I figured I'd go ahead and post the link to the documentation on nebulizing gentamicin along with links to the nebulizers I mentioned and the other items for reference in case anyone is searching on this for their ratties.
As mentioned I use a 24Qt Sterlite Bin + top w/ latches as the nebulizing chamber. I do not have any ventilation holes or meshing installed on the bin; the only hole is at the face of the bin and is cut to fit the nose of the nebulizer. The bin isn't air tight and the fitting between the lid and lip of the bin leaves enough space for air to circulate while allowing the medicine vapor to build up in the bin at the correct concentration. With this set up there will be some vapor seen escaping from under/around the lid.
Here is the bin that I use:
https://www.homedepot.com/p/Sterilite-25-Qt-Latching-Storage-Box-14958006/206721478
The only items I have in the bin are a folded medium sized hand towel and a small cardboard box for Beans to hunker down in. Since the box is cardboard I have to toss it every 4th treatment and replace it since the humidity from the vapor tends to make it funky and wash the towel every 4th treatment. I also make sure to wash the entire bin out/scrub it once a week since there can be some buildup of medication on the interior surfaces. Always keep the bin open to air it out between treatments.
Below are the nebulizers I have used w/ injectable enrofloxicin and gentamicin. I prefer the Philips Respironics SideStream Plus nebulizer for Gentamicin. The
Respironics Sidestream Plus is made for patients with smaller airways and/or difficulty taking deeper breathes such as infants, the elderly or patients w/ lung disorders (as is the PARI LC Star). The SideStream Plus nebulizer IMO is perfect for rats and I highly recommend it. The second nebulizer I would strongly recommend is the
PARI LC Star. The Star has a longer treatment time than the Sprint or Sidestream Plus. Both the PARI LC Star and Respironics Sidestream Plus are able to produce a finer particle size which is further enhanced when a volume greater than 5ml of solution is added to the cup.
The manufacturer websites over estimate the overall MDM (mass median diameter), FPF (fine particle fraction) and the FPD (fine particle diameter) on their websites/product manuals, so the data below is pulled from medical documentation and studies with the accurate numbers/measurements.
Always rinse out the nebulizer cup and mouthpiece with hot water after use. I use F10 to disinfect the nebulizer between uses and I sanitize it every 3 days in boiling water for 5 minutes. The PARI LC Sprint has a blue silicone tongue on the inside of the screw top that will need to be removed or folded back into an open position so that the vapor flows freely into the nebulizing chamber. The Phillips Respironics Sidestream Plus also has a "breath control" stopper that you will need to remove so that the vapor will pass through the nose of the nebulizer w/o requiring the act of inhaling to draw back the silicone flap. The stopper on the Respironics Sidestream Plus (it's a clear strip of silicone in the shape of a rectangle and is positioned on the top of the screw cap/mouth piece) is easy to pull out from the top. Once you can get a hold of the silicone with your nail it should just pop out pretty easily (it looks like a flap when it's removed). These nebulizers work with the patients breathing; the silicone stopper drops down when the user inhales which releases more medication during inhalation. Removing or folding back the stopper eliminates the "breath control" feature so that the vapor will continuously flow. Removing it isn't necessary because the vapor will still flow into the chamber, it just takes more time to complete a treatment and will push the treatment time beyond 25 minutes.
*Phillips Respironics SideStream Plus:
https://www.vitalitymedical.com/respironics-sidestream-plus-nebulizer.html
Output rate: 500 mg/min
MDM (mass Median diameter): 2.1 - 5 um particle size
FPF (fine particle fraction): 76.2
FPD (Fine particle dose): 402 meaning that the finer particles are nebulized per mg/minute with a total of 402mg/min as the amount that actually reaches the deeper areas of the lungs instead of getting stuck in the nose/mouth and upper respiratory tract.
PARI LC Sprint:
https://www.vitalitymedical.com/pari-lc-sprint-nebulizer.html
Output rate: 500mg/min
MMD: 3.5 - 5 um particle size
FPF: 68.72
FPD: couldn't find this information but I will update when I do.
PARI LC Star:
https://www.vitalitymedical.com/pari-lc-sprint-nebulizer.html
Output rate: 400 mg/min
MMD 3.1 - 5 um
FPF: 75.6
FPD: 298
The compressor I currently use is the PARI VIOS Green. I did order a new compressor by PARI called the VIOS Pro which has a Higher operating pressure (Pro is 23.2 Psi vs VIOS Green which has 18 psi) and is a better option if you're using the compressor more than once a day.
Another important thing to remember is after the nebulizing treatment is finished and the nebulizer cup is disconnected from the tubing, the compressor should be turned back on to run air through the tubing. There can be some condensation in the tubing after a treatment and running the compressor for 8 minutes will push the condensation out and dry the line. Forgetting to do this the end of every treatment will leave condensation in the tubing/line that could contribute to bacteria and mold growth that can unintentionally be nebulized and cause serious lung infections. It's always a good idea to replace the tubing, compressor filter and nebulizers every 6 months.
PERI VIOS Pro:
https://justnebulizers.com/products/pari-vios®-pro-nebulizer-compressor?gclid=EAIaIQobChMI2syyzPjG5QIVTRitBh3XBQqlEAQYBSABEgIpj_D_BwE
PARI VIOS Green:
https://justnebulizers.com/products/pari-vios?_pos=9&_sid=987b8eda7&_ss=r
In regards to keeping yourself, family members and other pets safe during treatment I would recommend a cut to fit filter that can be fitted along the rim of the sterlite bin chamber or draped over the bin and secured w/ the bin lid. Another option is keeping door closed in the room that you are nebulizing in and wear a 3M N95 respirator mask (simple face mask, nothing crazy).
Here is the cut to fit filter I purchased:
https://www.amazon.com/Ventilaider-...words=cut+to+fit+filter&qid=1572526111&sr=8-6
3M N95 respirator mask:
https://www.amazon.com/3M-8511PB1-Particulate-Respirator-10-Pack/dp/B0002YKBV2
Here is the documentation on gentamicin and the use of a filter to prevent inhalation by pets and other people that may be in the room during treatment:
https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.nationaljewish.org/NJH/media/pdf/MF-Using-A-Pari-LC-Plus-Nebulizer-with-Gentamicin.pdf?ext=.pdf&ved=2ahUKEwjfmvOr88blAhXwqlkKHY01DYEQFjAPegQIBxAB&usg=AOvVaw0IMW6bR3GCetZx5gLLA1qo&cshid=1572538837572
I think that about covers everything that folks would be interested in if they're searching for information on nebulizing Gentamicin.
