Heart Disease Overview

Heart Disease Overview

Heart disease is sadly, quite common in ferrets. There are many causes and man types of heart disease, but it is thought that genetics plays a large role in many of the cases. While some heart disease is congenital (a developmental defect present at birth), most cases develop later in life, when the ferret is an adult. It is important to be aware that while more common in older ages, heart disease can develop at any age.

Caught early, there are many treatments available that can significantly improve both quality and quantity of life. If you ever have even a slight suspicion that your ferret may have heart disease, you should have them seen by a vet as soon as possible .

Check out our other pages to read some more in-depth information on:

Diagnosis:

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

Diagnosing heart disease can often be done with a physical exam and X-Ray. It is recommended to get blood work as well to rule out any other potential causes of the symptoms. It is very inexpensive to check heart size with a quick X-Ray, and postponing diagnosis (and thus, treatment) until too late can allow the disease to progress faster. If you have even the slightest suspicion that your ferret has heart disease, it is worth getting an X-Ray to check the size of their heart, and look for fluid accumulation in the lungs and abdomen. This can also help to rule out other serious causes of their symptoms.

Other diagnostic tools include:

  • Echocardiogram (Echo): the best tool for diagnosis and accurately assessing heart function; may require a visit with a specialist. Diagnosis structural heart disease much earlier and more accurately than an X-Ray.
  • Electrocardiogram (EKG or ECG): to diagnose abnormal electrical rhythms (arhythmias) in the heart

If your ferret has symptoms of heart disease, and/or abnormal heart sounds on exam, but a normal sized heart on X-Ray, your vet may recommend an Echo or EKG to look for structural heart disease and/or arhythmias that have simply 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.

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.

 

Symptoms:

In the wild they are predators, as well as prey; if they show the slightest sign of weakness they could become someone else’s dinner. As such, they are experts at hiding illness. By the time a ferret shows significant symptoms of a disease, they are often extremely ill. Diseases may be caught much earlier by being very in-tune with your ferrets and noticing the symptoms early on, when they are very subtle. Though even subtle symptoms may be due to fairly advanced disease. To make things more difficult, many symptoms ferrets show when ill are the same for several different types of illness. For example a cough might be from heart disease, lymphoma, an upper respiratory tract infection, or even just a little stuck fur from shedding. If your ferret is ever showing symptoms that are even the slightest bit concerning, you should have them seen by your vet as soon as possible.

Ferret with Advanced Heart Failure – note the large, pear-shaped abdomen.
Ferret: Koda
Photo Credit: Katt

Boris demonstrates his enlarged abdomen due to fluid retention from heart failure.
Photo Credit: Heather Downie

Koda: Advanced Heart Failure -Pear-Shaped abdomen.
Photo Credit: Katt

 

Below are some symptoms that are commonly seen in ferrets with heart disease. Bold red symptoms are some of the most common, “classic” symptoms owners notice that are particularly concerning for a heart problem, especially when seen in combination.

  • Cough: often starts as a mild, intermittent cough that is frequently mistaken as a cough due to shedding or a mild URI. May progress to a characteristic deeper, hacking cough with raspy breathing as seen in this VIDEO.
  • Pear-Shaped abdomen, bloat (signs of edema)
  • Flat ferreting (especially flat ferreting every few feet when active)
    • Reduced energy and stamina; loss of interest in play
  • Fatigue and Weakness (generalized weakness, hind limb weakness)
    • Musce Wasting (esp hind limb)
  • Rapid, shallow breathing
  • Abnormal breathing sounds: gurgly, raspy, rattly, wheezy, clicking, squeaky
  • Poor capillary refill
  • Decreased alertness
  • Enlarged Liver
  • Enlarged Spleen
  • Blood Clots (Stoke, Saddle Thrombus)
  • Weight Loss
  • Pale or Blue-Tinged (severe) nose, gums, ears, and paw-pads
  • Hypothermia
  • Syncope (fainting/ passing out) – if this happens get your ferret to an Emergency Vet ASAP

 

Treatments:

There are many effective treatments available for heart disease that can drastically improve your ferrets quality and quantity of life. To read more about how the medications work to treat heart disease, see our page on Heart Medications.

Typical medications for structural* heart disease and heart failure include:

  • Enalapril OR Benazepril (Fortekor)
  • Furosemide (Lasix)
  • Pimobendan (Vetmedin)
  • Spironolactone

Typically when ferrets are diagnosed with heart disease or heart failure they are started on either Enalapril or Benazepril (Foketor) to treat their heart disease, as well as Furosemide (Laisx) for symptom control.

Later, as the disease progresses and the above 2 medications are no longer sufficient on their own Pimobendan (Vetmedin), and sometimes Spironolactone may be added.

*Electrical dysfunction of the heart (arrhythmias) are treated with very differently. 

Some potentially beneficial Heart Supplements include:

  • Tuarine: proven benefit
  • Hawthorn: probable benefits shown in humans; few animal studies
  • L-Carnitine: probable benefits shown in humans; few animal studies
  • CoQ 10: possible benefits seen in poorly done studies in humans; few animal studies

 

NOTE: You should never start your ferret on any medication, or change the dosing of a prescribed medication, before consulting with your veterinarian.

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References:

  1. Atkins, C., Keense, B., Brown, W., Coats, J., Crawford, M., et al. (2007). Results of the veterinary enalapril trial to prove reduction in onset of heart failure in dogs chronically treated with enalapril alone for compensated, naturally occurring mitral valve insufficiency. JAVMA. 23 (7): 1061-1069.
  2. Bernay, F., Bland, J., Haggstrom, J., Baduel, L., Combes. B., et al. (2010). Efficacy of spironolactone on survival in dogs with naturally occurring mitral regurgitation caused by myxomatous mitral valve disease. Journal of Veterinary Internal Medicine. 24:331–341.
  3. Bowles, D. Fry, D. (2011). Pimobendan and its use in treating canine congestive heart failure. Compendium: Continuing Education for Veterinarians. E1-E6.
  4. COVE Study Group. (1995). Controlled Clinical Evaluation of Enalapril in Dogs With Heart Failure: Results of the Cooperative Veterinary Enalapril Study Group. Journal of Veterinary Internal Medicine. 9 (4): 243-252.
  5. Gordon, S., Miller, M., Saunders, A. (2006). Pimobendan in Heart Failure Therapy – A Silver Bullet? Journal of the American Animal Hospital Association. 42: 90-93.
  6. Hofman-Bang,C., Rehnqvist, N., Swedberg, K., Wiklund, I., Astrom, H. (1995). Coenzyme Q10 as an adjunctive treatment of chronic congestive heart failure. Journal of Cardiac Failure. 1 (2): 101-107.
  7. Johnson-Delaney, C. (2017). Ferret Medicine and Surgery. Boca Raton, Fl: Taylor & Francis Group, LLC.
  8. Lango, R., Smolenski, R., Narkiewicz, M., Suchorzewska, J., Lysiak-Szydlowska, W. (2001). Influence of L-carnitine and its derivatives on myocardial metabolism and function in ischemic heart disease during cardiopulmonary bypass. Cardiovascular Research. 51: 21–29
  9. Lewington, J. (2007). Ferret Husbandry, Medicine, and Surgery, 2e. Philadelphia, PA: Elsevier.
  10. Oyama, M. (2009). Cardiac drugs for treatment of canine heart failure. NAVC Clinician’s Brief. 7: 56-59.
  11. Pittler, M., Schmidt, K., Ernst, E.Hawthorn Extract for Treating Chronic Heart Failure: Meta-analysis of Randomized Trials. The American Journal of Medicine. 114: 665-674.
  12. Quesenberry, K., Carpenter, J.  (2012). Ferrets, Rabbits and Rodents Clinical Medicine and Surgery, 3e. St. Louis, MO: Elsevier.
  13. Sander, S., Coleman, C., Patel, A., Kluger, J., White, M. (2006). The impact of coenzyme Q10 in patients with chronic heart failure. Journal of Cardiac Failure. 12 (6): 464-472.
  14. Sharma, A., Fonarow, G., Butler, J., Ezekowitz, J., Felker, M., (2016). Coenzyme Q10 and heart failure: A state-of-the-art review. Circ Heart Fail. 9 (4): 1-8.
  15. Struthers, A. (1999). Why does spironolactone improve mortality over and above  an ACE inhibitor in chronic heart failure? Br J Clin Pharmacol. 47: 479-482.
  16. Witte, K., Clark, A., Cleland, J. (2001). Chronic heart failure and micronutrients. Journal of the American College of Cardiology. 37 (7): 1765-1774.