Dear Suzanna:
 
>Does anyone here know anything about inflammatory bowel disease?  Zinc has
>been diagnosed with it (through biopsy).  Although I am familiar with
>the condition in humans, I am not sure of it's effects and treatments in
>ferrets.  Prednisone has been prescribed as a treatment, but it seems to
>be such a drastic measure.  (I have experienced its effects first-hand.)
>The interesting thing is that the diarrhea has virtually stopped since
>I've been feeding her watered-down, mushed-up Totally Ferret (post surgery
>food).  Could a change in diet help, instead of putting her on prednisone?
>Was the diagnosis a "default diagnosis" or is inflammatory bowel disease
>diagnosed through a positive biopsy?  Does anyone have experience with
>this that they could share with me?
 
The diagnosis of "inflammatory bowel disease" is a common "non-diagnosis"
given by pathologists who fail to ascertain the etiology of an inflammatory
lesion in the bowel.  It is what we call a morphologic diagnosis, one in
which you describe a lesion rather than ascribing a cause to it.  Between
pathologists, this type of diagnosis is relevant, but between a patholgist
and a clinician, it often does more harm than good, as it provides little
information for treatment. I try to avoid them as much as possible when
returning a result to an owner or clinician.
 
I am at a loss when trying to interpret this diagnosis without knowing more
about the case.  Coronavirus infection, or ECE, was the cause of over 50%
of the "inflammatory bowel lesions" seen in the archive at the AFIP over
the last five years; some pathologists are large referral lab continue to
miss the diagnosis of ECE and call it "inflammatory bowel disease" even
though we published the very characteristic lesions in the Journal of the
AVMA.  Through 2nd opinion on a number of other cases, a lot of these
diagnoses may be ascribed to Helicobacter as well.  Still others may be
the result of coccidiosis, in which the organism is not seen.  And some, I
am sorry to say, are simply the normal background inflammatory cells seen
in the intestine of older ferrets which pathologists who are not familiar
with ferret tissues may misinterpret.
 
The key is to know something about the animal and the case history in order
to make an educated guess as to the cause of inflammaory bowel disease in
the ferret, and not to believe that it is an entity unto itself.  Something
is causing the inflammation, it often just takes a bit of detective work to
figure out what.
 
Prednisone is often used in inflammatory lesions of the intestine to reduce
the amount of inflammation to a point where the intestine can regenerate
the damaged tissue.  If ongoing inflammation is present, it continues to
damage the tissue even if the original cause is long gone.  I routinely
use a low-dose of prednisone in ferrets who are having a diffiult recovery
from ECE.  Ferrets are a fairly steroid resistant species, so your concerns
about it being to strong for this condition are probably not well-grounded.
I usually prescribe somewhere around 0.5 mg/lb once daily for two weeks and
reassess after that.
 
With kindest regards,
Bruce Williams, dVM
[Posted in FML issue 3223]