ISSN 2398-2985      

Drug administration techniques

4ferrets

Introduction

Rationale for technique

  • Drug administration can be by injection (subcutaneous (SC), intramuscular (IM), intraperitoneal (IP), intravenous (IO), oral (PO) and topical.
  • Most drugs that are given IV can be given IO Intraosseous catheterization, except for hypertonic or alkaline solutions, which should be diluted when possible.
  • Pharyngeal or oral gastric tubes are rarely used in ferrets, but placement is the same as in dogs and cats.

Uses

Advantages
  • Injections deliver medication parenterally and therefore are not dependent on a functioning gastrointestinal tract for absorption.
  • Oral administration may be easier, but if there is gastrointestinal problems, there may be complications of absorption.
  • The disruption of the gastrointestinal flora in ferrets after administration of medication is considered to have negligible effects.
  • The SC route works well for larger volumes such as with fluid therapy, but the subcutaneous space of ferrets is relatively small when compared to other species such as dogs, cats or rabbits.
Disadvantages
  • Skin is thick and sensitive in the upper back and requires a larger needle (larger than 25 ga).
  • Small muscle masses including lumbar and anterior thighs for IM injections limits volume. Cranial thigh muscles are indicated for IM injection in ferrets.
  • IV administration is difficult due to small legs and thick skin (saphenous, cephalic, jugular):
    • The cranial vena cava is commonly used for blood collection in ferrets , but injection of drugs is not indicated unless it is a terminal injection for euthanasia.
    • If a catheter is placed in the jugular vein, it commonly requires a cut-down procedure to install it.
    • The ventral coccygeal vein can be used both for blood collection and for drug administration, although it is a small vein and any procedure performed in this vein is difficult.
  • IP injections can be done in the hospital, but is not a route for owners to medicate the ferret at home. IP injetions are commonly used in research facilities, but in clinical medicine other routes are preferred.
  • IO catheter placement requires heavy sedation and/or anesthesia for placement.
  • The oral route must be used with caution in ferrets with dyspnea, megaesophagus or vomiting. If there is oral/dental disease, the ferret may resist having a syringe inserted into the mouth with medication. Ferrets dislike the taste of some drugs, particularly metronidazole Metronidazole.
  • Most ferrets will react, vocalize or try to bite after a SC/IM injection; proper restraint is paramount.
Most drugs are not licensed to be used in ferrets.

Technical problems

  • Proper restraint is required for injections and oral administration of medication.
  • Volume for IM injection should not exceed 0.3-0.4 mL in any one site. Irritating solutions should not be used.
  • Volume for IP injections should not exceed 10 mL. The solution should be warmed to body temperature and not be irritating (very high or low pH).
  • A maximum volume of 5-10 mL is used for each SC site.

Alternative techniques

  • IO catheter placement is a good alternative to an IV catheter for fluid and medication administration.
  • Nebulization: allows delivery of drugs such as antibiotics, antifungals and mucolytic agents to the upper and lower airways and the lung parenchyma.
  • Intranasal administration: sedatives such as midazolam can be administered intranasally.
  • Antibiotic impregnated beads, tape, gel or gauze: for application to infected sites.
  • Intratracheal: for emergency drugs such as atropine or epinephrine. Increase normal IV dose by 2 or 2.5-fold when given intratracheal.
  • Vascular access devices are indicated for long-term, frequent delivery of chemotherapeutics or antimicrobials. As an example, it may be useful to treat lymphoma.
  • Transdermal: transdermal (topical) administration of some insecticides has several advantages, eg increased client compliance, ease of delivery, bypass of routes of metabolism.
  • Epidural: for chronic pain or abdominal, hindlimb or perineal surgery.

Time required

  • Injections (SC, IM, IV or IP) can be done rapidly.
  • Oral administration is usually fairly quick with proper restraint.
  • IO administration is rapid, however the procedure itself may take 15 min or longer for sedation/anesthesia to be induced.
Preparation
  • Filling syringes is rapid.
  • Oral medications should be palatable; many of these will be compounded from tablets and a sweetened pharmaceutical compounded solution can be used. Meat flavours also encourage ferrets to eat.
  • Ferrets are restrained by 'scruffing', which makes them open their mouth and facilitate oral administration. The oral medication is placed over the tongue and the ferret is allowed to swallow it.
Procedure
  • Injections themselves are rapid.
  • Oral medications placed directly in the mouth takes under a minute.

Decision taking

Criteria for choosing
  • Type of medication and route must allow for the best absorption of a particular medication.
Risk assessment
  • Anesthesia or heavy sedation with local anesthesia are needed for IO catheter placement.
  • Injection solution itself may cause muscle damage (such as enrofloxacin Enrofloxacin) and the volume and frequency of delivery may limit the IM injections in particular that can be given.
  • Restraint and the momentary pain of injection with any route can cause stress.
  • IP injections should not be given if there is abdominal distention or gastrointestinal distress or disease. If the ferret is having respiratory problems (such as dyspnea), the position for IP injections can exacerbate breathing difficulties and should probably be avoided.
Print off the Owner Factsheet on Giving your Ferret medicines to give to your clients.

Requirements

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Preparation

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Procedures

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Chitty J R (2017) Clinical Techniques. In: Ferret Medicine and Surgery. Ed: Johnson-Delaney C A. CRC Press. USA. pp 95-111.
  • Quesenberry K E & Orcutt C (2012) Basic Approach to Veterinary Care. In: Ferrets, Rabbits and Rodents: Clinical Medicine and Surgery. 3rd edn. Eds: Quesenberry K E & Carpenter J W. Elsevier. pp 13-24.

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