[Moderator's note:  I contacted Roger before posting this since it wasn't
clear to me who wrote what.  He informs me this was 100% written by Dr.
Brown, though typos are his.  As to allegations expressed here about the
origins of ECE, I'd like to remind us that it's pointless to argue about
it... let's all just learn what we can.  BIG]
 
From Dr. Susan A. Brown's "Ask the Doctor" Column...
 
I have been asked to comment on the "green slime diarrheal" disease that has
been affecting not only our GCFA shelter ferrets, but a number of other
ferrets in the Chicagoland area.  This is the same disease that showed up on
the East coast nearly three years ago and appeared to follow ferret shows
around that region.  Since this is a new disease for us to experience, but
it is "old hat" to those out east and particularly to Dr. Bruce Williams at
the Department of Veterinary Pathology at the Armed Forces Institute of
Pathology in Washington, D.C. I decided to do a bit of investigating.  I
spoke to Dr. Williams at great length about our experience and my thoughts
on the disease and here is what I can tell you: The disease in question is
an enteritis, or inflammation/infection of the intestine.  It damages the
mucosa (the delicate intestinal lining which is instrumental in absorbing
nutrients and water into the body) resulting in diarrhea and excess mucous
production.  In severe cases there may be deep ulcerations and bleeding into
the intestinal lumen.  Stools can range from bright green, loose and slimy
to dark red, black and tarry.  Dr. Williams has seen the lining of the
intestine remain abnormal for up to one year after the ferret initially
showed signs of the disease.  The cause is as yet unknown, but Dr.
Williams, who has a great deal of experience looking microscopically at
tissues affected by this problem, feels strongly that it may be a corona or
rota virus.  The virus can be transmitted by infected fluids from the body.
It can be spread through the air on tiny fluid particles or by direct
contact with an infected ferret.  The incubation period, according to Dr.
Williams, is about 2 days and he feels there can be carrier animals for at
least 4 months after the initial onset of disease.  Carriers are those
ferrets that have survived the disease and appear healthy but are shedding
the virus in their stools and are therefore still infective to other
ferrets.
 
The disease has a very high morbidity (number of animals affected by it) but
a very low mortality (those that die as a result of infection).  Ferrets do
not die from the disease directly, but from a combination of factors that
may have been exacerbated by the infection.  In a multi-ferret household,
once it enters it will affect nearly 100% of the population regardless of
how sanitary the conditions are.  With careful monitoring of sick animals an
appropriate treatment, the mortality may be 0 to 2%.  In ferrets under three
years of age, that have no other major health problems, the disease is
fairly swift, causing only a few days of slimy green stool and then it is
gone.  Most of the youngsters do not need any medications, but one should
watch closely to see that they are eating, drinking and urinating.  If a
ferret stops eating, becomes lethargic or dehydrated, then it may be
necessary to give fluids either by mouth or underthe skin by injection.
Some ferrets benefit from a more bland diet until the stools form again,
such as meat type baby food, or Science Diet AD.  We sometimes give
antibiotics to prevent secondary bacterial infections.  It may also be
helpful to use an intestinal coating agent such as Pepto Bismol or
Kaopectate (1-2cc two to three times daily) to coat the intestinal tract and
soothe potentially ulcerated areas.  There are a variety of other herbal and
homeopathic remedies that have been tried.  None have had consistent
reproducible success, but if you would like to try any remedies, please
consult your veterinarian first.  Some products, such as vitamin C may
actually make the problem worse because it is very irritating to the
intestinal lining in the presence of inflammation.  The older ferrets, that
likely have concurrent health problems such as lymphoma, insulinoma, adrenal
disease, heart or kidney disease, may be more seriously affected.  Although
the percentage of animals that actually die even in this age group is very
small, the disease can take a much longer time to resolve.  Older ferrets
are more likely to become dehydrated and develop bleeding intestinal ulcers.
We treated one ferret successfully with multiple blood transfusions because
her red blood cell count dropped dangerously low from intestinal bleeding.
These patients need more intensive nursing care and have to be watched very
carefully.  Of course one will need to stay on top of all the other diseases
that may be present and potentially weakening the pets immune system.  There
is another part to this disease that we have observed over the last few
months and it has only been in the older ferret.  We have seen a number of
ferrets over three years of age, usually with other serious health problems,
who successfully survive the diarrhea, only to lose significant amounts of
weight up to three weeks later.
 
In my discussion with Dr. Williams, he concurred that this was a problem of
absorption of nutrients from the intestinal lining.  As mentioned, the
intestinal mucosa may continue to be abnormal for up to a year after the
initial infection.  These animals have good appetites and normal stools, but
can't seem to keep the weight on.  Each pet has to be evaluated
individually, but one may be able to keep the weight from dropping by adding
more fat to the diet, such as whipping cream or eggyolk along with
supplemental feedings of ferret or high quality cat food.  (Do NOT use dairy
products when the ferret is experiencing diarrhea, as it may make the
problem worse).  Using high carbohydrate foods doesn't seem to work.
Ferrets use fat more efficiently for energy than carbohydrates, so in a
wasting situation, it is likely more effective to increase the fat content
ofthe diet.  Be careful about increasing the protein content (overuse of
eggs) because some of these older ferrets have underlying kidney disease
which will worsen in the presence of excess protein.  Dr. Williams
suggested that in some cases, the use of corticosteroids may aid in keeping
the weight on because it may suppress the ongoing intestinal inflammation.
Please use such drugs only under the supervision of your veterinarian.
 
There has been much concern expressed about whether or not we should have
our annual ferret show this year, due to the presence of this disease in the
area.  The concern stems from the fact that "green slime" showed up
originally along the show circuit on the East Coast.  Judging from the phone
calls I have been getting from other veterinarians across the country and
from my conversations with Dr. Williams, the disease is essentially
everywhere already.  One has the potential of exposing a ferret in a number
of places, including pet stores, shelters and veterinary clinics and a
friend's home.  It will soon be as common as the human flu virus.  There has
been some speculation that the GCFA show brought the virus here last year.
That seems unlikely when one considers that the show was in October and the
first reported case was in February.  The incubation period is about two
days, and we would have expected to see a major outbreak within a week
ofshow time.  Other veterinarians in the area did not reported such a
situation.
 
The bottom line is that the virus is here to stay will eventually run its
course.  It will affect the healthy ferrets very little and be a bit more
severe on the elderly (just like the human flu).  If we build up our pets
immune systems by giving them good diets and exercise and we are vigilant
about keeping up with other health problems, we do not have to hide our pets
in a dark closet to prevent exposure.  Ferrets that have experienced this
disease, do not seem to get it again, so they may, in fact be "vaccinating"
themselves for the future.  There are still far more pets that will die
DAILY from cancer related illness and heart and kidney disease, than will
die from this enteritis.  We have elected to go ahead with the show this
year, as have many other clubs.  I discussed this with Dr. Williams and
agreed that there was no reason to not go ahead, because the disease is
already here and exposure can take place at any place and any time.  The
same basic rules of sanitation will apply that ALWAYS HAVE in the past at
our show: The judges will be required to disinfect their hands and the table
in between each ferret.
 
Participants will be encouraged to not pass their ferrets around to other
people and to wash their hands if they do handle another pet.  Participants
will be encouraged to change their clothes when they get home and toss them
in the washer.  We will not allow kits that are under 12 weeks of age in the
show (because under this age they do not have fully developed immune systems).
There will be NO shelter ferrets at the show.
 
In addition we would ask that participants not bring any ferrets that have
experienced diarrheal  disease in the last 5 months or that are currently
having any stool abnormalities.
 
Reprinted from "Off The Paw" Official Newsletter of the Greater Chicago
Ferret Association.
[Posted in FML issue 1297]