Heart Disease – Diagnosis

Heart Disease – Diagnosis

There are a few different diagnostic tools that can help to diagnose heart disease. Below is a discussion of some of these methods, and the information each can provide.

Exam:

A physical exam is key in assessing any animal for any health problem. When considering heart disease your vet will look at several different things. First they will assess the ferret’s general body habitus – are they muscular and healthy, underweight, overweight? Do they have a characteristic pear-shape that can indicate either abdominal fat or abdominal fluid retention? Your vet will look at coat and skin condition, muscle tone, eyes, and mouth to ensure nothing else appears wrong with the ferret. They will also palpate the abdomen to feel for fluid and any potential masses.

They will listen carefully to the lungs to assess for sounds that might indicate fluid retention due to heart failure. They also want to ensure they do not hear any other abnormal lung sounds that might indicate other health problems.

They will listen carefully to the heart for any abnormal heart sounds such as a murmur, rhythm, or gallop. Any of these sounds can be a clue that a ferret has heart disease.

A note on murmurs: While a heart murmur in a ferret is almost always abnormal, a heart murmur alone is NOT sufficient to diagnose Heart Failure. Additionally, the severity of a murmur does not always correlate with the severity of the heart disease. If your vet detects a murmur on exam, or any other abnormal heart sounds, you should request that they follow through with further workup. Additionally, not all ferrets with heart disease will have an audible murmur. If you suspect your ferret has heart disease, you need to request your vet does further workup – which will be explained below.

Blood Work:

If your ferret has any symptoms that are concerning for heart disease or any other illness, a basic blood panel (CBC and CMP) should be done to rule out any other potential problems such as infection, liver disease, or kidney disease. Your vet may also suggest other tests in addition to the basic labs depending on your ferret’s symptoms.

The average cost of a CBC and CMP is $90-100 depending on region.

X-Ray: Simplest, Least Expensive

An X-Ray is one of the simplest, quickest, and least expensive ways to look for signs of heart disease. An X-Ray is inexpensive, simple to do, and gives you immediate results. An X-Ray will show you if your ferret has an enlarged heart, which is indicative of heart disease. It can also show whether there is any fluid accumulation in the lungs (called pulmonary edema if the fluid is IN the lungs, or pleural effusion if the fluid is AROUND the lungs), and sometimes abdomen, which may be a sign of heart failure. Repeat X-Rays can be used to track changes in your ferret’s heart size and pulmonary edema. Occasionally you can see an extremely enlarged liver or spleen due to advanced heart failure, but an X-Ray is not the best test for these. (If your ferret does have an enlarged liver or spleen, other diagnoses need to be considered as well, such as lymphoma or liver disease. Your vet will let you know if and what further testing is recommended).

If your ferret has symptoms of heart disease, and X-Ray shows an enlarged heart, most vets will provide a presumptive diagnosis of heart disease.

If your ferret has symptoms of heart disease, and X-Ray shows an enlarged heart and fluid in the lungs, most vets will provide a presumptive diagnosis of heart failure. HOWEVER, the BEST test to confirm heart failure and to determine what type of heart disease is present, is an Echocardiogram.

The average cost of an X-Ray is $90-150 depending on region and number of views.

The following series of photos show the progression of Koda’s heart disease.

Normal sized ferret heart. Koda at a few months of age. (2010)
Photo Credit: Katt

Koda’s enlarged heart at diagnosis – July 2015.
Photo Credit: Katt

Koda’s Heart Jan 2016

Koda’s Heart March/April 2017. Globoid Heart (extremely enlarged) with significant Pulmonary Edema (note the white, hazy lungs).
Photo Credit: Katt

Echocardiogram (Echo): Best to Diagnose

Stark getting an Echocardiogram
Photo Credit: Masa Vilar Stupica, ferret is Stark

An Echocardiogram (often called an Echo) is the best test to diagnose heart disease and heart failure. Where an X-Ray can only detect an enlarged heart and pulmonary edema, the Echo can look at the heart’s structure and function. An Echo is an ultrasound that looks at the heart muscle and valves, as well as the heart’s ability to pump blood. This will tell you exactly what type of heart disease your ferret has, as well as how well (or poorly) their heart is functioning. Measuring the heart’s ability to pump will tell you whether your ferret is in heart failure.

If your ferret has symptoms of heart disease, and/or abnormal heart sounds on exam, but a normal appearing heart on X-Ray, an Echo may be recommended to look for structural heart disease that has not yet progressed enough to enlarge the heart. Remember that the earlier you catch heart disease and start monitoring and treatment, the better for your ferret’s lifespan and quality of life.

Not all vets are able to perform an Echo in their clinic, and you may be referred to a specialist clinic where a veterinary cardiologist can perform the test. The cost of an Echo can vary by region and whether your regular vet or a specialist does it. If you have access to an Echo and are able to afford it, it can offer you invaluable information about your ferret’s heart disease.

Below is an example of a readout of the results of an Echo. Your vet will interpret the results to give you a diagnosis.

Stark’s Echocardiogram Results
Photo Credit: Masa Vilar Stupica

Electrocardiogram (EKG or ECG): Detects Arrhythmias

Start getting an EKG – note the Leads clipped on each of his legs.
Photo: Masa Vilar Stupica, ferret is Stark

The last (but not least) test your vet can do to check your ferret’s heart is an EKG. This test looks at the heart’s electrical activity to detect arrhythmias – abnormal heart rhythms. Left untreated, arrhythmias may lead to eventual cardiomyopathy, heart failure, and/or blood clots.

If your ferret has symptoms of heart disease, and/or abnormal heart sounds on exam, but a normal appearing heart on X-Ray, an EKG may be recommended to look for abnormal electrical activity in the heart. If your ferret has an arrhythmia, certain medications may help them to feel better and live longer. However, some arrhythmias require surgical treatments, such as a pacemaker, that are not yet widely available for ferrets.

Remember that the earlier you catch heart disease and start monitoring and treatment, the better for your ferret’s lifespan and quality of life.

 

 

 

 

 

 

References:

  1. Johnson-Delaney, C. (2017). Ferret Medicine and Surgery. Boca Raton, Fl: Taylor & Francis Group, LLC.
  2. Lewington, J. (2007). Ferret Husbandry, Medicine, and Surgery, 2e. Philadelphia, PA: Elsevier.
  3. Quesenberry, K., Carpenter, J. (2012). Ferrets, Rabbits and Rodents Clinical Medicine and Surgery, 3e. St. Louis, MO: Elsevier