Epizootic Catarrhal Enteritis (ECE) in Ferrets

TL;DR. Epizootic Catarrhal Enteritis is a highly contagious viral infection in ferrets that causes severe green watery diarrhea, vomiting, and rapid, life-threatening dehydration.

Early intervention and supportive care are key to helping ferrets recover from ECE.

What is it?

Epizootic Catarrhal Enteritis (ECE), frequently referred to by ferret owners and veterinarians as "green slime disease," is a highly contagious inflammatory condition of the intestinal tract. The disease is caused by Ferret Enteric Coronavirus (FECV), a virus that specifically targets the cells lining the ferret's gastrointestinal system. Because ferrets are exotic pets with highly specialized anatomies, gastrointestinal diseases can escalate far more rapidly than they do in dogs or cats.

The virus primarily attacks the microscopic, finger-like projections in the small intestine known as villi. These villi are responsible for absorbing nutrients, water, and essential electrolytes from digested food. When FECV infects these cells, the villi become damaged, blunt, and unable to perform their absorptive functions. This results in severe malabsorptive diarrhea, where water and nutrients pass straight through the digestive tract instead of being absorbed into the body.

For ferret owners, this disease is a significant concern due to how quickly it spreads and how rapidly it can compromise a ferret's health. Ferrets have an incredibly short gastrointestinal transit time—often taking only three to four hours for food to travel from the stomach to elimination. Because of this rapid transit, any disruption in intestinal absorption leads to immediate, profound dehydration and metabolic imbalance. In a multi-ferret household, shelter, or rescue facility, ECE can sweep through the entire population within days.

Causes & risk factors

ECE is caused by the Ferret Enteric Coronavirus (FECV). The virus is shed in the feces of infected animals and is transmitted via the fecal-oral route. This means healthy ferrets contract the virus by directly contacting infected feces, sharing contaminated litter boxes, food bowls, or toys, or through caretakers who carry the virus on their hands or clothing.

The classic transmission scenario involves the introduction of a new ferret into an established household. Frequently, this new addition is a young juvenile ferret (a kit). Juvenile ferrets often act as asymptomatic carriers; they harbor and shed the virus in their feces without showing any outward signs of illness. This occurs because the intestinal cells of young ferrets regenerate much faster than those of mature ferrets, allowing them to tolerate the viral infection without developing severe clinical disease. However, when the resident older ferrets are exposed to the newly introduced virus, they quickly develop severe clinical signs.

There are no documented breed predispositions for Epizootic Catarrhal Enteritis. Any domestic ferret, regardless of its coat color, breeding line, or origin, is highly susceptible to infection if exposed to the virus. The primary risk factors are environmental, including high-density housing, poor quarantine protocols for new arrivals, and the stress of rehoming, which can suppress the immune system and make a ferret more vulnerable to active infection.

Signs to watch for

Recognizing the signs of ECE early is critical to securing a positive outcome for your ferret. The clinical signs typically appear within two to fourteen days following exposure to the virus.

• Green watery diarrhea (Cardinal): This is the hallmark sign of ECE. The stool is often described as having a bright green, gelatinous, or "slime-like" appearance. The green color is caused by the rapid transit of bile through the damaged intestines, which does not have time to be reabsorbed or processed normally.
• Dehydration (Common): Because the intestines cannot absorb water, ferrets lose fluids at an alarming rate. Dehydration manifests as dry or tacky gums, sunken eyes, and a loss of skin elasticity (when gently pinched, the skin over the shoulders remains tented rather than snapping back quickly).
• Weight loss (Common): Due to severe malabsorption and lack of appetite, affected ferrets can lose a significant percentage of their body weight within just a few days.
• Anorexia (Common): Ferrets with ECE typically refuse to eat their normal food due to nausea and abdominal pain.
• Lethargy (Common): Sick ferrets will appear weak, sleep excessively, and show no interest in playing or interacting with their owners.
• Vomiting (Common): Vomiting often occurs in the early stages of the disease, further compounding the dehydration.
• Melena (Occasional): In severe or prolonged cases, the stool may become dark, black, and tarry. This indicates digested blood, which suggests bleeding in the upper gastrointestinal tract due to severe mucosal damage or ulceration.

Lethargy and a dull, unkempt coat are common signs of systemic illness and dehydration in ferrets.

How vets diagnose it

Your vet will begin with a thorough physical examination, paying close attention to your ferret's hydration status and abdominal comfort. On palpation, the intestines of a ferret with ECE often feel fluid-filled, thickened, and painful.

To confirm a diagnosis of Ferret Enteric Coronavirus, your vet will recommend specific diagnostic tests:

• Fecal RT-PCR (Gold Standard): A Reverse Transcription Polymerase Chain Reaction (RT-PCR) test performed on a stool sample is the gold standard for diagnosing ECE. This highly sensitive test detects the genetic material (RNA) of the Ferret Enteric Coronavirus. It is the most reliable way to confirm active viral shedding.
• Fecal electron microscopy: This specialized laboratory test uses an electron microscope to physically visualize the characteristic crown-like coronavirus particles in a stool sample. While highly accurate, it is less commonly used today because PCR testing is more widely available and highly sensitive.
• Histopathology of intestinal biopsy: In chronic, atypical, or severe cases where the diagnosis remains uncertain, your vet may recommend obtaining a small tissue sample of the intestine via surgery or endoscopy. Under a microscope, a pathologist will look for characteristic changes, such as severe blunting and atrophy of the intestinal villi, along with inflammatory cell infiltration.

Because ferrets are prone to other gastrointestinal issues—such as foreign body obstructions, bacterial infections, and inflammatory bowel disease—your vet will also perform baseline bloodwork (a complete blood count and biochemistry profile). This helps rule out concurrent diseases, assess kidney function (which can be compromised by severe dehydration), and monitor blood glucose levels, which is especially critical in ferrets suspected of having concurrent insulinoma.

Fecal RT-PCR is the gold standard diagnostic tool used to detect Ferret Enteric Coronavirus.

Treatment options

There is no specific antiviral medication that cures ECE. Instead, treatment focuses on aggressive supportive care to keep the ferret hydrated, manage pain, and control secondary complications while the intestinal lining heals.

Fluid Therapy

Fluid therapy is the most critical component of ECE treatment. Depending on the severity of the dehydration, your vet will administer fluids either subcutaneously (under the skin) or intravenously via an indwelling catheter. These fluids restore hydration, correct electrolyte imbalances, and maintain blood pressure.

First-Line Medications

• Metronidazole (Antibiotic / Antiprotozoal): This medication is prescribed to prevent or treat secondary opportunistic bacterial infections in the damaged gut. It also has mild anti-inflammatory properties that help soothe the intestinal tract.
• Buprenorphine (Opiate Partial Agonist): ECE causes significant abdominal cramping and pain. Pain management is vital, as pain causes stress, which further suppresses the immune system and discourages the ferret from eating. Buprenorphine provides effective visceral pain relief.

Second-Line Medications

• Famotidine (H2-Receptor Antagonist): This medication reduces stomach acid production. It is used to protect the stomach and upper intestinal lining from ulceration, which is a common and dangerous complication in stressed, anorexic ferrets.

Nutritional Support

Because affected ferrets refuse to eat, assisted feeding is essential. Your vet will recommend a highly digestible, high-calorie liquid or semi-liquid recovery diet designed for carnivores. This food must be syringe-fed gently multiple times a day to prevent hepatic lipidosis (fatty liver disease), a life-threatening condition that occurs when a ferret's body goes into starvation mode.

Prognosis

The prognosis for ferrets with ECE varies significantly based on their age and overall health status:

• Young, healthy ferrets: The prognosis is excellent. With prompt, aggressive supportive care (especially fluid therapy and nutritional support), young ferrets typically make a full recovery within one to two weeks, and their intestinal villi regenerate completely.
• Older, geriatric ferrets, or those with concurrent diseases: The prognosis is guarded to poor. Older ferrets, or those already battling chronic metabolic conditions like insulinoma (low blood sugar) or adrenal gland disease, have much lower physiological reserves. The severe stress, dehydration, and electrolyte imbalances caused by ECE can rapidly destabilize these pre-existing conditions, leading to multi-organ failure.

Some recovered ferrets may experience chronic malabsorption or intermittent soft stools for several weeks or months after the initial infection. These individuals may require long-term dietary management, such as highly digestible diets, to maintain their weight and gastrointestinal health.

Prevention

Preventing ECE relies entirely on strict biosecurity and quarantine protocols, as there is currently no vaccine available for Ferret Enteric Coronavirus.

• Quarantine: Any new ferret introduced to a household or facility must be strictly quarantined in a separate room with no shared air space, toys, or litter boxes for a minimum of three to four weeks. Because young kits can shed the virus asymptomatically, this quarantine period allows you to monitor for any signs of illness and prevents immediate exposure to your resident ferrets.
• Hygiene and Sanitation: Always wash your hands thoroughly, change your clothes, and sanitize your footwear after handling ferrets outside your home or before interacting with your quarantined ferret. The virus is stable in the environment but can be inactivated by standard disinfectants, such as diluted household bleach or potassium peroxymonosulfate-based cleaners.
• Avoid High-Risk Environments: Limit your ferrets' exposure to unknown ferrets at playgroups, pet stores, or shows, especially if you have older or immunocompromised ferrets at home.

When to call your vet

Because ferrets are small mammals with rapid metabolisms, they can deteriorate from stable to critical in a matter of hours. You should contact your veterinarian immediately if you notice any changes in your ferret's stool or behavior.

Seek emergency veterinary care immediately if your ferret exhibits any of the following red-flag signs:

• Complete lethargy or unresponsiveness (limp body)
• Continuous vomiting or inability to keep fluids down
• Black, tarry, or bloody stools (melena)
• Cold paws, ears, or nose, indicating poor circulation or shock
• Extreme weakness or inability to stand

Sources

Because specific textbook citations were not provided for this record, the clinical guidelines outlined in this article are based on standard-of-care veterinary consensus for exotic animal medicine and ferret-specific gastroenterology.