Heart troubles - advice?

[minnow]

One of my new girls, Lily, is showing signs of heart trouble - heavy breathing, hanging her head off shelves, slightly pale ears, muffled heart sounds, etc.. I've put her on Lasix until I can get her to the vet, and she's perked up a bit while on it. So, the question is, where do we go from here? My vet isn't very experienced with heart problems in rats, and I'm even less experienced, so whatever advice can be given here would be appreciated.

 

[jorats]

Hopefully lilspaz and SQ will see this and respond...

 

[Godmother]

If you have a copy of Debbie Ducommun's Rat Health Care guide, you could take it with you when you visit the vet. If your rat has been treated for respiratory problems with suitable antibiotics, yet still has trouble breathing and responds to lasix, she may indeed have heart problems.

My vet does an Xray to see whether the heart is enlarged (that affects the decision about whether or not to add digoxin medication). A trial of an ACE-inhibitor such as benazepril (Fortekor) will help determine whether your ratty has heart problems. It is a safe medication to give to help with diagnosis. If she responds to it, your vet may add atenolol (to lower blood pressure) and digoxin (to help the heart beat more strongly). All those meds are usually given twice a day.

I had one rat live another five months with heart meds. Another ratty got a good eight months. The trick is sometimes to find the medications. I have often had to buy pills and then crush them & mix them with liquid. Meds compounded by a pharmacy can be very expensive in comparison.

Good luck! For more details, check with Lilspaz & SQ (when she gets back online after her move... it will take a couple more days)

 

[Debbie]

Enalapril is a good heart med, though you have to start up slowly (once a day, every other day for the first 10 days...then once a day after that). Lasix is good, but only when excess fluid and congestion is apparent (sounds like it is). You should also always use an antibiotic. Baytril. When excess fluid is present, it also leaves way for infection to set in. So the antibiotic helps with that and any respiratory issues that are present.

When they are on the lasix, you have to be sure they are still getting enough fluids to drink. If Lily doesn't appear to be drinking enough water, offer her some Ensure, soy milk, oatmilk or whatever she'll take...so you can help keep her hydrated.

Hope your vet is receptive to trying the right meds for ratties. It's VERY hard to detect a heart anomoly in rats, even for good exotic vets. Often they'll just keep throwing more and more antibiotics at the rat when they aren't getting better.

If you are certain it's a heart issue and not just respiratory, perhaps you can insist on the Enalapril and Baytril (along with the lasix) and see if it starts helping.

Good thoughts for little Lily

 

[minnow]

Well, Lily went to the vet this morning, and all things considered it could be pneumonia or her heart or both. So, we're treating aggressively for pneumonia (while leaving the corticosteroids out of it), keeping the lasix in the mix, and if she's not significantly better by thursday we'll start on an ACE inhibitor to see if that makes an improvement.

 

[Debbie]

All fingers, toes and paws crossed for Lily!

We'll often treat the respiratory issues first, because they do need to be a bit stronger before putting them on the Enalapril. Sometimes you can't afford to wait, but if you can...it's best to get them on the abs first. Sounds like you are taking the right approach for your sweet girl.

 

[SQ]

Hope things work out well for Lily.

Besides lasix, for heart meds you give:
- a beta blocker such as atenolol (1mg/454.4g);
- and an ACE inhibitor such as enalapril (0.25mg/454.4g twice a day) or benazepril (0.25mg/454.4g twice a day) or lisinopril (0.125 to 2 mg/454.4g twice a day)

- If her heart is enlarged then digoxin (0.0025mg/454.4g twice a day) too

A bronchodialator may also help with breathing.

This is what my rats are on.
(Info from the Rat Health Care book www.ratfanclub.org)