Ferret Orthopedics
Ferret Orthopedics
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FERRET ORTHOPEDICS
Tracey K. Ritzman, DVM and David Knapp, DVM, Dipl ACVS
PHYSICAL EXAMINATION
From the Avian and Exotic Pet Medicine Service (TKR); and the Department of Surgery
(DK), Angell Memorial Animal Hospital, Boston, Massachusetts
RADIOGRAPHY
ORTHOPEDIC CONDITIONS
Traumatic Fractures
Data from Angell Memorial Animal Hospital, Avian and Exotic Pet Medicine Service, Boston,
Massachusetts.
tibia and fibula. Femoral neck fractures have not been noted in Table 1,
but this fracture type has been documented in one ferret.13
Figure 1. Radiograph of an adult, male ferret with forelimb lameness after a traumatic fall.
A right olecranon fracture with proximal displacement and soft tissue swelling is present.
Figure 3. Postoperative lateral radiograph of the right elbow joint after surgical reduction
of a right olecranon fracture. This fracture has been aligned and stabilized by means of a
single K-wire placed through the olecranon into the distal ulna along with a figure-eight wire.
Figure 4. Cranial-caudal radiographic view of the reduced and stabilized right olecranon
fracture in the ferret. The fracture has been aligned and stabilized by means of a single K-
wire placed through the olecranon into the distal ulna along with a figure-eight wire.
Figure 5. A ferret after internal reduction and stabilization of a right olecranon fracture. A
soft, padded bandage has been applied to the limb for support during the immediate
postoperative period.
Figure 6. Lateral radiograph of an adult female ferret with a history of trauma to the caudal
body. A fracture of the distal left femur is visible. There is severe soft tissue swelling
surrounding the area. Linear lucencies in the distal femur indicate possible intercondylar
fracture as well as the fracture of the distal metaphysis.
138 RITZMAN & KNAPP
Figure 10. Lateral radiograph of a 2.5-year-old ferret that was found suddenly lame within
its cage. Fractures of both the tibia and fibula are present.
142 RITZMAN & KNAPP
ture was reduced manually. Four cross pins were placed through the
tibia above and below the fracture site, and a type II acrylic K-E device
was placed with the intramedullary pin tied into it medially. A two-
layer subcuticular closure was performed using 5-0 absorbable sutures,
and tissue adhesive was used for the skin closure. Postoperative radio-
graphs showed that the tibial fracture ends had been brought into
excellent apposition and alignment. Repair of the tibial fracture had
brought the fibular fracture ends into alignment as well (Figs. 12 and
13). This patient was prescribed cage rest after surgery, and the implants
were removed 6 weeks later after radiographic confirmation of adequate
healing. A return to normal function of the limb was achieved.
Figure 12. Postoperative lateral radiograph of tibial fracture repair of ferret shown in Figure
10. The tibial fracture has been repaired using a combination of intramedullary pin and
external fixator. The intramedullary pin has been incorporated into the external skeletal
fixator device. Fracture ends are in excellent apposition and alignment. Repair of the tibial
fracture has brought the fibular fracture ends into alignment as well.
common in ferrets and have not been listed in Table 1, injuries of this
type can occur. Treatment in the ferret is similar to that used in other
domestic mammal species.
Elbow Luxations
Figure 13. Postoperative cranial-caudal radiograph of a tibial fracture repair. The tibial
fracture has been repaired using a combination of intramedullary pin and external fixator.
The intramedullary pin has been incorporated into the external skeletal fixator device.
Fracture ends are in excellent apposition and alignment. Repair of the tibial fracture has
brought the fibular fracture ends into alignment as well.
Figure 14. Lateral radiograph of a ferret with a left elbow joint luxation.
Figure 15. Cranial-caudal radiograph of a ferret with a left elbow joint luxation.
elbow joints were reduced and stabilized via an open surgical technique.
In this ferret, lateral approaches were used in both elbow joints and the
elbow luxations were reduced manually. A K-wire was placed normo-
grade down the humerus to stabilize the luxation and was seated in a
transarticular fashion into the proximal ulna. K-wires were placed on
the distal humerus and the proximal radius and were incorporated into
a lateral, type I external acrylic fixator on both elbows. Closure was
routine in a two-layer fashion with a 5-0 monofilament, absorbable
suture. This ferret patient did well after surgery with the bilateral exter-
nal fixators to stabilize the elbow joints. A radiographic evaluation of
both elbows was performed 3 weeks after the surgical stabilization. One
of the elbow joints in this patient developed progressive osteolysis in
the bones of the right elbow. The progressive erosion of the articular
surfaces of the right elbow was thought to be secondary to the trauma
that the joint experienced or to potential septic arthritis. Antimicrobial
therapy was initiated in this patient because of the potential for infection,
and the ferret continued to convalesce with both elbows remaining in
FERRET ORTHOPEDICS 147
Figure 16. Left elbow luxation reduction and stabilization in a ferret, using a transarticular
intramedullary humeral pin tied into a modified K-E apparatus.
Figure 17. Lateral radiograph of a ferret with bilateral elbow luxation secondary to a
traumatic fall. Both elbow joints were reduced and stabilized via open surgical technique
using an intramedullary pin in each humerus and intramedullary pins in the distal humerus
and proximal ulna of each elbow tied into a type I external skeletal fixator.
Limb Amputation
Spinal Injury
Figure 18. Lateral radiograph of an adult male ferret with acute onset of hind limb paresis.
There is a mass effect seen between the fourth and sixth thoracic vertebrae dorsal to the
vertebral canal. There is extensive lysis of the dorsal spinal process of T5 as well as the
vertebral laminae. A primary neoplastic process was suspected from the radiograph.
location for chordoma formation is on the tail; however, these are slow-
growing neoplasms and typically do not metastasize. Cervical spine
chordomas are uncommon, but several cases have been documented in
the ferret. Cervical chordomas may induce osteolytic reaction of the
vertebra and can compress the spinal cord or adjacent tissues.9 Osteomas,
chondromas, chondrosarcomas, fibrosarcomas, rhabdomyosarcomas, and
synovial cell sarcomas are all primary neoplasms of the musculoskeletal
system documented in the ferret.9
Neoplasia of the spine has been documented in ferrets as causing
hind limb paresis or paralysis.4, 9 Metastatic lymphoma to the vertebrae
can cause osteolytic lesions.9 A case of spontaneous plasma cell myeloma
that involved the lumbar vertebrae in a ferret with paraparesis has been
reported in the literature.9 Acute myelogenous leukemia was diagnosed
in a 1-year old ferret with nonsupporting lameness of the forelimb. A
cystic bone lesion in the proximal humerus was radiographically visible.
At necropsy, acute myelogenous leukemia was diagnosed in the hu-
merus and the thoracic vertebra.9 Figure 18 is a lateral radiograph of a
2-year-old ferret with a history of acute onset of hind-limb paresis and
urinary incontinence. Whole-body radiographs revealed an expansile
mass effect seen between the fourth and sixth thoracic vertebrae dorsal
to the vertebral canal. Extensive lysis of the dorsal spinal process of T5
and the vertebral laminae was visible. A primary neoplastic process was
suspected from the radiograph but was not confirmed in this patient.
Stifle Injury
Nutritional Disease
PREOPERATIVE CONSIDERATIONS
Anesthesia
Anesthesia for ferrets is similar to that for felines. Most ferret pa-
tients can be induced in an enclosed chamber with an appropriate gas
anesthetic. Most ferrets tolerate chamber induction better than active
restraint with facemask application. Intubation is recommended for di-
rect airway access and control of respiration. A laryngoscope with a
pediatric blade facilitates visualization of the larynx. A 2- to 3.5-mm
internal-diameter cuffed endotracheal tube will fit most ferrets.4a Ferrets
have a high level of jaw tone, and a proper level of muscular relaxation
is required for intubation.4a For the healthy orthopedic ferret patient
without other medical illnesses, anesthesia may include induction and
maintenance with an inhalant anesthetic such as Isoflurane.4a Monitoring
can be performed with electrocardiography or pulse oximeter. The reader
is referred to the current literature on this subject for additional informa-
tion.4a
FERRET ORTHOPEDICS 153
Analgesia
POSTOPERATIVE MANAGEMENT
AND PATIENT FOLLOW-UP
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FERRET ORTHOPEDICS 155
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e-mail [email protected]