Male rat- lump on jaw

Question
QUESTION: Hi Sandra,
I wrote to you a bit back about my baby with hind leg paralysis. The story did not end well, and I lost the rat love of my life. I might do a followup to that question just to share what I learned... once I get to talk to my vet in depth about it, too.
BUT here is the latest, poorly timed development for me:
My surviving rat, Nicodemus, has as of 6 days ago developed a prominent lump on his right cheek under his ear and above his jaw. The lump formed in about a 2 day span. He had been acting mopey, but I think a lot of this is due to the loss of his brother. Now the poor little guy has this to deal with, too.
My vet is out of town till this Friday, which is the day I have an appointment to take Nic in.
I am wondering if I should try to rush him to the other rat vet tomorrow or tonight instead [this is very poorly timed because I've been sick and missed some work, which is making the trip to the other rat vet- 45 minutes away from me- a difficult task.]
Here's the symptoms:
Large lump 6 days ago. Some occasional head shaking back and forth for a couple of seconds at a time. Activity and appetite seem normal. However yesterday I saw that the lump has caused a prominent malocclusion now. [Lower jaw has shifted significantly.] To ease stress on his jaw, I have started feeding him baby food mixed with crushed up Total cereal and some Nutri-Cal mixed in. He eats it just fine.
Yesterday I also noticed a scratch or two in the ear on that side, which tells me he's been scratching at it now... in discomfort, I'm sure. There are no scabs or change in the skin, except for it being stretched out above the lump. The lump feels hard.

Am I really going wrong by waiting till Friday to see my normal vet? I've read about Zymbar's [misspelling?] gland tumors and it really sinks my heart because the picture I saw with the explanation looks a lot like Nic's problem.

Thanks again for your time- I hope this makes sense.

* Extra note: I did adopt two more young boys [they are adorable] but I've put off integrating them as planned  because of Nic's recent development of this lump. No more pet store rats for me.

ANSWER: I am sorry for your loss.  You can let me know the details when your ready. I know its hard. Its hard for me even a year later to talk about certain rats I have lost.

As for your rat with the tumor...I was just about to mention zymbals gland tumor and it will indeed cause the teeth to shift like that and cause malocclusion.  Its a nasty Squamous cell carcinoma and unfortunately there is no happy ending when they have this, either. I have seen alot of them in my days and have had one of my own rats have them too. We put a drain in, I fed him baby food till he lost the use of his mouth and it also can travel to the lungs if it is indeed malignant and cause or actually mock a respiratory infection (chronic)

Its WEd. and Friday is just 2 days away...if its zymbals there isnt alot they can do but possibly debride the wound and provide different meds from antibiotics to narcotic pain killers and I am not talking about weak metacam that is nothing better than advil or motrin.  It requires stronger medication than an NSAID.

Please let me know if I can help you any other way. Lets hope this isnt what he has.  I could be wrong and these are the times I hope I am wrong in fact!

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

QUESTION: Hey Sandra...
I took my boy in for surgery yesterday to remove the tumor.
The vet suspected Zymbal's gland at the consultation, even before I showed her the research I had done on the Internet :) [I'm not a know-it-all, but I like to be well-informed... and sometimes that means self-informed!]
Boy, that tumor was large. I elected to have it sent to the pathologist, at the vet's recommendation, to see if it is malignant. I guess this will let us know if it will grow back or maybe has spread?
He had surgery about 1:00 pm yesterday; I picked him up at 5:00pm. I pretty  much let him stay unbothered in his cage for a while because my attempts at offering him food and water were unsuccessful, and he seemed groggy. And he looked pitiful!
I was sent home with a simple care instruction sheet and no meds. I didn't get a chance to speak to the vet, so I asked all I could think of to the nurse. I asked when to clean him with peroxide like the sheet said ["If the incision looks like it has gotten dirty"], I asked if there were meds ["No"] and I asked when the bleeding would stop ["Tomorrow there should be no fresh blood."]
Well, last night my attempts at getting him to eat or drink still didn't work. He walked to his water bottle but didn't drink. I tried to use my finger to release the water, and I put some water on my finger for him to lick. I tried apple juice, too. When he slightly seemed interested, it was more like he was touching his mouth to my hand but not really licking. I thought maybe his jaw was still asleep from the surgery. Well this morning is the same.
I'm wondering when to expect him to be able to use his mouth. His malocclusion had gotten severe, and even though it's much better now I'm wondering how sore/confused his jaw is now. I also know there's a possibility of partial face paralysis from this type of surgery [in the consultation, the vet had mentioned a case she just had in removing a tumor in the same place in an other rat; the rat lost movement in half of her face but was slowly regaining it.] I wonder if his tongue is working right. I feel like I can't force feed him- his incision area is on his neck, right where I would normally hold him to put a syringe in his mouth!
I'm also afraid I let him get too cold last night- he was in a cardboard hidey box with a clean rag, but no heating pad. It got colder in my room during the night then I thought it would :( I won't let that happen again.
So:
How long do you think I should try to keep him extra warm with a heating pad under part of his cage?
Anything in particular for his comfort I can do?
What can I do to make him eat/drink?
When do I need to be really worried about his lack of interest or ability to intake food/water?
Should I ask the vet about pain meds?
What else should I ask about him that I'm not thinking of, in your opinion?

The vet's desk doesn't open till 10:00AM my time, which is still a bit away. Thought I'd try to see what you said in the meantime, before I can call them.
Thank you for all your help!!!
Whew- I think I asked enough questions. Sorry to lay it on ya like this!

Answer
Hi

I am glad you had the surgery, however, super concerned that there are no meds.  He should have antibiotics and pain killers and I dont mean metacam which is no better than advil. I am talking narcotics. This is painful. He will make him feel so much better and allow him to move his jaw a bit so he can eat.  Eating is absolutely the best thing to get a rat to do after anesthesia to get them to absorb any residual left.

I just dont get why no pain meds. I know some vets think that the rat will feel so well that he or she may over do it. With their fast metabolic rate, their body will burn off a majority of the pain meds anyhow so its not like they are going to end up all euphoric or stoned and fuzzy.  The proper dose will simply provide comfort. Being uncomfortable causes stress. Stress weakens the immune system. Being comfortable keeps stress levels down and a rather than be stressed from pain and have their recovery slowed down, being out of pain will speed recovery.  I dont know why I would know this and the vets that I work for would know this yet so many vets DONT know this. Why? What the heck does it take to get them to understand? I just dont know.  ::sighs::

You can ask the vet for the meds but I can almost promise you may hear some song and dance about why its best NOT to use it blah blah blah so i would suggest what I said. Its not something i pulled out of my hat. I was taught this by exotic vets and in fact these vets are Diplomats with the American Board of Veterinary Practitioners and  are certified in Avian Practice along with being board certified in exotic medicine so if you want to pass this along to your vet its not really something from me, but from them if that helps any.

Also, zymbals can actually metastasize to the lungs so I would watch for any respiratory issues which is another reason why he should be on at least some type of antibiotic for secondary infection, just to use as as prophylactic measures.

Back to getting him to eat or drink.  This is critical. I wonder why they didnt keep him at the clinic until his eating practice was established again.  If he would dehydrate he could have fluids given and warm fluids after surgery is a good way to help increase body temp. He should be kept warm at least for 12 hours post op but if the room is cooler than say, 72 degrees, I would keep using the heating pad.   I have a little guy living in my closet in his cage. I know, sounds strange.  I wanted to keep him near me as much as I could but I Have lots of cats and he fears them even though he is totally blind. H e can tell when they are near.  He cannot live in the same room as the other three rats because he needs to be kept in a darkened room due to his blindness. He can see bright light and upsets him (he survived meningitis in January and it caused him to go blind in both eyes) but he does well despite his handicap. Anyhow, the closet is a big walk in type closet and it has a vent for the heat and cold air from the A/C
sooooooooooo anyhow (I am getting there..lol) moral of the story is the closet gets chilly so I keep a heating lamp on half of the cage and he usually likes it and stays more toward the heat lamp. I also think he is attracted to the red bulb since he is blind and he can sense it and maybe make out the glow to it...I dont know.

Anyhow, please keep me posted. I blabbed enough for a weeks worth.