Acute pancreatic panniculitis in a domestic ferret (Mustela putorius furo): diagnostic insights and a potential drug-induced etiology

Panniculitis is a rare condition in ferrets (Mustela putorius furo), previously linked to nutritional deficiencies, infections, trauma, and injections. Pancreatic panniculitis, caused by the systemic release of pancreatic enzymes during pancreatic injury, has been documented in humans and other animal species, but not in ferrets. This report describes the first known case in a domestic ferret. A 2-year-old male ferret presented with ulcerated cutaneous nodules predominantly affecting the hind limbs and inguinal abdominal region. The ferret had been treated with rifampicin and clarithromycin for suspected mycobacterial infection. Hyperglycemia, hyperglobulinemia, and elevated alkaline phosphatase were noted. Cytology and culture of the lesions revealed neutrophilic inflammation and Pseudomonas aeruginosa, respectively. The animal developed acute abdominal discomfort and died shortly after. Post-mortem examination revealed severe pancreatic necrosis and peripancreatic panniculitis, with splenic pyogranulomatous inflammation. Immunohistochemistry detected systemic coronavirus antigen (clone FCV3-70) only in the spleen. In this patient, prolonged use of rifampicin and clarithromycin is considered a potential contributing factor to the development of acute pancreatic necrosis. This case highlights the clinical relevance of pancreatic panniculitis in ferrets and suggests a possible association between extended rifampicin/clarithromycin therapy and pancreatic necrosis. Ultrasonography and serum glucose, lipase, and amylase measurements are recommended for early diagnosis. Histopathological evaluation remains essential for confirmation.