Nursing Care for Sick and Post Surgical Ferrets Presented at the June 2011 IFC Symposium by Barb Carlson
Topics Why in-home care The basics Special concerns Ill ferrets Elderly ferrets Rescued/found ferrets Measuring, math and mixing meds
Disclaimer I m not a vet This information is based on my personal experience This info is to be used with your vet s help not in place of it
Why in-home post-surgical care?
Less expensive Most ferrets don t need much more than food, water, warmth and meds.
Better hour-by-hour care You will be caring for only one ferret You can check on them more often
Ferret is more comfortable A gentle roommate can make a difference Helps keep them warm Comforting
Ferret is more comfortable Ferret is in a familiar environment Vet s office is bright, noisy and stressful
Familiar food Special food can be misplaced They might not be enthused about whole prey Storage could be a problem
Familiar food Sick ferrets like their familiar duck soup At the right temperature, too!
Ferrets respond to affection No one loves your ferret like you do They will often eat just to please you Sometimes they need a reason to stay
The Basics Hydration Temperature regulation Food Medication
Hydration Very Important
Hydration Dehydrated ferret won t eat or drink Slows recovery Damages kidneys
Check for tented skin Back of neck Easy Affected by weight loss Belly A little harder but more accurate
Neck pinch
Neck pinch If the skin stays up, that means the ferret is dehydrated
Belly pinch
Belly pinch The longer it stays up, the more dehydrated they are
Sub-Q Fluids You re going to do what?!
Sub-Q Fluids Sub-q stands for subcutaneous The fluids make a camel hump that is absorbed slowly I prefer my fluids on the outside.
Sub-Q fluids can save a life If severely dehydrated, they don t absorb oral fluids very well
Sub-Q is not that hard It can be done easily at home It s hard to do it wrong Air bubbles under the skin won t kill the ferret
Sub-Q Fluids are IV fluids You get them from your vet Different kinds are used for different things
To start, you need IV fluid
a 25-35cc syringe
and needles Some people use 22 gauge needles
Butterfly needles can be used
You need a distraction Ferretone, Nutrical or other tasty treat
A helper is nice Optional, but nice Helps by holding the ferret Will leave both your hands free
Draw fluid into the syringe
Use a fresh needle each time Goes into skin easier Warm fluid is nice
Give it in the scruff Reverse scruff the ferret Make a tent
Insert needle parallel to body Apply pressure and fluid will go in slowly Not too fast
Sub-Q tips Hang on tight Don t get bitten Pinch hole to help it close Leakage is common A little blood is common
How much, how often? Give 25-35cc two or three times a day Need around 60-90 cc of fluid a day Duck soup counts
Temperature Keep the ferret warm, but not hot If he is very sleepy, he won t move Snuggle-Safe Disk Doesn t get TOO hot No wires No electricity Non-toxic
Food: Fast recovery needs fuel Canned a/d Chicken baby food Homemade duck soup Hint: A Gerber baby food jar filled to the top is 60 cc
After surgery They can have hard food unless the vet says not to They usually prefer a soupy duck soup
Small amounts frequently At first, just a little Don t force them to eat right away if they don t want to By the next day they should be able to eat They need at least 60cc of liquid food daily
Sick ferrets like it soupy Should pour like soup They like it warm Put a towel down so they can stand more easily
Getting them to eat duck soup
Start with it on your finger Hold them if they aren t cooperating From finger, go to a spoon From a spoon, go to a bowl If they eat from the bowl, rejoice!
If you have to force-feed A feeding syringe with an O-ring lasts the longest
How to force-feed Scruff ferret Dribble a little at a time into front of mouth Give them a break from time to time You can fit 18cc in a ferret stomach, minimum
When to stop trying If they clamp their teeth shut and refuse to swallow, reconsider if you should be forcing them to eat Don t force feed if they are blocked Don t try to feed if unconscious
Medications: Ask questions! Name, dosage, how often. What is it supposed to do? Given how long, refrigerated, expiration Write things down
Medications: Check it Read the instructions back to the vet Check the bottle when you get it Vet techs and pharmacies can make mistakes
Medication tips Give meds near back of mouth Make sure you have a good grip on the ferret It s easier to depress plunger when held like this
Keep track of meds Make a schedule It s much easier to remember You can give accurate info to the vet 9:15 8:30 9:30 9:15 8:45 8:30
Pain Control Ask about pain control Most vets give a pain shot Ask to be sure If not, request something Ferrets heal much better when pain is controlled
Stitches: Concerns You can get stitches wet if needed Some watery blood leaking out is normal Call your vet if you see deep red blood dripping for more than hour
Stitches: Avoid problems No climbing for a week with abdominal surgery Take out hammock Day 4-5 is when stitches start to dissolve Watch for problems
Stitches: Scabs If scabs keep forming after a few days, something is going on (usually infection) Not always serious but should be addressed Check with vet for instructions
Stitches: Bulging is bad Soft and puffy Bulging out Red, hot, swollen A slight hard bulge is normal. You re feeling internal stitches
Stitches: If they rip open If you can see intestines, use sterile gauze moistened with saline to wrap the ferret. Transport immediately. If you only see flesh, not as serious Call the vet for instructions
Staples Usually heal quickly Sometimes will rotate as skin heals If loose, remove before they rotate Get a staple-remover on the Internet As they loosen, they can get caught on things no climbing!
Keep on top of things Keep a log List time & amount of feedings List time and amount of medications List changes in symptoms Take the log with you to the vet s office or have it next to the phone when you call More information helps the vet know what to do Know what the poop looks like
Elderly ferrets Keep track of: weight gain/loss temperature breathing activity level color of: skin, urine, poop how much water they are drinking what and how much they eat
Rescues: Special concerns Dehydration Weight loss Ear mites Fleas, ticks Wounds Intestinal parasites
Rescues: Special concerns Heat/cold Tooth damage ADV Distemper Quarantine!
Measuring, math and mixing
Measuring medication ml stands for milliliter 1mL = 1cc Marks are 0.1, 0.2, 0.3, etc. So 0.5 is half a ml Use the zero and the decimal point it avoids confusion
Measuring medication Use the top of the plunger This syringe is at 0.2mL
Measuring medication The arrow is pointing at 0.4mL
Measuring medication Here, the arrow is pointing at 0.45 halfway between 0.4 and 0.5 You would place the top of the plunger at that line
The math of medication ml = milliliter, wet measure mg = milligram, dry measure Know which one your vet is using
Know your pills The capsules are 250mg Amoxicillin The tablet is 875mg Amoxicillin
Compounding Your vet prescribes 25mg Amoxicillin twice a day. You have a 250mg capsule. Empty capsule into small container 250mg capsule/25mg dose = 10 doses. Add 10mL of water and the dose is 1mL. If you add 5mL of water, the dose would be 0.5mL.
Compounding Your vet prescribes 25mg Amoxicillin twice a day. You have an 875mg tablet. Crush tablet (use two spoons, pill crusher or mortar and pestle) 875mg tablet/25mg per dose = 35 doses If you add 35mL of water, the dose is 1mL If you add 17.5mL of water (half), the dose is 0.5mL
Compounding Your ferret needs 2mg of azathioprine (like Imuran) once a day. You have a 50mg tablet. You re told it can be mixed with Lactulose. 50mg tablet/2mg per dose gives you 25 doses If you mix in 25mL of Lactulose, the dose would be 1mL. You can cut everything it in half like we did with the Amoxicillin Grind the pill well and add just a little Lactulose. Mix thoroughly. Slowly add the rest, mixing well
Medication tips Unless told otherwise, store liquid medications in refrigerator Once mixed, Amoxicillin is no good after 14 days If you don t refrigerate, mixed Amoxicillin goes bad after 24 hours Mix liquid medications before drawing up Certain meds don t have to be mixed: Pediapred for example Note the color if it changes, the meds may be bad Most pills stay good for a long time if kept dry
Serious problems Pale gums, ears, nose Heavy, labored or fast breathing Collapse/coma Yellow skin Orange or green urine Straining in litter box Bulging stitches
A few bloodwork norms from http://www.miamiferret.org/fhc/physiology.htm Rectal temperature: 101-103 PVC 45-60 WBC (x10 3 /mm 3 ) 2.8-8.0 BUN (mg/dl) 8-37 Creatinine (mg/dl) 0.16-0.848 BUN/Creatinine 10-457 Total Protein (g/dl) 4.4-7.3 Hemoglobin (g/dl) 13-18 Albumin (g/dl) 2.5-4.17 Globulin (g/dl) 1.8-2.9 Total Bilirubin (mg/dl) 0.1-0.5 ALT (IU/L) 13-176 Glucose (fasted) (mg/dl) 65-164 (average: 100-110)
Sources Ferret Universe http://www.ferret-universe.com/ Blood values Drugs used in ferrets Info on illnesses Miami Ferret, Ferret Health Care http://www.miamiferret.org/fhc Info on illnesses Other sources of good info: How to check ferret s blood sugar http://www.unc.edu/~pjdutche/bloodsugar/
Duck soup: My recipe 10 lb chicken legs and thighs Put in crock pot, cover with water and cook for 24 hours or until bones get soft Grind up solids in food processor, bones and all Add fat and some of the juice to make smooth Freeze in containers
Duck soup: Other versions 1 can A/D and 2 jars chicken baby food, water Ground up kibble, a/d, chicken baby food, water Chicken or turkey baby food, water Look on the Internet for ideas
Thank you!!