when is it safe to leave a rat unattended postop

[yoland]

hi.

we are currently a 4 rat family. our oldest ( 2 1/2 yrs old)
had surgery 8 1/2 days ago and had 3 mammory glands & tumors removed. Unfortunately she had two seromas pop up by day 3
the vet drained the one on her leg as it was getting in the way of her moving- but left the chest one alone.
she has been on SMP- TMZ ( spelling?) and doxy since the day one post op
and under 24/7 supervsision as she has a history of ripping out her stitches and an allergy to Burprex.

Her sister had a allergy to metcam so we have never used that with her, the vet used morphine post op for 5 days.

Dispite having pain meds she still is very itchy and will not leave the area alone- .

we treated her and the other for mites just in case that was a factor but still she is very itchy.

When he looked at her yesterday he said the internal sutures were healed and the outer glue scab wasn't too bad.
however she has and is biting her scabs off when ever we look away or go to the bathroom.
Two leg scabs don't look too bad- the one on the chest with the largest seroma ( maybe 5mls) she has looking pretty
fresh blood- but very surface - no swelling - heat or smell
she just can't leave it be....

we stopped the morphine in case that was making her itch 3/4 days ago , she is eating like a pig
but angry that we are bothering her....

at this point we are going into day 9 of 4 hrs sleep each and can't keep this up much longer.

Anyone have a rat this persistant ? would it be safe to let her keep breaking the skin and just keep cleaning it and get some sleep and get on with our lives and jobs? We have tried the E- collar and body wraps but that freaks her out so much that she climbs the walls. this way she finally crashes after a while- and gives up.
but it isn't healing at this rate and we can't afford to hire anymore help to watch her.
Plus the stress of being poked everytime she grooms in that area is getting to her and us.

Ideas

thanks
yoland and Mike in support of Sophie , Bear, Gigi & Lola
former canadian living in the US

 

[hopefloats]

I know a certain type of drugs can cause a rat to have a PICA behavior. Is she chewing on only her sore or does she chew obsessively at other things?

I never had a rat need that much care after surgery. I have had to stay up till midnight or later on the first night but the symptoms always went away around that time.

I did have a boy develop a hematoma from neuter and it bled for days because of it. I also have had rats allergic to doxy which caused her to swell in odd places at odd times. She may just not like the scab on there they can tend to pull the skin if they are to tight.

Can you take pictures of what is happening?

 

[lilspaz68]

If the internal sutures are healed then I would just leave her be, no pain meds, no interference, anything she opens up would be surface and will heal on its own.

NOT a fan of buprenorphine as I have had several rats chewing on themselves after surgery, until it wore off. I assume you are still giving her the pain meds? For your next pain med you might want to try tramadol...no nasty side effects.

 

[*Rebel_Angel*]

I agree with lilspaz if all the internal stuff is healed then the worst is over and just let her be.

 

[yoland]

today is weds and she is still itchy like crazy and keeps biting the scabs off.

thinking back - surgery 1 she had similar trouble and barbered her chest and arms for about a month

Surgery 2 ( adernal) she was great - same meds but he added a steroid taper to let her right adernal gland
ease into taking over which it did very nicely.

Could she be allergic to the internal sutures? not the meds/mites like has been suggested

If that is the case do we use the left over steroids again?

Not sure I can convince him of this- he thought we were
pretty stupid for staying awake with her the last week. But after her first surgery taking 3 weeks to get over
as my husband looked away once and she pulled them out a 4th time we were not about to take the chance.

Our other girls have done fine after the first 2/3 days, it is just this poor girl.
Even calling him at this time and I'll get attitude. He is kinda of a ego type.

this will be her last surgery we knew that going in, she is just in such good shape- everything I have read said to remove the tumors as long as the rat was healthy. Which she still is- other than going out of her mind with the itchy.
She still wants to play, roam, eat like a pig, be petted ect she is a " big" personality in the house.


So if she is reacting to the sutures taking steroids for a week should help correct?

either that or benadryl.

I know that the steroid is bad for her immune system and she has had the odd sneeze for the first time in her life, which has me worried but frankly the insane itching is more of a worry to me.

I did call Debbie the rat lady and she said treat for mites and leave her be, which we did treat on Monday
but that hasn't taking any of the over all body itch away and it is hard t watch her grab at the scab and tear her skin away.

 

[yoland]

we had stopped the morphine last friday/sat? in case that was causing the itching....like she was allergic to all opioids we used it the first 3 days the day 4 and 5 at night to give her some sleep.

I did ask for tramadol, but this vet is very .....you know........and wouldn't let us try it.

 

[yoland]

Hi what a wonderful forum, Ive been learning alot today just poking around

Sophie our post op 2 1/2 yr old is still one itchy girl and pulling her scabs off as they reform -

she has also eaten all her fur off her arms and chest and a small 1/4 inch whole in her flank by the tail-
this is no where near a suture area so I'm not sure what that is all about.

We have stopped watching her and interventing as suggested and are just doing the saline flush twice daily and giving her
the SMZ TPM ( supposed to stop on Sunday) Doxy as a URI preventative and - benadryl twice daily 0.3ml

she & Bear ( roommate) moved back into there regular 4 story CN - Hospital cage is the single CN with lower shelf
I have extra shelves so the ramps aren't so steep
and she seems much happier to be with her "stuff" but still" itching and chewing away albeit happier as no one is yelling or poking her with chopsticks

I still do have to wonder if she is allergic to the internal sutures - with the knowlegde that surgery 2 was okay, and the only thing different was she was on prednisone.

At what time does anyone think I should just go ahead and put her back on that?
I do worry that suppressing her immune system at this time is risky as she has had a few sneezes , something she never has. Doxy should cover that. but still scary........
I do have Baytril here but its the 10 % stuff you have to compound yourself from the internet as pre the Rat Health Care Book and I read a couple posts on another forum saying that was caustic to there mouths
........no idea if that is true or not but I have been scared to use it.

anyways any ideas are welcome
I am going to attempt to attach pictures of the area as of 1 hr ago.
Surgery was last monday afternoon so 9 days ago and change.

thanks yoland & mike for Sophie ( Bear, Lola & Gigi)

 

[jorats]

If that was my girl, I'd probably put her back on prednisone and baytril since pred will affect her immune system.
I know that in dogs they treat severe itching/hot spots with prednisone. Maybe you could find a very low dose that works.

 

[jorats]

I'm wondering if perhaps the chest seroma should be drained as well, perhaps that's what is causing her a lot of discomfort making her pick at herself?

 

[lilspaz68]

I too would have that chest swelling drained. Seroma's are usually clear fluid, that looks more like old blood (hematoma).

the incisions look to be healing slowly but surely.

How much benedryl are you giving her?

 

[yoland]

I am giving 0.3mg BID benadryl of Childrens' 12.5 /5ml brand

I would have liked it drained as well, but the vet just did the leg one.

It looked similar , he said it was not a hematoma and not infected

that was my thought too!
as this was my 1st seroma that was purple and yes the seroma did return as he said it would but only to 1/3 th size and holding at that- and no blood tinge this time. thankfully

He balked at us for bringing her in , saying they really weren't that big- he expected they were bigger from my call
and explained the sterile enviroment and risks of asperating. ect the vibe we got was that we were wasting his time, but I might be a bit jaded at this point with rat vet experiences. I always feel like I have to be on the defensive.

He did the leg because it was so obviously causing her problems walking.

I got conflicting info - two vets ( my regular vet * who hasn't seen her
and a local vet who saw sophie as a ER last Friday)
and the rat lady Debbie said to never drain them and then our local rat rescue lady
who has been very helpful w/ me and Qs said for sure drain it- her vet does that all the time. Aghh

He was like whatever- let's drain this one as it's making her lame.

Getting him to call back period is rough. I called today saying she was still a mess and he hasn't called back.

At this point
I doubt I will hear from him till Monday in regards to her condition,
asking about possible if she is allergic to the internal sutures and whether we can start her on the steroids I have left over from her adrenal tumor surgery 3 months ago.


I feel like I am between a rock and a hard place , finding a vet around here that knows anything about rats has been infuriating . The ones that will see them think they're GOD and won't budge from their " box of tricks".
If it doesn't fit that mold then forget it- sorry!! No let's give this some thought or perhaps some of the newer research.

I really don't get the attitude of most of the medical practioners here in the US, like they are doing us a favor allowing us to be seen and give them our money-


I had a great vet for 10 years for our dog but she moved out of state. We had a working partnership.

Not sure where to go from here- she is getting some sleep.

I get my hopes up as things start to look better then hours later she has fresh bloody scabs and is chewing away.
I don't want to stress her out anymore by dragging her to any vet that might see her- I do know that the two local ones were too scared to drain them.

the surgeon vet said it would absorb on its own in time. Hot compresses might help ect
which we have tried to much stress and very little effect.

When he saw her scabs we had been watching her 24/7 - I do mean 24/7 thus why they looked okay
but the stress of no sleep for us and her being poked every time she groomed near them was messing with her
mind and immune system - after the danger time was over we had to stop
we had resorted to the body wrap then cone on her 1st surgery and she almost crashed w/depression
won't eat, drink, move!!

A normal rat would have a wound ignore it and it would heal
something else is going on here. She has only self barbered when something was wrong.
Not a lifetime habit. She is a really good girl almost perfect really. so very tame and gentle open heart.
She has an abcess recently and never bothered it.
2nd surgery never bothered her sutures site. ( on pred)
So it's not the scab persay I don't think.

blah anyways needed a safe place to get that out - as only a few blessed people in the world really know how special and spiritual these creatures can be.

Do I screw the vet and put her on the steroids for a few day the every other day to finish out a week
- make up the 10% Bird Baytril from the rat health book- that's the kicker!
I do not feel comfortable having her on prednisone with only doxy as the URI preventative
I do feel comfortable switching her off the Sulfa and on to Amoxi for skin infections in case the sulfa is making her skin itching worse.
so choice 1) Prednisone one week
/ Baytril ( less than ideal source) 2 weeks/
Amox one week after her skin has healed.

choice 2) Up her Benadryl from 0.3mg BID to 0.5 , or 0.3 TID
Baytril/ or Doxy and Amoxicillin for two weeks and hope for the best.

As for getting the chest seroma/hematoma drained I am not sure I can find anyone within an hours drive that would do it. I might be able to go to the ER in Baltimore 45 mins but there is no way to know if they will do it.
She does have a hard time grooming around it- but is actually leaving that area alone today-
more going after her knees scabs and chewing off her hair around her tail and privates when she can get in the hammock at just the right angle.

Maybe sending the pictures around to a few vets and seeing if someone will do it?

I wonder why everyone is so hestitant to drain this things? I have read about them in people and yes they do refill - but the leg one proved that it refilled much less and with no blood.
I do understand a sterile enviroment but her biting at something will soon be NOT SERILE !

The leg actually looks like it is starting to reabsorb abit today as well and she has been moving round alot more.

I do appreciate the feedback- my husband loves her but is tired of thinking about it and just want to let things be
, he wants to think the vet knows what he is doing ( which is nothing)
he is overtired- worried about the money ect

yoland

 

[jorats]

You are very much in a bind. It's near impossible to deal with stubborn closed minded vets. I wish I could offer you more advice or even a suggestion. All I can do is send you cyber hugs and good healing vibes for little Sophie.

 

[hopefloats]

I am not sure what that is either. Ringo had hematomas which bled out a bit. he was bruised and red. That blue is just off to me. We never drained his because for him to have them and be seeping still his blood was having problems clotting. he did heal up but it took a lot longer than a typical neuter would. My vet wasnt concerned because it was blood and he was on abs so his body would reabsorb it.

I can say that the dex shots worked wonders on making them go away on later boys. I had a few boys who had problems. and the steroids took it down fast.

 

[yoland]

sorry her baytril dose is 0.03 not 0.3 ml so just a few drops
i get the numbers mixed up but never the dose- it's just the 3rd line on the 1ml syringe hard to measure it;s so small. but it does seem to help.

Her skin looked better this morning- the drained seroma has really gone down alot, maybe 1/2 grape sized
chest one is hard to tell

she seemed okay in the evening- i had her out in the playroom to wander around for a while last night
then she crashed pretty hard. sleep good through the night

I did notice that she was really picky with her eating last night only ate the peas and quinoa
and didn't eat her banana this morning
just a bit of baby soy mix. I also noticed she was holding herself up with one leg to eat at the dish.
Sometimes she'll eat w/ her hands but not always.
Not sure if the benadrly is making her sleepy and lazy or she is just starting to show her age. 2 yrs 7.5 months

I was going to stop the bendrly this morning and see how she does w/ itching.
and try to make a high calorie slush for lunch & dinner. If she continues to look weak or off- we'll take her somewhereget the chest drained and get the baytril and talk about starting pred.
Lungs sound fine I think- no sneezing to speak of.

thanks yoland

 

[yoland]

" re
sorry her baytril dose is 0.03 not 0.3 ml so just a few drops
I meant Benadryl" .....Must be to tired to think
thankfully my husband gives the meds so he has all that straight and written down.

Still waiting on getting an Rxed baytril so I can start her on predisone.

 

[yoland]

Still worried about sophie.
She has stopped itching which is great.... her skin is finally looking like it might heal.
but she sleep alot and doesn't want to / can't? hold herself up to eat.
She is eating the things she likes ( chick peas, rice, avacado, yogurt - not w/in 2hrs of meds, peas, ect)
as long as I hand feed her. She seems pretty depressed as well.
The vet called and talked to my husband- I was out of town seeing my Dr today- 3 hrs away...sigh

anyways he wants to wait another week before draining her chest seroma.
She was started on baytril but I did the math and the dose is only 2.5mg/lb I thought 5mg/lb was the correct dose?
He did not want to do the predinose or anything else at this time.

We have fall proofed her cage and added an extra shelf and gentler ramps and fleece as she is slipping more.
I think just dragging that big ass seroma around has to be a drag!

Should I UP her Baytril to the 5mg/lb to start and then start looking for a second opinion?
She will walk around on the carpet and play a bit, she wants to go to her room ( our bedroom!) and play for real- but there is hardwood and too many steep things she can fall from!

healing thoughts would be apprecaited.
thanks yoland, mike

 

[Bundyrats]

I think you need a new vet.

 

[yoland]

I will call around today, what's scary is he is the go to guy in our area. It took me forever to find this one.
but I think maybe ferrets are more his concern? not sure- I want to to like him, he did such a good job on two surgeries, but everything went very easy w/those ones.

I hate this. -Y

 

[yoland]

sadly we are sure that sophie has PT, I had some clues last friday that I desperately called the vet about-
but he ignored me. called on monday and said she was fine leave her be- no steroids that pituitary tumors were rare........hmm not so much I have since found out the odds are really really high in an unspayed multiple
mammary tumor girl- like extremely high-

went to ER on monday night got pred okayed then
I found another vet and she was dx
he knew she had within secs- it explained all the sudden tumors
we started all the meds (dex shot then pills, cabergoline ,
the 2 herbs and baytril for the moment) today
she seems better- this last evening and ate lots of peas and soy - i couldn't peel them fast enough
hoping for a quality of life response soon- I think I caught it as fast as possible
given that until friday I had no idea what it was. wish she could have started meds on sat-

but I couldn't find anyone to see her who knew anything about anything
and she was still mobile then sigh

I will know for next time the first sign and now I have someone awesome vet in her corner
w/o their head you know where, trying hard not to be hating on her surgery vet, and praying that
he will learn a lesson from this. not sure even how to tell him-
although it's not like they'll call to find out how she is
but he does need to know so it doesn;t happen to someone else.

but the adjusting the cage came just in time before a major fall- so glad I trusted my gut
thanks again everyone
healing prayers- she's a great gal!
am beyond upset and heartbroken
but giving her all my love- LOL she's been queen bee for 2 1/2 years so she expects nothing less- time to get back to pealing peas !!
yoland

 

[yoland]

Hi

thanks for all your suggestions on sophie over the last 3 weeks

Just though I would update on how she is doing. I noticed red flag !!
signs on 7/10,
but knowing what I know now
she had some small signs right after post op - August 31st.

we have been treating her since 7/13.
started w/ dexamethasone shot- then went to oral pred @ 0.5mg/lb BID ( wrong dose but the ER wouldn't beleive me- after a week of steady decline- lost 30g - ect we upped it ourselves then got premission and the refill Rxed correctly @ 1mg/lb BID- within 30 hrs she was eating and drinking again

We started the cabergoline 7/16 which was as fast as we could get it Rxed -
using the standard 72hr dose except using daily- dividing the every 72hr dose by 1/3rd
this was strongly suggested by a number of people/vets treating successfully

it was expensive the first 4 doses ( 12 days worth) we got locally at $30 per pill ouch

then we found a place that is pet pharmacy Diamondback ( they compounded our dose for daily use
as per the vets Rx and it was way cheaper! about $30/month for our rat's weight up again to 454g )

Sophie is doing really well- we are very pleased at her quality of life at the moment w/ this treatment! eating like a pig, moving pretty easily in the 4story CN, balance is excellent now
very happy and active- busy- she'll be 3yrs come the end of Oct.

I still see the hindend a little lower to the ground then I like- but she gets around- jumps ect
and it out for a hour daily in the rat room for playtime and is not tiring
As well- she alternates what she eats with both paws - verses sometimes eats with one paw- holding herself up with the other.. Left side is a bit weaker- the vet thought she might have had a mild brain bleed or stroke back when this started
I cut up her food really small and different shapes to help eat easy.

on eval tuesday we will decide if adding the bromocriptine will be helpful at this time-
this option is Rxed and ready to order when I decide

Hoping to taper steriod at some point - but we 'll see-


yesterday will be one month since I noticed the weird stiff front paws,falling over, extra bruxxing, head pushing , Hind end weakness- not eating with paws-
staring in to space ect- list goes on- she had almost all the symptoms
3 weeks since treatment started, just over 2 weeks on the cabergoline

what we are going off of- as this protocol is working well for another lady w/ lots of PT rats & exerience

Cabergoline at 0.6 mg/kg q72 hours (you will give one
third dose daily though) for life- ( I have mine compounded to equal that and the dose for sophie
we had the compound to equal 0.1cc daily- easy to syringe ( Costs about $30/month)
Also bromocriptine 1.25 mg total dose ( will add on soon to see if it helps keep hind end stronger)
daily (I am trying using both drugs) for life - not expensive either
* my friend - her rat is post dx over 4 months now and an older girl like sophie

Pred 1 mg/lb twice daily for 8 weeks ( cost from vet $40/month- I am looking for a cheaper source)
then taper off and stop over a 2 week
period

Baytril 15 mg/kg twice daily for life
Doxycycline 5 mg/kg twice daily for life ( Deb D recommends Amox over doxy- as a different option)

anyways I wanted to post what seems to be working for us, in case someone else wants to try treating
PT this way. This is along the same Rxs at a number of the eastcoast USA that are treating are doing.
* one doesn't do the steriod past the initial dex shot - not the antibotics

We are using both as we do have a girl with a mild but active URI - being treated-
in the cage next door- so I did not want sophie to not have antibotics as prevention.

warm wishes
yoland