[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]