spinal surgery in a ferret

Re: spinal surgery in a ferret

Mark Lowrie — Tue, 04 Oct 2011 12:09:02 GMT

I cannot see the images clearly again I am afraid (sorry). Howerver, if your radiologist reports a micro-fracture combined the failure in recovery then this all points towards instability and so I definitely would consider stabilisation if the owner can stretch to it.

Re: spinal surgery in a ferret

jose targa — Tue, 04 Oct 2011 11:51:15 GMT

Hi Mark!!!!!

Yes, we didn´t understand very well the situation only with radiographs, that´s why we decided to perform a CT and the technician found a suspect image in the body of L-2. They told me it was a "micro-fracture" afecting the medular space on the left side. I´m not a CT expert, wath do you think about???. Not improvement for the moment...3 days after surgery. Once again, thank you very much for your interest!!!!!

Re: spinal surgery in a ferret

Mark Lowrie — Tue, 04 Oct 2011 11:33:50 GMT

I do think that stabilisation would be the best option in this case. You mention that you discovered a fracture of the L2 vertebral body, although I was not clear how you found this – was this using CT advanced imaging or was it during the surgery itself? The presence of a vertebral body fracture would make me concerned about continued instability. I am struggling to see the radiographs clearly so apologise if I have missed something obvious, although the dorsal view doesn’t seem well aligned again suggesting instability. Incidentally, the surgical image is nice although the presence of a grossly normal spinal cord doesn't mean very much - on-going contusion is not something we can see grossly. Has there been any improvements since the surgery?

Re: spinal surgery in a ferret

jose targa — Mon, 03 Oct 2011 21:14:47 GMT

Sorry!!! there´s a mistake, i was talking about hind limbs!!! (my "inglish" is poorer than the prognosis of the ferret jajajaja).

When the animal came there was correct sensibility, volunteer movements were present, but probably it was easier for him to walk only in his forelimbs, paraparesia is our description.

As you can see in the picture, there´s a subluxation of L-2-L-3, but unstability was no present!!! We decided to perform a dorsal laminectomy because of this, we didn´t want to touch the vertebral dorsal joints to mantain this critical vertebral stability points. Despite of this, do you still thinking that it would be better to give a surgical stabilization????

That´s the final surgical result L-2 is on the left side.the dorsal L-3 apofisis (right) has been removed and conservative dorsal laminectomy has been performed. The aspect of the medula was perfect for me. As you can see the joints were untouched. Intraoperative stability was checked.

Your opinion as an experts is very important for me. Thank you so much for your interest!!!!.

Regards from Spain.

Re: spinal surgery in a ferret

Judith Joyce — Mon, 03 Oct 2011 09:38:10 GMT

Hi,

Malcolm Ness here - away from home on Judy's computer.

I would reiterate Mark L's words of caution - I am not sure that decompressive surgery on an unstable spine is a good idea unless the spine is surgically stabilised as well.

Furthermore, the original post states a fore-limb neuro deficit. This could not be cause by a lesion in the lumbar spine but rather a lesion in the cervical or cervico-thoracic spine or a peripheral lesion in the brachial plexus. Was this a typo??

Re: spinal surgery in a ferret

Mark Lowrie — Mon, 03 Oct 2011 08:53:00 GMT

I know I am coming in on this a bit late and I am also not familiar with ferrets. However, from a neurological viewpoint I would add a couple of points:

· Prognosis will depend on the severity of neurological signs. Prognosis is extremely poor if deep pain sensation is lost to the pelvic limbs. If it remains intact then I think there is some hope of recovery of function in the coming months.

· I would also be concerned about continued instability of the spinal cord following the surgery you performed. The luxation will have been due to the vertebral body fracture (secondary to the trauma, as you mentioned) but without surgical stabilisation this is unlikely to repair. Conservative management may help but I would be concerned that a ferret is not easy to rest (I may be wrong?!) and so the luxation would not heal well too well. If this was a dog or a cat then conservative management would carry a guarded prognosis… The papers cited by Mark are all regarding ferrets with disc extrusion and not instability and therefore prognosis in these cases will be much better as the inciting cause (i.e. the disc) was removed surgically. I think your case will carry a poorer prognosis.

However, your choice of medication sounds good and I think continued conservative management now seems appropriate if surgical stabilisation is not an option in this case. Good luck and do let us know if you see a revovery.

Re: spinal surgery in a ferret

jose targa — Sat, 01 Oct 2011 13:23:55 GMT

....please marry me!!!!! jajajaja

I´m not sure how to thank you!!!!

Regards

Re: spinal surgery in a ferret

Mark Rowland — Sat, 01 Oct 2011 12:18:53 GMT

Intervertebral disk prolapse in a ferret

Vet Clin North Am Exot Anim Pract. September 2006;9(3):667-71.

Neus Morera¹; Xavier Valls; Joan Mascort

¹Exòtics, Balmes, 454, 08022 Barcelona, Spain.

Treatment of a prolapsed lumbar intervertebral disc in a ferret

J Small Anim Pract. October 2004;45(10):501-3.

D Lu¹; C R Lamb; J C Patterson-Kane; R Cappello

¹Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA.

Hope these help

Mark

Re: spinal surgery in a ferret

Mark Rowland — Sat, 01 Oct 2011 12:15:39 GMT

Prazosin is OK to use. It can take a week to reach therapeutic levels so you will need to monitor the bladder carefully.

Im not sure how well the convenia will work, Marboflox/buprenorphine/meloxicam sounds like a good choice to me. If you cannot find the references of previous cases yourself just let me know.

Re: spinal surgery in a ferret

jose targa — Sat, 01 Oct 2011 12:06:40 GMT

Thank you Mark!!!! I haven´t had any case like this before. In fact i´m writting it !.

Our antibiotic election is convenia and marbofloxacin. Which antiinflamatori would you chose? we´re actually using meloxicam. Buprenorfine is our chose for postoperative analgesia. About urinary, i was thinking in use prazosin. Do you got any experience with this in ferrets???.

Regards from Spain.

Re: spinal surgery in a ferret

Mark Rowland — Sat, 01 Oct 2011 07:53:34 GMT

In the 2 cases I can find the ferrets returned to ambulation 1-2 months following decompression. I would be going for strict rest and routine anti inflammatory/analgesic cover and monitor urination but make the clients aware of a protracted recovery period. Both cases were normal several months after the surgery.

Nice case, you should write it up

Mark