Hello,
I am attaching an e-mail that I also sent to the FHL telling about what
happened to my ferret Taz with the AV node block. I just wanted to add a
huge thank you to everyone that donated towards his surgery, and while I
will be responding to each of you individually, for those of you that
indicated to go ahead and donate the funds to Ferret Family Services, I
will do so, for those of you who did not say that, I will be returning
your donations to you unless I hear from you otherwise. There is always
the possibility that his AV node block will reoccur, especially since I
don't know what caused it to disappear, but I don't feel comfortable
keeping the donations on the possibility.
Thank you very much, there are some very generous ferret people in this
world.
--------------------------------
Some of you may remember, I posted a month or so ago regarding my ferret
Taz, who was diagnosed with 3rd degree AV block on top of his insulinoma.
As of Sunday, and confirmed by ECG on Monday, his AV block has
disappeared. I am curious as to what could have caused it initially, and
what could have caused the disappearance of it, and I would welcome any
thoughts or ideas.
Taz is a 5 1/2 year old male neutered sable ferret that I have owned
since he was 1 year old. He has always been very full of personality, my
primary troublemaker (and when you run a shelter for 3 1/2 years, and own
20 some ferrets personally over 10 years, that means a lot), and a very
needy ferret when it comes to attention. In December of 2000, Taz had his
left adrenal removed by my hometown vet, who is very good, and who treated
all of my shelter ferrets, but the only sterile part of the surgery room
is the instruments, the cover sheet, and the gloves. Otherwise, no gown
or mask, and people frequently come in to ask questions, and the door is
usually open to the rest of the clinic. However, I've never had a problem
with the many surgeries that have been performed on ferrets of mine there.
I do not usually give an antibiotic post surgery, and have never had a
problem with that. Also, during surgery Taz was on a heart monitor, and
his heartbeat was normal.
In July, Taz started to shake more than the normal waking up and
excitement shaking. After many attempts, I was finally able to obtain
enough of a blood sample to do a glucose test at home (with a very active
ferret, and no help from my husband who is "challenged" when it comes to
any kind of medical care for ferrets), and obtained 52, at which time I
started him on .5mg of pediapred once a day from some that I had left
over from other ferrets. When school started, I brought Taz down here
to Kansas with me. As I began to run out of the pediapred, I made an
appointment to take him into the clinic here at school so that I could get
a prescription locally for some, and I began to taper down his dose so
that I would not run out before hand and have to cut him off for several
days. At the time, I knew you had to taper down to discontinue pred, but
I was not aware that if you discontinue prednisone for an insulinomic
ferret, their blood sugar will crash lower than it was before. The
night before and the morning of his vet appointment, Taz had 2 major
hypoglycemic seizures, both of which I brought him out with first syrup,
then A/D, then the last of the pred that I had.
During his routine physical, (in early September) it was noted that Taz's
heart rate was only about 72, with a slight abnormal sound that none of us
could pinpoint. An ECG was done ( a week later, to avoid undue stress),
which revealed 3rd degree AV node block, which was confirmed by
echocardiogram (ultrasound). After a lot of research on both my part and
the exotic vet that was treating Taz (who is on this list :-), it looked
like a pacemaker was his only hope. I contaced Dr. Kemmerer who was
very helpful, and offered to perform the surgery in Florida. However
in spite of the generous donation of a pacemaker, cost of the surgery
and transportation was an issue, so it was put off while I tried to
raise money for it. During the next several weeks, Taz's insulinoma
deteriorated, to where he finally seemed to stabilize at 3mg per day.
Also, in my research in the area of human medicine and complete heart
block, I came across a few articles where AV node block had been caused by
bacterial infections, and parasites. I didn't really consider parasites,
but I did consider the bacterial infection idea, especially because of
his surgery in December. So, he was put on .5cc of Clavumox per day.
A week ago, on Monday night, Taz had another severe hypoglycemic seizure.
What caused it, I have absolutely no idea. All of his other symptoms
from the insulinoma seemed to be doing okay with the 3mg of pred. Also,
earlier that night, when I was listening to his heart, I noticed an
occasional extra beat. On Wednesday night (of course, the night before a
big test), Taz had what I can only call an episode. I was giving him his
eveing dose of pred, when his body suddenly gave a jerk, and he started
making raspy breathing sounds that I have only ever heard before in
ferrets that are breathing their last breaths as they die in my arms.
I tried to get a pain stimulus, and was unsuccessful. Taz then went
completely limp (absolutely no muscle tone), his nose went completely
white, I saw no evidence of breathing (and I did look), and I could not
feel a heartbeat. The vet treating him thinks it may have been a syncopal
episode (fainting), which is possible, I did not take the time to grab my
stethoscope and listen. Instead, I just went off of what I observed, and
initiated CPR. I had probably done about 20-30 compressions, and about
4-5 breaths, when Taz began intermittent raggedy breaths again, and as the
breaths slowly increased in frequency, to where it was finally very rapid
shallow breathing, his nose turned pink again, and he regained some muscle
tone, although he was still out of it. I again tried to get a pain
response, and he eventually did come around, although when he did, he went
right into a hypoglycemic seizure. He eventually came out of that with
A/D and pred again, and when I listened to his heart with a stethoscope,
it was extremely erratic.
On Thursday, Taz seemed about average. However, when I listened to his
heart on Thursday over lunch, it was cycling about every minute or so
between double beats of about 136 bpm, and his more usual 70 bpm. It was
the same on Friday, although maybe a little more of the double beats. I
do know just enough about cardiology to know that an irregular heartbeat
is even worse than a very slow steady heartbeat, so I scrambled to try
and get him into a pacemaker surgery here, as one of the surgeons here
had indicated an interest in trying it, we just had to get all of the
specifics. I did not listen to his heart on Saturday. On Sunday, when
I listened to his heart with a stethoscope, it sounded like a normal
heartbeat, averaging about 175-200 bpm.
Yesterday, Taz had an ECG, which revealed no evidence of 3rd degree AV
node block, just high QRS waves, indicative of enlarged ventricles, which
I already knew he had as a result of compensating for the AV block. From
what I have read in human literature, 3rd degree AV node block does not
typically just correct itself on its own. Usually, once the AV node is
blocked, it is irreversible. So, my current questions for any of the
veterinarians or anyone with experience with human or animal AV node
block are these? Could it have been the antibiotic, which he was on for
2 weeks, but which I discontinued last Wednesday night when he had his
"episode"? Could the prednisone have done something? Could the cardiac
compressions have done it? Another thought by one of the other vets here
is that it could be lymphoma, and that it is moving, and that it could
reoccur, what is the chance of that? Should he be going on any
medications? One of the internists here suggested two drugs, I think one
was Theophyline, and I don't remember what the other one was, but I'm not
sure for what, I didn't speak to him directly. Should I be treating his
enlarged ventricles, and if so, with what? To give some kind of
indication how much his heart had compensated, when he had his ultrasound,
his fractional shortening was 40, whereas normal is 42, but his left
ventricular end systolic was like 0.63, instead of the normal 6.4.
It seems to me (althought it could be my imagination), that since about
Saturday, Taz is slightly more active, is eating more, and up for longer
periods of time. However, I have noticed an occasional spasm, minor, but
it affects his whole body.
I would really like to hear from anyone who has any kind of input on this,
not only for Taz's future, but also since I am a vet student and a ferret
nut at the same time, for my own curiosity and learning.
Thank you,
Shelley Knudsen
Class of 2004 KSU Veterinary College
[log in to unmask] [log in to unmask]
http://www.tcgcs.com/~ferrets
785-565-9041 cel402-984-4217
"There ain't no limit in this life to how far you can get,
but if you're going all the way, you gotta break a sweat."
- Chad Brock
[Posted in FML issue 3587]
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