Rat has pneumonia

Question
QUESTION: My female rat Riley (who is a year and three months old) was diagnosed with
pneumonia last week. I got her and her sister Belle a new cage on Tuesday,
and maybe the stress was too much for her because she suddenly started
rocking back and forth, wheezing really loudly, and could hardly walk that
night.

I took her to an emergency vet the next day who gave her some oxygen and
an injection of Baytril. The day after, I took her to my vet and fought to get
Doxycycline. He gave it to me, but also said to only give Baytril once a day.
(As an aside, she absolutely abhors the Doxycycline and it has been a huge
stress trying to get it in her).

She is better--her breathing is normal, she's eating and drinking (though not
at normal levels), and still has energy to run around (though again not at
normal levels). But you can still see her breathing from her abdomen, and her
fur is incredibly coarse--it used to be really soft. She has also lost a lot of
weight.

So my main question is if this treatment is the best for her--should I be
giving Baytril twice a day? Does she need other antibiotics like zithromax or
gentomacin? How long should I continue with Baytril and Doxycycline (I was
only given 10 day supplies)?

Basically, her and her sister are the loves of my life and I want to do anything
I can to save Riley. She is so young that I am praying that she has a chance--
maybe you can tell me if she really does or not?

I am also worried about Belle. So far she doesn't have any symptoms of
respiratory disease, besides sneezing rather frequently. Should she be on
medication now too?


ANSWER: Hi there

Yes, Riley has a good chance because for one thing, she is young, and for the second reason, you got her medical attention and she is recovering.

The problem is she was not on the baytril long enough. 10 days of antibiotics is not long enough to kill off myco if this is myco related.

Also, in cases like this, I prefer having the rat nebulized baytril, amakacin or gentocin, albuterol and steroids can be used too.

In fact, I am going to copy and paste instructions written by a vet the best way to treat pneumonia, esp if it is related to mycoplasmosis.  These instructions call for the use of nebulization but if the client doesnt have one, they can either rent one from a medical supply place *they will let you do it with a script from the vet!) or have the rat stay at the vets a few days and when you bring him home put him on oral meds.  Most of these meds can be made to taste yummy. I get cherry, grape and strawberry syrups to add to my rats meds.   Just draw up a bit of the flavoring in a syringe, draw up the baytril you want in another syringe and mix up together on a flat dish and they will lick it right up!!

If Belle is sneezing, I would have her started on Doxy for a few days. If she doesnt imporve after just 3, add the baytril.  Once Riley is stable and over this, he should be given a daily dose of baytril for the rest of his life to prevent chronic lung disease. This has a great success rate of preventing pneumonia from happening again.  However, this all means your vet is really up to date on the most current treatments to prevent myco and secondary infections that contribute  and to chronic lung disease.

You can also use amakacin in place of gentocin. The rat should also be kept in oxygen for a few days while medications start to work.

A treatment regimen for serious and advanced respiratory illness

The following treatment regimen for use in rats with advanced lung infection or more serious respiratory illness with Mycoplasma as the suspected agent , is recommended by Dr. Michael Hutchinson, DVM; Animal General, Cranberry Township, PA., and is based on his experience treating rats and current literature:

    enrofloxacin (Baytril) 15 mg/kg BID, PO (oral) for 10-30 days
    doxycycline 5 mg/kg BID PO (oral) for 10-30 days
    nebulization for 15 minutes, 2 to 3 times a day, for 14 days, with the following mixture:
    8 mL sterile saline
    0.5mL gentocin injectable 100 mg/mL
    0.5mL Albuterol 0.083% Inhalation *Note: excess mixture for nebulization can be refrigerated for up to 3 days.

    dexamethasone 1 mg/lb BID, then weaned down as follows:
    1 mg/lb BID injectable or PO (oral) for 3 days
    1 mg/lb SID for 3 days
    0.5 mg/lb SID for 3 days
    0.5 mg/lb orally every other day, three doses

    Other veterinary recommended reduction schedules for dexamethasone may also be used.

Additional antimicrobial choices
Besides the above recommended antimicrobial choices, and treatment regimens for pneumonia, the following drug choices may also be used.

Tetracycline

Cefadroxil (for secondary infections - best used in combination with Gentocin)

Chloramphenicol

Enrofloxacin (Baytril) and Doxycycline simultaneously.

An aminoglycoside: (such as amikacin or gentamicin) in combination with Cefadroxil.

*Note: Combination of drugs given simultaneously like enrofloxacin (Baytril) + doxycycline, azithromycin + doxycycline, clarithromycin + doxycycline, have been found to be very effective in rats.

The choice of an antibiotic/antimicrobial or combination can be more effective when selected based on culture and sensitivity of organism.
Bronchodilators and Corticosteroids In Therapy
The use of bronchodilators given orally, such as Aminophylline/Theophylline, or Albuterol, may be added to help relax the smooth muscle and dilate the bronchi in the lungs to aid breathing.
Nebulized treatments with these medications as well as certain antibiotics (e.g., fluoroquinolones: enrofloxacin (Baytril), aminoglycosides: amikacin or gentamicin (gentocin), or a macrolide: tylosin, may be prescribed for rats that have difficulty taking the medications orally. Medications for nebulization need to be diluted in normal saline.
Ratio for dilution of medication per normal saline recommended as follows:
Enrofloxacin(Baytril) 10mg to 1 mL normal saline. 3
Gentamicin 5mg to 1 mL normal saline. 3
All others a 1 to 10 solution. 3

For the nebulization formula using gentocin and Albuterol in a treatment regimen, recommended by Dr. Michael Hutchinson, see above in the section: treatment regimen for serious and advanced respiratory illness. See Nursing Care below for more information on nebulizers.

In addition, a corticosteroid such as prednisone or dexamethasone may be added to the treatment regimen to help reduce inflammation of the bronchi and bronchioles in order to help the rat breath easier.

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

QUESTION: Thank you so much for answering my question (and so quick!)

I will call my vet and see what he says about nebulization, and ask for more
Baytril and doxy. I can try sweet fruit syrups, but it is as if Riley knows no
matter what that the doxy is there. The Baytril she has been taking no
problem--so that is a relief since she will be on that the rest of her life.

This whole thing has been kind of scary though--I feel like no one warns you
when you buy rats that they can end up costing you so much time and
money. I am a poor college student and the emergency vet alone cost quite a
pretty penny.

My follow up question was basically if I forgo the nebulization, how much
that would hurt her. I will do it if it means a good quality of life versus
suffering and/or death, but I can only imagine what my vet will say it costs--
just a plain visit costs almost $50, plus the cost of meds! I could try renting
one, but I am afraid that I wouldn't do it right.

Also, how much does good husbandry play a role in her recovery? I have
been cleaning the cage continuously (my family calls it "obsessive"), buying
supplements such as echinacea, etc. I have also heard that it is important to
keep them warm and not let them near drafts. But we are currently going
through a heat wave in the Bay Area, so I am conflicted whether to cool her
down and let her near a breeze, since she seems pretty miserable if she's too
hot.

And (sorry for all the questions!) I suspect that the two of them have mites--
they are constant itchers, and have been for a while. My vet gave them a fish
oil supplement a while back, but  through this whole mess I've been keeping
an extra close eye on them and they are still itchy and scabby. So I bought
Revolution online, but am wondering when it is safe to give to Riley?

Again, thanks so much!!
Jennifer

Answer
Hi Jennifer


Nebulizing should not be that expensive.  You can maybe have them just do it once or twice and let him spend the night at the clinic on oxygen while they give him this treatment.  It gets the meds into the lungs so fast and helps the meds work faster. However, if the right meds are used and he is recovering ok, the nebulizer can be bypassed. Its just a better way to go is all, but not necessarily something that MUST be done or he will die so dont worry about that.  As for renting one, its really easy to use them.  You just pour the medications into a little cup and turn it on. My rats used to be nosey and would go to the nebulizer tube and sniff it  and run and come back and do it again and again, but if you put him in a cage with a heavy towel over it and put the nebulizer tube by the bars and let it get misty in the cage he will inhale the fumes that way too....or even a glass aquarium. You can put him in that and pipe the steamy stuff into it that way.  

Again, though, you cant mess it up. Have some confidence, girlfriend:)

As for revolution, yes, this is the best medication for mites but it needs doses as per the rats weight. I can tell you how much to use once you get it.  It should be the kitten strength only. What did you get?