DISEASE SUMMARY PAGE

Fractures in Ferrets

Summary Information

Diseases / List of Physical / Traumatic Diseases / Disease summary
Alternative Names  
Disease Agents
  • Trauma, such as a fall from a height or getting stepped on. (J213.5.w4)
    • "High rise syndrome" may be seen in ferrets, as in cats. (B602.35.w35)
Infectious Agent(s) --
Non-infectious Agent(s) --
Physical Agent(s) Non-specific physical trauma
General Description
  • Fractures of long bones or the spine are relatively uncommon in ferrets. (J213.5.w4)
  • The sites most commonly involved are the major long bones of the limbs: the humerus, radius and ulna, femur and tibia and fibula. Fracture of the femoral neck has been reported, as have fractures of other bones such as the carpal bones. (J213.5.w4)
  • Fractures of the mandible or maxilla may occur due to trauma or secondary to bone disease. (J213.5.w4)
  • Fractures of the front leg below the elbow, or the hind leg below the stifle often are open, since there is only limited soft tissue present between the bone and the skin. (B602.35.w35)
Clinical signs
  • Non-weight-bearing lameness or sometimes weight-bearing lameness of the fractured limb. (J213.5.w4)
  • Soft tissue bruising/swelling of the affected limb. (J213.5.w4)
Further Information
Diagnosis
  • Fractures can be diagnosed based on clinical examination. (J213.5.w4)
  • Radiography confirms diagnosis and provides additional information, allowing better evaluation of the fracture and selection of appropriate treatment. (J213.5.w4)
Treatment
Initial treatment
  • First treat any shock, abdominal emergencies, respiratory compromise or bleeding. (B602.35.w35)
  • For open fractures, take swabs of the site for culture (aerobic and anaerobic). Debride the wound and use copious lavage for cleaning. (B602.35.w35)
    • If immediate repair is not undertaken, bandage with a sterile bandage, and splint the limb. (B602.35.w35)
  • Give appropriate analgesia, keep the patient comfortable and quiet until it is stabilised and further treatment (requiring anaesthesia) is possible. (B602.35.w35)
Fracture fixation

Treatment of fractures in ferrets follow the same principles in techniques as in cats and dogs, but with modification to allow for the small size of the patient. (J213.5.w4)

  • Fracture repair is carried out with the ferret anaesthetised. (J213.5.w4)
  • Absorbable sutures are appropriate for closing the surgical site, and tissue adhesive can be used to close the surgical skin incision. (J213.5.w4)
  • If external coaptation is used, it should immobilise the limb in a normal position with the joint above and the joint below the fracture immobilised, and at least 50% cortical contact of the bone ends present following fracture reduction. (B602.35.w35)
  • The small size of ferrets limits the use of plates. (B602.35.w35)
  • The pin diameter should be 60-70% of the diameter of the medullary cavity of the bone. (B602.35.w35)
  • Humerus:
    • Internal fixation is recommended. Intramedullary pins (stainless steel), orthopaedic wire or bone plates may be used depending on the fracture, as in other species; an external skeletal fixator can be used, if appropriate for the fracture. (J213.5.w4)
    • External coaptation by itself is not recommended and may result in malunion, since it is difficult to immobilise the shoulder joint. (J213.5.w4)
  • Radius and ulna
    • If one of the bones is intact to serve as a natural split for the fractured bone, external coaptation may be approriate. (J213.5.w4)
      • The elbow and the carpus must be immobilised. (J213.5.w4)
    • If there is severe distraction of the fractured bone, internal fixation may be needed to prevent development of synostosis. (J213.5.w4)
    • If there is a displaced or comminuted fracture, internal fixation is generally needed: open surgical reduction of the fracture and placement of intramedullary pins, orthopaedic wire or an external skeletal fixator as required. (J213.5.w4)
      • If repair does not involve an external fixator, following repair a padded bandage may be applied to reduce swelling and to prevent overuse of the limb. (J213.5.w4)
  • Olecranon (proximal ulna)
    • An olecranon fracture was repaired using a figure-of-eight Kirschner wire through the olecranon and the distal ulna. A padded bandage was applied, extending proximally to the axillary area for the first week, with gentle physical therapy (elbow extension and flexion) once the bandage was removed. The ferret was kept under cage rest during the fracture healing. (J213.5.w4)
  • Femur
    • External coaptation by itself is not recommended. A Spica splint would be required and this is difficult to place and maintain in ferrets due to their short limbs, active disposition and tendency to chew. A Svhroeder-Thomas splint might be used for a distal femoral fracture. (J213.5.w4)
    • Usually internal fixation is required. Intramedullary pins can be used, with additional support from cerclage wires if required. (J213.5.w4)
      • An external skeletal fixator may be used alone or in combination with intramedullary pinning. A type I fixator is appropriate; type II or type III fixators may be uncomfortable and cause damage to the ferret's body. If necessary, two type I fixators can be placed at 90 degrees to each other, if sufficient bone is available for placing the pins. Polymethylmethacrylate can be used to join the pins (form the external framework); this resists chewing by the ferret. (J213.5.w4)
  • Tibia and fibula
    • Usually, both bones are fractured. (J213.5.w4)
    • Rigid internal fixation is usually preferred, to provide good stabilisation of the fracture while allowing the ferret to use the joints proximal and distal to the fracture site.. (J213.5.w4)
    • In some cases conservative treatment may be used, e.g. with a modified Thomas splint. In such cases the joints proximal and distal to the fracture must be immobilised. (J213.5.w4)
    • Internal fixation usually involves placement of intramedulllary pins together with a Type I or Type II external fixator. Usually the external fixator is placed on the medial side of the limb. Generally, the tibia is reduced and aligned; this usually returns the fibula to alignment also and it heals without specific fixation once the tibia is repaired. (J213.5.w4)
  • Maxilla and mandible
    • Treatment of jaw fractures in ferrets is as in cats. (J213.5.w4)
Limb amputation
  • This is required with severe limb injury not allowing orthopaedic repair, or if financial constraints do not allow for complicated surgical repair and follow-up treatment, or if severe posttraumatic osteomyelitis fails to respond to treatment. (J213.5.w4)
  • The level of amputation depends on the injury site. (J213.5.w4)
  • The forelimb can be removed by amputation at the scapulofemoral joint, or the limb including the scapula may be removed. (J213.5.w4)
    • Leaving the scapula provides additional protection for the chest wall. (B602.35.w35)
  • For the hindlimb, a mid-femoral amputation provides the best cosmetic result. If the fracture is of the proximal femur or there is infection close to the joint, disarticulation and amputation at the coxofemoral joint is required. (J213.5.w4)
  • Cage rest and analgesia is needed until the surgical site has healed. (B602.35.w35, J213.5.w4)
Post-operative care
  • Strict cage rest is recommended following fixation, usually for 4-6 weeks. (J213.5.w4)
  • The ferret should be given appropriate nutritional support. See: Treatment and Care - Supportive Care and Nursing
  • Bandaging aims to minimise strain on the implants and maximise comfort for the ferret. (J213.5.w4)
  • Post-operative analgesia should be used routinely. (J213.5.w4)
    • Buprenorphine, 0.01 - 0.03 mg/kg intramuscularly or intravenously, every 8 - 12 hours. (J213.5.w4)
    • Butorphanol  may be used as an alternative. Carprofen can be used. (J213.5.w4)
    • Monitor for signs of pain (vocalisation, lethargy, reluctance to move, anorexia, squinting). (J213.5.w4)
    • Analgesics should be given until the ferret is eating well with normal production of faeces. (J213.5.w4)
  • Antibiotic treatment may be required for open fractures or if soft tissue wounds are present. (J213.5.w4)
  • The ferret should be monitored for signs of stress-induced gastrointestinal disease and treated as necessary, including with gastrointestinal protectants, subcutaneous fluids and nutritional support. (J213.5.w4)
  • With internal fixation/external fixator, the ferret should be checked after two weeks, with any bandages removed and the limb and surgical site examined. (J213.5.w4)
  • Repeat radiographs are recommended following surgical repair, at about 4-5 weeks (depending on the fracture site and type and the age of the ferret). (J213.5.w4)
Treatment of post-traumatic osteomyelitis
  • Collect samples for aerobic and anaerobic culture and sensitivity testing, if possible. (Clinical Pathology of Ferrets)
  • Treat with appropriate antibiotics, and drainage. (J213.5.w4)
  • Treatment is often successful. (J213.5.w4)
Associated Techniques
Host taxa groups /species Mustela putorius furo - Ferret
Author Dr Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referees  

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