Ralphie's abscess- Update: 6/7 - It's time to say goodbye :(

[Slapdash]

My poor old man Ralph is having a hard time aging lately, he'll be three on July 13th and up until about two weeks ago he was doing really well even despite his HED. Out of the blue he developed an abscess, I'm pretty sure it's from a penis plug turned infection or some sort of prepuital gland tumor/cancer. But I need a lot of advice here because I'm not sure what to do. He's neutered though and I was checking his penis every day since he started having HED issues until I read that there has really never been a rat that was neutered and had a penis plug so then I began doing a real check only every 3-4 days since he never had any issues before, but I still check him over every day during his scratch downs before I leave for work and when I come home and he never had an issue, always peeing fine. So, I'm really not sure what the origin of this is but Sat the 28th before I went to bed, I could tell something looked strange and I felt a tiny harness next to his penis and sure enough the next morning an abscess appeared.
So normally I would bring him right in to the vet but I really can't with Ralphie. He has major breathing issues and is almost permanently on antibiotics. The last time he was at the vet was a year ago and he ended up open mouth breathing in the waiting room and having to stay overnight with oxygen and it broke my heart when I realized he just wanted to be home. It's a long story but I'll never make that mistake again and I trusted the vet(not my normal) but my gut told me to go get him asap in the morning and sure enough he was back to himself when he got home. He loves his home and his buddies and I honestly can't see taking him out at his age, he gets worked up enough when if I need to rearrange the cage a little lol. So I've been trying to find a qualified vet that will make house calls in the area but no luck so far. In the meantime I could really use some help and sorry for the long post, I've had no time to get on here and need to take advantage of what time I do have!
We've been flushing the abscess at least three times a day with warm saline, and even though he was already on a doxy /baytril combo when this started I did also put him on a round of the TMS(Septra/Bactrim) because I wasn't sure they would be enough and I knew it was better for abscess'. I was able to get all the thick pus out the first two days and it almost completly closed up a week later and then bam we were back to square one out of the blue at the beginning of this week. So we're continuting the same treatment but noe there's an even bigger hard lump behinnd and around the abscess. And it's too painful for him when i try to work it out :cry: Then on top of it all he's started to develop bumble foot I believe. But I change his cage EVERYDAY and I've even been coming home on my break everyday just to change any soiled paper towel that I put in his bed/hammock because he can't always get up in time. And he's on all fleece in a one level cage with all comfy stuff, I don't get it! lol I put extra padding under a low hanging hammock he likes to sleep in because its all I can think of! I've been washing them as well a couple times a day and putting neosporin on them and they look a tiny bit better but is there anything else I can do? And my big question is as far as pain management, I've been giving him ibrufrofen for the past two days because he also looks to have sprained on of his feet some how or it's just the bumble foot but with everything that's going on I feel so bad for him! I do have metacam but with his respiratory problems I'm afraid to give him that, what do you think? I'm working in posting pictures now. thanks again, and sorry it's so long!

 

[Slapdash]

The abscess on May 3rd

and tonight...
\

His poor feet...

This is the swollen one...

 

[jorats]

Poor old man... he's developing quite the issues, I guess his immune system is quite weak. The meds are perfect for what you are battling with. Other than that, lots of TLC. Keep him comfortable. The red mark on his foot is more like a sore than a bumble, I wouldn't worry about that. The metacam, I would definitely give it, it might even help with his breathing issues too.
He's nearing the end of his life, he's had a good long one. It's up to you now to decide when he's had enough. Palliative care, lots of cuddles and a close eye on your sweet old man.

 

[mamarat]

Ralphie has had a very long life with you. Lots of cuddling now and enjoy every day with him. I find Metacam helps my oldies with breathing problems too.

 

[Slapdash]

Thanks guys, I appreciate the kind words, I wish he could stay young forever.I may have found a vet that will come to my house, just waiting to hear back, which would also be great because when the time comes it would be so much easier on him if we could do the euthanasia here. I just want to know I'm doing everything for him, I'll start the metacam today, he's such a trooper. I could never let him suffer, he is still SO happy, and loves getting spoiled as an old man, I customized the cage(one level) to his needs and it's always extra comfy and padded, he gets glucerna/baby cereal in the morning with his meds, mushy lab blocks or baby food for a snack twice a day, and he still wants his veggies every night before bed, I think his appetite is the only part of him that hasn't slowed down! :laugh4:
Also, right now he lives on the upper half of my FN with Clarabelle Cow (15months) and when I get home from work I put Penny and Annie(3&4months) who live in the bottom of it up into the top. They are all one big happy pack now and he LOVES getting groomed and inspected by the babies but sometimes they're too much for him mostly because they destroy his cage and eat/stash the food I leave out close to him so it's easy to get to. I feel bad seperating them when I'm not home but they literally destroy everything and make it hard for him to drag himself around because all the fleece is piled up and everythings knocked over lol So they can really only be all together when I'm home :? I don't know what else to do in the meantime. Thanks again everyone, he's doing pretty good for now all things considered :heart: Here he is last month, I had just given him a wipe down/bath and sometimes I'll spike his hair into a fohawk while it's still damp so I wanted to take a picture, little did I know I would also capture him mid eye boggle!!!

 

[hopefloats]

I love that picture. I nominate for rpom.....


Need a seoncd.

We are just getting into the old rat phase...it is quite an adjustment.

 

[mamarat]

He is gorgeous. I think you're doing right by him,(I mean separating the youngsters when you're not there), you're a good rat mama.

Second the nom!

 

[jorats]

I third it. He's adorable sand clearly spoiled by his mom. Lucky rat for sure.

 

[Godmother]

What a sweetie. I hope that he will have lots more quality time with you. He knows how much he is loved!

If you ever had to take him to a vet, is there any sedative they could prescribe for you to give him beforehand?

 

[Slapdash]

Thank you so much everyone for the nom and kind words he's doing really well today! In fact this is his best "good day" in over a month by far. He was crawling around after the babies when i put them up top earlier and it was the cutest thing, he got right in the middle of their groom pile too :heart:
He seems to be doing well on the metacam, unfortunately I've had no luck with finding a vet to come here, of the places I called/emailed that will travel to my area, none see rats, only cats and dogs. I'm hoping to have a nice long chat on the phone with my normal vet tomorrow, she hasn't been in all week and I'd like to ask her some questions and about a possible sedative if it comes to that to get him there because at least this place is only 15min away opposed to the vet I used to use more frequently was 1hr drive. But he's still peeing/pooping ok so I don't know if he needs to be seen right now I'm mostly concerned with keeping him comfortable at his age, but today it seems to have opened up even more. I'm not sure what to do with it at this point. There's such a hard mass behind it, it's hard to explain, it feels almost like the entire thing could just prolapse outward if you squeezed behind it hard enough :shock: I was able to get a really good picture right after we irrigated it so he's still all wet...
[spoil:3dh2jkv9]

[/spoil:3dh2jkv9]

Oh also, I've read different opinions on keeping seniors on antibiotics indefinitely, but he can't seem to stay off of them, so I usually just switch up the combination. Right now he's on doxy/baytril but when this round is done he's probably going to go about 2-3 weeks before having to start back up again with some combo. I've also noticed the prednisolone has helped him a lot when hes really bad but don't want to have him on it for too long. And while on the topic, how long should he stay on the metacam? As long as he has the open abscess? Thank you again everyone!

 

[jorats]

We've had rats here on long term Baytril and Zithro, both a year or more and when they did finally pass, the postmortem showed absolutely no ill effects to any of the organs. So I'm definitely not worried with long term meds other than the fact that at some point, they could become resistant. But if it's either on meds and be better or off meds and dying... I'll put them on meds first.

 

[EDK]

Poor old guy, hang in there little man

 

[Slapdash]

Hello,

So the abscess is pretty much the same, I called the vet a few days ago to see if I could just come in and show her the pictures and get her advice and she gave me her email and said to send them there and she would be glad to help/answer any questions she could and prescribe the refills on all the meds he needs even though she can't actually see him :joy: I was so relieved so, she said based on the pictures to keep doing what I'm doing with the abs/metacam and irrigating with saline. She also said I could try packing it with some honey to inhibit the bacterial growth.
So, that was all well and good but now since Saturday night he's been acting very strange so I emailed her back today but I'm not sure when I'll here from her,so I'll probably call in the morning but could really use some opinions in the meantime. I think it may have been a stroke or seizure(s) of some sort. He's been very lethargic, but still able to get around, and eat ok but he's been bruxing and eye boggling almost non stop when hes not sleeping or eating? And he's been drooling very frequently, not a lot but his chin has been wet a few times today and yesterday when I checked. He also keeps cleaning his mouth(probably because of the drool I assume?). I posted a video, not sure what to do, it seems neurological somehow, the only thing that has changed in the past week is the metacam and I don't think he's ever been on it before. Should I take him off it tonight just to be sure? He's also been head bumping a little so I was thinking PT but he's always done that on occasion and he has no issues with his front hands,as you can see from him cleaning his face. My poor old man Thanks again everyone!

View My Video

 

[Joanne]

Hmmm, odd...
I know this sounds basic, but have you checked his mouth lately to see if his teeth are OK?
I know that wouldn't have any bearing on his abscess, but may be related to bruxing and drooling and messing with his mouth.

 

[Slapdash]

Thanks, yeah I thought that too but his teeth look fine, I'll try to get a picture tomorrow though just to be sure. Thanks again

 

[Fidget]

Oh, beautiful precious boy!
Sounds like you're doing everything that can to help already...
I wouldn't take him off the metacam, but I'd quit the ibuprofen (tho I'd check with people who knew more than me)..
Maybe the foot swelling and his not acting normal is from poor circulation? I think both metacam and ibuprofen could impact that, but I'd stay with the metacam low dose as gives him comfort.. Also could he have developed diabetes or kidney failure? Both could cause the foot swelling and not acting normal. Usually one part crashes and it's clearer what's going on, but sometimes everything wears out gradually together and the whole body gets affected...
Clearly TLC is the best medicine at this point, you have a whack of it there and no side-effects.
He'll be ok away from his friends while you're gone, sleeping in comfort with his well-stocked pantry around him, certainly more ok than you are having to be away from him. It'll sure enhance the time you can be together..
Our hearts go out to you cause we know where you are, the only heart that will carry you thru this tho is Ralphie's. And only cause the best medicine for both of you right now is your love for him.

 

[Slapdash]

Thank you for such a sweet reply, he's the best old man
I'm really worried about him now and I had to go with my gut so I did not give him the dose of metacam yestesterday and he did seem a little better today but was still bruxing and boggling so I gave him a slightly lower dose and since earlier tonight his face now seems swollen and he's still drooling on/off. Oh and l forgot to mention he's not on ibruprofen anymore it was only for the couple days his foot was swollen. So I don't know what is going on, he's getting very upset when we try to get a good look at his mouth, so I think its related to his gums/jaw or the metacam but I wish I knew what to do or how I could better help him. I haven't heard back from the vet via email and she wasn't in the office today. My poor boy I wish I knew what was going on, I'm going to try, if I can to get a picture of his mouth in the morning. Thanks again everyone!

 

[Bundyrats]

Poor boy. Sending him good vibes.

 

[Slapdash]

It's been quite the difficult past few weeks and I'm heartbroken to say we're bringing Ralphie in tomorrow to be PTS :cry4: It's been really tough and I've been giving him as much TLC as I could round the clock, but I think it's his time now, he's losing the fight :sad3: I was luckily able to talk to the vet almost everyother day via email/phone and she was so understanding about me not being able to bring him in and never charged me a dime, except what I payed for the meds. She did confirm it seemed he had an abscess from a malocclusion in his mouth, it was just too far back for us to see but he had all the symptoms and was bruxing/grinding all the time to try and correct it himself. But up until two days ago his teeth looked pretty good, and there was no obvious breaks/misalignment, but now you can't miss it, his top teeth are uneven lengths and both sets of teeth almost appear crooked :cry: I don't know how/why this all started since he's been on a one level all padded/comfy cage for two+months now and was still crunching on lab blocks until this all started, just old age I guess? He also still has the abscess near his penis and the tumor underneath is growing, you can feel a hard mass all the way from his penis to his bum now. And since he will be three July 13th and already has major respiratory issues, obviously surgery isn't an option and I don't see any way we could trim his teeth without putting him under, he won't even let me look in his mouth unless he's in a half asleep state and even than gets all worked up and I would hate for something to happen if we tried to force him to let us. So with everything combined it's just too much on my old man now :heart: Would you all agree? It's such a hard decision on me with him because not only is he my first, my baby; I've had him since he was only 4 weeks, but also because in the past with my other guys it's always been a PT or something definitive that it was time. He has lost weight but he's still trying to kiss me, and eating (sometimes with a little difficulty) but only certain soft foods/baby food and I have to put it right in front of him or let him lick it off my fingers and even then his appetite isn't what it was a couple weeks ago. :cry:
So the vet was going to come out to the house but if she did that it wouldn't be gas and she couldn't do the abdominal injection either because she wouldn't be able to wait the time necessary, so we decided it's probably best to just bring him in. I am so worked up about it though, she's going to prescribe a sedative that we're going to give him a couple hours before we take him out of the house and hopefully it will keep him calm. Then she will use the gas/cardiac injection but I can't be with him for the gas, which is also killing me because he really is SO sensitive and SO attached to us I can't even explain. He tries to scurry and follow me whenever I walk away from his cage now unless he's asleep, I just hope he doesn't stress without me there :sad3: Sorry for the long post I just really needed to get all my feelings, thoughts, and concerns out and I know you guys will understand! I'm going to miss him so much!

All tucked in before bed last night...

 

[lilspaz68]

If you can get the metacam into him I would...make him feel a lot better...its often used with respiratory rats to reduce inflammation in the lungs.

You also might want to look into Rescue Remedy as well, you cna rub the liquid into his ears and it absorbs into his blood stream. I have used it on nervous rats for trips and its worked pretty well.