Three Vaccinations, Three Reactions

Ella, Zephyr and Chin Soon all went to see Dr. Lauren Powers at Carolina Veterinary Specialists today to have their regular checkups and their annual distemper vaccinations. All three ferrets have had previous reactions to Merial Purevax, which has become the standard distemper vaccination. The older vaccine, Fervac-D, had a high rate of adverse reactions. Merial Purevax is supposed to have a very low reaction rate. Unfortunately my ferrets don't seem to know that. Anyway, in the past when a ferret of mine had a relatively minor reaction we pretreated with Benadryl the following year and there were no problems at all. This year my ferrets all had adverse reactions despite being pretreated, something I had never seen before.

The reactions included vomiting and diarrhea. Chin Soon's reaction was relatively mild. Ella and Zephyr both needed dex-s injections, a famotidine injection to settle their stomachs, and sub-q fluids to rehydrate them. Zephyr, who seemed to have the most severe reaction, stayed with Dr. Powers the longest. After three hours at the vet we finally were able to head for home thinking the worst had passed.

On the last leg of the trip home one of the ferrets (probably Zephyr, but we can't really be sure) had nasty, seriously bloody diarrhea. That qualifies as a severe reaction. I called Dr. Powers and while my housemate watched the ferrets like a hawk I ran out to the pharmacy before closing to get some carafate. If the problem recurred someone was going back to the vet for the night. Thankfully that didn't happen. Zephyr and Ella still have upset stomachs (not unexpected) but no blood. Chin Soon had little energy tonight but her stool is almost back to normal. Everyone involved, ferret and human, had a very rough day. It also turned into a somewhat expensive day, as in well over $200 all told.

Ella will be eight before she is due for another distemper vaccination. Dr. Powers has already advised me not to vaccinate her again. Between her age and the reaction it just is safer not to. Zephyr and Chin Soon will be vaccinated next year assuming they are healthy but will be pretreated with dexamethasone as well as Benadryl to prevent this from happening again.

After the fourth of July weekend all go back to the vet for their rabies vaccinations. They all have reacted to that before as well. Rabies vaccinations are mandatory where I live so we will go ahead with those. Hopefully we won't have a repeat of today's very long and very unpleasant vet visit. Ella will also have blood work done then. No, nothing is wrong. It's just something our vet likes to do every six months to catch any problems early in ferrets over seven years old.

There was good news today. Chin Soon's blood glucose was a nice, normal 109. She got a clean bill of health and has completely recovered from her April insulinoma and adrenal surgery. Dr. Powers commented that her coat is so full now you can't even tell that she had surgery. Her teeth and gums are still pretty nasty and she will have them properly scaled and cleaned next visit.

Ella is also blissfully healthy. Even though she is just about blind and occasionally bumps into things her pupils still react to a strong light and there are no signs of cataracts. Her spleen is still moderately enlarged but, as expected, we aren't going to worry about that and she has no symptoms that indicate it's a problem. It's been four and a half years since Dr. Powers did her adrenal surgery and she really has had no problems other than vaccination reactions (now three in all) since then.

Zephyr is the only ferret of my three who has never had a major health issue. Despite all that happened today she had a decent amount of energy tonight and acter like her normal self.

It's been a long day and I'm glad it's over.

Chin Soon Update: Surgery Next Tuesday

Chin Soon is going back to see Dr. Lauren Powers at Carolina Veterinary Specialists in Huntersville again next Tuesday. She will have surgery for both insulinoma and adrenal disease.

At her last recheck her blood glucose was still only 57. She's gained a fair amount of weight, a side effect of the pediapred (prednisolone) as well as a consequence of eating lots of high calorie chicken gravy. As a result we could increase her pediapred dosage again a little. It's still not enough. Yes, Chin Soon is bouncy and playful but her stamina still isn't what it used to be and she still slips and has hind-end weakness. Her insulinoma can't be controlled with a moderate dose of pediapred and that means it's time for surgery. We no longer have any other good options.

Her adrenal disease is progressing as well despite increasing her lupron dosage to 200mcg. She's still losing hair all over the place. The only cure for adrenal disease is surgery. The only good thing about having both diseases at once is that she will only have to go through one surgery instead of two.

I'm worried, of course. This is major surgery and there is always a risk that something can go wrong. At least I have complete confidence in Dr. Powers. She did Ella's adrenal surgery more than four years ago and Ella has been fine ever since. I'm hoping the surgery will give us several more good years with Chin Soon.

The cost? Depending on what Dr. Powers finds and how well things go it will be anywhere from $850 to $1175. There is no getting around the fact that ferrets are expensive pets and that the average ferret will have at least once health crisis requiring surgery and costing $1000 or more during their lifetime.

Anyone who is a pet owner knows that pets become family members. Medical care like this is, unfortunately, a mandatory part of being a responsible pet owner.

Please keep Chin Soon in your thoughts over the next week.

Chin Soon Update: Insulinoma and Adrenal Disease

Last Tuesday I made the three hour drive to get Chin Soon to a vet I really trust: Dr. Lauren Powers at Carolina Veterinary Specialists in Huntersville.

During the entire time I've been in North Carolina and have owned ferrets Dr. Powers has always been our backup vet, the one Dr. Hudson would send us to when he wanted a second opinion or the one we went to when there was an emergency and a local vet simply wasn't available. She's an outstanding vet with a fantastic reputation in the ferret community but she is just plain far from home. The net result is that she always sees our ferrets when they are on death's door. OK, Pertwee lived for another four years after his visit with Dr. Powers but he wasn't expected to. It was nice, for once, to have Dr. Powers see a ferret she actually could treat. I guess I should point out that Dr. Powers did Ella's entirely successful adrenal surgery more than four years ago. That was a couple of months before I adopted Ella.

Dr. Powers confirmed what I pretty much knew: in addition to insulinoma Chin Soon has adrenal disease. Her nipples are enlarged and her hair loss is starting to look like a classic adrenal pattern. Dr. Powers also said something that Dr. Hudson said to me whenever I caught adrenal disease early: surgery will have to wait a little to make sure that it's clear which adrenal gland is enlarged. The disease has to progress far enough for the surgeon, in this case Dr. Powers, to actually be able to see that one gland is really bigger than the other. Chin Soon is looking at a combined adrenal and insulinoma surgery, essentially the same surgery Lady Ayeka had back in 2004, at a cost of around $900.

Dr. Powers also rechecked Chin Soon's blood glucose. Despite obvious clinical improvement from the pediapred it was still very low: 44. The pediapred dosage was increased to .18ml (5mg/5ml concentation), still less than a fifth of what the nightmare vet wanted to prescribe. Dr. Powers also started Chin Soon on 100mcg of Lupron (the one month depot) to relieve her adrenal symptoms. Lupron worked very well for Podo when his adrenal disease recurred late in his life.

Chin Soon also gained 110 grams in just a week, a side effect of the pediapred. The fact that she is voraciously eating Bob Church's Chicken Gravy twice a day when she gets her medication is almost certainly also contributing. She had actually lost weight this winter due to her illnesses so this weight gain is a good thing.

While the expense of surgery is going to be difficult to meet in the current economic climate at least I know Chin Soon can be treated and is being cared for by a great vet. As I noted in my last post Chin Soon is definitely feeling much better. The net result is that she's bouncing and war dancing and wrestling more. When she plays more Ella and Zephyr get excited and play with her. Things are better all around.

Chin Soon Is Feeling Much Better

Chin Soon is feeling much better since starting on pediapred. I used what our original vet always used as a starting dosage: .01ml twice a day (5mg/5ml concentration) and it's pretty obvious she didn't need 10 times that much. She is very much her old self, ferreting away her favorite toys and running down the hall with abandon and, best of all, no more signs of hind end weakness.

Of course I have no idea what Chin Soon's actualy blood glucose level is at the moment. We'll know on Tuesday when she goes to see Dr. Lauren Powers, the outstanding ferret vet I've mentioned before. Then we'll know whether the pediapred dosage needs to be increased, decreased, or left alone.

Chin Soon Has Insulinoma & A Nightmare Vet Visit

I'm back after a long absence... This post is long but I want to get all the facts out so please bear with me.

Chin Soon is 5½ now and until recently she has had no health problems at all other than minor vaccination reactions. Lately she's had two symptoms: hind end weakness and hair loss, almost entirely on her tail. Chin Soon has rat tail at every coat change and she always grows the hair back quickly. This winter she didn't. My fears were insulinoma and adrenal disease. I've had a couple of ferrets in the past have both at once. I also thought of lymphoma. Anyway, off to the vet...

I've been back in North Carolina for a while now but I was in a quandry about what vet to take Chin Soon too. Our original vet here, Dr. Dan Hudson, retired a few years ago. The vet we used after that rarely sees ferrets now. The other vet I really trust moved all the way across the state a few years back. There are two ferret vets left in my local area. One has a fantastic reputation in terms of care but also has a reputation for being outrageously expensive and for doing everything and anything extra to increase the bill. Another who shall remain nameless was recommended by one of the active members of the local ferret club for both quality care and reasonable prices. In the current economy I decided I really had to go to the second vet.

The new vet checked Chin Soon's fasting blood glucose which was 41 so that confirmed insulinoma. She wants to do an ultrasound to see if an adrenal tumor shows up. All well and good so far. She said some other things vis a vis adrenal treatment that made no sense to me but I filed them for later research. She called in a perscription for Pediapred which I picked up yesterday afternoon. This is where things started to go seriously wrong.

The dosage with the perscription was 1.0ml twice daily, 5mg/ml solution. Yes, 1.0 not 0.1. Every other vet I've dealt with started my ferrets at 0.1ml, rechecked the glucose, and adjusted the dosage. A dosage 10 times higher worried me greatly. I called the vet's office to confirm that this was an error and that someone slipped a digit. No, it turns out that because Chin Soon's blood glucose level was "so low" she really wanted to give her 2mg per day. I wasn't going to give that much without a second opinion
.
This morning I called that vet that had moved across the state who I really do trust. She told me that the dosage prescribed was higher than what they give with chemotherapy to destroy a ferret's immune system! While she wouldn't prescribe a dosage without a visit (and I don't blame her for
that) she read me the textbook maximum dosage and it is less than a third of what the new vet prescribed for Chin Soon.

My decision, of course, is to drive three and a half hours and to take Chin Soon to the vet I spoke to today. The new vet's dosage would actually have been dangerous if not eventually life threatening for poor little Chin Soon. Thankfully I knew enough about ferrets after 11 years of having them and going through all their medical issues with them to question that dosage. Imagine if I didn't. Imagine if I just did what the new vet said. Most people would have done just that. I would have 10 years ago.

This incident, this nightmare vet, reinforced my belief that ferret medicine is a specialty and that ferrets have to go to vets who have both experience and a high success rate with ferrets. Thankfully there is an active ferret community online and in most major cities which allows ferret owners to network and get the information I need.

I also realize just how spoiled the ferrets and I were when we were in Green Bay and had a great ferret vet 20 minutes away.