Ferret spay

Re: Ferret spay

Marie Kubiak — Sat, 22 Mar 2014 18:46:33 GMT

[quote user="grumpyoldman"]

do not do it unless they sign a disclaimer over the adrenal problems , we stopped several years ago after that paper on the incidence of adrenal problems post neutering , and the implants work really well. If you do get an adrenal case in post spey ,the surgery is really tricky ,the gland right next to the vena cava requiring a delicate dissection ,which of course you will be expected to do for nothing because you spayed it which makes it your fault !!!.

[/quote]

Do you get all bitch spay owners to sign a disclaimer about urinary incontinence as this is a more common problem?

The incidence of adrenal disease in European ferrets has been shown to be somewhere around 0.55% and I very rarely see any cases despite the overwhelming hysteria. I am absolutely honest with owners who come in for neutering/oestrus control and explain that there is a potential increase in adrenal disease incidence but since the treatment is the GnRH agonist implant and surgery is not considered the most appropriate treatment anyway they will often accept the future complication and opt to implant later on if clinical signs develop.

I don't see it as my role as to police owner behaviour absolutely - I offer them the various options for estrus control (implant/neuter/implant + neuter/repeat delvosteron/vasectomised hob) along with pros and cons (and costs) of all and let them make an informed decision. Of course all discussions are recorded in clinical notes but I don't make them sign anything.

Marie

Re: Ferret spay

grumpyoldman — Sat, 22 Mar 2014 17:20:16 GMT

Re: Ferret spay

Michael Woodhouse — Thu, 20 Mar 2014 23:24:54 GMT

March 2015 Delvo is due for re-licensing. I suspect it will quietly disappear from the shelves. We stopped even stocking it once the single use claim came about. Have quoted a couple of people and no-one wants a full bottle. We only used to jab half a dozen per year as it was.

I know at least one local practice has an open bottle for mass use at a silly price. What can you do?

Re: Ferret spay

mariette asselbergs — Thu, 20 Mar 2014 23:13:29 GMT

Exactly, I often have a feeling that a lot of this licensing and regulating, cascade and all is working out in practice as dumbing down a vet's professional judgement and risk assessment. We have the background to understand risk issues of drugs without preservatives and the way to deal with that cautiously. A lot of the 28 day stuff is totally non evidence based.

I have used on my own animal;s ketamine that was 20 years out of date, it worked a treat. And in Mozambique we always worked with out of date stuff from the hospital for our small animal work. You come here, industrial quantities of the most useful drugs are thrown out. Madness.

Re delvosteron, in one practice I work in the ferret owner buys her own bottle of delvosteron which is used on her jills until finished. Consent form signed. No probs.

Now my other point/question is this. In the BSAVA book on Rodent and Ferret medicine and surgery they seem to be very convinced that spaying ferrets is obsolete and wrong, because so many spayed ferrets then become hyper adrenal patients. I don't hear that opinion/standpoint reflected in this forum. At least not as strongly as presented in the book. What do others think/what is your experience?

Mariette

Re: Ferret spay

Rob Loxley — Thu, 20 Mar 2014 20:53:26 GMT

It's a licensing issue rather than necessarily a true safety/efficacy issue; if you look at the Delvosteron datasheet for New Zealand no mention if made of immediate disposal... Likewise compare the UK and Australian datasheets re Alfaxan sterility when broached.

Re: Ferret spay

a.bardell — Thu, 20 Mar 2014 19:50:09 GMT

My boss phoned up the drug company who basically sat on the fence. Nothing has changed with the drug, preservative etc from previously its just the European legislation on labelling and licenincing that have got involved.

We now have an open bottle on the shelf for ferrets- we honestly tell our clients about the problem and give them the choice of what to do- either buy a whole bottle or sign a disclaimer re off label use and have a jab from the open bottle.

I have no problem with this as long as I'm happy the client is informed, I still use it on my family's ferrets. If nothing has really changed I don't see what the problem is, been doing this for the last 15 years

Would rather see jill's treated than have major problems and most of the ferrets we see are working ferrets so owners are not realistically going to fork out for a whole bottle.

I now wait to be shot down....

Re: Ferret spay

Rob Loxley — Thu, 20 Mar 2014 17:41:28 GMT

[quote user="Marie Kubiak"]do we use logic and say that sterile withdrawal of liquid from a sealed vial is not going to change the contents and multiuse although off label is unlikely to be detrimental but open ourselves up to liability?[/quote]

Did you previously multi-use vials? Did you previously have any infections/problems?
It's another case where it would be good if the drug company could respond by producing smaller bottles, but that would probably require the VMD to make it cost effective for them to go through the license changes...

Re: Ferret spay

Gillian Mostyn — Thu, 20 Mar 2014 16:21:17 GMT

[quote user="Marie Kubiak"]We're having this debate currently. Do we charge a full bottle (~£50 plus mark up I think but stand to be corrected on that) and lose clients/leave ferrets untreated, or do we use logic and say that sterile withdrawal of liquid from a sealed vial is not going to change the contents and multiuse although off label is unlikely to be detrimental but open ourselves up to liability? It's not comfortable reasoning to me either way![/quote]

Yep - not an easy one at all! Let me know what you decide!!!

The problem is you aren't just going off license - you're actually going against recommendations. Very difficult to defend really.

Re: Ferret spay

Marie Kubiak — Thu, 20 Mar 2014 16:13:45 GMT

[quote user="Gillian Mostyn"]

Do you not find a problem in that delvosterone is now only licensed as a single use bottle, so each client should pay for the whole bottle? I find it has made it cost prohibitive for most people. (But, on the upside, that has made suprelorin more affordable!!)

[/quote]

We're having this debate currently. Do we charge a full bottle (~£50 plus mark up I think but stand to be corrected on that) and lose clients/leave ferrets untreated, or do we use logic and say that sterile withdrawal of liquid from a sealed vial is not going to change the contents and multiuse although off label is unlikely to be detrimental but open ourselves up to liability? It's not comfortable reasoning to me either way!

I like the idea of booking them all in together but we don't see enough at any one time to do a day of jill jabs, plus our clients tend to be impatient and not want to come in when it is convenient to us.

Marie

Re: Ferret spay

Marie Kubiak — Thu, 20 Mar 2014 16:08:50 GMT

[quote user="Adrienne McPartland"]

Hi,

Apologies if this seems like a silly question but I don't see ferrets very often. Colleague saw female ferret tonight who is in season, owner concerned re anaemia d/t chronic oestrogen levels. Is it possible to spay ferret while in season or would it be recommended to intervene with hormones to stop the heat and then spay her?

Anything different about a ferret spay? Anaesthetic recommendations? Any do's and dont's for the procedure?

Thanks in advance

[/quote]

If you're at all concerned about persistent oestrus or anaemia then definitely don't spay as there is usually a concurrent thrombocytopaenia and post-op bleeding is likely. You are better off using devosteron and waiting a few weeks. I wouldn't normally spay an in season ferret as there may be the start of clotting compromise there plus the tissue is more friable and vascular and there is rarely any urgency in spaying them.

I starve for 4hrs pre-op as they have a very fast transit time, so usually they have breakfast at home and are done late morning. I use dom/torb sedation subcut (0.05-0.1mg/kg medetomidine and 1mg/kg butorphanol) and then IV propofol to effect if too light to intubate after that. To be honest there are a massive range of pre-med/GA protocols out there based on feline/canine dosing and I haven't seen any concerns with any that various colleagues use.

Spay itself is pretty similar in technique to a bitch spay but ligaments are a little looser and bursa has more fat so I rely on palpation of the ovary rather than visualisation. I cut open the bursa post-removal to be sure the entire ovary is removed. I also do intradermal sutures to prevent interference. Metacam dosing post-op I use 0.2mg/kg sid for 3-5d, they are susceptible to gastric ulceration so consider concurrent gastroprotectants if any evidence of GI/other disease or you continue NSAIDs for longer periods.

Worth discussing with the owner the increased risk of adrenal disease following surgical neutering of ferrets, there are threads on here covering that issue.

Marie

Re: Ferret spay

Hannah Wynne Richards — Thu, 20 Mar 2014 15:41:49 GMT

Gillian I didn't know that!

Now what do I do?

Wynne

Re: Ferret spay

Beats — Thu, 20 Mar 2014 15:38:49 GMT

You can stick with the rules and still offer Delvosterone at a price cheaper than a bottle per ferret with a "Jill Jab Day".

You're doing them all about the same time anyway, so just designate a day and anyone who rings up gets booked in on that day and cost of bottle is split between them. If they tell their ferret-owning friends it'll be cheaper for them all.

Re: Ferret spay

Gillian Mostyn — Thu, 20 Mar 2014 15:33:55 GMT

[quote user="Richard Carter"]Also interested to see you starve overnight - I was under the impression that the ferret was one of these animals that if starved would become hypoglycaemic??[/quote]

Older ferrets (usually, but not always, 3+) are very prone to having an undetected insulinoma hiding away.... hence why the caution about starving them.

Re: Ferret spay

Gillian Mostyn — Thu, 20 Mar 2014 15:27:28 GMT

[quote user="Charlotte Lusted"]Is it? Bah when did that happen?[/quote]

From the data sheets:

Shelf life

Shelf life of the veterinary medicinal product as packaged for sale: 3 years.

Shelf life after first opening the immediate packaging: use immediately.

Special precautions for storage

Do not store above 25°C. Do not refrigerate. This product should be used immediately and not stored after opening.

It has been like that for quite a long time.

A ferret owner recently rang us for a quote for a 'jill jab' and was astounded when we told them the cost - another practice local to us (anyone who knows me will be able to guess which one...) are apparently only charging £15. We rang (openly) and confirmed it with them - they seemed to think that because they'd had the bottle for ages it didn't count under the 'new legislation' .

I get frustrated because I agree that a product with no preservative should be single use, but if we aren't all playing by the same rules then it makes some of us look like we are profiteering!!!

Re: Ferret spay

Charlie Lyon — Thu, 20 Mar 2014 14:56:12 GMT

[quote user="Gillian Mostyn"]

Do you not find a problem in that delvosterone is now only licensed as a single use bottle

[/quote] Is it? Bah when did that happen? To be fair haven't had to do a Jill jab in forever. And obviously was writing too late last night as we do spey when in season too just most of the ones we do are from the local rescue place so get them done early. We feed them as soon as they are awake and (touch wood) have not had issues with hypos

Re: Ferret spay

Sarah Rothwell — Thu, 20 Mar 2014 13:54:04 GMT

[quote user="Hannah Wynne Richards"]

I starve,as I've had one regurgitate - never had a prob - they come throughthe anaesthetic OK

Wynne

[/quote]

On the other hand, one of mine did become hypoglycaemic post op. Awkward creatures

Re: Ferret spay

Hannah Wynne Richards — Thu, 20 Mar 2014 13:43:48 GMT

I starve,as I've had one regurgitate - never had a prob - they come throughthe anaesthetic OK

Wynne

Re: Ferret spay

Richard Carter — Thu, 20 Mar 2014 13:27:56 GMT

Also interested to see you starve overnight - I was under the impression that the ferret was one of these animals that if starved would become hypoglycaemic??

Re: Ferret spay

Gillian Mostyn — Thu, 20 Mar 2014 13:18:35 GMT

[quote user="Charlotte Lusted"]We use delvosterone to suppress seasons routinely. [/quote]

Re: Ferret spay

Hannah Wynne Richards — Thu, 20 Mar 2014 09:25:04 GMT

Exact opposite. I only do them when in season. When out of season the ovarian ligaments are so tight it's easy to leave some ovarian tissue behind - and that can be catastrophic.

Wynne

Re: Ferret spay

Charlie Lyon — Thu, 20 Mar 2014 01:01:36 GMT

We spey and castrate\vasectomise ferrets all the time, although not when in season (exactly why I'll need to ask\look up but it's late) We use delvosterone to suppress seasons routinely. Our GA involves starving overnight, then xylazine\ket and o2\iso to maintain via mask, very similar to midline cat spey just smaller and use metacam for analgesia - no problems over the past 5 years (touch wood ) and we do a lot of ferret neuters as a lot of rescue centres and working ferrets in the Fens.

Re: Ferret spay

Gillian Mostyn — Wed, 19 Mar 2014 23:23:09 GMT

Excellent question, but a controversial one! Marie Kubiak will hopefully be along with some expertise, but the decision is really spay vs suprelorin implant. If the cost is not an issue, and future further implantation is an option, then I'd go with the implant. If the owners want a once-only 'cure' then you should be fine to spay at this time of year. Future adrenal gland issues should be explained to the client though.