
- Lower respiratory tract:
- Pneumonia.
- Bacterial (uncommon) Bacterial pneumonia:
- Streptococcus pneumoniae, S. zooepidemicus, Groups C and G Streptococci.
- Bordetella bronchiseptica.
- Listeria monocytogenes.
- Mycobacterium spp.
- Viral (common):
- Influenza Influenza.
- Canine distemper Canine distemper.
- Coronavirus Ferret systemic coronavirus.
- Foreign bodies/material (aspiration):
- Common.
- Can be sequalae to force feeding, administration of oral medication, or incorrectly placed feeding tube.
- Fungal:
- Blastomyces dermatitidis.
- Coccidioides immitis.
- Histoplasma capsulatum.
- Cryptococcus neoformans.
- Aspiration pneumonia may follow force feeding or oral medication.
- Neoplasia: lymphoma Lymphoma overview, pulmonary adenoma.
- Pulmonary edema (usually cardiogenic).
- Pulmonary contusion from trauma.
- Allergy (not well documented).
- Intrathoracic tracheal disease including neoplasia, abscess, foreign body.
- Extraluminal tracheal compression due to abscess or neoplasia.
- Traumatic airway rupture.
Non-respiratory causes
- Any cause of anxiety, pain.
- Obesity Obesity.
- Heat stroke Heat stress.
- Abdominal distension: pregnancy, organomegaly, dilation of stomach, ascites.
- Cardiac disease, including congestive heart failure, shock, severe arrhythmias Heart disease.
- Metabolic acidosis or uremia.
- Severe central nervous system disease such as trauma Trauma overview, abscess, neoplasia, inflammation.
- Spinal disease (trauma) Traumatic injuries.
- Anemia Anemia overview, common in hyperestrogenism in unmated in estrus jills.
- Iatrogenic: following multiple attempts at intubation or recent intubation.
- Diaphragmatic hernia.
Predisposing factors
General
- Poor husbandry which contributes to irritation of the airways, including:
- Use of substrates that contain aromatic oils (such as pine, cedar).
- Disinfectants/cleaning chemicals.
- Poor sanitation that leads to ammonia build-up within the cage.
- Smoke.
- Inadequate/improper ventilation.
- Ambient temperature.
- Humidity.
Specific
- Immunosuppression due to poor diet, stress, age, overcrowding, concurrent disease, corticosteroid use.
- Laryngeal edema or trauma due to traumatic intubation, multiple intubation attempts, or inadvertent laryngeal trauma that occurred during dental procedures.
- Unvaccinated for canine distemper vaccine (no licensed ferret vaccine available in the UK).
- Contact with humans or other ferrets with respiratory signs.
- Contact with dogs or foxes transmitting canine distemper.
- Entire jills in season not being mated or not being brought out of season.
Pathophysiology
- Primary respiratory disease: upper or lower respiratory tract disease or dysfunction.
- Non-respiratory disease:
- Abnormalities in pulmonary vascular tone as seen with central nervous system disease or shock.
- Abnormalities with pulmonary circulation as seen with congestive heart failure.
- Problem with oxygenation as seen with anemia.
- Problems with ventilation: obesity, ascites, abdominal organomegaly, or musculoskeletal disease.
- Aspiration pneumonia: caudal portion of the left cranial lung lobe and the right middle lobe are most often affected.
Timecourse
- Depends on underlying disease.
- If dyspnea becomes severe such that there is open-mouth breathing; that is an acute development.
Epidemiology
- With infectious disease, there may be transmission between ferrets in a colony or household, including humans for viral infections.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Hawkins M G & Graham J E (2007) Emergency and critical care of rodents. Vet Clin North Amer Exot Anim Pract 10 (2), 501-531 VetMedResource.
Other sources of information
- Hoefer H (2012) Gastrointestinal Diseases of Ferrets. In: Ferrets, Rabbits, and Rodents Clinical Medicine and Surgery. 4th edn. Eds: Quesenberry K E, Manns C, Orcutt C & Carpenter J W. Elsevier, USA. pp 27-38.
- Rettenmund C L & Heatley J J (2011) Dyspnea and Tachypnea. In: Blackwell's Five-Minute Veterinary Consult: Small Mammal. Ed: Oglesbee B L. Wiley-Blackwell, USA. pp 262-264.
- Johnson-Delaney C (2010) Ferrets, Skunks and Otters. In: BSAVA Manual of Exotic Pets. 5th edn. Eds: Meredith A & Johnson-Delaney C. BSAVA, UK. pp127-138.
- Chitty J (2009) Ferrets: Physical Examination and Emergency Care. In: BSAVA Manual of Rodents and Ferrets. Eds: Keeble E & Meredith A. BSAVA, UK. pp 205-218.
- Orcutt C & Malakoff R (2009) Ferrets: Cardiovascular and Respiratory System Disorders. In: BSAVA Manual of Rodents and Ferrets. Eds: Keeble E & Meredith A. BSAVA, UK. pp 282-290.