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Pet Rats/Male rattie still bleeding from penis

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QUESTION: Dear Debbie: my rescue rattie Tony had paraphimosis the vet told me. He gave Baytril. After 2 weeks the bleeding has not stopped although it has decreased and Tony is eating. He had previously lost weight also. Now he is not 100 percent but he eats and drinks. He was lethargic from the day I rescued him and his brother from SPCA so .....?We have an appointment to neuter Tony on Monday April 14. But here is my concern:

1 Tonys penis is consistently bloody. The blood is coming from the tip and running down into the sheath
2 Baytril did not stop the bleeding but made him better in way described above
3 Dr gave prednisone to control any swelling. Penis is not swollen and the paraphimosis has receded
4 Cancer? Tony is about 15 months old.
5 What if he is in pain and I can't tell

Please help. I love the little guy. Brought him back from the brink once before.
PS. This has been going on for a month now!
Thank you
Jo

ANSWER: Hi Joanne,
I'm so sorry to hear about Tony's problem. I do not recommend having him neutered until we figure out what is going on. What is the reason to have him neutered?

Tell me exactly what the blood looks like. Is it bright red?  Or is it brownish red. Does it seem to be the normal thickness of blood, or thinner, like it is diluted?

The first antibiotic I recommend trying in almost every situation for rats is amoxicillin, not Baytril, so that is worth a try. See more info below.
Deb

For a rat who is sick, no matter the symptoms, amoxicillin is the first treatment I recommend. This is because amoxicillin is best for secondary infections, which can get very severe very quickly, killing a rat in a matter of hours or days, and require immediate treatment. Baytril is not always effective for secondary infections, so if you try it first, the could die. Therefore, I recommend all rat owners have amoxicillin on hand. If the amoxicillin doesn’t work within 2-3 days, then you can try doxycycline or Baytril for mycoplasma, which is a slow chronic disease, so you usually have more time for treatment. Secondary infections can cause respiratory symptoms (but not always), lethargy, poor appetite, and other symptoms, and are common in rats, especially young rats and those from pet shops. Older rats can also get secondary infections on top of mycoplasma. Amoxicillin is also best for abscesses.

All vets will have amoxicillin, and in the U.S. you can also get amoxicillin over the counter as aquarium fish capsules from some feed stores and specialty aquarium stores, and online. 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.  

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 normally also get doxycycline capsules from www.aquaticpharmacy.com. Currently there is a world-wide shortage of doxycycline capsules, so instead you can get doxy tablets from Jedds Pigeon Supply.
To mix doxycycline capsules (or crushed tablets):

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 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 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: Thank you Deb for prompt reply.
Blood is bright red.appears to be normal thickness.

Vet recommended neutering due to recurrent swelling of penile area/paraphimosis.
Tony was on amox for 2 weeks prior to vet appt. (I get amox from Fish Mox)and have
read your advice regarding this as primary antibiotic.

ANSWER: Okay, so the amoxi didn't help, so it doesn't sound like the cause is an infection. I'm sorry, I really don't have any real good idea of the cause. It is possible that a cancer is growing in his penis, causing the swelling and bleeding.

The way to tell if he is in pain is to put him on a pain killer and see if his behavior changes and gets better. Normally I would recommend ibuprofen, but the problem is that it interferes with blood clotting, so it wouldn't be a good idea to use it since he has chronic bleeding. So, I recommend trying acetaminophen (Tylenol). You can give 90-140 mg/lb every 4-12, as needed. So, start with the highest dose to see if seems to make him feel better. If it does, then you should try the lower dose, and if that doesn't help enough, then gradually raise the dose to the point that it helps.
Deb

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

QUESTION: Dear Debbie: Apparently the amoxicillin did not work as Tony had been on it for 2 weeks. Neither is Baytril because he still has a little blood oozing from his glans penis.
My concern is: if he has prostate cancer then neutering him is not therapeutic but torture.
I suppose that my question is : have you ever heard of this condition as it
Applies to my Tony, and if so, is it hopeless?

Answer
ADDITIONAL NOTE: I do not think neutering would help with penile cancer. So, at this point, since you don't know the cause, I do not recommend neutering him.
Deb

I don't think I would ever describe neutering as torture. Any discomfort can be controlled with medications. Actually, if he has prostate cancer, then neutering would probably slow its growth. The question is, would the cost outweigh any potential benefit?

I do not have any experience with prostate cancer in rats, but as far as I know, bleeding from the penis is not a symptom of prostate cancer. Since the blood is fresh (bright red) my guess is that it is coming from the penis itself, not farther down. I doubt that neutering would help with cancer of the penis. I don't have any other experience with continued bleeding from the penis, just a few cases of temporary bleeding.

I wish I had better answers for you. At this point I think all you can do is make sure he stays comfortable, with pain meds if necessary.
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.

Experience

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.

Organizations
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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