ISSN 2398-2985      

Dyspnea

4ferrets
Contributor(s):

Jemma Hildrew

Sarah Brown

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.
Print off the Owner factsheets on Nasal discharge and Pneumonia to give to your clients.

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):
    • 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.

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