Need to decide Quickly what to do, PLEASE HELP ME.

Question
QUESTION: Hi,
  I have a rat named licorice, she is almost 3 years old. She started showing odd symptoms on Tuesday evening. She seemed unstable, off balance, walking funny, she was flailing her head around and seemed anxious. She was drinking a lot of water, but seems to have normal bowl movements and urination. She has been eating normally and hasn't had any vomiting, discharge or bleeding from her mouth, nose or ears. When she climbed up the side of the cage to see me she kept falling off backwards. I took her to the vet the very next morning. I put her on the floor and she had all her limbs spread out as if to balance herself, then she started walking backwards, she was throwing her head back (rearing it like a horse) and she seemed anxious. It was like she was desperate or franticly looking around for something. The vet said he hadn't seen anything like this (the walking backward thing). He decided it was either an ear infection, a stroke or more likely something neurological like a brain (or pituitary) tumor.
  I know my rat... this is soooo not okay. These symptoms seemed to have come out of nowhere so suddenly. I have had her on oral "Baytril" antibiotic for 24 hours now and they gave her a "Depo Medrol" injection yesterday morning (a time released anti inflammatory medication) and her symptoms haven't gotten any better.
  I would like to know if you think this sounds neurological. And if so, I am assuming the prognosis is grave. I love this little girl and I don't want her to suffer or have a poor quality of life. I don't think she is in any pain, but it's hard to know. If she doesn't get any better the vet says I should euthanize. How will I know when to consider this option? How long should I wait with this treatment before I give up? The vet says that it is a strong antibiotic and if there aren't any changes in 24 to 48 hours  it's probably not an ear infection. Can you think of anything else this might be that we haven't considered?
  Please contact me ASAP so that I can come up with a plan of action and decide what to do. Watching her struggle like this is breaking my heart.
         Thanks for your time, Petula

ANSWER: Petula

DONT PANIC!!!  I just went through this in January with my boy SMudge.

It was indeed an inner ear infection but I was so convinced otherwise because he was SO bad!!  He was literally flipping flips forward, couldnt stand to eat, flaring his head all over till he would roll and fall.  Now I have rat care under my belt and have a top notch exotic vet to care for my rats and I was still freaking!  I work with rats daily on a semi professional level (I say semi pro since I am not certified) and yet I was not convinced this was his ears either.
Days went on with treatment. We pumped him with steroids and baytril and fluids and ran test upon test and NOTHING came up other than he had an infection.
I kept thinking a brain abscess or infection and the vet supported my theory to a degree  but after about day 5, he started to get a bit stronger.  He spent 10 days at the vets while they tried to get him stable.

That was in January and it is not  just about June.  He still is a bit off, I have to say that much.  He will walk in a huge circle when he is in a new area he doesnt recognize. He no longer can live with his brothers in their giant ferret nation.  He needs a single story cage because he still seems a bit drunk when he gets  excited.

He still points his nose straight up to the ceiling and he will flip a bit when he gets excited and wants to fight me to get down, but he is 75% better than he was in January and I thought for sure he had some kind of terrible neurological disease.

I will say this...he has damage.  We think that some kind of virus perhaps, not sure,  has damaged the nerves, possibly the 8th cranial nerve and this controls equilibrium. His balance is better but nothing like it should be. He is happy, healthy as ever (he dropped weight in the hospital but gained it all back plus a bit more!) and he bruxes, boggles, grooms, uses his litter box like a champ never messing anywhere else....but we think he is either totally blind or close to it. Again, damage from whatever in the heck he had wrong in January.

With your rat I feel that she has not had enough time on the meds at all to make any sort of decision.  Head tilt and other signs and symptoms can take longer to go away even if the infection is going away. The residual symptoms can linger for a while. I know sometimes headtilt never resolves fully but enough that the rat can adjust to it and live a happy life.

I would suggest perhaps adding a second antibiotic for secondary infection.   Often mycoplasmosis is the culprit for otitis media but if there is a secondary bug going on, something such as cefa drops or keflex would be a good idea.
Steroids (prednisone)should also be used and this should continue for at least a few weeks, and when it is time to get the rat off of them, they need properly weaned down just like humans have to do.THe antibiotics need continued at least a full 30 days!

Is your vet an exotic vet?  

Normally if a rat is sick, esp with a respiratory infection, that if they dont show signs of improvement in the first 3 days, the meds need changed etc.... but with inner ear infection, it needs more time. The inflammation on the 8th cranial nerve can be so severe that it just wont go down overnight. Again it may take days to see any marked improvement and weeks for a full recovery.  Now, if the rat gets worse, like stops using her front paws, or becomes listless and just continues to decline, I would think it was something more serious.

You may need to assist her in eating and drinking which is critical she drinks while on the meds etc...

Use a syringe in the side of her mouth, offering her pedialyte, watermelon juice, sugar water or ask the vet for something from the clinic. You can let her lick baby food from your fingers too!!

I am trying to get this out to you as fast as I can so I hope I didnt miss anything and ignore the typos...I am going a million miles an hour so I can hit SUBMIT!   I wish I got to this sooner....I had several others ahead of you but I should have read this an hour ago!!

please let me know what the deal is now...


hang in there!


Sandy

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

QUESTION: Thank you soooo much for your quick response. I am relieved to hear there is more I can do to help her. I have had trouble finding a vet that has any expertise in dealing with rats but am continuing my search today over the internet to find one. I live in Santa Clarita (Los Angeles county) so you'd think it would be easier. I should have set myself up with a "rat" vet before this happened but I am a first time rat owner (Licorice actually belongs to my little girl) and didn't realize I needed to do that and what a great pet she would be and how much all of us would come to love her (and our other rat "Happy").
   I will contact my vet today about a secondary antibiotic and steroids. In the meantime I will also nail down an exotic pet vet today and try to get this resolved so I can take her to a specialist on Monday.
   I am a little sad that Licorice may not make a full recovery and that she may never be the same, but I am hopeful that she will recover unless she gets worse. I haven't noticed anything wrong with her front limbs, she isn't listless either, in fact she is extremely hyper (anxious) and she is strong! She is eating and holding her food by herself although I have to help hold her steady because she is wobbly when she tries to balance on her hind legs.
She is also still doing this strange behavior of walking and running backwards and also walking backwards in circles, but oddly it is only when she is on a surface that doesn't have carpeting. When she is on carpeting she walks/runs forwards. She runs around like a maniac, sometimes going in circles and sometimes just sporadic.
I thank you again and if you want I will email you and let you know what happens. Petula

Answer
Yep I had to hold smudge steady too while he ate but he caught on and started to lean against the side of the cage to steady himself.

As for her being anxious, so was Smudge. I think the entire situation makes them a bit anxious and thats another thing your vet can help your rat with: he can call in liquid valium.  It wont make her all doped all since they have a fast metabolic rate, it will calm her anxiety and thats all it will do which is   what we are aiming to do anyhow.
Also, the fact her front paws are strong is a good sign too. Often with a brain tumor (pituiarty tumor) they lose their strength in their front paws during all of this and she didnt, and she probably would have by now....so I am confident this is from the ear.  DO NOT give up on her.......I mean, I cant tell you what to do but I would give her a good chance  to recover unless as I said and you also said, something else should happen that you find her perhaps lying on the floor unresponsive and having seizure etc...that would be a different story entirely.

As for vets, I have the perfect thing for you. Check my website and in fact I will give the URL to you. Its a page about vets and finding a vet for your rat and please click the link on to the AEMV. You will find a list of vets in California that are certified exotic vets. I think California has 41 total REAL exotic vets.  Some states have 10, some have 2 and some, unfortunately have none :(

Anyhow, my Smudge walked backwards too...it was so strange...

PLEASE keep me posted.  My personal email is askcritterkeeper@yahoo.com.

Please reach me right away, I am hoping she is doing ok!