Henry- the ongoing saga continues...

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Henry- the ongoing saga continues...

Post by izzerie » Fri Jun 03, 2011 10:23 pm

My poor Henry's run of ill health continues and I really need some help figuring out what to do for him next. We have a vets appointment Monday morning to discuss our next steps with the vet so i'd love some input and ideas to take with me.

It started with an infected facial wound at the beginning of May for which he had treated by the vet. During he treatment the vet gave him a baytril injection which resulted in a nasty baytril burn on his back. This didn't get better despite twice daily cleaning so we returned to the vet who suggested some other ideas but these aren't likely/have been proven not to be the problem. We were prescribed metacam and dermasol and told to continue twice daily cleaning with hibiscrub. This eventually had some effect and at the weekend his back looked better than ever- he still had a bald patch of very white skin (looks like scar tissue) that had a couple of minuscule open bits but it looked pretty amazing compared to what it was like. Then I got him out Tuesday morning to find the bald path had became raw and open again overnight! And since then it has just got worse, the area has grown yet again and the whole thing is raw and weeping and some areas are open and bloody. We've continued with twice daily cleaning and dermasol but this is having no effect what so ever, his back is just getting worse. I don't know what else I can do for it- he doesn't have mites, the fungal skin test he had was negative and there's no signs of any infection and he's on meds anyway. Does anyone have any ideas?

Then just under two weeks ago I picked Henry up to clean his back one morning (it as a Sunday) and he was crackling constantly so I took him to the vet. She said it was an upper respiratory problem, possibly a myco flare up caused by his recent course of baytril for his face. She out him on synulox. On the Wednesday he was much worse- not eating or drinking, sleeping all the time- so we went back to the vet. She decided that she didn't want to do anything without consultating a specialist and sent us home to try and keep him alive. We heard back from the specialist Thursday evening we said to switch baytril. I said this wasn't enough and pushed for doxy which we got. By the Friday morning (last week) he looked awful, side sucking and not moving so that vet kept him for the day. Basically they didn't give him the right meds (I kicked off when i found out and refused to leave the vets until they prescribed and dispensed the right meds to take home) and when I got him back he was worse than ever and I thought he would die that evening. However, he defied the odds and really improved. In the last week he has started eating and drinking and being more active. He is still skinny (he lost a lot of weight), scruffy, sleeps more than he did and looks unwell but he is a million times better than he was. However, we have reached a kind of plateau- he's not getting worse but he's also not getting any better. Like I said he still doesn't look right and he still has periods of crackling and sometimes hooting. Currently he's on 0.2ml of baytril twice daily and 1/8th of a doxy tablet twice daily. What can I do to help him to carry on improving? I was going to suggest to the vet an increase in dose and to continue with the meds. Is there anything else that can done? The vets have already said that if this course of medication doesn't work there is nothing else but at the moment, despite not being well, he seems happy most of the time and he doesn't seem to be suffering. Surely an increase in dose and extending the course is a possibility? If he was still like he was last Friday I would call it a day but he isn't, he has improved, just not enough.

Like I said at the start, I'm all out of ideas and I don't really know what to do next for my little man. I'm sorry for such a long post and I appreciate anyone who manages to get through it all and give any advice at all!
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
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Re: Henry- the ongoing saga continues...

Post by sati18 » Fri Jun 03, 2011 10:30 pm

could you give his weight, his current doses, how long he has been on each medications, and if possile upload a video of him and the noises.

my guess for the wound would be some sort of infection keeping it open and making it come back like that- have you had a culture done at all for bacterial infections?

It could also be a very low immune system meaning that he can't heal because he can't fight off even normal bacteria/irritants. Especially as he got so ill after he baytril burn- maybe whatever it is has trashed/is trashing his immune system and that'swhy he'splatoed respy wise.

i wonder if rats can get auto immune type problems.....

pure speculation on my part though
Proudly owned by the big boys (Jeff, George & Toby) and the babbies (Sid & Ozzy)
RIP Monty, Emile, Leo, Angus, Otto, Remy and Rafe... mummy misses you every day.

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Re: Henry- the ongoing saga continues...

Post by izzerie » Fri Jun 03, 2011 10:48 pm

I have to take a guess at his current weight because the vets didn't tell me and my scales are rubbish but I would estimate 425-450g (previously 525g at the end of April).

Current medications: baytril @ 0.2ml twice daily, has been on for a week now. Doxy @ 1/8th of a tablet twice daily, also been on for a week. Improvement was fairly quick after starting on correct meds but has now stopped improving. Antibiotics always given atleast one hour apart. His back is cleaned twice daily with diluted hibiscrub and then a generous layer of dermasol applied. He also has malt paste twice daily and constant access to water with probiotic and vitamin powder. I have some poly-aid on it's way as well.

Video of noises: have tried several times but not been able to pick them up. The crackling sounds upper respiratory and isn't a dry crackle. The hooting does just sound like an owl hooting- hedoesnt do this often though, just for a couple of minutes a few times a day.

Culture: he had some hair samples from around the area taken two weeks ago, the vet was primarily looking for fungus but nothing has been found at all on the culture.

Does that cover everything?
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
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Re: Henry- the ongoing saga continues...

Post by izzerie » Fri Jun 03, 2011 11:43 pm

I should probably also add that we still have meds left- we were given enough doxy for 16days and enough baytril for 10 :) so we're not quite at the end of the prescribed course yet.
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
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Re: Henry- the ongoing saga continues...

Post by izzerie » Sat Jun 04, 2011 8:38 am

Managed to get a video of Henry this morning. Actually, the video doesn't feature Henry on screen because I was sitting in my t-shirt and pants and Henry was in my lap :p but it does have the noises Henry has been making in it. 

This was at the end of a fairly bad episode this morning. It is typical of the noises he has been making. 

Oh and ignore the crash at the end, it was my rabbit deciding that he wasn't getting enough attention!

Here's the video :)
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
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Re: Henry- the ongoing saga continues...

Post by sati18 » Sat Jun 04, 2011 3:46 pm

how do you access it? my computer keeps trying to download it rather than go it it as a link?!

Re: meds- it's good that he picked up initially as that means they are fighting the respiratory infection. the fact that he has plateauted wouldn't worry me quite so much, given that he has only been on that combination for 1 week. a minimal course would be 2 weeks in my opinion and usually i keep them on for 4 weeks after anythign but a very minor infection to ensure they are properly clear of it. I think you're vets point of doing nothing more if this doesn't fix him is rediculous- clearly if he's improving then what you're doing is right and therefore you should keep doing it untill he's completely better. Is there no option for you to find a better vet as these ones have really let you down :-(

There's also the likelihood of scarring since he did have quite a severe infection- scarring can mean that they make respiratory noises forever, it's just difficult to tell what's scarring and what is infection. the hooting is something i hear recurrently in my rats who have on/off respy problems, it's upper respiratory problems and i've not found anythign that removes it permanently. To me it's not a problem unless accompanied by other symptoms such as heavy breathing, indication of infection in the lungs, or an obviously il rat which henry was. If his other crackles are wet sounding then try diuretics to clear fluid out, furosemide is the common one.

Re: the wound... was that all before he was prescribed the synulox for the respy problems ... or did him getting better co-incide at all? just becasue synulox is better for skin problems, while batrl and doxy are effective for respy problems so it's possible they wouldn't treat a bacterial skin infectin effectively. im sorry i'm not too good with wounds/abscesses (fortunately i've not had many *touch wood*)... hopefully someone else can be more helpful.

To be fair though you have had the best of my advice already so really hoping someone else replies and can add an alternative perspective or some sugestions as well.
Proudly owned by the big boys (Jeff, George & Toby) and the babbies (Sid & Ozzy)
RIP Monty, Emile, Leo, Angus, Otto, Remy and Rafe... mummy misses you every day.

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Re: Henry- the ongoing saga continues...

Post by izzerie » Sat Jun 04, 2011 6:11 pm

Let's try this for the video:

http://s269.photobucket.com/albums/jj49 ... d2d659.mp4

I was anticipating that there would be some scarring from this infection. The Henry I'm seeing at the moment is still an unwell ratty. I guess in the future it's just a case of not jumping at the first noise he makes and looking at his behaviour alongside the noises.

I was also thinking that a week on the new meds isn't long enough but we will run out of baytril on monday morning so I need to go to the vets anyway and ask for more medication. I think a month long course, considering the severity of his illness, is a sensible idea. I shall ask for that :)

Re: wound. Thinking about it now, the synulox and the condition of his back is linked. He started on the synulox on Sunday 22nd May. His back improved all that week and by the weekend of the 28th/29th was looking really good. On the 27th, the synulox was replaced by the baytril and doxy and it was the 30th/31st that his back suddenly got a lot worse. So it would seem the synulox was helping his back and not the respiratory problems and the current meds are not helping his back. Can he be on all three (doxy, baytril and synulox) all at once?

As for changing vets, I have thought about it. But money comes into this a lot. They are by far the most reasonably priced vets in town and apart from that Friday they have been good. Also, all of the staff (apart from one who I shall avoid) listen and are more than willing to learn and openly admit that they have limited knowledge and will seek out further information and treatment. I also have no transport so I have that to think about as well- although they are a bus ride away they are on the most frequent route. I have enquired about other vets and all have said they have limited knowledge of rats and one even told me not to bother taking them there as they don't want to see them!So I'm really stuck for anywhere decent and I think if I can keep pushing and teaching them then we might be able to get there. Plus once they have knowledge it can help other people's ratties in the future.

Thanks so much sati, you have been totally invaluable! Henry definitely appreciates it :)
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
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Re: Henry- the ongoing saga continues...

Post by sati18 » Sat Jun 04, 2011 6:33 pm

No worries- i was just getting a bit worried that because i was always replying other people weren't offering their suggestions and i don't want to limit your options.

To me there is no obvious reason why you can't have him on all three:- i've had baytil + doxy in combo, i've had baytril + synulox in combo and i'm pretty sure somewhere along the line i've have synulox and doxy (although that may have been my own concoction rather than the vets :oops: i do tend to medicate at home when i know what the problem is and have the meds there). The only thing that may be a concern is that it's a lot of antibiotics, and synulox is one of the hardest on gut flora, so regular, maybe daily, dosing of a pro biotic would be an absolute necessity, and you would need to monitor him very closely for signs of gastro intestinal upset and probably feed him anti diarrhea friendly foods such as egg food every now and then as well.

if he did start getting a very poorly tummy then you would need to make a call on which antibiotics were the most essential and reduce it. If your vet quibbless about giving so many maybe offer to stop either the baytril or the doxy while he is on the synulox. a 10-14 day course should be sufficient if it almost cleared up in a week- certainly you should know if it's going to help within 3-4days most likely.

FYI Here's synulox info- it's particularly effective against staphylococcus bacteria which i believe is a common infection of the skin. Actually, googling staph infections too it seems they can make a rat feel quite unwell too so that may be the other reason he's not picking up as quickly as you would like.... some links below:- (most of them talk about abscesses so it may be an unusual presentation but still worth thinking about...
My Georgie had some wounds on his face once from scratching at mites which just didn't heal until we popped him on synulox

http://ratguide.com/meds/antimicrobial_ ... lanate.php
Staph infections: http://www.petmd.com/exotic/conditions/ ... _infection

Although it's not 100% his symptom because the woun is on his back... the more i read that link the more i think that could be the root of both his back and sudden respy flare up... what do youthink? The causes and progresion seem to fit rather too well ...
Proudly owned by the big boys (Jeff, George & Toby) and the babbies (Sid & Ozzy)
RIP Monty, Emile, Leo, Angus, Otto, Remy and Rafe... mummy misses you every day.

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Re: Henry- the ongoing saga continues...

Post by sati18 » Sat Jun 04, 2011 6:48 pm

found some further links for you on FR about staph infections- in all honesty i think you can argue with your vet if the give you trouble about tthat many antibiotics at once:
1. the wound improved with synulox
2. its not improving with baytril + doxy so they definitely aren't treating it
3 the respiratory problems did not improve with synulox yet they did with baytril+doxy so they must be cause by myco which synulox does not treat
Hence- no option at all but to try all 3....

Topics on staph infections from FR
http://fancy-rats.co.uk/community/viewt ... n#p1455487

Topic link with pictures of what a staph infection/necrosis looks like, along with further info and more pics (second page) of similar staph infection caused after a baytril burn this does suggest some alternative remedies as well to synulox in case the vets put their foot down-savlon apparently has antibacterial action against staph infections
http://fancy-rats.co.uk/community/viewt ... +infection

think that may be sufficient evidence to persuade your vet if his wounds match anything like any of those....

Hope this helps :-) and reallyhope you get a helpful open minded vet- if not, id suggest being very naughty and bringing him to another vet purely for the skin thing and seeing if you can get synulox that way, not mentioning any other meds.... not something i would ever usually advise but you can check the evidence over yourself and decide what you think is his best interests.

i really hope i'm right and this helps the poor little mite
Proudly owned by the big boys (Jeff, George & Toby) and the babbies (Sid & Ozzy)
RIP Monty, Emile, Leo, Angus, Otto, Remy and Rafe... mummy misses you every day.

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Re: Henry- the ongoing saga continues...

Post by sati18 » Sat Jun 04, 2011 7:09 pm

aaaaand i lef it too long to edit before remebering to listen to your video :oops: eeeek i'm filling your whole tread up by myself!! that sounds to me like a nasal raspy sound.... pure instinct but i don't think it's all scarring just yet. defintiely keep him on the antibiotics for a month, see about getting his skin infection undr control, and see where that leaves him. it doesn't to me sound hugely wet so maybe not diuretics, although a vet listening to his lungs can probably tell you more whether fluid is present. you could try asking for a bronchial dialator such as corvental or ventipulin, to try to open up his airways which may make it quieter as that *sounds* laboured to me.

alternatively if you think that might push the vets over the edge with the meds requests, you could go to a human pharmacy and ask for childrens sudafed which will do the same thing (contains pseudoephedrine, a decongenstant)- don't tell them its for a rat though!

right no more posts i promise this is getting embarassing! :o
Proudly owned by the big boys (Jeff, George & Toby) and the babbies (Sid & Ozzy)
RIP Monty, Emile, Leo, Angus, Otto, Remy and Rafe... mummy misses you every day.

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Re: Henry- the ongoing saga continues...

Post by annc » Sat Jun 04, 2011 9:27 pm

I'm glad the Baytril/doxycycline combination seems to be helping his respiratory problems. Did the vet say that to get full effect they should be given at least an hour apart? There should also be an hour either side of the doxycycline without milk products, Dr Squiggles or other calcium-containing supplements. On the other hand, in the window between he could benefit from a probiotic supplement - either one for rats or Activia or similar.

As regards the baytril burn, when Roland had a really bad one I was recommended to use aloe vera gel - unless there is any pus, in which case another antibiotic, probably applied locally, would be indicated.
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Re: Henry- the ongoing saga continues...

Post by izzerie » Sat Jun 04, 2011 10:47 pm

Sati you are a star :) thank you so much!

I am definitely going to be asking for a combination of all three antibiotics- the poor boy is having to fight possibly two infections at once and needs all the help he can get! I have even written down how much more we'll need to ask for to finish a four week course. :oops:

The idea of staph being the root cause of both his back and his respy issues is interesting- surely one of the antibiotics would help both though if this was the case? Or is it more the location of the infection that would determine which antibiotic would be suitable?

His back wound doesn't really look like those pics, it's hard to describe. This is an old pic but it looks pretty much the same this time around, it's just bigger now.
http://i269.photobucket.com/albums/jj49 ... 9b0bef.jpg

His breathing probably sounds laboured in the vid because I had just clean his back and syringes baytril into his mouth so he wasn't particularly happy with me! I will keep an eye on it though and will ask for the meds you suggested if I am concerned.

Thanks for the advice Ann- I was previously using aloe vera gel but the vet gave me dermasol and told me it would probably be better for him. Could I apply some aloe vera gel after the dermasol has soaked in?
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
At the bridge: Henry & Rupert

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Re: Henry- the ongoing saga continues...

Post by sati18 » Sun Jun 05, 2011 12:29 am

when i say all linked i mean, maybe his original facial wound got infected with staph, which compromised his immune system, which meant the baytril burn got infected. Which further trashed his immune system, allowing mycoplasma already present in the lungs to flare up in a very nasty way. Even if the facial infection was a different bacteria the progression fits i think. Although is just a theory. :) but with this many multiple infections his immune system must be in a very bad way. I wonder if there could be an underlying factor or something thats making it weaker apart from the infections. Maybe a deficiency of some sort... Just speculating tho. Good luck with the vets please keep us posted. :) edit. Just looked at that photo... Do a forum search on staph infections there were definitely ones that looked like that too x
Proudly owned by the big boys (Jeff, George & Toby) and the babbies (Sid & Ozzy)
RIP Monty, Emile, Leo, Angus, Otto, Remy and Rafe... mummy misses you every day.

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Re: Henry- the ongoing saga continues...

Post by izzerie » Sun Jun 05, 2011 6:59 am

Ah, I see what you mean :) that would make perfect sense!

Poor little guy, his immune system must be in tatters! I know how that feels, I completely trashed mine as a teenager and it has never recovered fully- I used to never get ill and now I get everything going! Thinking of boosting his immune system, he is having supplement in his water (the P@H equivalent of Dr Squiggles), malt paste twice daily and I've just had some poly aid turn up; I ordered it when he was much worse than he is now, is it going to be of any benefit now? Is there anything else I can do to boost his immune system for him?

Shall do a forum search for staph :)

Sati, you are seriously amazing, I don't know what Henry and I would have done without you!!! :D
Albert, Annie, Matilda, Sidney, Ivan, Mozart, Samson, Pablo, Tabitha, Rose, Violet, Hettie, Billy, Horatio, Flash, Atlas, Bentley
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Re: Henry- the ongoing saga continues...

Post by annc » Sun Jun 05, 2011 8:13 am

I should think using dermisol and aloe vera at separate times could bw a good idea.
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