Should I take Snowy back to the vets?

Discussion in 'Health & General Care' started by Jaana, May 10, 2019.

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  1. May 15, 2019 #21

    Jaana

    Jaana

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    Hello this is a video I have just taken. I was giving her a treat. I did try and wipe the porphin from her nose. I will try and mash it up and give it with some form of food or something. Just hope she eats it, otherwise don't know what to do if she don't.

    https://www.youtube.com/watch?v=pzmi4Dkost4
     
  2. May 16, 2019 #22

    Dena

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    What was her weight? Half a tab seems like a lot. Check out www.ratguide.com and look at steroids. Or it may be under anti-inflammatory. Check the dose there. Or Lilspaz can tell you what to give and how to mix it.
     
  3. May 16, 2019 #23

    Jaana

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    having looked at the rat guide it only states that the tablets come in at 2.5mg, 5mg, 10mg & 20mg, but hers is only a 1mg tablet, so if she s getting half of that tablet she is getting 0.5mg a day I think. She weighs about 415 grams. The dosage bit on the rat guide confuses me a bit with the abbreviation's (well I think they are).
     
  4. May 16, 2019 #24

    Lise Patterson

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    First, I'm surprised by the vet's decision to discontinue the antibiotic, given that Snowy will now be taking prednisolone, a coritcosteroid. While helping to suppress inflammation, such steroids also act to suppress the body's immune system - and this is why the Rat Guide (and all my vets) recommend using a good broad spectrum antiobiotic when administering a potent dose of prednisolone over many days. Snowy is already struggling with a major health problem - add to this a suppressed immune system and she will be a sitting duck for nasty infections.
    But it is the vet's reasoning here that I find most surprising - i.e. that he sees no point in continuing with an antibiotic simply because Snowy "hasn't improved whilst on Metacam and baytril" He seems to have missed the point entirely, and this could be a life-threatening error on his part. This alone might have me seeking out another vet.
    I do hope others weigh in here...I think Snowy deserves much better.
    Did the vet say he was familiar with PT in rats? Did you give him the Rat Guide info and ask him about the possible use of cabergoline?
     
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  5. May 16, 2019 #25

    Jaana

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    Hello... I had the rat guide stuff with me but didn't really look at it, but he said there is no way to determine if it is a PT tumour as it could be any other form of tumour on the brain. I really don't know what to do now as I've been to 2 different vets and thought as the most recent vets I went to, the vet had a interest in exotic animals that it was going to be good. I didn't know that the steroids make the immune system weaker so I am concerned now why he did tell me to stop it. I do have some baytril left but it won't be a lot. Should I use what I got left? With the cabergoline that's is only for PT tumours isn't it?
     
  6. May 16, 2019 #26

    Lise Patterson

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    Perhaps I was too hasty; if your new vet is truly interested in treating exotics then he may deserve more chances...so long as he proves open to learning.
    Of course he's right that rats can get brain tumours other than PT - but If he had more experience with rats, he would probably weigh the fact that PTs are by far the most common brain tumour found in female rats. And some of Snowy's specific symptoms (e.g. the rigid forearms) are highly indicative of PT. Success with cabergoline is far from assured in any event. But it may offer the best prospect of extending Snowy's life beyond a few weeks. (Remember that steroids alone usually buy very limited time where any fast-growing tumour is involved.)
    Your vet might understandably not know about the use of cabergoline in treating rat PTs; and while it's unfortunate that he didn't glance at the Rat Guide info you presented, he might have felt pressed for time. Can you send short emails to this vet? He might be more inclined to digest short blurbs selected from the Rat Guide, such as the following bit from the PT article http://ratguide.com/health/neoplasia/pituitary_tumor.php:

    Recommended treatment is geared for comfort and the reduction of clinical signs, and may include the following:
    • Cabergoline or bromocriptine, a dopamine receptor agonist, that inhibits prolactin secretion; thereby reducing circulating prolactin in the blood stream and reducing tumor size. Depending on when initiated in the disease process may extend life/quality time from 3- 6 months.
    • Since it has been shown that significant shrinkage of the tumor may take a number of weeks following the initiation of a dopamine receptor agonist; vets may wish to treat with a corticosteroid (e.g.,dexamethasone or prednisone or prednisolone) on a more extended reduction schedule to address brain swelling, until tumor reduction is significant enough to alleviate clinical signs.
    • In the event long-term corticosteroid (e.g. prednisone, prednisolone,or dexamethasone) therapy is instituted, given the commonality of chronic mycoplasma infections in the pet rat population, it is advised to consider including broad-spectrum antibiotics such as Baytril and doxycycline.
    You might also quote an article by the much-respected rat expert Debbie Ducommun to help demonstrate the high incidence of PT tumours in female rats. From http://www.ratfanclub.org/tumors.html :

    The second most common type of tumor in female rats (next to mammary tumours) is an adenoma (benign tumor) of the pituitary gland, which lies beneath the brain. In fact, this is probably the third most common cause of death in female rats. The incidence in my unspayed female rats has been 20% and in my male rats 7%.

    By all means start Snowy on the prednisolone as recommended, but do keep a watchful eye for signs of respiratory infection as the days pass. Your doctor's chosen dosage (0.5 mg/day) seems well within the Rat Guide's recommended range of 0.25-1.0 mg/lb per day, given that Snowy weighs close to one pound. Meanwhile, I hope you can find a way to access cabergoline and a good antibiotic in order to give Snowy the best shot possible.

     
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  7. May 16, 2019 #27

    Jaana

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    Thankyou so much for your help. I don't know what I would do if I just followed the vets advice. I was going to call the vets tomorrow to see if I can speak to him and mention that I would like to get Snowy on Cabergoline and some more Baytril, due to the high associative symptoms that she is showing being linked to a PT. I will also see if I can get an email address from him so I can send the back up evidence and hopefully he will be inclined to learn. I will give her the medication as recommended and hopefully see how it goes and fingers crossed that I can have a chat with him tomorrow and will update.
     
  8. May 16, 2019 #28

    Dena

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    Also, keep in mind that steroids can't be stopped abruptly after they've been on them for a long period of time. :)
     
  9. May 16, 2019 #29

    Jaana

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    So many things to try and remember. Thankyou. Can't say this hasn't been stressful when all I want to do is try and get her better. Luckily she has only just started (yesterday evening) so I assume she will be on them for some time now...
     
  10. May 16, 2019 #30

    Jaana

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    I have written out exactly what I am going to say to the vet (fingers crossed I can talk to him tomorrow) does any one know how much maybe the cabergoline is in the UK? I just don't like the fact that I feel as if I am telling the vet what to do, instead of it being the other way round, but I guess we all learn some where.
     
  11. May 17, 2019 #31

    Lise Patterson

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    It can be tricky to deal with vets who lack specific experience with rats - I often face this dilemma when taking my critters to an emergency animal clinic. Some vets are very good about acknowledging this limitation, and I truly credit those who undertake some research on the spot. Others seem defensive, leaving me to do a diplomatic dance as I try to present important rat-specific info. In any event, I try to signal my respect for their general expertise. Above all, I hope for analytical rigour in my vets. I would much rather deal with a strong analyst who lacks exotics expertise than an exotics specialist who is prone to questionable analysis - knowledge is one thing, good judgement another. Strong analysts tend to seek out needed info and then make good use of it.
    Sorry, I can't speak to the UK price of cabergoline; I'd be interested to learn what you find out though.
     
  12. May 17, 2019 #32

    Jaana

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    So I spoke to the vet today and explained that I sincerely beielve that what Snowy has is a PT. I have managed to email him and provided the link for Debbie's article and the ratguide about PT. I made it clear to him to look at the paragraph about PT on Debbie's article and what stuck out the most to me from that was if she can't hold food to her mouth, she has a PT. so I emphasised on that. I also stated what medication I would like to get her on, but ofc all that info is included in the links. Snowy hasn't really improved on just the Prednisolone, just seems to be the same, so doesn't appear to be getting worst, so he is considering maybe increasing the dosage, to which he will be calling me on Monday once he has read through what I had sent. He seemed okay in the possibility of using Cabergoline but did say that this isn't normally for animals or that species of animal and I would have to get it off lience. Hopefully the outcome will be good on Monday and I will keep you updated.
     
  13. May 18, 2019 #33

    Lise Patterson

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    Well done. You are doing your best for Snowy and also helping to educate a vet!
     
  14. May 18, 2019 #34

    Jaana

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    I want to do all that I can for her as I'm not ready to let her go, so if there is a chance of extending her life I want to be able to do that. I wouldn't of been able to have done that with out all of yours and everyone's help on here, so thank you.
     
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  15. May 19, 2019 #35

    Jaana

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    Just an update Snowy appears to now be getting a bit worst. She walks a bit still but now she tends to roll to side and struggles a little bit. I don't think she is drinking by herself so I am trying to feed her fresh fruit/veggies high in water (she seems to be eating them a bit) and trying to syringe her liquid, (bit it hard.)Any suggestions on help to help make the syringing easier? Also I'm thinking about increasing her prednisolone to 1mg as 0.5 doesn't appear to help much. Do you think this would be okay, or wait until I speak to the vet on Monday?
     
  16. May 19, 2019 #36

    SQ

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    rats can have 1 mg of prednisone per Ib of rat once a day according to the rat guide http://ratguide.com/meds/endocrine_hormones/prednisone_prednisolone.php

    I buy prednisone in liquid form from the drug store by prescription from my vet
    It is easier then using pills

    as others said, an antibiotic such as baytril must be given twice a day while a rat is on prednisone
    prednisone + baytril is the treatment for all types of brain tumours - an reduce inflammation to buy time but do not stop the tumour from growing
    and if she has the most frequent type of pt, then cabergoline will help for awhile

    I syringe feed my rats that are unable to eat …. organic soy infant formula thickened with baby cereal …. often they will lick it off the syringe, but if unable to do that then I put it into the side of the mouth, one drop at a time so it does not go into their lungs
     
  17. May 19, 2019 #37

    Jaana

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    Well should be speaking to the vets tomorrow so hopefully will be using all 3 meds very soon. Just need her to hang on. In the mean time the soy infant formula with baby cereal, do you have like a ratio for this to make up? Or just make the formula as per the instructions and add the cereal until it's just the right thickness.
    EDIT - This is the most recent video of Snowy and she seems to be declining very badly now. She can barley walk much with out her stumbling over :( is it time to let her go? or is there still a chance if I can get the medication. If i do have to let her go, she has a cage mate called Coconut and I am thinking of getting another rat, as I know they shouldn't be alone, but what's better to buy a young set or to try and adopt an an older rat? I hope it isn't her time to go yet, but I know it only gets worst from here. It is horrible seeing her like that and being so helpless.

     
    Last edited: May 19, 2019
  18. May 20, 2019 #38

    Jaana

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    So as per my last video of Snowy we was going to put her to sleep this evening as she does find it hard to walk and stumbles, she also is finding it bit harder to eat/drink but I think she is still taking some. We didn't go in the end because I was waiting on a phone call from the vet after giving him the info last Friday and he evtually rang back. He seemed happy about the research I present and did some of his own and he is happy to give her the medication she needs. Now do you think it's to late due to her symptoms now or is there still a chance. I really do hope so as this is what I have been pushing for.
     
  19. May 21, 2019 at 5:45 AM #39

    Lise Patterson

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    I have had rats in a fairly advanced state of pt respond to cabergoline; that said, it has often taken some days or even a week before seeing improvement. Meanwhile, the rats required close supervision and a lot of help eating/drinking. I also had one who died early on in the treatment - so there are absolutely no guarantees.
    At least you have found a vet who is willing to research and respond positively - that is no small thing.
    It is somewhat concerning that Snowy has declined so much even while starting on corticosteroids. Have you kept her on the prednisolone? Would your vet consider upping the dose while you wait to see if the cabergoline works? As SQ noted, the maximum recommended amount is 1.0 mg/lb per day, double your current prescribed dose.
    I do hope your vet will now prescribe an antibiotic along with the corticosteroid.
     
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  20. May 21, 2019 at 6:52 AM #40

    Jaana

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    I have kept her on the prednisolone and I increased the dosage to 1mg myself 2 days ago. As I believe this was going to happen anyways. I'm not sure why she has declined badly. The Saturday she was walking okayish still, but Sunday just she seem to of went downhill a bit. I am trying to keep up her food/water. I know there's no guarantee that it will work, but I feel I need to give it a shot at least. Otherwise I'll feel like I have let her down.
     

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