Convenia for pneumonia?

Question
QUESTION: Hello, I hope you can offer an opinion on my rat Lily's treatment.  She is 1 year, 10 months old.  She was diagnosed with pneumonia on Monday, primarily due to her spells of labored breathing through her mouth.  She's also had hunched posture for just under a week, eaten and drunk less for a couple of weeks, been pretty lethargic for a few weeks, and had what I guess are panic attacks when she couldn't breathe well--she would leap around, and she doesn't leap like that.  The vet gave her a dose of Convenia, a broad-spectrum cephalosporin  that is injected subcutaneously and is effective for 2 weeks (or was it 10 days?).  He has treated one other rat's pneumonia with this so far, and said this is a newer drug.  I will take her back for a second dose on Dec 22  (due to his vacation, she'll get it a couple of days early, which he says will be ok).

I haven't been able to find a lot about this drug other than its original use in dogs and cats, but have found mention of it treating pneumonia in rabbits, at least!  Importantly, she is doing MUCH better.  My rat's breathing problems started the same night that I brought her to my mom's house, about 1 week ago.  She would have 15-20 minute spells of gasping breathing through her mouth, in response to a little bit of stress--like me picking her up to cuddle!  Sunday night she just didn't stop gasping, so we took her back to my house in hopes that removing her from the "scary" situation, or whatever she might object to in the air, would make her better.  The following morning, she was still breathing through her mouth, but gently.  We made a quick appointment with a recommended vet ,but had no time to research her symptoms and the usual drugs until later.  

Should I ask the vet to add more typical treatments to her regimen?  Or something as a follow-up drug after this treatment?  All her life, she's had a runny porphyrin nose and has sneezed a lot.  There are tiny dots of porphyrin all over her things.  She's always been really healthy, otherwise.  Do you think this porphyrin and runny nose indicate a myco problem that makes her more likely to relapse with pneumonia?  

Also, right now I can only get her to eat yogurt off my finger, and drink a little milk or water, plus she ate part of a grape today.  And she'll usually take chocolate, half a chocolate chip, which helps her breathing (if only we could have gotten her to eat some after an attack would start--but no way, she needed her mouth to breathe!).  Should I get some baby food to give her a better diet right now?  What in particular should I get?

Thanks in advance for your thoughts!

--Annette


ANSWER: This is a pretty new drug and it is pretty expensive, or at least it is here. We had to use it on my cat because he was a real pain when we tried to dispense meds so the vet gave him this injection and charged me out the window for one injection.  We never used it on rats, mine or the clinic rats and the main reason is because cephalosporins, which may have broader spectrum of activity than penicillin, it is still not as "broad spectrum" as we want.  Pneumonia in rats can be caused by mycoplasmosis or a secondary bacteria, Klebsiella pnuemoniae or the dreaded Streptococcus or worse, the deadly Streptococcus pneumoniae.  

If the cause is mycoplasmosis without a secondary bacteria involved, a cephalosporin is not going to be good enough on its own, and that being said, baytril along with Doxycycline or erythromycin or zithromax/azithromycin.

When dealing with Streptococcus pneumoniae. amoxicillin and or a cephalosporin should be used.

Klebsiella: A cephalosporin should be used and if the infection is severe,  For severe infections, amikacin should be used, which in fact, I like to use anyhow.

The more common pneumonia that our rats can recover from are usually myco related but often the seoncdary infection is klebsiella.


You asked :
Do you think this porphyrin and runny nose indicate a myco problem that makes her more likely to relapse with pneumonia?  

I think she already has pneumonia, and she was hypoxic earlier, unable to breathe which is why she had the panic attacks. She also needs to have albuterol to take at home.  I would ask if the can be kept at the hospital. To be honest, in order to recover properly, she should be kept in oxygen, her baytril and albuterol along with a steroid should be nebulized and she should be getting fluids too. Keeping her super hydrated is vital during this illness.  

My next question: Is this vet an exotics specialist? Keep in mind there are only 150 of these vets worldwide and the rest are simply DVMs that have a special interest in exotics but do not carry the title legitimately as exotic specialist. There is a huge difference. Dont get me wrong, a regular DVM can really be a great vet for small mammals, but they need to be properly equipped to handle situations like this and not treat them like a cat or dog. If you need someone else or just want names to see where these vets are located I would be happy to give you names of these vets, no obligation to go to them of course, but let me know your zip code or area etc...

how is she doing tonight?

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

QUESTION: Thanks for your response.  Lily is still doing well, breathing normally, and getting a little more playful.  She has always been such an explorer, but for the last couple of weeks she has mostly just snuggled up to me and stayed there when I brought her to the couch.  But today  when I eventually needed to put her back,  now that she is feeling better she didn't want to go, she wanted me to carry her around with me.

But she still isn't eating much more than yogurt.  She ate part of a grape, and a few oats.  She has diarrhea today, which is probably from her bad diet, but may be because of her medication.  I mixed some Benefiber into the yogurt and milk, I hope that will help her.  

The vet only charged $5 for the dose of Convenia, and says he won't charge at all for the 2nd.  This vet is not a specialist in small mammals, but came highly recommended and is dearly loved by many patients so I chose him over the vet who saw my BF's rat a year ago.  I've since found a link to the "specialist vet finder" you provided in an old post, and the vet we didn't want to go back to is actually the specialist.  I'm lucky that there are actually several small mammal specialists around me, so I can go to yet another vet specialist if I need to.

I think the Convenia has to be working, because of the quick change in her breathing.  Because she seems to be breathing fine, do you really think she needs oxygen treatment?  Do you think I can call and leave a message for the vet, (I'm assuming I won't get him directly on the phone) asking if he'll add a program of Baytril and...?  You suggested a few different things to treat the Myco, but you also mentioned albuterol.  Does the albuterol  help with her breathing, or treat the illness?

Thanks for sharing all this information!

Answer
As long as she isnt hypoxic she should not need the oxygen. When she does have these panic attacks, note the color of her extremeties....see if they remain pink or if they turn blue or purple.  If she is responding to the meds the vet gave her, she probably doesnt have the myco organism, but a secondary infection instead, which is good news. Myco leaves scarring of the lungs and can end up returning, causing chronic lung disease. I would add baytril only if she doesnt seem to be responding.
As for the vets, some vets that are exotic vets can have a bad attitude, and sometimes they dont even know about rats and have more experience with snakes or birds (Avian) and even more so, word of mouth is always a good thing. If other people recommend him highly and he knows about rats, by all means, keep going there. Its hard for me to know who is really good without reviews on them and to judge others would not be fair. I have had vets write me hate mail saying that I have no right giving out any medical advice and I write back and say WHY NOT? If I know what I am saying is accurate, I am not causing any harm in making suggestions to anyone. On the other hand, I have had vets write and ask to have a phone consult with me, asking me about my experience with this or that, so it doesnt really matter what is hanging on the wall of the Vets office, its about experience and how much time the vet has had with a certain species. This, along with the proper implements for surgery etc.. is what makes the vet good for the rat. It has alot to do with experience more than anything.  It sounds as if she is on the mend which is good. As for the albuterol, it opens the airways so the rat can breathe easier and is used to control the attacks she has when she gasps etc... but again, if she isnt having them anymore, she probably doesnt need it. It CAN cause rapid heart rate in some rats so its used cautiously.