Suspected Pituitary Tumour & Cabergoline/Bromocriptine Dosing

Harway

Member
Joined
May 25, 2021
Messages
10
Location
United Kingdom
Hi there.

After some extensive research I believe my 17 month old rat Peach may be suffering from a Pituitary Tumour. My partner noticed on Tuesday that she seemed lethargic and uninterested in food/treats. At first I just attributed it to being grumpy as we have had a very warm few days in the UK for September, and despite doing all we can for them when it is warm, they definitely slow down and take it easy when it is hot. However, in the early hours of Wednesday morning I found her slumped on her left side, which I feel is important in specifying as it seems she is always leaning or slumping to her left side since. She looked void of all energy and emotion, did not respond to her favourite treats unless being hand fed, and when she did move, she was very low to the floor and dragging her legs a little. She also suffered from poor balance and would stumble a lot, and even fall to her side when she tried grooming. I also noticed that she was not using her front hands at all well, and upon testing her with her favourite foods (frozen peas and mealworms), instead of holding them with her hands, she would sort of just drop her face into it. I tried to force her to use her hands, which caused her to fumble and drop it, before then resorting back to eating the best she could with just her face. This change was really scary and literally happened within a few hours. The only small positive at the time was she became really cuddly, and after some hand feeding and some heavily diluted juice, she simply cuddled up and lay with me for about two hours.

From what I have read on here it seems that these are common symptoms for a PT. I took her to the vet on Wednesday evening and he said she had lost a bit of weight and although he couldn't offer a CT/MRI to investigate if it was a PT, he was happy to give her a steroid shot (she had dex*) to see how she responds. I informed him that the general online consensus and reliable resources such as ratguide.com suggest Cabergoline/Bromocriptine if it were a PT, and he said he would be happy to pursue this Friday if she responds well to the steroids as he is unfamiliar with rats/PTs, and would need some time to review the sources and do some independent research and make some calls. Further, he did also point out that she is squinting with one eye and that the other seems to be bulgling/enlarged, which would lend some credence to the assumption that there is some sort of pressure within the brain/cranium.

Thursday morning comes around and she looked a lot brighter and was moving better. She was still a little lethargic, but she even went for a climb, which did prompt us to separate the cage into two sections to try keep her a little more grounded just in case. She was keen to eat by herself, and managed to use her hands a little to crack open a seed, but she was definitely struggling and has stopped using them since. Unfortunately, she has been struggling to drink by herself, but will willingly take water and heavily diltued juice if given by syringe or if we hold the bottle for her. While in the cage she mostly lays down and keeps to herself. If I try to get her out of the cage she does not seem that interested even if I'm coaxing her out with her faovourite treats. She will wait for me to give her them and then just recoil back to her spot. However, when I do get her out of the cage, she bursts into life and is very affectionate in her grooming and has a little walk about and explore. She is also definitely more herself, and resists going back into the cage. However, when I do put her back into the cage, the same behaviour I just outlined resurfaces.

Obviously I'm very pleased the steroid had such an impact. She went from looking like she was ready to serve her notice on this world to being mostly normal. From being unable to move properly to skittering around on our bed. I will now hopefully be pursuing Cabergoline/Bromocriptine to see if there is chance for further improvement. I just wanted to ask for a little bit of information regarding the dosing. It seems that the dosing for Bromocriptine is very cut and dry, 3mg/kg, but I am getting little information regarding the Cabergoline (which I understand would be the best option if it is indeed a PT that will respond to such treatments), and I will admit the dosing page on ratguide.com has left me a little confused.

Any anecdotes, advice, and general support would be much appreciated.

Thank you kindly.
 
Last edited:

lilspaz68

Administrator
Staff member
Admin
Joined
Jul 21, 2007
Messages
24,192
Location
Toronto, Canada, Earth
I have only used bromo myself (my vet writes a prescription that I fill at the drugstore), so I can only advise on that. The only problem with Bromo/cabergoline is they only work on the most common rat PT, a prolactinoma. So if there's no response you might want to just consider steroids instead.
 

Harway

Member
Joined
May 25, 2021
Messages
10
Location
United Kingdom
Unfortunately my vet called today and said following his discussions with some colleagues that there is little to no evidence to suggest that Cabergoline/Bromocriptine is actually helpful assuming it is a prolactinoma. He did concede it would make sense for it to work, but he could find no cases or studies that show it actually working in rats. He was open to reviewing some sources that I have since sent him (primarily from ratguide.com), so I am hoping that come Monday he will reconsider when she goes for another dex shot. In the meantime I have reached out to a few exotic vets inquiring about rat experience and using Cabergoline/Bromocriptine for prolactinoma treatment, and two have responded saying to ring Monday morning to register and book an appointment

I know you only have personal experience with Bromocriptine, but perhaps you have more anecdotal evidence than I. If you could choose between either all else considered equal, which would you prefer? I have been reading a lot about how Cabergoline is intolerable to them, and Peach is the difficult rat for getting to take other medications. Although I suppose once every 72 hours will make syringing more manageable.

Obviously I am hoping for a prolactinoma for a better chance at a longer life. The thought of losing her while she is only 17 months old is heartbreaking. Assuming I can get the medicines, if I have no response after two weeks I will resort to steroids only and then make the call to ler her move on depending on quality of life. Today she is actually even better than yesterday following Wednesday's dex shot. She is still a little slow and falls when grooming too aggresively, but she is climbing, has more albeit limited use of her front hands, and is drinking and eating entirely by herself.
 

Negoonus

Member
Joined
Jan 6, 2020
Messages
19
Location
Hamilton
From what I've seen, Cabergoline doesn't taste good and if Peach is difficult with taking meds, I'd imagine it would be very frustrating trying to get her to take it. I just took my rat Latte to the vet to diagnose her PT and my vet and I were discussing both meds as a way to slow the tumor's growth. She's on prednisone to hopefully shrink the tumor some and then I was going to get her on Bromocriptine as the next step.

That's great that Peach is feeling better after the dex shot. Best of luck with the decision you make.
 

lilspaz68

Administrator
Staff member
Admin
Joined
Jul 21, 2007
Messages
24,192
Location
Toronto, Canada, Earth
A good dose of dex can last up to 3 days then regression sets in.

My vet and I tested bromocriptine years ago with my rat. my Issa was the guinea pig for it and we had some wonderful successes with it. Issa had other issues that shortened her life.
My vet was Dr. Munn now at Jamieson Queen Animal Hospital in Toronto.
Email is [email protected]

I'm sure if your vet logged into V.I.N. they could find the info they need.
 

Rattdad

Supporting Member
Supporting Member
Joined
Mar 9, 2019
Messages
30
Location
Rhode Island
I put one of my first rats on cabergoline for a PT. She took it every three days, administered by force (unfortunately). She definitely improved the day after dosage, then by the third day the symptoms would return. It was wonderful to see her return to her old self for a while, but it was a case of diminishing returns and after a month it didn't work as well and she had to be put to sleep. The cost was rather expensive, $60/month, but I would have paid more for something that worked better. (I have very poor financial judgment when it comes to my rats.) My advice is, it's worth a try but be honest with yourself about the situation as it develops. Don't be too hard on yourself, part of being a rat owner is being able to let go. And perhaps your vet is good, but here in the US there are good and bad ones and I try to inform myself and take what the vet says with a grain of salt (cabergoline definitely works, whether it's worth it, I'm not sure... My sweet girl Saya lived for another month, but I'm not sure if it was worth it in the end--not in terms of money, but in terms of her suffering).
 

Harway

Member
Joined
May 25, 2021
Messages
10
Location
United Kingdom
After showing my vet some clinical studies I found, and in conjunction with an email from Jameson Queen Animal Hospital and another vet in the UK saying they use both drugs in managing suspected prolactinomas, my vet is now onboard with pursuing these drugs as treatment.

Peach regressed a lot today (this being the 5th day so that makes sense) leading up to her second dex shot. If she responds well again tomorrow, my vet will try sourcing either drug (he did say they are hard to find and expensive) to begin treatment. If she doesn't respond tomorrow, it will be time to say goodbye.

Thank you for your inputs. I will post an update when I have one. Fingers crossed it can be a happy update.
 

lilspaz68

Administrator
Staff member
Admin
Joined
Jul 21, 2007
Messages
24,192
Location
Toronto, Canada, Earth
Bromocriptine is readily available at most bigger (not mom and pop) drug stores. You just need your vet to write a prescription for the 2.5 mg pills and you can call around to find out who has it on hand.
 

Harway

Member
Joined
May 25, 2021
Messages
10
Location
United Kingdom
Bromocriptine is readily available at most bigger (not mom and pop) drug stores. You just need your vet to write a prescription for the 2.5 mg pills and you can call around to find out who has it on hand.
I think things work a bit differently in the UK because I am not aware of any big drug stores over here that operate this way. I will run the idea by my vet though to see what he suggests. Maybe I am simply ignorant.

Cabergoline/Dostinex seems to only come in tablet form. Bromocroptine/Parlodel on the other hand can come in 5mg hard capsules. If I remember correctly capsules are sometimes coated for a whole variety of different reasons. I wonder if this would rule using the capsules and emptying them out entirely? Have you ever used the capsules or only the tablets?
 

Harway

Member
Joined
May 25, 2021
Messages
10
Location
United Kingdom
Awww I'm so very sorry. I've had quite a few of these unresponsive PT cases with my rescues over the years. It's so sad. :(
She responded so well to the first shot, but absolutely no change with this one. She still has her spirits and we are enjoying some time together with her cage mates now. One of them will not leave her side. I feel like they know. Meanwhile, I've gone through a box of tissues.

Part of me feels guilty for not convincing the vet to try the other treatments sooner. Part of me is happy that moving forward I know that I have a vet who knows the signs of PT and how to approach it, and can hopefully help treat my rats and others too.

Thank you, guys. At the very least I've given her a fun and love filled extra week, and learned how to react moving forward when I inevitably encounter this again. I'll update if anything changes, or this evening following her final vet visit.
 

Harway

Member
Joined
May 25, 2021
Messages
10
Location
United Kingdom
Peach has moved on after a day filled with continuous cuddles and her favourite treats. Thank you to everyone for your advice and kind words.

The most beautiful thing happened while we were waiting for the vet to help her pass. Peach and her best friend, Luna, had a quick last cuddle in their final moments together. It broke my heart, but I'm glad that they got to say goodbye to one another.

I've shared one of the last pictures I managed to get of her while we were at home still, and then the sweet final moment as we waited at the vet.

RIP Peach. You are my first rat to pass and I will always cherish our time together.
 

Attachments

  • 20210914_141602.jpg
    20210914_141602.jpg
    41 KB · Views: 7
  • 20210914_175835.jpg
    20210914_175835.jpg
    55.6 KB · Views: 7
  • 20210914_175939.jpg
    20210914_175939.jpg
    53.4 KB · Views: 7

Latest posts

Top