Gastric Ulcers

Presence of digested blood in the stomach of a ferret signifies the presence of a gastric ulcer. (87K)

Note small ulcers in the stomach lining following removal of blood. (49K)

Fatal pyloric ulcer resulting in sudden death in a ferret. (89K)

Note the color variation between tarry stools containing digested blood (above) and normal blood (below) from a ferret with a gastric ulcer. (74K)

(Photographs No. 2 courtesy of Dr. John Gorham, Department of Pathology, Washington State University.
Photograph No. 3 courtesy of Dr. John M. King, Department of Pathology, Cornell University.)

GASTRIC ULCERS AND YOUR FERRET

(Article reprinted courtesy of Modern Ferret magazine.)

General.

One of the most insidious diseases of pet ferrets, and one of the most commonly overlooked, is gastric (or stomach) ulcers. Ferrets, like humans, are predisposed to the development of ulcers during times of stress, and this debilitating, and potentially deadly disease should be considered in any systemically ill ferret.
Ferrets are not alone in their predilection for ulcer development. In fact, many of their mustelid cousins share a similar predisposition. My first experience with this common mustelid malady happened in Valdez, Alaska, during the big oil spill, where the majority of the otters we saw, both alive, and dead, had evidence of ulcers from that terrible ordeal. In addition to otters and ferrets, I have also seen them in pet skunks and mink, during times of systemic illness.
How does stress cause ulcers in these animals? Actually, stress-induced gastric ulcers are most likely a combination of factors which serve to upset the imbalance between the normal acid secretion of the stomach, and the mechanisms by which the stomach lining protects itself against the acid's caustic capability. The precise mechanisms are not yet clear, but the following are all suggested to play a role:

decreased oxygenation of the stomach lining due to changes in blood flow priority during the "fight or flight" response
decreased gastric cell turnover
decreased gastric emptying
increased gastric acid secretion
the effect of corticosteroids (elevated in times of stress) on healing in the stomach

Another possible contributor to this problem is a relative newcomer on the scene, the bacterium Helicobacter mustelae. This common inhabitant of the ferret stomach causes a progressive inflammatory response in the stomach lining over the lifetime of the ferret, further predisposing it to damage. (In fact, this bacteria's cousin, H. pylori, has now been definitively incriminated in the development of ulcers in humans).
What problems do ulcers cause in ferrets? They can cause problems for the ferret in a number of ways. First and foremost, the abdominal pain and discomfort caused by these ulcers can start a vicious cycle in sick ferrets, decreasing their food intake, predisposing them even further to the ravages of disease. The presence of the ulcers decreases their ability to digest their food -- decreasing the availability of nutrients to the body, and increasing the occurrences of diarrhea and vomiting. Finally, loss of blood from these ulcerated sites in the stomach can result in a life-threatening anemia. ( A common cause of sudden death in the ferret is the presence of a deep ulcer which erodes into a large caliber blood vessel, which can result in fatal gastric hemorrhage in a little as two minutes.)
Clinical signs.

The symptoms of gastric ulcers can be difficult to pick up. Many ferrets with ulcers will go off their food and may become lethargic. There may be soft, poorly digested stools, or the animal may begin to vomit. Two signs, however, point strongly to the presence of ulcers, and should not be ignored -- grinding the teeth (a sure sign of abdominal pain), and the passage of thick, black, tarry stools (see the illustration below), or the presence of this type of material around the anus. The tarry material that is passed is largely digested blood.
In animals who are exhibiting signs of gastric ulcers, treatment is symptomatic and often prolonged. Treatment for Helicobacter infection is generally pursued simultaneously. Amoxicillin at 10 mg/lb twice daily is given, along with a stomach protectant, such as Pepto-Bismol (1/15th of a tablet four times daily, ground in food) or Carafate (1/8th of a table four times daily). Finally, a bland, highly digestible diet (Duck Soup, Hills A/D, or my personal choice, Gerber's Second Meals Chicken baby food) is administered. Sick ferrets often require hand feeding to ensure adequate intake. (Antacids are generally not prescribed, as many sick animals have decreased acid production due to concomitant Helicobacter infection, and too little acid will impair your ferrets ability to digest its food. ) This is not a quick treatment - the treatment often takes 4 weeks or longer (remember - every time acid is secreted in the stomach, it irritates and enlarges the ulcer, so it will take a while before that ulcer has a chance to heal.
Prevention.

The best way to treat ulcers in ferrets is to prevent them before they start. Overcrowding, poor sanitation, introduction of new animals into an established group, rearrangement of the normal social order - all of these commonly cause an increase in stress and the incidence of gastric ulcers.
Summary.
Gastric ulcers are commonly seen in the "modern ferret" as a result of the hustle and bustle of life in the 90's, and in older ferrets as a result of other stressors, such as intercurrent disease (insulinoma, adrenal diseases, etc.) Be on the lookout for the warning signs of gastric ulcers (tarry stools, grinding teeth), and if you see them, call your vet to start treatment before the problem gets any worse.

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