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QUESTION: Dear Irene,

I am looking for ideas on what could be wrong with my female rat Episkey. About 2 to 3 weeks ago I noticed that Episkey seemed fatigued, week and her breathing seemed somewhat labored. I took her to the vet and he had a hard time finding out what was wrong with her, she was put on antibiotics in case of a diffuse infection (a Combination of Baytrill and Ronoxan). Since then I have taken her to the vet 3 times and they are still struggling to find what is wrong with her. There is no doubt that her fast and labored breathing is her primary symptom. In the examination her Heart and lungs seem absolutely healthy, and the vets now believe that the problem stems from somewhere in the nose region, though nothing has been detected in examination. The Vets have a hypotheses that it could be caused by her front teeth growing backwards and by that putting pressure on the nasal region, Thus causing swelling. Her teeth in her mouth seem healthy and normal. From the "teeth hypothesis" she is put on noninflammatory and painkillers as that should offer relief and by that confirm that diagnosis. She has been on the new meds for 5 days with no change. Episkey haven't been x-rayed as the vet fears that she would suffocate if she was put on anesthetics with her having to struggle for breath. I am taking her back to the vet put I am very frustrated that they cant determine what is wrong with her, and I fear that I will have to have her put Down without knowing how to help her (she has no quality of life at the moment). Episkey is only 5 months old and live with 3 other female rats that have no symptoms. The vets are the best in Denmark when it comes to rats (most have Little to no knowledge or interest in that species), so I have nowhere to go for a second opinion. Do You have any recommendations or thoughts that I could share with my vets? I really hope that there is still a chance to help the Little girl. I apologize for my poor writing, English is my second language.

Thank You so much for Your time!
Best Regards
Maria

ANSWER: Your English is nearly perfect...I didn't realize until the very end of your message that this was not an American speaking :)

Your little girl is so very young to have such a serious problem.  When you say she has no quality of life now, can you tell me what you mean?  Is she not eating or drinking?  Is she not moving much?  If she's not eating or drinking, try stage 1 baby foods because they contain a lot of water. Rats that cannot breathe don't want to exert what little energy they have on chewing, but licking does not take much energy.  Soy milk is also good for vitamins and she can lick that too. Watermelon mashed up is also a good source of water.  Feed her as much as she wants, whenever she wants it. Leave some down on a flat plastic dish right in front of her if she is not walking much.

Also, until you can get her back to the vets, to help her breathing, do the following things:  take her into a hot steamy bathroom and keep her there for at least 15 minutes, and repeat every time her breathing gets worse, or at least several times a day and night.  Hopefully this will help a little.  The other thing is to feed her bits of extra dark chocolate (melt it so she can lick it)...this also is a natural remedy for labored breathing.  Also, if you use a loose bedding in her cage such as Aspen or other shavings, replace all of that with soft fleece and clean white paper towels and change them daily.  Keep her cage free of dust and anything that has an odor like ammonia from urine.    

Still assuming that this may be a respiratory infection (even though they think her lungs are clear), take her back to your vets and ask if they can use a nebulizer for her.  The medicine Albuterol, especially when used through a nebulizer, can open her airways.  If there is any inflammation in her lungs, steroids also through a nebulizer can help. Ideally, she should be kept in the vet hospital for a day or two and have aggressive antibiotic therapy and oxygen therapy done with the nebulizer.  

She should be given this treatment as follows:

Baytril 15 mg/kg twice a day orally for 30 days
Doxycycline 5 mg/kg twice a day orally for 10-30 days

To nebulize, the following mixture should be used in the nebulizer:
(Nebulization for 15 minutes, 2 to 3 times a day)
    8 mL sterile saline
    0.5mL gentocin injectable 100 mg/mL
    0.5mL Albuterol 0.083% Inhalation
    
I hope that your vets can translate these medecines in your country (perhaps they can look online for a translation).

Below, I'm including instructions written by a vet for the best way to treat a severe respiratory infection.  These instructions call for the use of nebulization.  I recommend you bring them with you to the vet and make certain he is familiar with the treatment.

Meanwhile, I can also ask for help from some of my friends who are breeders and experts on rat medical problems.  It may take a day or two to get responses.  Can you tell me how she is doing today?  Have there been any changes in her condition since you wrote to me?

Here are the instructions:


A TREATMENT REGIMEN FOR SERIOUS AND ADVANCED RESPIRATORY ILLNESS

The following treatment regimen for use in rats with advanced lung infection or more serious respiratory illness with Mycoplasma as the suspected agent, is recommended by Dr. Michael Hutchinson, DVM; Animal General, Cranberry Township, PA., and is based on his experience treating rats and current literature:

   enrofloxacin (Baytril) 15 mg/kg BID, PO (oral) for 10-30 days
   doxycycline 5 mg/kg BID PO (oral) for 10-30 days
   nebulization for 15 minutes, 2 to 3 times a day, for 14 days, with the following mixture:
   8 mL sterile saline
   0.5mL gentocin injectable 100 mg/mL
   0.5mL Albuterol 0.083% Inhalation *Note: excess mixture for nebulization can be refrigerated for up to 3 days.

   dexamethasone 1 mg/lb BID, then weaned down as follows:
   1 mg/lb BID injectable or PO (oral) for 3 days
   1 mg/lb SID for 3 days
   0.5 mg/lb SID for 3 days
   0.5 mg/lb orally every other day, three doses

   Other veterinary recommended reduction schedules for dexamethasone may also be used.

Additional antimicrobial choices
Besides the above recommended antimicrobial choices, and treatment regimens for pneumonia, the following drug choices may also be used.

Tetracycline

Cefadroxil (for secondary infections - best used in combination with Gentocin)

Chloramphenicol

Enrofloxacin (Baytril) and Doxycycline simultaneously.

An aminoglycoside: (such as amikacin or gentamicin) in combination with Cefadroxil.

*Note: Combination of drugs given simultaneously like enrofloxacin (Baytril) + doxycycline, azithromycin + doxycycline, clarithromycin + doxycycline, have been found to be very effective in rats.

The choice of an antibiotic/antimicrobial or combination can be more effective when selected based on culture and sensitivity of organism.
Bronchodilators and Corticosteroids In Therapy
The use of bronchodilators given orally, such as Aminophylline/Theophylline, or Albuterol, may be added to help relax the smooth muscle and dilate the bronchi in the lungs to aid breathing.
Nebulized treatments with these medications as well as certain antibiotics (e.g., fluoroquinolones: enrofloxacin (Baytril), aminoglycosides: amikacin or gentamicin (gentocin), or a macrolide: tylosin, may be prescribed for rats that have difficulty taking the medications orally. Medications for nebulization need to be diluted in normal saline.
Ratio for dilution of medication per normal saline recommended as follows:
Enrofloxacin(Baytril) 10mg to 1 mL normal saline. 3
Gentamicin 5mg to 1 mL normal saline. 3
All others a 1 to 10 solution. 3

For the nebulization formula using gentocin and Albuterol in a treatment regimen, recommended by Dr. Michael Hutchinson, see above in the section: treatment regimen for serious and advanced respiratory illness. See Nursing Care below for more information on nebulizers.

In addition, a corticosteroid such as prednisone or dexamethasone may be added to the treatment regimen to help reduce inflammation of the bronchi and bronchioles in order to help the rat breath easier.




---------- FOLLOW-UP ----------

QUESTION: Thank You so much for Your kind and very helpful reply,

What I mean about quality of life is that she is very passive, seems weak and doesn't engage in any activities.

She only eats when i spoon feed her with food that is semi liquid. I have had the greatest success with a blended mix of bananas dried dates, cacao powder, Vanilla and soymilk. But I try a lot of different Things, so far I have had no luck with baby formula, but I will try and get some watermelon. She doesn't seem to be willing to eat chocolate, but maybe she gets some of the good stuff from the cacao powder?

I will try to help her with steam as You suggested.

I use a bedding that should be good with rats (without phenols), but i will change it for fleece and paper towels.  

She is on baytrill and also the doxycyklin (Danish trade name Ronoxan), she has been on it for 14 days now, with no change. I have been told to give her medication once a day, but I will follow Your advise and give it two times a day instead. I will take Your other recommendations with me to the vet.

I am going to the vet again tomorrow, this time she will be anesthetized ,despite the risk, so that she can be x-rayed (at least dental and chest) done in order to find out more about the origin of her distress. If it turns out that her breathing distress is  caused by teeth growing backwards into her airways (as my primary vet fears)I will have her put to sleep as it will only get worse with no hope of a cure.

There has been no change in the last few days.

Thank You again, it means a lot to me.

Best Regards
Maria

Answer
Thank you so much for the update...I am worried for her too as well as my friends who are rat experts.  They are all asking for a video...can you take and attach one here?  Or you can email it to me at irenemurphy@cox.net.  

Is it possible if this is caused by teeth that the teeth be surgically removed?  A rat can live a good life without teeth, on soft foods.  Please find out from your vet and let me know after the visit.

When is your appointment?

Praying for Episkey...<3

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Irene Murphy

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I can answer a variety of questions regarding adoption and care of pet rats throughout their lifetimes, including questions about their health and well being, temperment, diet, bedding, cages, toys, etc. I will try to answer your questions to the best of my ability in a timely manner and I have an abundant amount of resources to help me to help you with your pet rats. I love rattie pictures, so include pics with your question if you can. You may ask me medical questions, but please be advised that I am not a vet. I may use my resources to answer some medical questions, however, I will need to refer you to your local vet with medical questions that I feel I am not qualified to address.

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I have been a huge rat enthusiast for many years. Since becoming a rat owner, I have educated myself in all areas of pet rats from every resource I could find including the internet, books, conversations with local exotic vets, as well as several local rat breeders.

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I have a college degree but not in the area of animals. I have obtained my extensive experience and knowlege of pet rats all on my own because in my eyes, pet rats are the most interesting and fascinating creatures you can ever imagine to have as pets. I also am saddened by how mislabeled and misunderstood these amazing and extremely smart animals are by the majority, and my mission in life has become to educate and change as many people's perceptions of rats as I possibly can.

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