joint infection

Question
QUESTION: Hi, I wrote to you a few days ago about my rat Molly, who had the fatty tumors. Well we had had her on Baytril for about a week because she and a few other of our rats were doing a little sneezing, and we wanted to make sure it didn't turn into something serious. On Monday I noticed that one of Molly's back feet was swollen. In the past we've had a few rats get a swollen foot from a sprain, and since Molly hops around and it very active we assumed she sprained it or twisted it somehow. By Wednesday it looked "too swollen," I mean how usually when they have a sprain I've never seen one this bad, so we made an appointment for the next morning. The doctor at first thought it was a sprain, but she felt a pocket of swelling that she wanted to drain and although she didn't find any pus, she was convinced that it was a joint infection, and was very concerned. She mentioned that she would put her on a topical spray for the foot along with oral Baytril and when I said that she had already been on Baytril for about a week, she became even more concerned and seemed at a loss as to what to do. Since the vet is a 24 hours vet she is still there tonight beacuse they wanted to keep her under observation. The vet decided to keep her on the oral baytril and the topical is I think it's called DMSO with 2 or 3 antibiotics in it. Have you ever heard of this, and do you know a way to help? My vet said they are incredibly hard to get rid of. What do you think of treating it with IV antibiotics? My doctor just seemed so concerned and made it sound like there weren't too many options, I wanted to know if you knew of anything else that I could mention to her that could be potentially helpful. In the meantime, we're going to call the vet in the morning and if she is worse, we will probably take her to Tufts (which I wanted to avoid if at all possible because they charge $140 JUST for a routine office visit, not counting any additional treatment! They were going to charge my $1400 for a biopsy on my rat's kidney once)
Please let me know if you have any ideas or advice. If we need to bring her to Tufts, we will.


Swollen foot   ANSWER: Before I go any further, does your rats foot happen to look like this photo at all?



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

QUESTION: Yes, that's what her foot looks like. What is it?

ANSWER: Your girl may very likely have what is known as Ulcerative Pododermatitis, which is infection of the plantar surface and connective tissue of the foot that can cause severe swelling of both the plantar surface (the heel, which is common) and also may become a nasty acute infection that involves the connective tissue and can even migrate up into the rats leg.

The common name may be more familiar to you: Bumblefoot

If you are familiar with bumblefoot, you may be confused as to why he didnt start off with the typical small ulcerations on the heel of his foot. This is a bit more aggressive case that is acute, which can be very dangerous if not stopped in its tracks before it involves the rat leg.

Since I have not seen her in person of course, I cannot say for sure this is what she has, but if it compares to the photo, its a safe bet she does.

Most vets that are not real up to par with uncommon rat ailments will miss this, as you have found. They first conclude it may be a terrible sprain or even fracture, but they are not taking into consideration the extreme swelling to the point that it begins to weep fluids. When pus is found, they assume its infection of the joints, but it is an severe acute case of bumblefoot.  Treatment, however, is what she is getting now: Aggressive antibiotic therapy, but I am afraid the baytril is not going to really do the trick alone.  What she needs, and I do suggest you telephone the vet ASAP since she is at a 24 hr clinic, is treated immediately with the prednisone for the swelling.  

Drug of choice should be trimethoprim-sulfa.

SHe should also be given Torbugesic, which is a narcotic pain medication, as this condition is terribly painful for rats.

You can tell the vet you were given this information but a rat care specialist, but some vets turn their nose up at outside help, esp if they are not certified Vets.  So far though I have been lucky enough to work with vets that have as much respect for me as I do for them, but that is not always the case.  Hopefully the vet working on your girl will be open to any outside info.  Trust me, she has this condition if it looks anything like this photo.  Baytril may do the trick, but she still needs other meds like the steroids to help aid with the severe swelling.

Please keep me posted.

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

QUESTION: Hi! The minute I got your last email I called the vet immediately and told them all the info you gave me, then I printed the email and brought it into the doctor the very next day. The doctor said she'd seen many cases of bumblefoot and was very familiar with it, but this definitely wasn't what this was. She ended up on Baytril, metacam and the topical spray. The doctor said that on Friday the foot was so swollen it was glistening...by saturday it was 1/3 the size and we got a call this morning saying THE FOOT IS BACK TO NORMAL SIZE!!! We picked her up this afternoon and she is very happily cuddling her Papa as I write this. There is a little scabbing on the foot from the skin being so stretched, but other than that it looks good! Thanks so much for your advice, and I just wanted to let you know that as of right now she is here and looking good and feeling much better!
Thanks again!

Answer
It WAS bumble foot.  That photo I showed you was from an actual case of bumble foot.  The reason she got better was because of the medication that was used.   Trust me, this was indeed an acute case of bumble foot. The rat guide is written and endorsed by exotic vets. That photo was from that site.  Something tells me this vet is not a board certified exotic vet but rather, a general DVM that sees exotics as a special interest or she would know that bumblefoot is not always classic textbook localized just to the heel of the foot but can indeed cause this.  Here, check this link out with the photo and write up and see what it says so you know this was legit and not just pulled out of mid air.


This is the write up about the photo  I showed you. It says they also thought it was an injury at first etc... well let me know what you think. That irks me when a Vet has to be so arrogant as to argue with an actual case that was PROVEN to be bumblefoot. Just because it was something she had never seen doesnt mean she is right!!

http://ratguide.com/health/figure/ulcerative_pododermatitis_figure_2.php