Introduction

• Cause: gastritis (bacterial/viral/parasitic, eg coccidiosis), gastric ulcers, gastroenteritis, foreign body, Helicobacter associated ulceration, pancreatitis, dysbiosis, long term use of ulcerogenic medication, rodenticide poisoning.
• Signs: lethargy, anorexia, abdominal distension, bruxism, bloating, dark, digested blood originating from the small intestine.
• Diagnosis: clinical history, fecal examination.
• Treatment: dependent on the cause, can range from antibiotics, fluid, and nutritional support to euthanasia.
• Prognosis: guarded.

Pathogenesis

Etiology

• Hypergastrinemia because of H. mustelae infection Helicobacter mustelae gastritis.
• Ulceration resulting from gastrointestinal surgery.
• Chronic, partial foreign body or trichobezoar obstruction Hairballs.
• Infectious agents such as nematodes Roundworm infection and protozoa Coccidiosis Cryptosporidiosis Giardiasis Toxoplasmosis.
• Rodenticide poisoning Anticoagulant rodenticide toxicity may result in melena: ferrets should never be left unsupervised outside.
• Gastrointestinal neoplasia Gastrointestinal neoplasia?

Predisposing factors

General

• Poor husbandry with an inappropriate diet.
• Access to inappropriate toys and objects increasing the likelihood of foreign body ingestion Gastrointestinal foreign bodies.
• Animals housed outdoor may be checked less frequently and presented later on in disease process.

Specific

• H. mustelae infection Helicobacter mustelae gastritis in ferrets.
• Long-term use of non-steroidal anti-inflammatory medication such as meloxicam Meloxicam without the use of gastroprotectants and whilst using higher doses.
• Chronic azotemia due to kidney disease.
• Raw feeding predisposing to bacterial infections Bacterial gastroenteritis.

Pathophysiology

• Infection of H. mustelae Helicobacter mustelae gastritis leading to chronic hypergastrinemia:
  • Koch’s postulates have been fulfilled, and the oral administration of H. mustelae to ferrets free of this bacterium produces colonization, chronic gastritis and a rise in anti-H. mustelae antibody titer.
  • Histologic changes consist of superficial mononuclear gastritis in the body of the stomach and diffuse mononuclear gastritis in the pyloric antrum.
  • The highest number of bacteria are usually found in the pyloric antrum.
  • Ferrets free of H. mustelae do not have these lesions.
  • Severity of gastritis is correlated with the number of organisms.
  • In addition, some authors state that disease is more frequently seen in older animals, while other authors believe stressed young (3-5 months old) animals are more susceptible to the disease.
  • Infection by H. mustelae produce auto-antibodies, which can contribute to the development of gastritis. Severity of gastritis is correlated with the number of organisms.
  • It is possible that these auto-antibodies could also be implicated in the reactivity of spleen and mesenteric lymph nodes, although lymphoid tissue (particularly mesenteric) reacts significantly in ferrets with any inflammation.
  • The infection is also associated with hypochlorhydria and hypergastrinemia, and it has been observed that the hypochlorhydria caused by the administration of omeprazole increases fecal excretion of the bacteria.
  • Hypergastrinemia is linked to the development of gastric ulcers. This in turn may result in intermittent or ongoing bleeding.
• Long-term use of anti-inflammatory medication and inhibition of cyclo-oxygenase-1 (COX-1) receptors in the gastrointestinal tract reduces prostaglandin secretion. Prostaglandins have a cytoprotective effect on the gastric mucosa. This increases the risk of mucosal injury and development of ulceration.

Timecourse

• Ulceration takes time to develop, but any signs of gastrointestinal disease should be investigated thoroughly.
• Ulceration may develop acutely following rodenticide toxicity or gastrointestinal surgery.

Epidemiology

• Female ferrets may be overrepresented in gastric ulceration Gastric ulceration.
• Young, stressed, and immunocompromised animals will be more predisposed to infectious causes of gastrointestinal ulceration.
• Geriatric animals will be more predisposed to gastrointestinal ulceration as they will often have coexisting conditions such as kidney and heart disease as well as neoplasia.

Diagnosis

Treatment

Prevention

Outcomes