Lung Mysteries - Looking for Thoughts on Further Testing

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Velo

Well-Known Member
Joined
May 13, 2014
Messages
1,053
Location
Bolingbrook, IL
Hey all.

So one of my boys, Duke (approx 16 months old) has had some breathing mysteries for the past 7-8 weeks or so.

Approximately 7 weeks ago, I noticed that he was breathing faster than everybody else. We went to the vet, suspecting a heart problem. We decided to try out Lasix to see if that helped - it didn't. So shortly after, we came back and got an x-ray done.

The x-ray showed "stuff" around his lungs. We of course are not sure what it is - fluid, infection, cancerous cells? So we decided to treat for pneumonia. We started out with Baytril, Doxy, Metacam & Theophylline. We added in Zithro after 3 weeks of no response from the Baytril/Doxy.

As of this point, it has been 6 weeks since the x-ray. The antibiotics have not improved his fast breathing. The Zithro has run out, although I do still have some Baytril so I have been keeping him on that (for my own sanity I suppose).

He does not have any other symptoms - no sneezing, wheezing, coughing, pory, chest noises, grunting, etc. He eats, drinks, poops, pees & sleeps well. He has not lost any weight throughout this, he has actually gained some (the whole colony is on a diet now =_=) He does have less energy than his brothers, but still comes out to play every night - at least an hour at a time, sometimes even two hours.

I am starting to feel like the mass in his chest is cancer. I'm just not sure where to go with my options as of this point. Per the vet recommendation, we are staying on the metacam and I have decided to try out nebulizing with him - it will be a mix of Aminophylline (he will be taken off the theophylline) and Amikacin.

I plan to keep giving him his Baytril till I run out, because I figure what is the harm?

Anyway, back to the choices I have for further testing. The plan now is to try the nebulizer for a week, see if it helps. I'm not very hopeful it will, but of course I am willing to try.
We have to go back next week for a re-check. We have a couple of testing options we can try at that point.

We can run a blood sample through a virology panel - she says we can see if we get any matches for viruses or mycoplasma. He will have to be sedated and I understand it is a small amount of blood. She feels it is possible that he has Myco (or some other infection/combination of) along with scarring. If the panel yields results, we may be able to develop a better antibiotic therapy. Of course, it could yield results that show no effective antibiotic therapy, or no result at all.

And/Or we can do another x-ray. I am not sure on the xray. It will only have been 7 weeks since he last had one, and I have read that x-rays are very bad for humans. I don't know if it is a good idea to x-ray a rat again so often.
I'm also not convinced the x-ray will show anything. If the mass had grown any smaller or larger, would I not have seen a difference in his breathing? At most - the x-ray would show a size change - if larger, I don't think we learn anything, if it is smaller then I suppose we believe that they antibiotics are slowly working?

I'm just feeling really conflicted. I don't suppose the blood panel is super awful - however I do hate sedating him because I know it is very scary and I worry with his breathing. But it could help. I believe it is also very expensive. But honestly, cost is the very very very least important thing to me.

So ya, anyway. Does anyone have any thoughts or opinions on any of this? Has anyone ever done multiple x-rays on one rat, especially in a <2 month period?
Let me know what you think. Thanks. :)
 

Here are some videos of his breathing, for anyone curious:
[ame]https://www.youtube.com/watch?v=7UGp7OP1Lnk[/ame]
[ame]https://www.youtube.com/watch?v=QIBq_03D5kI[/ame]
 
Just going to throw some stuff out there that comes to mind. He's a squishy, stairs aren't working huh. Did the x-ray show anything defined and would actually look like a tumor or mass? My boys always show nodules, circulars areas that you can tell are masses/tumors. He reminds me of one of our boys, but I just cannot remember who... Does he have a barrel chest? Have her look up GMC's records if they still have them. They thought he had myco too and ended up with a very nasty lung cancer - that's who he reminds me of, I think, but I don't think we ever x-rayed him. Is he losing weight? If the nebulizer makes him jittery try half solution half water.

EDIT: I re-read GMC's thread and someone suggested this http://www.idexxbioresearch.com/serology and it was also suggested to add low dose dex OR pred to baytril/doxy, but you would have to stop the metacam for 72 hours first. He did have audible wheezing though and your guy doesn't. I however, would not sedate a comprised rat without it being absolutely necessary.
 
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Could it be pulmonary abscesses? Does his chest feel harder than normal? Victoria had mentioned to me Viagra has helped in some rats with PA. As for further testings...I'm not sure. If your rats have CAR B then PA is likely.
 
Lol yeah the ratties aren't too crazy about the stairs. I did start them all on a diet though - no more unlimited oxbow. He's only about 650 grams though so he's not too bad.

The xray did not show anything defined from what I recall. I'm going back on 6 weeks memory so I may be a bit fuzzy. But the xray showed a large mass surrounding his lungs... not really a particular shape or circular, etc. Just something surrounding/pushing on his lungs.

He does not have a barrel chest.
I will definitely bring up GMC then! I think she would look into that, I know she has been using her resources to try and figure it out. She did feel like there was a very good chance it was lung cancer.
How long did GMC live after being diagnosed? Or was he not?

He has not lost weight. He has gained about 50 grams actually. Trying to get it back off of him now. I'm the type to hide meds in food so I believe that's why he's gained!

I'm gonna go look at that link, thanks. I'm not against a steroid, but you know how they are there... they seem to really be against them.
So if you were me, you wouldn't do the xray or blood? That's what I'm scared of, triggering him into a worse state. The first time we really really had to do it, to see wtf was going on in there. This time, I don't know. But I don't want to do nothing either!!!


Jorats, I mean technically it could be PA. His chest is not hard and the doc did not feel like PA was likely. She felt like the mass would be more condensed if it was PA, not spread about like it is. Pardon my lack of correct terms.
But ya, the mass itself is around his lungs. He is breathing so quickly because the mass is compressing his lungs, causing him to take smaller breaths. So he's taking more of them to make up for it.
I will say that he doesn't look anything like Rocky did with PA. I'm sure it can present itself differently, but I don't see similarities.

Ahck. I just don't know if I should go through with any of these tests. I mean he is happy, from what I can tell. His quality of life is good.
He has been stable for 6 weeks. Yes, he has not gotten better, but he hasn't gotten worse either. And in some ways he actually is better, I do feel like his mood and energy levels are higher.

Thanks for the thoughts, guys!!
 
Anyone know how enclosed of a space is necessary for nebulizing to be worth it?
I tested it out in the cage tonight and he doesn't mind it being right up close to him, but I'm not sure it's even gonna matter if I don't have him in a "sealed" space. I do want to see if he's okay in the cat carrier with a towel over it too.
I still have some serious doubts with nebulizing though...
 
Anyone know how enclosed of a space is necessary for nebulizing to be worth it?
I tested it out in the cage tonight and he doesn't mind it being right up close to him, but I'm not sure it's even gonna matter if I don't have him in a "sealed" space. I do want to see if he's okay in the cat carrier with a towel over it too.
I still have some serious doubts with nebulizing though...

We put them in our travel cage with a towel over it and the neb blowing in the front "door" of the cage. We even hold them sometimes and blow it at their faces, but the stuff bothers my asthma. If you put him in a sealed cage they end up all wet from the neb stuff
 
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I did have a rat once with a thymus tumour. Nothing could be done in this case and we didn't know until the necropsy but the main symptom was rapid breathing and laboured breathing. Until the tumour grew so big it pressed on the lungs and killed him. Also, another rat of ours had a PA on the outside of the lungs. And another where a whole portion of lung cemented and fell off away from the other lobes.
My vet through the years has convinced me that doing many tests is useless and costly. She told me most of the time we can't treat anyways.
 
We put them in our travel cage with a towel over it and the neb blowing in the front "door" of the cage. We even hold them sometimes and blow it at their faces, but the stuff bothers my asthma. If you put him in a sealed cage they end up all wet from the neb stuff
Well I tried again this morning. He was not really feeling the cat carrier/towel deal so I just let him hang out in the cage and held it in front of his face again. It freaks most of the colony out, so I don't know about it. u_u
I mean, it's probably getting into him if I am holding it close to his face, right? :/

What about cardiomyopathy? Read this through he could fit the symptoms as they could be really mild right now. Our cardiac rats have done good on enalapril.
http://ratguide.com/health/cardiovascular/cardiomyopathy.php
I don't know, that didn't seem to explain the mass in his chest though? Some of it is similar though. His heart was fine on his last x-ray, but I know that can change. Maybe we could try another heart med, we had gone out on a limb with the Lasix before, not sure what she'd say to the other heart meds though. Maybe if we did another x-ray and his heart looked different. I'm not so sure about any of these tests anymore though....

I did have a rat once with a thymus tumour. Nothing could be done in this case and we didn't know until the necropsy but the main symptom was rapid breathing and laboured breathing. Until the tumour grew so big it pressed on the lungs and killed him. Also, another rat of ours had a PA on the outside of the lungs. And another where a whole portion of lung cemented and fell off away from the other lobes.
My vet through the years has convinced me that doing many tests is useless and costly. She told me most of the time we can't treat anyways.
See, this is how I kind of feel... Like, is it worth it to put him & me through these tests? I mean, what's the REAL likelihood that this is some kind of crazy stubborn virus that we are somehow going to figure out an antibiotic regimen for?
Doesn't seem as likely as a tumor or some kind of growth, to me.

Anyway, I might be crazy but I feel like he looks worse after nebulizing. And I don't know if it's from the stress, or maybe it's from him not getting Theophylline now? Or the fact that he's only on Baytril?

The Baytril/Doxy (Zithro seemed to work ok too, but it's super expensive and didn't seem to make any change)/Metacam/Theo seemed to be keeping him stable and happy. Maybe it's just best to keep on with that for the rest of his life.

So conflicted!
As of now, I don't think I am going to do the blood or xray. I'm just not comfortable putting him through it when we have very little chance of learning anything valuable.
 
I decided to invest in a quieter nebulizer. My current one is LOUD, it was the only one they had available when I got it.
This one states it is as loud as a refrigerator, so the volume change should help.
Only had to pay $27 with 1-day shipping too, I just love rewards points on credit cards. :p
 
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How else does one diagnose a heart problem, other than x-ray or Lasix?
I'm not sure, I will have to keep a close eye on him and see how he's doing with it. I only got to see him for about 15 minutes this morning before work. I'm sure it's hard to distinguish between stress and an actual issue with this though. That's why I want to try the quiet nebulizer, should reduce the stress so I can see if the medications are actually doing anything. I have heard that the Amikacin is actually a very good antibiotic, just difficult to administer due to the nebulizing process. I will definitely stop it if he really is doing worse on it though. I do wonder if it's moreso the lack of bronchodilator too. The nebulizing solution has one, but I'm not sure he has gotten much in him.
 
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Oh really? How so? I've no experience with heart issues except two rats and we only found out after with a necropsy.
You can hear when the heart isn't beating at a normal sinus rhythm. There are many arrhythmias which cause odd heart rates. Also, if the lungs aren't involved you will not hear the wheezing, crackling, or other lung sounds - just the irregular heart rate. Its definately easier with a stethoscope.
 
WOW. The new nebulizer is such a difference from the old! The lack of incredibly loud noise really helps the whole process.
Am I sold on nebulizing or the medications in the solution for Duke? No, not necessarily. But it's nice I can give it an actual chance now.
 
We are going to the vet in a few hours. I don't believe we will do any tests that require sedation. I have written down everything in this thread & from some of my FB posts & things that I have discussed with Dspch so we can try and make a good decision for long term treatment and maybe test out some meds.

Any other thoughts are welcome too!
 
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