DISEASE SUMMARY PAGE

Gastric Ulceration in Lagomorphs and Ferrets

Summary Information
Diseases / List of Miscellaneous / Metabolic / Multifactorial Diseases / Disease summary
Alternative Names --
Disease Agents
In Rabbits
  • May be stress-related; in a study, fundic ulcers were often seen in association with other pathology (usually more significant). (J42.90.w1, J213.8.w2)
  • Caused by aspirin in an experimental study, also by intraperitoneal adrenaline. (B600.10.w10, J213.8.w2)
  • In hypovolaemic shock, fundic ulcers may develop rapidly (three hours). (J213.8.w2)
In Ferrets
Infectious Agent(s) --
Non-infectious Agent(s) --
Physical Agent(s) --
General Description
Clinical signs
In Rabbits
  • Signs of abdominal discomfort to severe pain, including anorexia, tooth grinding, reluctance to move. (B601.8.w8, J213.8.w2)
  • Signs indicating anaemia and hypoproteinaemia: pale mucous membranes, dyspnoea, weakness, collapse, shock (J213.8.w2)
  • Death (with perforated pyloric ulcers). (J42.90.w1)
In Ferrets
  • Ferrets may show no clinical signs. (B627.11.w11)

Gastrointestinal

General

  • Anaemia. (P132.7.w1)
  • Lethargy. (B232.7.w7)
  • Teeth grinding (indicating abdominal pain and nausea)]. (B232.7.w7)
  • Dehydration in severe cases. (B232.7.w7)
  • Clinical pathology: regenerative anaemia, lymphocytosis. (B232.7.w7)
  • Possible death. (B232.7.w7)
Pathology
In Rabbits
  • Gastric fundus: dark erosions in the mucosa, up to 2.5 mm diameter, usually multiple. (J42.90.w1)
  • Pylorus: ulcers up to 1 cm diameter, often perforated an associated with peritonitis, occasionally localised but more often generalised (stomach contents, haemolysed blood and blood clots in the abdominal cavity). (J42.90.w1)
In Ferrets
  • Gastric haemorrhage. (B232.7.w7)
Further Information
In Rabbits
  • In one necropsy study, seen in 73/1000 domestic rabbits. (J42.90.w1)
  • This condition may be underdiagnosed. (B601.8.w8)
  • Gastric ulceration was noted in all of 14 Lepus americanus - Snowshoe hare held in individual cages in a laboratory for a week (compared to no gastric ulcers in 55 free-ranging hares). Relative neutrophilia and lymphopaenia was also noted in the laboratory-held hares. (J400.66.w1)
Diagnosis
In Rabbits
  • With perforation and peritonitis: clinical signs of acute abdomen and sepsis. (J42.90.w1)
  • Radiography may indicate peritonitis. (J42.90.w1)
  • Endoscopy. (J42.90.w1)
In Ferrets
  • Radiographs can highlight foreign bodies. (B232.7.w7)
  • Parasitology should be run on faeces to diagnose or rule out any parasitic infection. (B232.7.w7)
  • Histology can be performed on a biopsy of the stomach mucosa. (B232.7.w7)
  • Endoscopy can be used to examine the stomach, with a 3 mm fibre optic endoscope. (B232.7.w7)
    • This can help with viewing the ulcer and assist with taking a biopsy. (P132.7.w1)
Treatment
In Rabbits
  • N.B. prognosis is grave if the ulcer has perforated and peritonitis has occurred. (J213.8.w2)
  • Supportive treatment: fluid therapy, analgesia, antibiosis, supporting nutrition. (J213.8.w2)
  • Decrease acid production and provide protection for the ulcerated mucosa. (J213.8.w2)
    • Omeprazole (B600.10.w10, B601.8.w8, J213.8.w2)
      • Omeprazole inhibits basal acid secretion and increases gastric pH in rabbits. (J213.8.w2)
      • This is only available (Losec, Astra) as a capsule for human use, therefore is difficult to split for dosing rabbits. (B600.10.w10)
    • Ranitidine (B600.10.w10, B601.8.w8, J213.8.w2)
      • Ranitidine can inhibit gastric acid secretion by as much as 73% and decrease peptin secretion to a lesser extent (37%). (J213.8.w2)
      • This is available as an oral syrup (Zantac, GlaxoWellcome), therefore accurate dosing is possible. (B600.10.w10)
    • Sucralfate may be used to treat ulceration. (J213.8.w2)
In Ferrets
  • Reduce stress. (B232.7.w7)
  • Supportive care. (B232.7.w7) See Treatment and Care - Supportive Care and Nursing
  • Small meals should be given regularly, if the ferret is not vomiting. (B232.7.w7)
    • Food should be high in carbohydrate and low in fibre. (B232.7.w7)
    • If the ferret is vomiting, food should not be given for six to twelve hours. (B232.7.w7)
    • If the ferret is vomiting metoclopramide can be given 0.2 - 1 mg/kg (Note: This has not been fully assessed in ferrets). (B232.7.w7)
      • Metoclopramide at 0.5-1 mg/kg every twelve hours. (P132.7.w1)
    • Fluid therapy may be required, if the ferret has been vomiting. (B232.7.w7)
  • A broad spectrum antibiotic should be given. (B232.7.w7)
  • To stop stomach acid secretions, give an H2 blocker: (B631.22.w22)
    • Cimetidine 10 mg/kg orally, subcutaneously, intramuscularly or intravenously (slowly) every eight hours. (B631.22.w22)
      • 5-10 mg/kg every eight hours. (P132.7.w1)
      • Cimetidine can be given orally three times daily. (Famotidine 2.5 mg per ferret orally, subcutaneously or intravenously, every twenty four hours). (B631.22.w22)
      • Ranitidine 3.5 mg/kg orally (unpalatable). (B631.22.w22)
    • To decrease stomach acid secretion : (B631.22.w22)
      • Omeprazole (a protein pump inhibitor) 4 mg/kg orally every twenty four hours. (B631.22.w22)
    • Give a gastric protectant before a meal: (B631.22.w22)
      • Sucralfate 25 mg/kg orally every eight hours. (B631.22.w22, P132.7.w1)
      • Sucralfate 1/8 tablet four times daily; this is cytoprotective and will bind to the ulcer. (B232.7.w7)
    • Bismuth subsalicylate (Gastric protectant) (B627.11.w11) 0.25 - 1 mL/kg orally three to four times daily. (B232.7.w7)
    • If a foreign body is present this should be surgically removed. (B232.7.w7) See Gastro-intestinal Foreign Bodies in Rabbits and Ferrets
    Prevention
    In Rabbits
    • Consider prophylactic treatment for rabbits in late pregnancy, and during treatment for enteritis, anorexia or chronic disease. (B600.10.w10, J213.8.w2)
    In Ferrets
    • When giving ferrets NSAIDs, give gastrointestinal protectant, antihistamine and anti-acid treatment should be given. (B631.22.w22)
    • Stressed, post surgery or sick ferrets should be given gastrointestinal antihistamines during this period. (B631.22.w22)
Associated Techniques
Host taxa groups /species
Disease Author Debra Bourne MA VetMB PhD MRCVS (V.w5); Bridget Fry BSc, RVN (V.w143)
Referees William Lewis BVSc CertZooMed MRCVS (V.w129)

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