Inflammatory Bowel Disease Due to Lymphocytes and Plasma in Ferrets
Lymphoplasmacytic Enteritis and Gastroenteritis in Ferrets
This is a form of inflammatory bowel disease characterized by lymphocyte and/or plasma cell infiltration into the lamina propria (a layer of connective tissue) underlying the lining of the stomach, intestine, or both. It is thought to be caused by an abnormal immune response to environmental stimuli due to loss of normal immune regulation, in which bacteria in the intestine may be a trigger. Continued antigen exposure and unregulated inflammation may also be underlying factors for the disease.
Symptoms and Types
Signs vary dramatically from patient to patient depending on disease severity and the organ affected. Symptoms to look for include:
- Loss of appetite (anorexia)
- Long-term weight loss, muscle wasting
- Chronic diarrhea (sometimes with blood or mucous)
- Black blood in stool
- Coughing up/vomiting up blood
- Excessive salivation, pawing at the mouth
Moreover, plasmacytic (white blood cell) infiltration indicates long-term or a more severe inflammatory reaction.
Causes
The exact mechanisms, irritants, and factors involved in initiation and progression remain unconfirmed. However, intestinal and gastric lesions which cause unregulated inflammation and food allergens (meat proteins, food additives, artificial coloring, preservatives, milk) are suspected.
Diagnosis
There are many possible diseases that can cause the aforementioned symptoms, so your veterinarian will need to rule out many of them before moving on to lymphoplasmacytic enteritis as a potentinal cause. Besides the physical examination, he or she will conduct blood tests and a urinalysis, as well as a fecal examination and cultures. A definitive diagnosis, however, usually requires a biopsy and cell culture, obtained via exploratory laparotomy. Intestinal fluid may also be cultured if bacterial overgrowth is suspected.
Treatment
Your pet will be treated as an outpatient, unless she is debilitated from dehydration. Patients that are dehydrated or emaciated may require hospitalization until they are stabilized. Highly digestible diets with protein sources that are different than those they are accustomed to may be useful for eliciting remission. If attempted, choose feline diets since ferrets’ foods have high nutritional protein and fat requirements.
Your veterinarian will keep your ferret in the hospital if it is severely dehydrated due to chronic vomiting and diarrhea. There, your pet will be given fluids intravenously. (It should not be fed by mouth while it is still vomiting.) If your pet is severely underweight, your veterinarian may insert a stomach tube.
Foods that have been anecdotally reported to elicit remission include feline lamb and rice diets, diets consisting exclusively of one type of meat (lamb, duck, turkey), or a "natural prey diet" consisting of whole rodents. If remission is elicited, continue diet for at least 8 to 13 weeks; this diet may need to be fed lifelong. Anorectic ferrets may refuse dry foods but are often willing to eat canned cat foods or pureed meats.
Living and Management
Your veterinarian will want to monitor your pet frequently until the symptoms have been resolved. Severely affected patients may require even more frequent monitoring; medications will be adjusted during these visits. Ferrets with less severe disease should be checked by their veterinarian two to three weeks after their initial evaluation and then monthly to bimonthly, or until immunosuppressive therapy is discontinued.
Prevention
If a food intolerance or allergy is suspected or documented, avoid that particular item and adhere to the recommended dietary changes.