Things to discuss before surgery

[SQ]

Surgery on rats is different then surgery on cats and dogs.

Rat owners must be very proactive as many vets do not know how to treat rats.
Very few people have access to exotic vets trained in the treatment of rats, as Jorats' vet is.
It is dangerous to just trust that the vet knows how to properly treat rats, no matter how well you know the vet or what their reputation is.

1. It is extremely important to educate ourselves as rat owners.
When we go to the vet we need to have done our research, ask questions, etc.
This site is a good place to start looking for information.

2. If possible, it is important to use vets experienced in successfully treating rats.
Ask your vet about their experience treating rats, their training re. treating rats, what procedures they have successfully done on rats, you may want to speak to people with rats that have been treated by this vet.

3. The following list includes some topics that rat owners need to discuss with their vet prior to making an appointment for surgery.

It is extremely important for rat owners to discuss the following with their vet before surgery:

a. anaesthetic
- isoflurane gas only, injectable anesthetics can be deadly

- pre-anaesthetic (or a sedative/analgesic) can be deadly to rats. "The
combination of the sedative and anesthetic can be fatal for rats." (p. 17)
This should not be given to rats by the average vet.
Some very experienced, well trained, exotic vets specializing in rats do give this safely.
However, the use of pre-anaesthetic is used with caution as it is often fatal to rats.

b. pain med (analgesic) is necessary
- acetaminophen can be given before the surgery
- Vets often give an injection of Metacam after surgery to control pain for 24 hours. After 24 hours the rat is given oral Metacam to control pain.
- some vets give butorphanol after surgery, but this should be only after the rat is awakens from the anaesthetic and is alert
- Some very experienced, well trained, exotic vets specializing in rats may give pain medication during and after surgery (info. from Lilspaz68) ​

c. suture material
- "when the incision is small, subcuticular sutures may be used" (p. 17)
- "for larger incisions needing more sutures, rats often have an inflammatory reaction to
absorbable sutures" (p. 17)
- vets may use Michel wound clips, staples, surgical glue, or steel wire sutures for large
incisions, depending on the vet

d. keeping the rat warm during and after surgery as rats can not regulate their body
temperature for up to 24 hours after getting anaesthetic. If a heat source is used, they need to be able to move closer and away from the heat source.

e. a full course of an antibiotic is recommended and should be started several days prior to
the surgery (to prevent infection, or respiratory problems in rats previously treated for respiratory problems/myco.)

f. pain meds to give at home for at least 3 days after surgery (oral metacam)
- rats hide their pain very well. After a spay or neuter, rats "may experience severe
abdominal cramping for up to 3 days after surgery." (p. 17) "Analgesia may help prevent
rats from chewing out their sutures." (p. 17)

g. fasting before surgery - Do Not fast rats

h. will the vet do a health check prior to surgery - for example: rats with respiratory problems or heart problems are at risk from anaesthetic. Surgery should be delayed until the rat is healthy or not done at all.

(most of this info. was taken from the Rat Health Care book)

Both the Rat Health Care book and the rat guide (http://ratguide.com/) have useful information.

EDIT: Jorats' vet is a trained exotic vet that has specialized training and experience in treating all sorts of problems in rats. This vet is willing to discuss the treatment of rats with other vets. If your vet would like to consult with Jorats' vet, please pm Jorats for her vet's contact information.

 

[pomegranate seed]

Thanks for posting this Holly. I've been researching rat surgeries as I have 2 new baby boys (they've yet to be introduced as I've been into lurking mode lately and have no working camera again) And have 4 girls, so obviously I want to have the boys neutered. The one thing I would like to know is what suture material is the least likely to cause neuter abscesses and which kind to avoid. I can't seem to find the names anywhere, just that some kinds can cause abscesses. I'm extremely nervous about this whole process and can't imagine my boys having surgery as they are so tiny (just under 7 weeks old). Thanks for any info in advance.

 

[ryelle]

Is there any type of suture material that people have had more trouble with? On either sex - or does one sex react to certain suture material more than the other?

 

[Dahlas]

e. a full course of an antibiotic is recommended and should be started several days prior to the surgery

f. pain meds to give at home for at least 3 days after surgery (oral metacam)

I have had 15 rats spayed and neutered and have not given antibiotics or pain meds to any of them.....I watch mine to see if they show signs of pain and so far none have. My rats receive pain meds at the vets and that is good for 24 hours....... I don't give meds unless they are necessary.

 

[jorats]

Same here... I only give antibiotics if the rat is not in top shape. As for pain meds, only if I think my rat needs it which is hardly never. But good to know that it's something to be discussed.

 

[Dewi]

Suture material:

This doesn't relate to neuters, but it is very relevant to spays (especially) and tumour removals. It is worth noting that internal sutures greatly reduce the risk of rats chewing out their sutures and thereby preventing loss of life or a slow and uncomfortable recovery that can result from a surgical incision being chewed open. In my experience, internal sutures can sometimes cause a mild localised reaction in some rats, but this has never been problematic and greatly outweighs the risks. I can find out the type of sutures my vets use if anyone is interested.

One of my vets did (and possibly still does) use a very fine overcast style of stitch when doing external sutures on rats which was more effective at preventing unplanned suture removal as compared with the conventional surgical stitch. Personally I still prefer the internal sutures for peace of mind.

One final comment, Elizabethan collars and body socks (or whatever they are called) are not a good idea due to rats being such good escape artists and it causes substantial stress.

Does anyone have any experience with the use of surgical glue? Does it cause any reactions in rats and is it an effective alternative to external sutures?

 

[Dewi]

e. a full course of an antibiotic is recommended and should be started several days prior to the surgery

f. pain meds to give at home for at least 3 days after surgery (oral metacam)

My vets recommend that I give antibiotics (Baytril twice daily for 7 days) after spays and any of the larger surgeries. All my guys get oral metacam post surgery, excluding neuters unless the rat looks to be in pain. If my rat is sickly, sniffly or elderly I start the antibiotics days before the surgery where possible.

 

[eagle]

Suture material:
Does anyone have any experience with the use of surgical glue? Does it cause any reactions in rats and is it an effective alternative to external sutures?

All of my male rats have had glue after their neuters and I have not experienced any problems.

 

[jorats]

Suture material:
Does anyone have any experience with the use of surgical glue? Does it cause any reactions in rats and is it an effective alternative to external sutures?

All of my male rats have had glue after their neuters and I have not experienced any problems.

Same here... never had any complications and never had abscesses either.

 

[Dewi]

That's good to know.

 

[Lise]

- pre-anaesthetic (or sedative/analgesic) is deadly to rats

Sorry but this is absolutely nottrue! Don't give a pre-operative analgesic? I'm wondering who wrote this....

Rats can and should be given an injectable pre-anesthetic medication like all other species. At the very minimum of an analgesic (pain medication) to help them through the surgery, and they can also be given a pre-medication (like glycopyrrolate) to help protect the heart though I believe it is debatable how much it helps in rats (but my exotics vet still gives it).

I'm sure if you go to an exotics conference they will give you many options of pre-med that are acceptable to use in rodents (different vets have different protocols).

To say that it is deadly is just ridiculous.

 

[SQ]

- pre-anaesthetic (or sedative/analgesic) is deadly to rats

Sorry but this is absolutely nottrue! Don't give a pre-operative analgesic? I'm wondering who wrote this....

Rats can and should be given an injectable pre-anesthetic medication like all other species. At the very minimum of an analgesic (pain medication) to help them through the surgery, and they can also be given a pre-medication (like glycopyrrolate) to help protect the heart though I believe it is debatable how much it helps in rats (but my exotics vet still gives it).

I'm sure if you go to an exotics conference they will give you many options of pre-med that are acceptable to use in rodents (different vets have different protocols).

To say that it is deadly is just ridiculous.

The info. I wrote is from the Rat Health Care book.
My vet agrees with what was written.

Why do you feel pain meds are necessary to help an unconscious rat get through surgery?
The rat would be deeply unconscious, being masked and getting isoflurane gas.
Depending upon the vet and the type of pain meds, vets are known to give rats pain meds prior to surgery, during surgery or immediately after surgery. I will look into the diff. pain meds that vets give rats re. surgery.

The meds that are given as a pre-anaesthetic (also refered to as sedative/analgesic), are deadly to rats and have killed rats. The combination of sedative and anesthetic can be fatal. I know this to be true and have discussed it with my vet. Injectable anaesthetic is deadly to rats and should never be given. I absolutely stand by the info. previously given.

 

[Dewi]

Next time I see my vet(s), I'm going to ask them about pre-meds, analgesia and the anaesthetics used by them during rat surgery. I'm very curious now. I'll report it here when I do.

 

[lilspaz68]

My vet gives analgesia before, during and after the surgery. For bigger surgeries (bigger tumours, eye removals like Lady) she is now giving a baytril injection as well.

She gases them down for their surgery I believe.

If a rat is a bit compromised or will be going through something more extensive then I will start up meds about 3-4 days before surgery (Fred and his tilt, and Lady with her eye, and Angel for her respiratory and her teeth).

For neuters, metacam usually for 1 day after (more if they show discomfort like owwie stretches or pressing their body down) is usually sufficient. I might not need to use it for them, but it makes ME feel better

Goliath performing the Owwie(don't worry he got metacam soon after)

For spays, metacam for 2-3 days sometimes less, depending on the girl and her situation/age, etc...I give abs after spays as a preventative as the surgery did go into the body cavity.

For tumour removals, metacam for 1-3 days depending on the surgery itself. Leetle ones often just get a day. Big ones get for as long as they need and abs.

I sadly have experienced too many neuter abscesses. My vet changed her suture material after 3 of the 4 boys abscessed originall, but in the last 5 there was only 1 neuter abscess, so its improving I guess.

 

[Lise]

[quote="SQThe rat would be deeply unconscious, being masked and getting isoflurane gas.
.[/quote]

You should know that isoflurane gas has ZERO analgesic properties.

They are absolutely still affected by pain even when unconscious with isoflurane.

Go into a surgery with an animal who hasn't had a narcotic pre-med vs one that has. The same surgery will be competely different... the animal that has had the narcotic 1/2 hr prior to surgery will be stable throughout and will be able to be run the entire surgery on a much lower gas level. The animal who has not will have a much more erratic heartrate, respond to painful stimulus much more quickly, and needs to be run on a much higher gas level throughout the surgery.

There is no reason because it is a pocket pet to put them through this and run them on unneccessarily iso flow rates, rather than give an analgesic pre-med.

 

[theratlady]

lise is right iso just knocks them down and provides no pain relief.
you can take a rat and put them under with 5 % gas until they no longer respond to stimuli(toe pressure) then turn them down to 3. but once surgery starts and the first cut and ligationg of vessels like the uterus or spermaticord that causes PAIN response because the brain can still "feel" pain. at that point sometimes you need to turn the gas up to maintain a level of anesthesia. having pain meds on board prior to surgery can prevent this pattern from happening and allow smoother anesthetic.

injectables like ketamine, rompun, acevet, torbugesic dont need to be used much anymore and if used incorrectly can be deadly. but things like metacam and different forms of morphine have good pain control. i can see glyco or atropine being acceptable as well but i havent used them in rats.

 

[SQ]

Thank you for the info.
As I wrote originally, some vets do give pain meds prior to surgery ... good to know that this is essential.

It is the pre-anaesthetic that is so dangerous
not pain meds, if given propperly.
I am aware that many vets give metacam.

 

[Dewi]

lise is right iso just knocks them down and provides no pain relief.
you can take a rat and put them under with 5 % gas until they no longer respond to stimuli(toe pressure) then turn them down to 3. but once surgery starts and the first cut and ligationg of vessels like the uterus or spermaticord that causes PAIN response because the brain can still "feel" pain. at that point sometimes you need to turn the gas up to maintain a level of anesthesia. having pain meds on board prior to surgery can prevent this pattern from happening and allow smoother anesthetic.

injectables like ketamine, rompun, acevet, torbugesic dont need to be used much anymore and if used incorrectly can be deadly. but things like metacam and different forms of morphine have good pain control. i can see glyco or atropine being acceptable as well but i havent used them in rats.

I'm finding this really interesting. At work (I'm a nurse) atropine is used to treat bradycardia, what would it's use be in regards to animal surgery?

 

[theratlady]

exactly right dewi! and also to decrease salivation.

 

[Dewi]

Oh yeah, I've seen it used for excess salivation too.