Post Op Concerns Follow Up

Question
QUESTION: We have a 32-month old female rattie, Squeaker.  Squeaker's sister, Mouse, who just passed last weekend, had several mammary tumors removed by our vet with great success.  Squeaker had not had the health problems of her sister, but a little over a week ago she developed an open wound (round and hardened, about the size of a penny, slightly concave) on her abdomen overnight, just above and to the left of her vagina.  We had not noticed a tumor prior to the appearance of the wound, though we checked her regularly due to her sister's health problems.  However, Squeaker has gotten a bit thicker around the middle ever since we had to remove her sister from her cage (a few months ago, following a suspected stroke that left her sister partially paralyzed)...so it's possible that we missed it, especially because of its location.  We took Squeaker into our vet's office, though we had to see a "zoo vet" instead of our usual vet (who specializes in small, exotic mammals).  She prescribed antibiotics and was not quite sure what to make of the wound.  We put her on the antibiotics, but returned for a visit with our normal vet in a few days.  She believed it was a ruptured tumor, and based on her age, was torn on whether or not to keep the wound clean and on antibiotics or to have the tumor removed.  We opted to have the tumor removed, as Squeaker is ridiculously healthy for her age.  The vet removed as much of the tumor as possible, however, it was on her urinary tract, and as such, not all of it could be removed.  Her surgery was Monday; she came home with 3 days of metacam (I've only recently read your warnings on metacam) as well as Baytril.  While I have not observed Squeaker worrying the wound (internally sutured and then glued shut), a small gap (less than 1/2 inch) appeared in the incision last night in the spot right next to her vaginal opening.  We took her in for a check today, and the vet added a second antibiotic (Doxycycline Hyclate).  The wound is showing some slight swelling and a little pus, which the vet attributes to the portion of the tumor she was unable to remove.  Her advice was to keep the wound clean, continue (and increase) antibiotics, and reschedule another visit if the wound does not improve or worsens in the next 2-3 days.  Squeaker does not seem at all uncomfortable (and I'm declining to adminster the 3rd and final day of metacam, after reading your warnings and seeing no signs of discomfort), she is eating, drinking, lounging, and nesting (her favorite activities).  Our vet is quite experienced, and up until now, I feel like they've always done a wonderful job caring for our little ratties.  However, I'm just wondering if she or we are missing something...Does this sound par for the course for a ruptured tumor in a compromised location?  Do you think giving antibiotics and keeping her cage and incision clean are sufficient enough actions at this time? I think I'm just overly worried because we just lost Mouse, and Squeaker has been so healthy...I'm not ready to lose her over what, overall, seems like a pretty minor health concern.  Do you have any advice that could be helpful?  I'm so sorry to bother you, but will be appreciative of any information or advice you can offer.  Many thanks!

ANSWER: I do agree with your vet, its not worth putting her through the stress of sewing her up again. To be honest, mammary tumors are very non invasive and are subcutaneous. You wont see blood and guts, maybe some tissue and muscle.  If its infected, thats not a surprise either due to her age. The older the rat, the longer it takes to heal, which is why it is an increasing risk to do surgery on older rats, but hard to deny them when they are healthy like she is.  I hate surgery on rats. I really cringe, but when the vet is experienced with small mammals and truly knows what he or she is doing, this of course decreases the risks but the rest of course puts the ball in your rats court. Age is a factor as well as location. If the surgical site is dragging on the floor etc...this will hinder healing.  If they rat has any underlying and un-diagnosed problems, even a little bit high in sugar content, this could create a bit of a problem.

Your vet COULD have put a staple or two in the area, but if that was indeed pus, its best to keep it open and let it drain and keep it clean.  If it doesn't start to heal within a few days, switch antibiotics, using trimeth sulfa or keflex and make a solution of hibicleanse to clean the wound with.
The minute she becomes lethargic and stops eating or acts unusual in any way, contact the vet and let me know as well.  

Oh, do you notice an odor from the wound?

I am glad you are not going to use the metcam.  Should she act like she is uncomfortable, ask the Vet for a narcotic pain killer instead of metacam.

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QUESTION: Thanks so much for your (very speedy) reply -- it has given me some extra peace of mind! (Another thanks for your website, which is a great collection of information!)

To answer your question:  I have not noticed an odor from the wound.

I'm not familiar with hibicleanse -- I googled it and it came up Hibiclens (is this the same thing?)but I could only see it in reference to humans -- so could you tell me what dilution/how you use it with your ratties and what chain stores might carry it (I'm in the midwest)?

ANSWER: Yep, your right, I spelled it wrong...nothing new. LOL

Its safe to use on rats, as alot of human grade meds are.  


Use a cap or two full of solution and add four parts water (four parts water) make a soapy solution.  Using a cotton ball, saturate the cotton ball and dab the entire wound with it.

It should NOT sting, but if it does, just gently blow on the area to help ease the temporary sting.  

Chain stores that carry it would be Walmart (the cheapest of course!) and most any large chains such as Walgreens or CVS.

My website, sandyscrittercity.com has a special page devoted to post op complications, esp when a rat decides she wants to rip out the stitches each time she has tumor surgery!!

I try to think of the most common occurrences to write about. Things that I have gone through with my own rats and also, just from being on all experts the past three years, I have seen ALOT of things happen with rats and this prompts me to write new pages on my site, which is why I have such a vast collection of things that seem to hit home with many rat owners and their rats!

---------- FOLLOW-UP ----------

QUESTION: I cleaned her wound with the hibiclens solution this evening...and though she is still active and cuddly, I'm afraid she isn't going to make it through the night.  The gap in her wound is larger, probably an inch and it is definately more infected -- more swelling and pus.  I'll call the vet again in the AM (they were closed when I got home)...we don't have an emergency vet close, and if she is as bad off as I fear, I don't want her spend her last night in the car and in a vet's waiting room.  The last time we went, it was a 6 hour, $400 ordeal...which makes much more sense for a young rat with a better prognosis. I guess I don't have a question...am just sad and wishing ratties lived longer.

Answer
One reason I always say that risks increase with age is because of poor healing and chance of infection. I am sorry.....maybe she is stronger than you think.
She needs trimeth sulfa and perhaps gentocin injections for a few days to try to avoid sepsis. I am hoping it hasnt started yet.  

I wish they lived longer, too, but 32 months is a nice age to get your rat to live to be.  I have been lucky to have them live to be over 3 years old, 3.5 yrs, even 3 weeks into their 4th year, but that was only with maybe, 10 rats out of 60?   That stinks!!

It takes a strong person to own rats.   We have to accept, like we seem to accept with human life expectancy, that they live their life , as short as it is, this is their life, period.  Like humans live to be 80, and when they die at that age, we are grateful they lived to be that age, so with rats, 2.5 yrs old is our humans 80.   That may not be said in a professional way that makes sense, but its 5am and thats all I can think of to say that sounds right at this  time.

I hope she is still hanging in....