Possible Pituitary Tumor

Question
QUESTION: My pet rat Imoen just had two growths removed and was tested for UTI which came up negative, but her symptoms are continuing, which, based on internet research, indicated to me that she has a pituitary tumor.  She is walking in circles, may have possible blindness in one eye, has lots of trouble eating (I can only get her to eat ice cream and gnaw on a tortilla chip, she won't even touch the baby-food I prepare for her).  Even before the surgery she would not use her paws when eating, she would just push the food around with her nose and eat it as she could.  Before the surgery I was able to hand feed her baby-food, but now she won't even touch that.  Her sister Haddaway had similar symptoms back in December and she died within a week so I was frantic.  Based on more internet research I learned about an artificial hormone called Lupron which is said can possibly reduce the size of a pituitary tumor.  I took Imoen to the vet today and convinced the vet to try the Lupron, which, in addition she gave a shot of bayatril (because it's hard for me to get her to take it orally), a sub-cutaneous hydration shot, and a steroid, I think it started with dex-something.  It's hard to tell if she's improved any, it seems like she's a little better at walking in a straight line, but that might have to do with her healing from the surgery too.  The vet also expressed some concern about the steroid with regards to healing from the growth removals, she she only gave a half dose.  I want to know if I did the right thing, and if so, how frequently I should continue the doses of Lupron and/or steroids, and what amount of Lupron I should use (the site I looked up said once a month).  Also, considering all she is eating right now is ice cream, should I continue giving it to her to keep up her strength or will that cause even worse problems?  Over the last 4 days or so she's had no substantial food except ice cream and 2 sub-cutaneous hydration shots.  Thank you so much for helping,
Chris Celaya

ANSWER: I have had alot of experience with lupron  (Have you read my website, sandyscrittercity.com on tumors and also a page on pituitary tumors?  I, sadly, have not had much luck with PTs and lupron mainly because most Vets are not aware of the proper doses and the dosing schedule using lupron depot.  The proper most cost effective way is to use a high end dose once per month.  

Also, you said she was tested for a UTI which came up negative.  I may be confused as to what you mean, but a UTI in the vet world means Urinary tract infection and I was not seeing the correlation between a urinary tract in infection and the signs of a pituitary adenoma.  

Has she been put on antibiotics and treated for a middle ear infection before going straight to the diagnosis it may be a pituitary adenoma?  Otitis media, when advanced, can cause identical problems that a PT can cause.  A disturbance in equilibrium due to the pressure on the Vetstibular cochlear nerve, both a PT and inner ear infection can cause loss of balance, head tilt, spinning or walking in circles, loss of appetite, even enophthalmos (also called exophthalmia) which is a bulging of the eye.  The only thing that usually is not seen with a PT is the loss of use of their front paws or a severe weakness in them to the point they are unable to grasp and hold food properly.  They also may lose the ability to chew and finally, are unable to swallow, which of course means the rat should really be put to sleep at this point as its obvious she has lost these motor skills and is unable to eat/swallow and this is no life for any animal.  With otits media, these signs are not usually noted.  

The thing is, many vets are not really sure how to treat otits media properly and aggressively and so sometimes the rat doesnt recover well, leading the owner and Vet to assume it could be neurological . Often its the rat owner that comes up with the idea it could be something else, such as a PT because they do exactly what you did, RESEARCH, and it takes a bit of convincing to the vet esp if the vet is not really a certified exotic companion mammal specialist with alot of experience with common rodent diseases.   The is alot of confusing and inaccurate information floating around out there on the internet.  I will tell you that there are only a few sites that come to mind that are totally accurate (aside from my own site, Sandyscrittercity.com, of course, LOL!!) and that is THE RAT GUIDE.  This website, for the most part, has the most accurate information on the internet next to mine and if I am correct, there are only a few sites out there that have Veterinarians helping them write these articles etc.... including my own, much of my advice is also backed by a licensed DVM and also a board certified avian/exotic Vet so the information on my site is not something I simply pulled out of my hat.  LOL

I am not saying your girl DOESNT have a PT, I would love to say that she doesnt, that would be awesome because sadly, if your dealing with an intact female over the age of 14 months old with  signs of a PT that has not responded to antibiotic and steroid therapy usually DOES have a PT and is usually suggested by the rat owner before being suggested by the Vet mainly because of lack of experience on the Vets part.

I do want to tell you this about the use of steroids and the tumor removal though: for starters, the steroid treatment will NOT hinder the rats healing process when  used short term nor will it cause an interference with lowing the rats immune system response.  Not with short term use.  Rats have a fast metabolic rate, and many general DVMs forget this or actually never even KNEW this due to lack of education on rodentia.  Anyhow this means the rats body will burn through this medication faster than normal, leaving the body faster than normal and in turn, not causing side effects that are seen more common with some drugs as fast as expected.  It would take a healthy rat several months to show any signs of a lowered immune system that was drug induced because of the fast metabolic rate. Also, its pretty normal to put rats on steroids after tumor surgery to prevent the tumors from growing back as fast as they sometimes do, but this type of practice doesn't seem to be stopping the re-growth of the tumors mainly since the problem is with the high hormone levels of prolactin and estrogen that fuel the growth of mammary and pituitary tumors to begin with.  Lupron is a good idea to use to not only shrink but to prevent the rise in these hormones and thus in turn, it is the goal to keep more mammary tumors from showing up on your rats body, but as far as luck in shrinking an advanced pituitary tumor if that is what she has, usually once the ball is rolling with these, its pretty grim news. Lupron also wont work over night, it takes at least a week or more to see any kind of results. so if you did see any relief in your rat, it was steroid related since the reaction to steroids is almost immediate, the same day for sure.

I also hate to hear about rats getting injections.  There is so little body mass to use for injection and unless the vet injects in the flank area, alot of the solution in the syringe is dispensed almost subcutaneously and it is not properly absorbed.  One of the dangers of injections on a rat using baytril, esp if it is not diluted, is the development of a nasty ulcer in the injection site.  Baytril solution is very caustic to the skin and when injected in a rat without being diluted, can coagulate under the skin and start to cause a horrible ulcer. This is known as baytril burn and has become a wide spread problem not only with rats but now its being seen in dogs and cats that are on the thin side and have little body fat.  Steroids can also be in liquid form and both baytril and steroids can be made into a palatable elixir that most rats love so much they want to grab and suck on the syringe themselves its so yummy!!  Also, one shot of baytril is not enough.  Your rat will need to be on baytril for at least 21 to 30 days and one shot lasts for 12 hrs max.  You can mix baytril with anything, from ice cream to yogurt to a dab of chocolate flavored syrup just to get her to take it.  Have you tried feeding her baby foods?  I prefer to use stage one baby food since it has alot of water in it. Vegetables such as peas, carrots, sweet potatoes and fruits such as pears and some custards are a hit, but avoid the strained meats or the combo dinners. Too much sodium for the rats at this point.  You can also try to offer her some watermelon juice after you mash up a bit of melon, there is alot of juice left and rats  tend to love this.  
Is she using her front paws to groom?

Anyhow, please look over my site, Sandyscrittercity.com and refer to the page on tumors and pituitary tumors too and let me know when your done, lets compare notes.



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

QUESTION: Because my Imoen does have loss of use of her front paws for eating, and she doesn't want to drink water and has no head tilt, I'm pretty sure that it's a PT.  When I mentioned the UTI, my vet and I thought that UTI might be a problem because there was a lot of build-up in her vagina and before the surgery she wasn't walking around in circles, she was just weak.  I looked up the PT part of your web site and I didn't see any information on Lupron, only prednisone, and I was wondering if you could give me information on it.  Your site, and most sites, indicate to me that with a PT, it's only a matter of time, but what I read about Lupron on at least a couple of sites is that it can actually reduce the size of a PT, and along with steroids, or another anti-inflammatory, it's possible to remove the threat of a PT.  If you could please clarify my understanding, I would greatly appreciate that, and if Lupron has any chance of working the way I think it does, please tell me what dosages I should administer in what frequency of both the Lupron and the other medications (prednisone, bayatril, etc).  Thank you again, my baby means the world to me.
Chris Celaya

Answer
I dont want to give you false hope. I have had luck with lupron and mammary tumors, but not with PTs.  Its worth a shot, though, and I am all for trying it. My fingers are crossed that this may work and if so, this could really be a huge plus for our rats.  I have learned not to get my hopes up though, but again, its better than not doing anything and it certainly wont hurt her any by trying.  The steroids may also make a difference but only for a short time.
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ORAL SOLUTION 1mg/mL
Prednisone should be used as follows:  
.25 to 1cc/lb  orally once per day.

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BAYTRIL 2.27%

5mg/lb ---- which would be .20cc/lb  for 30 days


As for the lupron depot, this should be monthly  but I am not remembering the dose as of this writing.  I contacted a Vet for this, who is a good friend, but I also need your rats weight.