Dear Lisa:
 
>I too was under the impression that a "rotten egg" scent of stoles went
>along with ECE.  I had no idea that the stoles did not have such a rank
>odor.  I thought it had something to do with the virus eating away at the
>intestinal wall and this was what caused the strong odor.  What you've
>stated makes sense though.
 
No, unfortunately, any odor in the feces is likely due to the presence of
partially digested material - sometimes it's blood, often not.
 
>More recently, my 3 1/2 year old boy was diagnosed with Inflammatory Bowel
>Disease via biopsies on his stomach wall, liver, and mezonteric lymphnode.
 
Boy, I hate hearing this.  IBD (to start with, not a real diagnosis, but
the convergent end point of a number of conditions, with ECE being the most
prevalent) is a disease of the intestine, and cannot be diagnosed based on
biopsies of other organs.  If the diagnosis was based on the results of a
stomach biopsy, the obvious diagnosis is Helicobacter infection.  With
chronic helicobacteriosis, you get inflammatory changes in the liver and
enlargement and reactive changes in the mesenteric lymph nodes.  The liver
and lymph node changes are not specific to any one etiology or disease.  It
really makes me scratch my head to wonder how people can make such classic
leaps of faith in diagnosis, based on biopsies of the wrong tissues.
 
Not that I am saying that the intestine is without problem - the clinical
signs certainly say so, but you can't diagnose them if you don't biopsy
them!
 
>I noticed that before surgery, and for the first 3-4 weeks of treatment,
>his bowel movements smelled worse than anything I'd ever smelled.  Because
>of my belief that ECE is what smells rank, I worried that he may have had
>ECE.  If I was on the same floor as him in my house, I knew whenever he
>went to the bathroom - it smelled SOOO bad.  It was also a bright yellow
>liquidy bile type consistancy - ick!
 
Once again, malabsorption making stools smell bad.  Was it ECE - I'm not
sure - as it was never considered, it can never have been ruled out.  We
have seen yellow liquid stools with ECE.  Is there a history consistent
with ECE - recent introductions, visit to a pet shop, multiple animals
with diarrhea?
 
>I'd done some research on IBD, and also spoken with some other people who
>have ferrets with IBD and all have said that that they experienced that
>same horrible smell with their IBD ferrets.  Again, something with the
>inflamed stomach lining.
 
>Also, some of the research stated that IBD is much more prevelant that
>originally thought - and it has been known to be misdiagnosed as ECE or
>other forms of intestional viruses in the past.  Do you think this is
>what leads to an improper diagnosis of ECE as well?
 
You know, there is some bad "research" out there.  I discussed one report
on "IBD" in ferrets with the pathologist who participated in it, and
stomach samples were not taken properly to identify Helicobacter, and ECE
was not even considered when evaluating intestinal biopsies.  As these two
diseases are the most common GI diseases of ferrets, this severely flaws
the study.  Unfortunately, you just can't believe what you read about IBD
in ferrets - it has yet to be proven as an entity.
 
Usually, this "IBD research" is put forth by practitioners with little
experience with ECE, or actually any standing to comment at all.  In many
cases, intestinal biopsies are not taken to establish a diagnosis; but
if the animal responds to a diet change and steroids, it is ascribed to
IBD.  IBD has not been identified as an entity by any means other than
subjective - there has never been a study to show that chronic inflammatory
lesions are due to food allergy, although this has been put out on the Web.
 
Last August, 5 years of clinical and laboratory research on ECE was
published in the Journal of the American Veterinary Medical Association,
the premier journal for veterinarians in the world, and one whose
peer-review process is a stringent as any out there.  I'm not sure why some
practitioners claim to know better, but appearnetly deign not to put their
work out in print.  Not even a single letter to the editor was written
offering an alternate opinion (which would be difficult, as the the results
were pretty ironclad - but that's another matter.)  Personally, it doesn't
matter to me, but when this type of misinformation and innuendo about
"IBD" appears anonymously through the Internet, it is damaging to people
who legitimately are out there working with ferrets and putting their
reputations on the line.  And the bottom line is that unfounded claims
such as this hurt ferrets - some now, and many more later.
 
Personally, I rarely make a diagnosis of ECE without talking with owners
about the history and circumstances of how diarrhea started (you may have
noticed that).  Even with appropriate intestinal biopsy material, ECE is
a diagnosis that can be rendered only when a good clinical history is
completed and when certain key information about the outbreak is gained.
 
IBD is a diagnosis that is made when someone doesn't have the time or
inclination to investigate further.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3286]