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Pet Rats/Blood in Urine

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QUESTION: We know that blood in the urine is a bad, bad thing.  We are awaiting a return call from our vet as I type.  We have two 2+ year old rattie ladies.  Gilda, who I am inquiring about, has had a rough time of it lately.  She is on theophylline, azithromyacin, and prednisone.  If we take her off meds, her myco respiratory issues flare up until she can barely breathe - so we keep her on meds.  We also have her on a small dose of Children's Mucinex, since she choked on her phlegm three weeks ago.  Since keeping her on meds non-stop, her wheezing has improved and she seems to be breathing well. She has, however, lost a lot of weight - we haven't observed her eating her regular critter cubes in awhile.  We've been supplementing critter cubes with Nutrical (Ferret), lots of fresh fruit, and baby food.  Her teeth had grown long, and were just trimmed two days ago (at the vet - who we've kept up with all along). I found blood in the cage when I cleaned today, and I thought perhaps it was from her tooth, which got nicked a bit low on one side. However, while hand-feeding her some babyfood today I witnessed her actually pee blood.  I suspect this is related to her weight and her declining eating habits, what I don't want to do is cause her more stress or pain.  If she's already on the strongest antibiotics available to her - is there anything that can be done?  I don't want to drag her to the vet (which she hates), if there's nothing to be done.  I'd rather spend whatever time she has left not in severe pain with her.  She does not appear to be in pain right now (she's still hand feeding, still wants to ride on shoulders and be snuggled), but she's good at hiding it.  Any thoughts?  We are really at the quality of life stage and don't want to let her suffer nor do we want to needlessly keep dragging her to the vet and stressing her out.

ANSWER: Hi Meadow,
Besides taking into account the relative strength of an antibiotic, you also have to choose an antibiotic that will work against the infection the rat has. I actually do not consider azithromycin to be that strong. I've never had much luck using it for myco in rats. I have much better results using doxycycline most of the time, or occasionally Baytril.

For a urinary infection in rats the recommended antibiotics are a combo of amoxicillin and Baytril for several weeks.  See more info below.
Deb

For a rat who is sick, no matter the symptoms, amoxicillin is the first treatment I recommend.  Secondary infections, which can include respiratory symptoms, lethargy, poor appetite, and other symptoms, are common in rats, especially young rats and those from pet shops. Older rats can also get secondary infections on top of mycoplasma. In my experience, amoxicillin is the best treatment for secondary infections in rats.  Amoxicillin capsules are good to have on hand for secondary infections, which can get very severe very quickly, killing a rat in a matter of hours or days, and require immediate treatment.  Amoxicillin is also best for skin infections. (However, amoxicillin does not work against mycoplasma. For that I recommend doxycycline, and maybe also Baytril.)

All vets will have amoxicillin, and you can also get amoxicillin over the counter as aquarium fish capsules from some feed stores and specialty aquarium stores. Call the stores in your area and ask before driving there.  Do NOT tell them you are buying it for your rats!  It is legal for them sell it over the counter only for fish.  You will not find it at Petco, PetSmart, etc.  If you can’t find amoxicillin, you can use ampicillin which is basically the same thing, it just isn’t absorbed as well, so just double the dose to 20 mg/lb twice a day.

Some vets won’t prescribe amoxicillin for rats because they learn in vet school that you can't give amoxicillin to hamsters or guinea pigs (it will kill them) so they sometimes generalize this to all rodents.  But amoxicillin is fine for rats and mice, whose digestive systems are very different from quinea pigs and hamsters.  I use it all the time.  (For more about getting your vet to prescribe amoxicillin, see the info at the bottom.)

Rarely you will have an individual who will be allergic or sensitive to amoxicillin, and the most common side effect is diarrhea.  In most cases, this diarrhea is mild enough to be controlled with probiotics (good bacteria for the intestines) but if the diarrhea is severe it will stop when you discontinue the treatment with amoxicillin.

You can order amoxicillin and doxycycline capsules from www.aquaticpharmacy.com. If your rat is already sick, be sure to ask for overnight delivery!

You can also get amoxicillin mail order from Jedd’s Pigeon Supplies at 800-659-5928.  Ask for Greg, and be sure to order CAPSULES.  Also, you can get it from Doctors Fosters & Smith, 800-826-7206.  Order the capsules for aquarium fish, item #CD-18876.  (Please note that they sometimes change the item number, so just search for amoxicillin in the fish department.)  

You need to know about how much your rat weighs.  The dose is 10 mg/lb twice a day but you can safely go as high as 50 mg/lb.  In most cases (check the package) each amoxicillin capsule contains 250 mg, which is 25  1-lb doses.  

If you have access to small syringes for measuring (a 1 ml syringe or insulin syringes with the top broken off) you can mix the amoxicillin in a liquid.  Amoxicillin does not dissolve but forms a suspension.  The powder will sink to the bottom, so before taking out a dose, you need to stir the mixture with the syringe extremely well, being sure to scrape up all the powder off the bottom so it is in suspension.

Mix one capsule of 250 mg amoxicillin in 7.5 ml of flavoring such as Ensure or slightly diluted Hershey’s strawberry syrup. (If you have 500 mg capsules, use twice the amount of flavoring: 15 ml.) A small pill bottle is about the right size to mix it in.  Keep in the refrigerator.  Amoxicillin doesn’t taste too bad to most rats and most rats will eagerly lick this right from the tip of the syringe.  The normal dose is 0.3 ml/lb twice a day.  (Note: 1 cc = 1 ml = 100 units on an insulin syringe, so 0.3 ml = 30 units.)  You can go as high as 5 times that normal dose if necessary, and it’s a good idea to give a double dose the first time.

If your rat won’t take the amoxicillin mixture voluntarily, you can make the dose 0.1 ml which is too small for them to spit out when you put it in the back of their mouth.  Mix one capsule with 2.5 ml of flavoring. Then the dose is only 0.1 ml/lb twice a day.

If you don’t have small syringes, you can mix it in food.  Dump a capsule out on a plate.  If it is granular, grind it to a powder.  Divide the powder in half, and half again, etc.  Until you have 24 piles. Since it’s hard to divide it more than this, you can give the 1-lb dose to rats who weigh less than a pound.   It’s better to give too much than not enough.  Scrape a pile into a little bit of food such as baby food, mashed avocado, etc.  

Give the dose twice a day.  If it's going to work the symptoms should improve within 2-3 days.  If it does work you need to continue the treatment for at least 2-3 weeks.  If it doesn’t work then you need to try a different treatment.  If the symptoms are all gone within 3 days you should continue the treatment for 3 weeks.  If it takes longer for all the symptoms to go away, give it for 4-8 weeks and maybe longer.  The longer it takes for all the symptoms to go away, the longer you should continue the treatment.  If the symptoms stop improving, or if the amoxicillin doesn't help at all, you will need to try doxycycline instead.

You can buy 100 ml of 10% oral generic Baytril (enrofloxacin but they call it Enroxil) from Jedd's Pigeon Supply for $40 plus shipping.  The dose for a 1-lb rat is 0.1 ml, which means that 100 ml is 1000 rat doses!  Very economical.   You need to give it twice a day.  Do not refrigerate the Baytril!
I’ve had the best luck giving it in in 4-6 ml of a product such as strawberry Ensure or Boost in a baby food jar lid, or in 1/8 teaspoon of the soy baby formula powder, making a paste.  It helps if you put the baby food jar lid on a small magnet to help keep your rat from tipping it over.  

Jedd’s Pigeon Supplies is 800-659-5928. If you order by phone ask for Greg. When ordering, just ask for the 10% Enroxil.  Do not say “for my rats” because it is available without a prescription for pigeons only.  Greg is cool about it though.  You can also order it on their website at http://www.jedds.com/StoreFront.bok. If ordering online, order item #5002.  It won’t say it’s Baytril, as they keep it quiet.

You can also get doxycycline capsules from Jedd's.  Ask for Greg.  Be sure to ask for CAPSULES otherwise they will send loose powder.  It will cost about $35 for 100 capsules of 100 mg each plus shipping.  Don’t say “It is for my rats.”  You can only buy them over the counter for birds. However, Greg is very cool about it.

To mix doxycycline capsules:

In a small pill bottle, put 12 cc (12 ml) of liquid such as Hershey’s strawberry syrup.  Open and dump in the contents of one 100 mg doxycycline capsule.  Stir well.  The amount for the typical dose of 2.5 mg/lb is 0.3 ml/lb (0.3 cc or 30 units on an insulin syringe) twice a day.  For 5 mg/lb give twice that.  To use an insulin syringe for oral dosing, break off the whole needle assembly.  Be sure to refrigerate the mixture.

If you don’t have the proper syringes for dosing, dump the capsule out on small plate and divide the powder into 40 equal piles.  (Divide in half, then in half again, etc.)  Each pile is a dose and can be scraped into soft food.

You will find more info about treating respiratory infections on my website at www.ratfanclub.org on the Rat Info page.  I also highly recommend you order my Rat Health Care booklet.  It is only $7 plus $2 shipping (CA residents add 58 cents tax.)  The address is Rat Fan Club, 857 Lindo Lane, Chico CA 95973.


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Concerning amoxicillin and veterininarians:  Many vets don’t want to use amoxicillin on rats.  This is probably because in vet school they learn that amoxicillin can’t be used in guinea pigs, rabbits or hamsters (because it kills the good bacteria in their intestines), and they probably generalize this to rats and mice.  However, rats and mice usually tolerate amoxicillin quite well.  In my experience only a very small percentage of them will get diarrhea from it, and this is not life-threatening; it will usually clear up with a probiotic, or the amoxicillin can be stopped.

Here are some references for using amoxicillin in rats for your vet to check if they are reluctant to prescribe amoxicillin:

Exotic Animal Formulary, Third Edition, James W. Carpenter, MS, DVM editor, Elsevier Saunders Publishing
Page 377, Antimicrobial and antifungal agents used in rodents.
Ampicillin for mice and rats: dosage 20-50 mg/kg PO, SC, IM q12h
(Note: ampicillin and amoxicillin have essentially the same adverse reactions and effectiveness, so they can be used interchangeably)

ViN (Veterinary Information Network, Inc.) Website

Thomas Donnelly, BVSc on 02/05/2006  “Amoxicillin is safe to give rats.”

Johanna Briscoe, VMD, on 07/08/2004  “I have used Clavamox liquid in a rat and it worked beautifully on an abscess that I thought may have been from a bite….  Clavamox dose same as in other mammals—13.75 mg/kg PO BID.”
(Note: Clavamox is the brand name for a mixture of amoxicillin and clavulanic acid.)

Elizabeth Mitchell on 06/01/2007  “I have used Clavamox a few times in rats without problems, although I am always very careful to warn owners to watch for diarrhea.  I  generally have gone with a dose more similar to dogs and cats (20-30 mg/kg BID) but if you search on PubMed you will find all sorts of much higher doses.”
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---------- FOLLOW-UP ----------

QUESTION: Thanks for the prompt and informative response! It seems that blood in the urine is likely a urinary tract infection.  We are hoping that it is nothing more serious.  I will speak with the vet about amoxicillin tomorrow AM when we take Gilda in.  We haven't tried amoxiciliin with her, however, we did the whole doxy/baytril dance for months, we had no improvement in either rats respritory symptoms until we started the Azithro & Theophylline. Are Amoxicillin and Azithro contraindicated?  If doxy and baytril were ineffective, is it more likely that the girls have a different respritory illness other than Myco or did they just happen to respond better to a different med?  I suppose we should double check what doses we had them on, perhaps the doses were too low.  Our vet is fairly knowledgeable about rats but I do think they tend to underdose in general.  Thanks again!

ANSWER: For some reason I can't read the far right section of your messages, but I think I can tell what you asked. When you saw improvement with the azithro and theophylline, I would guess the main thing that helped was the theophylline.  Yes, if Baytril and doxy didn't help, the cause is most likely a secondary infection, or something else, like an allergy or congestive heart failure. How old is Gilda?
Deb

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

QUESTION: I haven't been able to read the far right (or left the first time) of your answers, either -- I've been copying and pasting the text into word, which lets me see all the text.  Gilda is 2-2.5 yrs old.  She is a rescue rat (she and her sister came from a hoarder's house where a great volume of rats were confiscated or surrendered).  The vet gave us Amoxicillin in case it is a secondary infection; milk thistle in case it's her liver.  We declined blood testing, as she is an old lady and we want to do our best for her without subjecting her to anything too invasive or stressful. Thanks for the Amox recommendation, I felt more informed when discussing options today at the Vets.

Answer
Smart idea to cut and paste into Word!  I hope she does better on the amoxicillin. The other things you can try are prednisone at 1 mg/lb twice a day, and the heart medications I discuss on my website in the article about Respiratory & Heart Disease on the Rat Info page.
Deb

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Debbie Ducommun

Expertise

I can answer any questions about pet rats, but you will probably be able find answers to simple questions more quickly on my website at www.ratfanclub.org/helpfinfo.html. If you have a life-threatening emergency you can try calling me at 530-899-0605. I am not usually on the computer on the weekend.

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I have been "The Rat Lady" since 1985 and am recognized as one of the world's experts on pet rats. I have 3 published books and already answer lots of questions about rats daily.

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President of Rat Assistance & Teaching Society

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I am a monthly columnist for Pet Business magazine, and my writing has appeared in other magazines. I have 3 published books.

Education/Credentials
BA in Animal Behavior

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