at-home nursing care for ferrets€¦ · nursing care for sick and post surgical ferrets presented...

Nursing Care for

Sick and Post Surgical Ferrets

Presented at the

June 2011 IFC Symposium

by Barb Carlson

2011 Symosium International Ferret Congress

Topics

Why in-home care The basics Special concerns

Ill ferrets Elderly ferrets Rescued/found ferrets

Measuring, math and mixing meds

2011 Symosium International Ferret Congress

Disclaimer

I’m not a vet

This information is based on my personal experience

This info is to be used with your vet’s help not in place of it

2011 Symosium International Ferret Congress

Why in-home post-surgical care?

2011 Symosium International Ferret Congress

Less expensive

Most ferrets don’t need much more than food, water, warmth and meds.

2011 Symosium International Ferret Congress

Better hour-by-hour care

You will be caring for only one ferret

You can check on them more often

2011 Symosium International Ferret Congress

Ferret is more comfortable

A gentle roommate can make a difference

Helps keep them warm

Comforting

2011 Symosium International Ferret Congress

Ferret is more comfortable

Ferret is in a familiar environment

Vet’s office is bright, noisy and stressful

2011 Symosium International Ferret Congress

Familiar food

Special food can be misplaced

They might not be enthused about whole prey

Storage could be a problem

2011 Symosium International Ferret Congress

Familiar food

Sick ferrets like their familiar duck soup At the right

temperature, too!

2011 Symosium International Ferret Congress

Ferrets respond to affection

No one loves your ferret like you do

They will often eat just to please you

Sometimes they need a reason to stay

2011 Symosium International Ferret Congress

The Basics

Hydration

Temperature regulation

Food

Medication

2011 Symosium International Ferret Congress

Hydration—Very Important

2011 Symosium International Ferret Congress

Hydration

Dehydrated ferret won’t eat or drink

Slows recovery

Damages kidneys

2011 Symosium International Ferret Congress

Check for tented skin

Back of neck

Easy

Affected by weight loss

Belly

A little harder but more accurate

2011 Symosium International Ferret Congress

Neck pinch

2011 Symosium International Ferret Congress

Neck pinch

If the skin stays up, that means the ferret is dehydrated

2011 Symosium International Ferret Congress

Belly pinch

2011 Symosium International Ferret Congress

Belly pinch

The longer it stays up, the more dehydrated they are

2011 Symosium International Ferret Congress

Sub-Q FluidsYou’re

going to do what?!

2011 Symosium International Ferret Congress

Sub-Q Fluids

Sub-q stands for ―subcutaneous‖

The fluids make a ―camel hump‖ that is absorbed slowly

I prefer my fluids on

the outside.

2011 Symosium International Ferret Congress

Sub-Q fluids can save a life

If severely dehydrated, they don’t absorb oral fluids very well

2011 Symosium International Ferret Congress

Sub-Q is not that hard

It can be done easily at home

It’s hard to do it wrong

Air bubbles under the skin won’t kill the ferret

2011 Symosium International Ferret Congress

Sub-Q Fluids are IV fluids

You get them from your vet

Different kinds are used for different things

2011 Symosium International Ferret Congress

To start, you need IV fluid …

2011 Symosium International Ferret Congress

… a 25-35cc syringe …

2011 Symosium International Ferret Congress

… and needles

Some people use 22 gauge needles

2011 Symosium International Ferret Congress

Butterfly needles can be used

2011 Symosium International Ferret Congress

You need a distraction

Ferretone, Nutrical or other tasty treat

2011 Symosium International Ferret Congress

A helper is nice

Optional, but nice

Helps by holding the ferret

Will leave both your hands free

2011 Symosium International Ferret Congress

Draw fluid into the syringe

2011 Symosium International Ferret Congress

Use a fresh needle each time

Goes into skin easier

Warm fluid is nice

2011 Symosium International Ferret Congress

Give it in the scruff

―Reverse scruff‖ the ferret

Make a ―tent‖

2011 Symosium International Ferret Congress

Insert needle parallel to body

Apply pressure and fluid will go in slowly

Not too fast

2011 Symosium International Ferret Congress

Sub-Q tips

Hang on tight

Don’t get bitten

Pinch hole to help it close

Leakage is common

A little blood is common

2011 Symosium International Ferret Congress

How much, how often?

Give 25-35cc two or three times a day Need around 60-90 cc of fluid a day Duck soup counts

2011 Symosium International Ferret Congress

Temperature

Keep the ferret warm, but not hot

If he is very sleepy, he won’t move

Snuggle-Safe Disk Doesn’t get TOO hot

No wires

No electricity

Non-toxic

2011 Symosium International Ferret Congress

Food: Fast recovery needs fuel

Canned a/d

Chicken baby food

Homemade duck soup

Hint: A Gerber baby

food jar filled to the top is 60 cc

2011 Symosium International Ferret Congress

After surgery

They can have hard food unless the vet says not to

They usually prefer a soupy duck soup

2011 Symosium International Ferret Congress

Small amounts frequently

At first, just a little

Don’t force them to eat right away if they don’t want to

By the next day they should be able to eat

They need at least 60cc of liquid food daily

2011 Symosium International Ferret Congress

Sick ferrets like it soupy

Should pour like soup

They like it warm

Put a towel down so they can stand more easily

2011 Symosium International Ferret Congress

Getting them to eat duck soup

2011 Symosium International Ferret Congress

Start with it on your finger

Hold them if they aren’t cooperating

From finger, go to a spoon

From a spoon, go to a bowl

If they eat from the bowl, rejoice!

2011 Symosium International Ferret Congress

If you have to force-feed

A feeding syringe with an ―O-ring‖ lasts the longest

2011 Symosium International Ferret Congress

How to force-feed

Scruff ferret

Dribble a little at a time into front of mouth

Give them a break from time to time

You can fit 18cc in a ferret stomach, minimum

2011 Symosium International Ferret Congress

When to stop trying

If they clamp their teeth shut and refuse to swallow, reconsider if you should be forcing them to eat

Don’t force feed if they are blocked

Don’t try to feed if unconscious

2011 Symosium International Ferret Congress

Medications: Ask questions!

Name, dosage, how often.

What is it supposed to do?

Given how long, refrigerated, expiration

Write things down

2011 Symosium International Ferret Congress

Medications: Check it

Read the instructions back to the vet

Check the bottle when you get it

Vet techs and pharmacies can make mistakes

2011 Symosium International Ferret Congress

Medication tips

Give meds near back of mouth

Make sure you have a good grip on the ferret

It’s easier to depress plunger when held like this

2011 Symosium International Ferret Congress

Keep track of meds

Make a schedule

It’s much easier to remember

You can give accurate info to the vet

9:15 8:30

9:15

9:30

8:30

8:45

2011 Symosium International Ferret Congress

Pain Control

Ask about pain control

Most vets give a pain shot

Ask to be sure

If not, request something

Ferrets heal much better when pain is controlled

2011 Symosium International Ferret Congress

Stitches: Concerns

You can get stitches wet if needed

Some watery blood leaking out is normal

Call your vet if you see deep red blood dripping for more than hour

2011 Symosium International Ferret Congress

Stitches: Avoid problems

No climbing for a week with abdominal surgery

Take out hammock

Day 4-5 is when stitches start to dissolve

Watch for problems

2011 Symosium International Ferret Congress

Stitches: Scabs

If scabs keep forming after a few days, something is going on (usually infection)

Not always serious but should be addressed

Check with vet for instructions

2011 Symosium International Ferret Congress

Soft and puffy

Bulging out

Red, hot, swollen

A slight hard bulge is normal. You’re feeling internal stitches

Stitches: Bulging is bad

2011 Symosium International Ferret Congress

If you can see intestines, use sterile gauze moistened with saline to wrap the ferret. Transport immediately.

Stitches: If they rip open

If you only see flesh, not as serious Call the vet for

instructions

2011 Symosium International Ferret Congress

Staples

Usually heal quickly

Sometimes will rotate as skin heals

If loose, remove before they rotate

Get a staple-remover on the Internet

As they loosen, they can get caught on things – no climbing!

2011 Symosium International Ferret Congress

Keep on top of things

Keep a log

List time & amount of feedings

List time and amount of medications

List changes in symptoms

Take the log with you to the vet’s office or have it next to the phone when you call

More information helps the vet know what to do

Know what the poop looks like2011 Symosium International Ferret Congress

Elderly ferrets

Keep track of: weight gain/loss temperature breathing activity level color of: skin, urine,

poop how much water

they are drinking what and how much

they eat

2011 Symosium International Ferret Congress

Rescues: Special concerns

Dehydration Weight loss Ear mites Fleas, ticks Wounds Intestinal

parasites

2011 Symosium International Ferret Congress

Rescues: Special concerns

Heat/cold

Tooth damage

ADV

Distemper

Quarantine!

2011 Symosium International Ferret Congress

Measuring, math and mixing

2011 Symosium International Ferret Congress

Measuring medication

mL stands for milliliter

1mL = 1cc

Marks are 0.1, 0.2, 0.3, etc. So 0.5 is half a mL

Use the zero and the decimal point – it avoids confusion

2011 Symosium International Ferret Congress

Measuring medication

Use the top of the plunger

This syringe is at 0.2mL

2011 Symosium International Ferret Congress

Measuring medication

The arrow is pointing at 0.4mL

2011 Symosium International Ferret Congress

Measuring medication

Here, the arrow is pointing at 0.45 –halfway between 0.4 and 0.5

You would place the top of the plunger at that line

2011 Symosium International Ferret Congress

The math of medication

mL = milliliter, wet measure

mg = milligram, dry measure

Know which one your vet is using

2011 Symosium International Ferret Congress

Know your pills

The capsules are 250mg Amoxicillin

The tablet is 875mg Amoxicillin

2011 Symosium International Ferret Congress

Compounding

Your vet prescribes 25mg Amoxicillin twice a day. You have a 250mg capsule.

Empty capsule into small container 250mg capsule/25mg dose = 10 doses. Add 10mL of water and the dose is 1mL. If you add 5mL of water, the dose would be

0.5mL.

2011 Symosium International Ferret Congress

Compounding

Your vet prescribes 25mg Amoxicillin twice a day. You have an 875mg tablet.

Crush tablet (use two spoons, pill crusher or mortar and pestle)

875mg tablet/25mg per dose = 35 doses If you add 35mL of water, the dose is 1mL If you add 17.5mL of water (half), the dose is

0.5mL

2011 Symosium International Ferret Congress

Compounding

Your ferret needs 2mg of azathioprine (like Imuran) once a day. You have a 50mg tablet. You’re told it can be mixed with Lactulose.

50mg tablet/2mg per dose gives you 25 doses

If you mix in 25mL of Lactulose, the dose would be 1mL. You can cut everything it in half like we did with the Amoxicillin

Grind the pill well and add just a little Lactulose. Mix thoroughly. Slowly add the rest, mixing well

2011 Symosium International Ferret Congress

Medication tips

Unless told otherwise, store liquid medications in refrigerator

Once mixed, Amoxicillin is no good after 14 days If you don’t refrigerate, mixed Amoxicillin goes bad

after 24 hours

Mix liquid medications before drawing up Certain meds don’t have to be mixed: Pediapred for

example

Note the color – if it changes, the meds may be bad

Most pills stay good for a long time if kept dry

2011 Symosium International Ferret Congress

Serious problems

Pale gums, ears, nose

Heavy, labored or fast breathing

Collapse/coma

Yellow skin

Orange or green urine

Straining in litter box

Bulging stitches

2011 Symosium International Ferret Congress

A few bloodwork norms fromhttp://www.miamiferret.org/fhc/physiology.htm

Rectal temperature: 101-103 PVC 45-60 WBC (x103/mm3) 2.8-8.0 BUN (mg/dl) 8-37 Creatinine (mg/dl) 0.16-0.848 BUN/Creatinine 10-457 Total Protein (g/dl) 4.4-7.3 Hemoglobin (g/dl) 13-18 Albumin (g/dl) 2.5-4.17 Globulin (g/dl) 1.8-2.9 Total Bilirubin (mg/dl) 0.1-0.5 ALT (IU/L) 13-176 Glucose (fasted) (mg/dl) 65-164 (average: 100-110)

2011 Symosium International Ferret Congress

Sources

Ferret Universe http://www.ferret-universe.com/

Blood values

Drugs used in ferrets

Info on illnesses

Miami Ferret, Ferret Health Care http://www.miamiferret.org/fhc

Info on illnesses

Other sources of good info: How to check ferret’s blood sugar

http://www.unc.edu/~pjdutche/bloodsugar/

2011 Symosium International Ferret Congress

Duck soup: My recipe

10 lb chicken legs and thighs

Put in crock pot, cover with water and cook for 24 hours or until bones get soft

Grind up solids in food processor, bones and all

Add fat and some of the juice to make smooth

Freeze in containers

2011 Symosium International Ferret Congress

Duck soup: Other versions

1 can A/D and 2 jars chicken baby food, water

Ground up kibble, a/d, chicken baby food, water

Chicken or turkey baby food, water

Look on the Internet for ideas

2011 Symosium International Ferret Congress

Thank you!!

2011 Symosium International Ferret Congress