3 vets and no diagnosis :(

Question
Hi Sandra, so happy that I stumbled upon this site!  I currently have 9 rats, Lemmiwinks being my oldest and first acquired.  She is just under a year and a half.  A few weeks ago I went to give the kids their dinner and noticed that Lemmi was lethargic, breathing rapidly and completely uninterested in her food.  I took her out and noticed that something in her abdomen felt firm and large and she had what appeared to be dried urine or discharge on her genital area.  My first thought was pyometra, so I rushed her to the emergency vet.  They did a urinalysis, a vaginal cytology and an ultrasound.  The urinalysis did not show infection, the cytology showed "a normal or slightly elevated amount of bacteria and white blood cells" (as read directly from her discharge sheet) and the ultrasound showed debris in her bladder, an enlarged spleen, and some fat accumulation in her liver.  There was no distention of the uterus.  Their diagnosis was a urinary tract infection.  They gave her injections of pain medication and sent us home with Baytril.  A few days went by with no improvement so I brought her to a different vet.  The new vet had Lemmi's records faxed from the first vet and based a similar diagnosis on the first vet's findings.  She sent us home with pain meds.  We had a follow up appointment a week later and saw a more experienced vet at the same (second) clinic.  He seems to think that she has some type of liver disease but felt that taking blood would be too risky as she appeared to be anemic (and also jaundiced).  He put her on Metronidazole and gave us some Nutrical.  He told me to discontinue the pain meds.  I was hoping to get her red blood cell count up so we could do blood tests, so for the past week I've been trying to feed her chicken, oysters, liver, Ensure, etc.  I think her skin color looks a bit pinker, we'll see what the vet says tomorrow.  She has good days and bad days.  Sometimes she's slightly more active and has an appetite and sometimes she is lethargic and won't eat.  She will not eat anything solid, so I have been putting everything in the food processer or feeding her baby food.  She is defecating and urinating, and I would say it's a good amount each time but it doesn't seem like she is eliminating as frequently as she should. She has lost weight.  I can feel her ribs, shoulders and hips...but her stomach is distended.  This little girl is such a fighter but I don't know where to go from here.  I don't feel right letting her go without a proper diagnosis and knowing whether or not her illness can be treated.  I am totally at a loss.  I love her so much and it kills me to see her this way, but I can't help but feel like it is NOT her time yet and something can be done for her!  Any advice, info, ideas or shared experiences you could offer would be so helpful and very much appreciated!

Answer
Hi Rachel

First off, let me start out by saying I am sorry your going through this. It is so frustrating when your fragile little rat is ailing and you feel your at a dead end with her and a dead end with the vet (s)
You have seen three and no doubt have spent a significant amount of money, especially for the ultrasound, which can be extremely expensive, even on a tiny rat.
I do want to question the credentials concerning the three vets you have taken Lemmiwink to see.  Some vets are exotic vets that have gone on after normal required courses are taken to be a general small animal vet and they have gone on to study exotics, also having to pass specialty boards in order to earn the title as an exotic veterinarian. Next, there are vets that are general vets but also advertise in big bold letters in the yellow pages that they see exotics, too. Some have even been bold enough to lure the public by not being honest and saying they are vets that have an interest in exotics. This only means they have taken some time on their own to learn about other animals aside from cats and dogs since over the past 25 years more people own smaller compact pets, such as rabbits and guinea pigs. Some are good, others cause more harm than good.

Now, about the diagnosis.  I would lean toward the third vet that suggests liver disease, possibly infection. The good news is that liver cells can regenerate themselves in some cases depending on the ailment.
Was she checked for diabetes do you know?  I am sure it would have showed in her urine test though but just wanted to ask to be sure.

Polyuria (urinary frequency)can be another sign of liver problems but it can also mean alot of other things such as UTI as well. Is she urinating more than normal or possibly at the same frequency but excessive amounts of urine?
One thing about the fatty liver is that small amounts of fat is normally present with the source of this fat stemming mainly from the rats diet. Triglycerides tell more of the story which is why the blood work needs to be done in order to really be able to confirm this is liver problems though.

Being put on Metronidazole was a good move and in fact should she have infection (such as a liver abscess) this is a great drug for it.

I wish I could help more but there are so many symptoms that can lead to so many other ailments, although the fact she is anemic with jaundice and distended abdomen does lean more toward the liver not functioning properly.
If the vet feels she is strong enough for blood work, this is the best way, but without it, I would still treat for liver disease especially if your already seeing some improvement since being put on the medication. Your doing all you can from feeding her baby foods (I always suggest that) to making sure she is properly hydrated.
A few things are in her favor and one is her age (she is still young and otherwise healthy and I dont often consider age a factor anyhow, it all depends on the over all health of the rat. A rat can be 3 and be more healthy than a 1 year old so I usually dont go by age and say "Well gee she is 2 now so its not worth removing the tumors" blah blah blah. I have seen to many rats recover when given the chance despite their age. Many of them were turned away by other vets suggesting they were too old for surgery and we,in turn, end up doing the procedure needed that was in question due to her age and the rat gets an extension to her life by 12 more months!! Your doing all you can and just by seeking second and even third opinions tells me what an excellent rat keeper you are. Your going by your gut and also by the knowledge you have about rat ailments and when you see the rat isnt improving you have enough sense to seek further medical attention. That right there is dedication and I like to see that but it is, unfortunately, far and few between. I usually hear that this person or that person cant afford a vet but want some miracle home remedy that I wish I could cook up, but its not that simple. Other times they are younger kids that have rats and the parents see the rat as a disposable pet, which is also heartbreaking and even more so when the child writes begging for help for his dying rat and tells me Mom and Dad refuse to spend money on a vet for a pet that can fit in their pocket.  Its sad.
Oh and I almost forgot, when you see the vet and if indeed it is liver problems, ask the vet what he or she thinks of using milk thistle.

Please let me know how  things are going. I like to keep tabs on rats that people write to me about but dont often get updates. One person wrote me a few weeks back worried her new rat was pregnant and I havent heard a peep since and I would LOVE to know if she was or not.

Also, if you need me to check the credentials on the vet(s) you have seen or are currently seeing please let me know the name of the vet and I can check. You can do this in a private follow up if you prefer not to post his name in a public forum.  

Hope things work out!

Sandra