Irritable Bowel Disease (IBD)

Irritable Bowel Disease (IBD) in Ferrets

Author: Katt Crouch

Irritable Bowel Disease (IBD) is a very common issue in ferrets. Most cases of IBD can be controlled through diet and supplements while more extreme cases require prednisolone to reduce the chronic inflammation. If IBD is not managed properly, the chronic inflammation can have devastating results. Inflamed intestines are not able to properly absorb nutrients from food, which can lead to malnutrition and serious nutrient deficiencies over time and the loose stools characteristic of IBD can lead to dehydration. IBD also affects the gut motility, meaning that food will move more slowly through the GI tract. In addition, chronic inflammation of any tissue can lead to scarring and/or a significantly increased risk of developing tumors.

What is IBD?

IBD is a condition in which the gastrointestinal tract is chronically inflamed. True IBD refers to inflammation of the large intestine, an in humans refers specifically to Ulcerative Colitis and Crohns Disease. In the ferret world however, “IBD” is a bit of a misnomer – it has become a blanket term used to encompass any chronic inflammation of the stomach, small, or large intestine for which an obvious cause or cure cannot be found. Some cases of  “IBD” may be true IBD, and many seem to be related to food sensitivities. Several cases are likely IBS (Irritable Bowel Syndrome), which is different from IBD and consists of episodes of constipation, diarrhea, and abdominal pain which can be triggered by stress or certain foods. Many cases may actually be chronic gastritis (stomach inflammation) caused by a chronic, resistant Helicobacter pylori infection that is not eliminated by antibiotics. In any of these cases, the inflammation can be instigated by stress (positive and negative stress), illness, irritants, or allergens.

Ferret IBD is often diagnosed primarily by symptoms; however, a biopsy can be done to confirm the specific diagnosis. This may be advisable in extreme cases to ensure that there isn’t something more serious going on. Generally though, diagnosis by symptoms is the least invasive and preferable course.

A note on Helicobacter pylori: H. pylori is contagious and is very common in ferrets, particularly ferrets who came from a breeding mill. This bacteria can cause inflammation of the stomach and can lead to ulcers, and even gastric lymphoma. It is a difficult bacteria to kill and often requires longer courses of treatment with multiple medications. Many individuals and vets feel that a vast number of cases of  ferret “IBD” are truly chronic H. pylori infections. In this case the ferret gets H. pylori and is treated, but not all of the bacteria are killed and what bacteria remains gain a level of resistance to the antibiotics used. The meds do decrease the number of bacteria though, so the symptoms improve and the ferret seems to get better. For a while the immune system keeps the H. pylori in check so the ferret shows few, if any, symptoms. Then something occurs that knocks down the immune system (stress, illness, sudden diet change, etc) allowing the smoldering H. pylori infection to grow rampantly again and now the ferret is seen to have a “flare.”

Symptoms of IBD

The symptoms of IBD can also be symptoms of various other medical conditions. If your ferret is having any of these symptoms it is important to see a vet. You must make sure that something else is not the cause of the symptoms, and it is important to get an IBD flare up under control as soon as possible (discussed later).

Symptoms include:

  • Chronic “bad” stools – often high in mucous, runny, seedy, off-color, diarrhea, blood in stool, etc
  • Tooth grinding (sign of abdominal pain)
  • Lack of appetite
  • Weight Loss
  • Lethargy
  • Ulcers (blood in stool, tooth grinding) – ulcers are more of a side effect than a symptom

Treating IBD with Medications

It is important to get IBD flare ups under control. Initial flare ups, and any flare up that cannot be brought under control by diet should be treated with medication.

Triple Therapy: The typical course of treatment for IBD is called “Triple Therapy” and consists of: Amoxicillin, Metronidazole, and Sucralfate (Carafate). The Amoxi and Metro help to reduce any secondary infection from opportunistic bacteria overgrowing as a result of the imbalance in the intestines. The Carafate is a “tummy coater” and soother that helps to reduce inflammation and protect the intestinal lining so it can heal. This can and will interfere with nutrient and medication absorption so it is super important to follow your vets instructions for the dosage and TIMING of these meds very closely.

Pepcid: Often Pepcid (famotidine), is added to the Triple Therapy regimen. Famotidine is a drug that helps to reduce stomach acidity. This helps to further protect the inflamed stomach lining from being further damaged by exposure to the stomach acid.

A note on PeptoBismol: PeptoBismol used to be routinely used as an addition to the Triple Therapy regimen, along with Pepcid. In recent years the veterinary community has begun to recommend against PeptoBismol because it contains small amounts of a derivative of aspirin, which is a type of NSAID. NSAIDs can reduce gastric defenses and increase the risk of a stomach ulcer, particularly in our pets. However, the bismuth in PeptoBismol helps to kill Helicobater pylori. The dose of PeptoBismol is small, and the amount of NSAID in it even smaller. In cases of a strongly suspected or confirmed H. pylori infection, many feel that the added benefit toward killing the H. pylori outweighs the risk of an NSAID-induced ulcer – cost vs benefit. This is something you should discuss with your vet, research, and think about carefully before making a decision at your own personal discretion.

Pred: When IBD cannot be brought under control via diet and antibiotics, then steroids are the next course of action. Prednisolone is the preferred steroid treatment as it is easier on the liver than prednisone. Steroids have a lot of side effects and are very hard on their little bodies so this should be a last course of action. However; do NOT avoid giving your ferrets pred when it is needed simply because you are afraid of the side effects. Uncontrolled IBD can kill your ferret – and it will be a long, slow, and painful death.

Pain Meds: In some cases pain medication can help to reduce stomach pain that is interfering with appetite.

Treating IBD with Diet

The best way to control IBD is through diet. Unsurprisingly, a balanced raw diet is the BEST diet for a ferret with IBD. The high moisture content and easily absorbed proteins and nutrients are vital. In addition, by feeding raw you have complete control over what ingredients your ferret is getting. This makes it MUCH simpler. Both of my ferrets have IBD. My vet who is pro-raw told me this about Kenai during one visit “the fact that you feed raw is probably the only reason his IBD is as under control as it is.”

It is very important in IBD to identify the triggers for your ferret. This is a long and involved process that requires careful recording and a lot of trial and error. The best way to do this is to do an Elimination Diet in which you eliminate all but one protein and then progressively add new proteins one at a time to see which foods cause what reactions. Supplements (described below) can also be very helpful but should be secondary to dietary changes.

This is very much a trial and error thing. Every ferret with IBD is different. Some have food sensitivities, some have full-on projectile vomiting allergies. Some ferrets with IBD do best with very gradual changes in proteins, while others do best if they are not kept on any one protein for more than 1-2 meals at a time. This is where keeping a journal of your ferret’s input, output, symptoms, and additional notes is VITAL. The journal will help you notice patterns over time so that you can figure out what works best for your ferret.

Ferrets with bad IBD tend to do best with easily digestible foods such as commercially ground raw meats that are easy to absorb.

Lamb is your friend! Lamb is a very gentle, easy to digest meat that is often considered “hypoallergenic.” While ferrets can be allergic to lamb, allergies are uncommon. Goat is very similar to lamb and often less expensive if you have access. The important thing with IBD and food trials is to start with a novel protein (one that they have not had before). Elimination diets will be described in a separate article.

Supplements for IBD

There are many supplements that are helpful for ferrets with IBD. Below are the most common ones:

  • Reishi – reduces inflammation and very high in antioxidants
  • Slippery Elm Bark – prepared as a syrup, acts to reduce inflammation/irritation and coats and soothes the stomach. This is a tumme coater which, like Carafate, can interfere with digestion so it is best to only give Slippery Elm during flare ups, it should not be used long-term.
  • Pancreatic Enzymes (Pancreatin) – sprinkled over food (preferably 1 hour prior to feeding to give it time to act) this enzyme helps to break down food so that it is easier to digest and absorb nutrients from.
  • Probiotics – added into food as a powder supplement, or via kefir. Probios help to reestablish the proper balance of the gut flora. These are good to give as a regular supplement, but are particularly important after a course of antibiotics to help “reset” the intestines.
  • Salmon oil – helps to provide omega fatty acids. This is a good supplement regardless of the health of your ferret but in a ferret with trouble absorbing the nutrients from food it might help add some of the missing fats back in. Only use in small amounts as you do not want to further exacerbate IBD poops. Popular brands include Grizzly Salmon Oil, and Yummy Chummies Wild Alaskan Salmon Oil.
  • Call of the Wild Wysong supplement – this is essentially a multivitamin supplement that can help to fill in some of the nutrients that aren’t being absorbed during a flare up.
  • Carnivore Care – Carnivore Care is a high calorie, nutrient dense food sold by vets. You can get it over the counter at most vet offices. CC is a powder that you mix with warm water to make a soup for your sick ferret. It is designed especially for carnivores! You can use CC as a supplement to add extra nutrients to their food (use it like a gravy over their regular food), or in very sick ferrets, as their primary “emergency” diet. This is not a long-term diet, but it is very, very useful for extremely sick ferrets.

IBD and Other Diseases

IBD appears to often go hand and hand with Adrenal Disease. If you are having trouble getting your ferret’s IBD under control, or if they show any symptoms of possible adrenal disease it is often worth doing a 3 month trial of Lupron or getting a Deslorelin implant.