URGENT-rat still bleeding

Question
QUESTION: Hi I wrote to you about a month ago about my rat Isis. I will recap in case you forgot. A little over a month ago she started having bloody urine so I put her on Baytril for a week. When it didn't clear up after a week I had her spayed (but kept her on baytril so she was on it 2 weeks) and the dr found a lesion on her uterus and cysts on her ovaries so was pretty sure she was bleeding from that. She xrayed her abdomen and her bladder and everything looked fine. After the surgery the bleeding seemed to lessen for a few days, then got worse again and the dr said give her a few more weeks to see if it's hormones that need to calm down. After a few more weeks the bleeding was continuing to get worse, then better, then worse....one day I noticed she looked a little pale and there was a small blood clot on her bed so I thought it was time to bring her back in (this was about a month after she started bleeding). The dr tested her urine and said it was positively LOADED with bacteria, so they put her on baytril and tribrissen and told me to give her some baby yogurt that has iron in it (the yogurt is also good while she's on 2 antibiotics to keep the good bacteria level up!). She was on these 2 antibiotics for about 5 days, and I thought the bleeding was clearing up. I keep a white towel in the cage for a bed and I wasn't seeing any blood... just kinda very slightly tinted urine so I was really happy I thought she was finally going to get well. Well, I walked in about a week ago and there was a lot of blood on the towel, like it was at her worst. Through all this she has been acting perfectly normally, eating great, active....I brought her back in, they xrayed her again, nothing showed up, they tested her urine again and they said the bacteria had cleared up a lot, but they switched her to zithromax once a day. They kept her for a few days and said she went 24 hours with clear urine, so I brought her home tuesday, and the next day there was pink urine on the bed again. It's been over a month now with this bleeding, and she still acts like a normal, healthy rat. I called the vet today to update her and she said she thinks, since the antibiotics are working in clearing up the bacteria but there is still blood and nothing is showing up on the xray, that they should go in and check in her bladder to see if there are stones that aren't showing up on the xray and to take a bladder biopsy. I think that is the only thing left to do, but I did want to run it by you first just to get an additional opinion (I know you're not a vet but you know more than most vets anyway). My biggest fear was that it was some kind of tumor, but the blood isn't getting worse, and she's still acting completely normally. What do you think? The dr. said she can do the surgery tomorrow. I just don't want to put her through something like that if you had another idea so I thought I'd run it by you. Thank you so so much for your time!

ANSWER: Hi

Yes I remember you and cant believe this is still going on!  The vet, she is an exotics vet that I gave you names and she was on the list, right?  Just checking......

As for what they want to do.....I would have to agree.  If she has  stones or crystals, blood may be seen due to sharp, rough edges of the crystals or stones and when they pass through the urethra, this can  cause the bleeding from cutting the tissue inside.

 Do you notice if she is urinating ok?

Is she swollen in her abdomen?

Has her bladder been empty when the vet checks her?

The continued stones/crystals do go hand in hand with infection. Do you know the type of bacteria they found, by chance?

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

QUESTION: Hey, well we opted to do an ultrasound instead of the surgery. And yes, it is an extoic certified vet! So they did the ultrasound today, and it turns out that one of her kidneys looks really bad, the vet said "there is definitely something really awful going on with that kidney" and there is also a mass in her bladder. The vet is pretty sure that the kidney is cancerous, and she doesn't know if the mass in the bladder is also cancer, or if it's just a blood clot. She said they could remove the kidney, and she might be fine, but if it really is cancer they might remove it and it will start popping up everywhere else. She just did an ultrasound on a hedgehog who was having bloody urine and in that case it was just a hematoma, so she thinks that might be the case with Isis. However, she said this is beyond her experience, and she doesn't really know what to do. She ended up saying as long as Isis is happy, we should just leave her alone. I don't know and I wanted to run it by you. I don't want to just leave her if there is the chance that by removing the kidney she would be fine. But if you have seen this before, and know that there aren't good results, I don't want to kill her by taking out her kidney if that will be too dangerous. They tried testing her blood to check kidney levels, but her veins are too small and they couldn't get any. Since the vet hasn't seen this before and doesn't really know what to say, I wanted to ask you. What do you think? I just feel so badly for this little girl, and she's still young, just 15 months. She has been bleeding on and off for about 2 months now though. Originally her urine had so much bacteria in it they were pretty confident it was just a bad bladder infection. Her urine is now clear of bacteria (she finished a course of zithromax yesterday) but it is still occasionally bloody. As it has been, it will be clear for a few days, then some days I'll see a little drop of blood, then some days there will seem like a lot of blood, then it will clear up....etc. I could just really use some advice! I don't want to give up on her if she has a chance. She doesn't act sick at all still, she's very active and alert, eats really well, loves coming out of her cage and exploring my room. I would appreciate any help at all!

Answer
Oh no...I dont know what to say. It doesnt sound good. The vet is a certified specialist and you would need to go another step to find antoher vet for a second opinion and to find another one that is certified would probably mean traveling some. I am lucky and have three in my state. I am not sure your location. I do know someone that wrote to me floored me with the fact his rat was having low doses of radiation at University of California - Davis.  He never kept me updated so I have no idea the outcome. I wish I had everyones email addresses so I could write and ask people how things are but when people write to me at allexperts, the messages go to allexperts first and come to me second after the personal info is removed.  Anyhow, to be honest? I would either seek another opinion and if the second vet agreed, let your original vet do the surgery ...OR.....let her be and let her be happy now while she is happy. Without a second opinion I just dont know if I would do it. See how your vet feels about a second opinion by someone as qualified as she is mainly since she herself just isnt so sure, which you cant blame her. Medicine, both in animal and human practice, is just that...a practice of medicine and never a guarantee.  

She may live a few more months happy and feeling ok and a few months with her is better than doing the surgery when things are less than 50% and the chance her life could end much sooner, possibly with her feeling very uncomfortable.....well....I just am at a loss for words right now. I wish I knew what to say.I have never seen a rat have a kidney removed. usually the clients are not willing to even consider half of the things you have done for your girl because of cost and here you are going above and beyond to try to get your little girl to be ok and you are showing these vets things that they havent seen before, so there may be no real guarantee no matter where you look if that makes sense.  

Where are you located?  I am just curious who is practicing exotic medicine in your area.