This item is for widest dissemination, including all newsletters. No
copyright required or permitted.
As the Green Diarrhea appears to be once again spreading into several
new states, and concerns have been voiced on the FML, I have decided to publish
this information and hope for widest dissemination to veterinarians, breeders,
and rescue operators.
From: Dr. Bruce H. Williams, Department of Veterinary Pathology, Armed Forces
Institute of Pathology, Washington, D.C. 20306-6000
In several states along the East Coast, including Maryland, Virginia,
Pennsylvania, and New York, and more recently the Southwestern and Western U.S.
(Texas, Arizona, and California), a new, highly contagious diarrheal disease has
appeared in several ferret rescue/breeder operations. In outbreaks, infection
rates approach 100%; however, mortality in treated animals averages less than
5%. The disease appears to strike all age groups, but is rarely reported in
kits.
Clinical signs include a profuse green, watery diarrhea which is rapidly
dehydrating. Occasionally, affected animals may progress to coma and death
within 48 hours. Death most commonly occurs in older animals with concurrent
health problems, such as insulinoma or adrenal disease. Vomiting does not
appear to be an associated sign; several ferrets have shown icterus in terminal
stages. Complete blood counts are within or close to normal ranges. Azotemia,
hyperglycemia, and elevated alanine aminotransferase and alkaline phosphatase
have been seen in affected animals.
Microscopic examination of tissues from deceased animals are consistent
with, although not diagnostic of, a viral enteritis. Microscopic examination of
intestines from affected animals have shown changes that are consistent with a
viral disease which causes the cells lining the intestine to die and impairs the
animal's ability to reabsorb water and nutrients. Specifically, there is
necrosis of enterocytes at villar tips; crypts are moderately to markedly
hyperplastic. A moderate lymphoplasmacytic infiltrate and variable degrees of
villar atrophy, blunting, fusion, and loss are seen in the intestine in more
long-standing cases. Intestinal changes are seen up to eight months after
infection.
Treatment of affected animals should include subcutaneous or intravenous
fluids (affected animals may require up to 90 ml/lb/day), and systemic
antibiotics Amoxicillin 10-20 mg/lb twice daily) to prevent secondary bacterial
infections. Antispasmodics (Centrine, Lomotil) or gastrointestinal protectants
(PeptoBismol, Kaopectate) have been used at normal cat dosages with some success
in isolated cases.
Recovered animals may show low body weights, poorly-formed stools, and
weakness in the hindlegs, which may persist for months following recovery from
the acute disease. In our experience, this disease may be spread by apparently
healthy carriers as long as four months after infection, and most likely longer.
Naive animals being brought into close proximity with recovered animals should
be expected to break with diarrhea.
Care in handling of affected ferrets is paramount. This disease is most
likely spread by direct and/or fecal-oral contact. Affected animals should be
isolated, preferably in separate rooms. Food bowls, toys, litter boxes should
be considered capable or spreading this infection and not transferred between
affected and unaffected areas. Litter boxes should be kept cleaned on at least
a daily basis. Cleaning of these items may be accomplished with a 1% bleach
solution and thoroughly rinsed. Individuals who handle infected ferrets or new
arrivals should shower and change clothes before handling uninfected animals.
The best way to avoid infection is to prevent exposure to ferrets from
other homes, colonies, etc. New additions to households, breeding operations, or
rescue facilities should be isolated and examined for signs of diarrhea for a
minimum of one week, as healthy-appearing animals may transmit this disease..
Events at which large numbers of ferrets are congregated, such as ferret shows,
are most likely an excellent venue for dissemination of this disease.
Remember, however, that the signs of greenish diarrhea are not
restricted to this disease. Other diseases that may cause profuse watery green
diarrhea in ferrets include intestinal lymphosarcoma, coccidiosis, and
eosinophilic gastroenteritis. Your veterinarian should evaluate all ferrets
with diarrhea for these diseases also.
The Department of Veterinary Pathology, Armed Forces Institute of
Pathology is currently investigating this disease outbreak. As of yet, an
etiologic agent has not been identified; more material is needed. If you
suspect this disease in one or more of your ferrets or ferret patients,
histopathology will be done at no cost to you. Additionally, we are looking for
feces and/or serum from acutely ill and recovered animals in hopes of isolating
the agent.
Full necropsies, preferably on moribund animals, are preferred. Tissues
from animals dead longer than 24 hours yield questionable results due to
post-mortem autolysis of the intestinal mucosa. In addition to a wide range of
tissues, several 2-inch loops of jejunum should be ligated and frozen, in
addition to several sections of liver and 1 cc of serum. If histopathology
shows lesions compatible with this entity, then we will contact you for these
frozen sections at that time, in order to perform virus isolation and serology
on these samples.
The Department of Veterinary Pathology, Armed Forces Institute of
Pathology is currently investigating this disease in hopes of finding its cause.
We currently are requesting feces and/or serum from acutely ill animals, and
tissues from animals that succumb to this disease. For more information on how
to send specimens, please call Dr. Bruce Williams at 202 782-2600/2602.
Bruce Williams, DVM Department of Veterinary Pathology
[log in to unmask] Armed Forces Institute of Pathology
(202) 782-2600/2602 Washington, D.C. 20306-6000
[Posted in FML issue 0992]
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