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Lethargy, weight loss, clumsy movement...

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lilspaz68

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You can try to wean her off the prednisone/Baytril. How long has she been on the Prednisone now? Over a week and you have to wean them down carefully. If you tell me her dose now I can work out a weaning off schedule if needed.

While doing a wean off the steroids you are watching for signs of regression meaning the bromocriptine isn't doing it all and she'll need to stay on pred as well the rest of her days.
 

SQ

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yes it is
some people will gradually reduce the steriod until the rattie can be taken off it and the antibiotic
but I maintain the rattie on all three (Prednisone must be very gradually reduced by cutting the dos in half and baytril or another antibiotic must be given as long as the rattie is on prednisone)
 

rmn34

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She started on Cabergoline on 5/19 and Prednisone a few days later.

She actually had a relapse of symptoms last week. Shortly after I made my last post actually, she started getting worse. She was back to falling all over the place, sitting in her hut immobilized, not eating much, and looking very weak and stressed.

However since last Friday she has improved. Now she is back to eating her oxbow food (still cant pick it up however), she will come out and greet me and beg for treats, and she climbed up to the hammock yesterday. Is it normal for the symptoms to fluctuate like that?

I may have let her spit out part of her cabergoline dose accidentally. That's the only thing I can think of other than the Revolution treatment for mites. I am now giving her the cabergoline in smaller increments to make sure she takes it all.

Also the vet recommended switching to q48h cabergoline instead of q72h.

Is it possible the Revolution caused her symptoms to return? It is about time for the second dose but I am worried because the Ratguide page says not to give it to sick rats.
 

lilspaz68

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Most likely the missed dose caused this. Eventually the symptoms return for most PT rats but just enjoy your reprieve as much as you can.
Usually Revo only needs one dose, why do you think you need to do another?
 
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SQ

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My vet said that cab accumulates so he said it is not safe to give sooner then every 3 days.
You might want to get another opinion or go back to every 3 days since the missed dose may have lead to her decline
 
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rmn34

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I went back to q72. It appears that the treatment is losing its effectiveness, sadly. I'm not sure she is responding to it. (But there's no way to know for sure- as there is no way to run a control experiment)

Just curious- what would the symptoms be of too much/too frequent cab?

Unless it is possible that the cab loses its potency quicker than the pharmacist said? (They said the oil-based compounding should be good for 90 days)

What else can I try?

You inferred they develop a dependence on the prednisone, would they also develop a tolerance? Would increasing the dose (of either) do anything?

Thanks
 

SQ

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My rats with pt are put on the max dose of prednisone + baytril and stay on hos for the remainder of their lives. Prednisone (or dex) will reduce the inflammation in the tissue thus reducing symptoms …. if the pt is slow growing then this will help. If the pt is fast growing it will help little or not at all.
Then they are tried on Cabergoline and if it helps they are maintained on it for the remainder of their lives.
Eventually symptoms return and the time frame varies from rat to rat. I have found that there is a rapid decline once symptoms return, and I usually have my rattie humanely put to sleep by a vet that knows how to do it properly once my rattie has a very poor quality of life such as they stop being able to take food or meds, or seem to be in pain.

I buy cabergoline pills from the human pharmacy, cut them in half as needed, and when needed grind up half the pill, dissolve it in water& strawberry quik (to make it taste better - it doesn't work) and syringe feed it orally to my rattie.
The vet or pharmacy where you purchased the cabergoline should be able to tell you how long it is good for and if it needs to be kept in the fridge, in the dark etc

all the best to both of you
 

rmn34

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It is very strange- Last week she was unable to walk more than a step without falling over. When she did take a step she would wobble uncontrollably. She could not even hold her head still enough to eat or drink. She looked very bad.

I started giving her amoxicillin in case of a secondary infection. Because at that point, why not. Although I am not convinced that did anything...

Yesterday she is once again back to being able to walk, and can eat baby food from a spoon with only minimal trouble. She looks much better and has more energy.

If you say these kind of cyclical symptoms are not normal for a PT, then the only common factor is the Salemectin. Both times I gave it to her, she got a lot worse approximately a week later, and then got better again.

I'm not going to test this theory by giving her any more of course, but I just thought it worth mentioning.
 

rmn34

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The improvement was short lived.

I think she might be developing pneumonia. In addition to the PT symptoms getting worse I just noticed a sound she is now making while breathing, and wetness in her nostrils.

She is currently on baytril (since the prednisone started) and amoxicillin for 4-5 days now. Over the last few days she now seems very stressed and has many of the symptoms listed under the clinical signs for pneumonia on ratguide.
  • Porphyrin (already had this from PT)
  • Wheezing
  • Congestion
  • Labored breathing (maybe?)
  • Lethargy
  • Poor or loss of appetite.
  • Panic type movement
  • Changes in behavior -avoidance

Also when I try to feed her she will rapidly shake her head "no" from side to side as if mimicking the human gesture. She is not hungry. When I hold her she will try to crawl away and due to the PT she is unaware that she might fall.

I know she doesn't have much time left but I just want her to be comfortable. As she has already improved on two separate occasions I am holding out hope that she will again. She was fine just a few days ago (relatively speaking) and was happy when getting syringe fed treats.

Is it common for this to accompany the PT at the late stage or is this a separate thing? And is there any hope for treating this?
I know you said when they can no longer eat there is nothing else that can be done, however what if that is due to something other than the PT?

Thank you again, both of you, for everything thus far.
 
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