Sid - downhill fast. PT?

[Joanne]

How can you resist that soft belly?!

 

[temblabamomo]

Feeling like dex would be good. He is doing nothing but sleep or slump in his corner. He is eating mush and does not feel dehydrated. I guess what I'm saying is he isn't getting worse as far as the balance/coordination/confusion symptoms go, but his activity levels are in the basement.

Any advice appreciated. If dex is something to try now, I don't know his dose. It is dex sodium phosphate @ 4mgs/ml and Sid is 755g.

If no response will call Dr B tomorrow to ask.

 

[Joanne]

OK, so looking at the Rat Guide, the dosage for Dexamethasone Sodium Phosphate is 0.23 mg/lb to 0.9 mg/lb. Sid weighs 755g which is 1.661 lbs. Therefore, his dosage range is 0.38203 mg to 1.4949 mg, which at 4 mg/ml works out to a range of:
0.1 ml to 0.37 ml, BID (twice a day)
You are also aware that you can't just stop Dex cold turkey, right? If it is more than one dose, then it should be gradually decreased over a specified time.
If you can talk to your vet tomorrow, it may be wise to wait if Sid's not in crisis.
For my Dixie, we did three days of Dex BID, then three days SID, then every other day for three more doses. That was at the beginning of treatment. She has not had any more Dex since.

 

[lilspaz68]

I often just give one dose of dex and wait for the response. The anti-inflammatory works so fast, and is so effective you often don't need more. You just need to give them a boost until the treatment (bromo or caber) kicks in about 5 days.

You cannot use metacam with a steroid and you don't give dex with pred as you are doubling up your steroids. The only way you do the dual steroids is with the fast-acting dex given once and the pred given orally (as it takes days to build up in the system to effect an improvement).

 

[temblabamomo]

Thanks lilspaz & Joanne. He isn't in crisis and is still eating and getting some fluids into himself on his own. I will hold off and wait to see what vet says tomorrow.

I guess I am confused about dex use. What I have now is meant for Eugene, who has confirmed pulmonary abscesses and getting near the end. It's the same drug/concentration listed on my above post, but the instructions are .1ml once every 3 - 7 days. So he isn't on a daily regimen, but the spaced out doses aren't exactly on a set schedule either.

I also don't understand dex v. Dex sodium phosphate obviously different dose guidelines. I'll just see what vet says...

Checking for plugs and wiping off his tum (he keeps peeing himself)

 

[Joanne]

Eugene is being treated for a completely different problem, so the medication is used in a totally different way. One of my girls who had severe respiratory problems was on long term steroids (Pred). It was the only thing keeping her breathing.
That's totally different from what you are trying to achieve for Sid, which is to try and reduce the inflammation in the brain short-term so the medication can get to the tumour and start working.

 

[2Rats]

Now that's a picture you need to have framed !:love2:

He looks pretty comfy!

 

[temblabamomo]

Dare I say he looks improved this a.m? Don't want to get my hopes too high....But he ate all the mush I left him last night, and a mountain of poops beside the plate. He was in his house when I got up but after brushing my teeth he'd come out and was washing himself, staying upright a little better, then actually came to the door and tried to stand when I approached. Belly soaked in pee so did a quick wipe down w promises of a real bath when I get home, and he definitely made more of a struggle against the indignity of being cleaned up (yesterday he just lay limply and let me work). Made one full trip around the room with his back legs looking stronger and made some feeble chews on the snack shack under the FN! Didn't pause to brux and zone out at all. He went into his box then but came out on his own when I brought breakfast. Ate pretty well then washed up and curled in for a nap. Went back to the food dish again when I put him back in cage before work.

All in all he is far from himself, but after the near comatose lethargy of yesterday it is so good to see some life in him.

Will call Dr B today and ask what he thinks about a dex "booster" to give more time to see if the meds are going to do something.

 

[Joanne]

Sounds promising!

 

[temblabamomo]

We have not seen much improvement in my big boy this week. Monday was good, but mostly downhill from there.

He did get a dex shot and from there has been on oral prednisolone.

He has had 3 Cabergoline doses.

He still eats (makes a terrible mess ) and will take some ensure from his dish; I dilute it with water at times. He is staying hydrated on his own so far.

He drags himself around the room with difficulty, but seems glad to be out of the cage to "stretch his legs". I sleep on the floor with him (he cannot sleep in bed w me because he likes to go over the edge).

He needs baths twice a day since he he's food all over himself. He seems I enjoy the warm water and some support while he grooms his whiskers. Plugs are found morning and usually evening.

At the point it seems like we are just waiting for him to fade away. Honestly thought last night was his last - he lay on my chest with his head under my chin until 2 and at times I wasn't sure if he was still breathing. Then he woke up and ate a saucer of baby food so definitely had me fooled.

Does it seem cruel to keep him alive while he body will not obey him? He appears comfortable and content to sleep, eat a bit here and there, and be loved on. Obviously I would prefer him to pass here at home with me, but mom is wondering if it would be kinder to have him PTS. He isn't completely out of it yet, but still aware enough that he would know if he was at the vet being carried away by some stranger (the local e vet we use weekends doesn't allow you to be present for PTS which is why we only go there for true emergencies). Sid has always been a people rat and a mama's boy; given the choice I'm sure he wouldn't want to go that way. But he's also still aware enough to know his body is failing him.

As I was lying on the couch with him last night, it occurred to me that I had done the same thing with him 2 years ago when I brought him home as a 4 wk old with pneumonia and thought he wasn't going to make it. Kind of a big bittersweet full circle.

 

[Joanne]

Since most PT rats don't seem to be in any distress, I will keep them at home until they refuse food (usually syringe feeding by then.) Then I bring them in to be PTS as I don't want them to starve to death. So it's up to you - how much of his slow decline can you tolerate, or if you are enjoying your time together as his nurse.
How great he made it through his pneumonia to spend two wonderful years with you! Scritches to Sid.

 

[Sheldon]

It sounds to me like you two are enjoying each other's company too much right now to make a weekend decision like that. He sounds comfortable and content and you are meeting all of his needs. I too have slept on the floor with loved ones in their last days and have never regretted the resulting backache, lol.