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