Respiratory infection-youngster not responding to treatment

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vegan_jen
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Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Mon Aug 01, 2011 12:31 pm

So sadly both Ratty and Bella who I adopted last year have both passed on despite treatment. The three young girls I adopted since then are all now ill. Being that symptoms appeared at 4 months, they were started on Baytril, which has been reasonably successful in Coco and Jinny (though symptoms return if I stop treatment), but Shiloh is much worse. She has been on a combination of baytril and ronanxan (and bisolvin and prednisorone- a steroid anti-inflammatory) for two weeks. No improvement. When I adopted Ratty and Bella, Ratty was already at the very noisey breathing stage-she only survived four months despite aggressive treatment with various antibiotics. Eventually she developed pneumonia and had to be put to sleep. I am scared the same thing is going to happen to Shiloh. That's a horrible way to die and an awful thing for us to go through. I want to prevent that happening. Also she is so young. Ratty and Bella were over 18 months when they were at that stage-Shiloh is barely 7 months old. She should have a lot of life left yet :(.

I have read on some sites that you need to continue treatment for 6-12 weeks-but then again that you should see improvement within 3 days. I'm not sure what to do with Shiloh, whether to continue with this treatment or whether to try something else. Either decision has a risk of allowing things to get worse. Baytril and Ronaxan is supposed to be the most effective/most powerful combination. So I don't want to "down-grade" to something weaker-but at the same time, if this isn't working I don't want to sit by and let things get worse. IS there anything else that can be done/tried? Unfortunately septrin didn't work for Ratty, and I think the other one we tried was Ceporex or something like that for Bella. Baytril+Ronaxan seems to be the best, but what do you do when that doesn't work? :(. Off to the vet now (been going in with my rats every fortnight since November last year!!). Unfortunately the vet I had been seeing has unexpectedly left, so we have to get to know a new one.
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by Neotoma » Mon Aug 01, 2011 6:28 pm

I'd try draaxin in that situation (it's a relation of zithromax, but more effective). It's an injection, once a week for 3 weeks (or longer if necessary), and you can carry on giving doxy in combo with it (not sure about baytril). I've had generally good success with it. The only caveat is it's a farm drug, so your vet might not carry it if they don't do agricultural work. If they won't give it then you could try zithromax.

Thing about baytril and doxy is it is one of the best combinations, but if you've been using it in a group for a while, then resistance will build up. I've found that resistance is 'contagious' (presumably because rats in the group are continuously passing bug strains between themselves), but also relatively short-lived. So when one rat starts showing resistance to one drug, I change to something else for everyone who needs treating in the next few months.

I'd also think carefully about how much benefit the steroid is giving - my vet considers them pretty much kill or cure, as on the one hand they reduce the inflammation in the lungs, but on the other, they can also have a suppress the immune system, which isn't great if you are dealing with an active bacterial infection.
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Re: Respiratory infection-youngster not responding to treatment

Post by sati18 » Mon Aug 01, 2011 7:10 pm

^^ she talks a lot of sense. Steroids do depress the immune system so in a youngster i would switch to metacam which is an anti inflammatory like ibuprofen. it can help to reduce inflammation without effecting the body's ability to fight. the other thing is that mysoplasma is a chronic disease- in very young rats it's apparently mroe likely to be a different organism. baytril and dxy are very effective against myco, but less effective against many other organisms. i wuld suggest covering the myco aspect with either zithromax, erythromycin, or draxxing (if as neotoma says it is related to them) and try septrin 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: Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Mon Aug 01, 2011 11:02 pm

Thanks guys. I have suggested zithromax, erythromycin, draxin and metacam in the past. The vet that was treating them wouldn't give them any of those. With the first two I think it was because of the danger of fatalities. With Draxin I don't think they carried it and it was going to be reserved as an absolute last resort due to the stress of the rats being injected-it's not a nice thought. I can't remember the reason she didn't want to give metacam, I think she said prednisolone was more suitable. She did mention it supresses the immune system a bit. I don't give it daily, it's something I reserve for when breathing is more visibly laboured. In the last couple of months of her life, Bella had asthma-like attacks (due to lung damage). The prednisolone was fantastic for that. It defiently does seem to make them more comfortable. It helped Ratty stay happy and active in her last week. I think because we had successfully used it in the past, she wanted to continue with it.

Unfortunately the vet I had been "training", who has been treating all the girls for many months has suddenly left! So I need to start all over again with a different vet. Went in today, unfortunately the man we saw had absolutely no clue about myco! Couldn't recommend any medication and couldn't even confirm what it was. Not a helpful trip (and all the rats find it a bit stressful). He wants Shiloh to be gassed and x-rayed (£40!) in order to make a diagnosis. Personally, I think it's pretty obvious what the problem is considering all the rats have suffered from it to varying degrees and have been being treated for it for some time now. I am thinking of going back and trying a different vet :-?

The only upside of a new vet is that I can suggest those medications again and see what the opinion is.
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Mon Aug 01, 2011 11:34 pm

Hmm having done a bit more reading, perhaps it might not be such a bad idea to get an x-ray after all. I think mostly I am concerned about the stress it will cause Shiloh. All three of the youngsters are quite timid and skittish (and BOLT at the drop of a hat). I'm not too confident about strangers handling her..I did mention that to the vet today, he said "just make a note of that when you bring her in", fair enough, but as a worried ratty-parent it doesn't alleviate my fears (I think I'm one of those over-protective "mothers" who doesn't trust anyone else to look after my babies properly lol!-I just know how they are, it's taken a long time to earn their trust and build their confidence). So unless an x-ray changes the outcome of the medication she is given, I'd like to avoid it. But then this particular vet wouldn't comment on treatment of any kind without doing an x-ray (but then honestly I think that's because he doesn't know-he said he was going to have to ring and ask about what medications to use).

She obviously has a respiratory infection-but can you diagnose the type of respiratory infection by looking at an x-ray?

To x-ray or not x-ray, that is the question!

Thanks guys x
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by sati18 » Tue Aug 02, 2011 11:14 am

I don't think so- Xray shows objects and spaces by density so it'll show you that something is in there and where it is (as far as I know, iand how thick/dense whatever it is but as far as i can think the onyl way to find out what organisms are causing infection is to do a swab and cuture. So it would tell you if she had lung tumours instead of an infection, but it won't help with diagnosing the type fo infection if that's what she has.
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: Respiratory infection-youngster not responding to treatment

Post by Neotoma » Tue Aug 02, 2011 5:18 pm

An x-ray might show if it's fibrosis rather than infection, should show up any abcesses or masses etc, and might give the location / extent of the inflammed tissue - but I don't think it will tell what strain the infection is. It's not something we've ever done - and tbh, since giving gas to a rat with resp problems isn't at the top of my desirable list, it's not something I'd do without a very definite useful outcome.

I've not heard of fatalities with zithromax - I've used it on and off for years now without a problem and without the vet being worried. Admittedly when I first suggested it in the days before my current vet, the then vet did suck her teeth and refuse. But the current exotics vet has no problem at all - so it might depend on how much knowledge of rats they have.

Some vets are reluctant to give metacam because it can have an adverse effect on the kidneys. This isn't something to ignore, but on the otherhand, in a case of active infection, I'd consider it the less dangerous option than a steroid. Steroids are good for managing inflammation in late stage resp disease, but not something I'd use routinely when trying to clear the problem rather than just ease incurable symptoms.
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Re: Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Tue Aug 02, 2011 7:07 pm

Ah yes kidney risk, I remember that was the reason now. I think that scared me off it at the time.
Bella had an x-ray (for which she was gassed-apparently only a "whiff"). I was so scared before hand, but she was fine. Her x-rays actually came back a lot clearer than expected. The vet had predicted that from the sound of her lungs there must have been a lot of damaged tissue resulting in reduced lung capacity and she probably didn't have long left. However the pictures came back pretty clear, with a lot less damage than expected, which was a lovely surprise. I think she lasted 2 or 3 months after that.
Bella was over 18 months at the time of x-ray, so I am less worried of the risk to Shiloh, but again I don't want to put her through any unnecessary stress as I'm not sure whether an x-ray will be greatly helpful...I might ring and ask if it's possible to get a swab done while she's out, then at least we'd have a full picture. I don't know if that is possible (or how much it would cost!), but I don't want her to have to be put out twice.
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by Neotoma » Tue Aug 02, 2011 7:17 pm

I think the question to ask is whether what you find out will actually tell you anything useful. For example, I wouldn't do an x-ray to find out the extent of fibrosis, because there isn't actually much you can do about it - it's either there or it's not, and my knowing doesn't make any difference. Ditto with swabs - I'd only do them if the results will be reliable, and if they will tell you something that makes a difference to treatment.
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Re: Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Mon Aug 08, 2011 12:58 pm

So I saw a different vet-she agreed there was no need for an x-ray! She contacted an exotics vet who has dealt with respiratory infections before. He advised the use of Tylan , a water-soluble anti-biotic (usually used for cows, pigs and chickens). I expressed my concern about using anti-biotics in the water (as in you don't know how much of a dose they're getting). Apparently the dose is worked out so that if they only drink the minimal amount of water you would expect a rat to drink, it's still strong enough.

I didn't want to use it and suggested the alternatives (e.g zirthomax etc), but she insisted we give this one a go on the basis that the exotics vet had had success with it and "would know more than people on the internet"!..So I have given it a try, but asked her to look in to the alternatives. 100g tub cost £30!!!!! She also didn't want to use any sort of anti-inflammatory for such a young rat (and was absolutely against metacam).

I mixed it up according to instructions (half a gram to 1 litre of water).The rats wouldn't drink it...So I tasted it (and spat it out). It is absolutely disgusting. Really very bitter-no wonder they won't touch it! I added a teaspoon of sugar to their little water bowl (which is a LOT of sugar, probably proportionately like a bucket to us!). Coco and Jinny seemed to like it, but Shiloh (the one who needs it!) still would barely touch it. I have also mixed some with fruit squash instead of sugar, but no success there.

Unfortunately I think Shiloh's breathing actually sounds worse (as she has effectively been without any antibiotics for 3 days-today will be the forth). I also worry she will be dehydrated if she doesn't drink enough. I'm not happy at all. I am awaiting the vet to call me back for advice on what to do next.

I really want to give her the baytril+ronaxan again just in the mean time until I can get something else, but obviously I don't want to do that without veterinary approval in case it's not safe to mix with Tylan (even if she only has a small amount in her system).
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by Neotoma » Mon Aug 08, 2011 4:30 pm

Yep, I wouldn't mix ABs unless you know what they are.

The other problem with ABs in water (apart from the rat in need not getting the right dose), is that the rats not in need are also getting a random dose - which is not exactly ideal.

I know she's not going to believe a random person on the internet, but my advice is all directly culled from my vet, who is also an exotics specialist (a very very very good one, in my opinion). In a serious rat who is not responding and deteriorating, we would now go straight to draaxin by injection. But zithromax is a reasonable alternative (same family, so same basic action).
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Re: Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Wed Aug 10, 2011 5:53 pm

I have been told I can use baytril at the same time, so that's some comfort. I expressed my concerns that Shiloh wasn't drinking enough due to the taste, but the vet insisted that I try mixing it with apple or black current juice and persevere for a few days. It still tastes absolutely foul! I'm not sure how much she's getting but there certainly hasn't been any improvement. The vet told me to ring again tomorrow for an update.
We're not concerned about the other girls drinking it as they show symptoms on and off, so the vet wants to blanket treat them all to prevent them passing it back and forth with one another. Thankfully Coco and Jinny seem alright at the moment.
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by vegan_jen » Fri Aug 12, 2011 10:33 am

No improvement, and Coco is starting to sound respy now (though she has on and off in the past weeks-but a sad development considering she is also on baytril+tylon in their liquid!). Unfortunately I missed the call from the vet yesterday, but the message was that since there has been no response to ABs, the vet wants Shiloh to have an x-ray and swabs before trying any further ABs. The thing is, the reason the Tylon has had no effect is because Shiloh won't drink it!-So of course it hasn't worked! I am very frustrated that she refuses to give me Zirthomax. She's not in again now for advice until Monday, but that's a few days of worry. There is no other vet at the surgery that has any clue about respiratory illness in rats, so it would be pretty useless trying to see another one today :(.

I am annoyed that last week I was told an x-ray was unnecessary, yet still paid £40 for consult+meds (that I didn't want!)-and now after those have been useless, this week am told a £40 x-ray + swabs (however much they cost!) is needed. I am struggling to afford it, and I still think it's alternative ABs that are needed.

If she won't give me Zirthomax, I am thinking of asking for the septrin+erythromycin combo, as I have had septrin in the past (not for the current patients). Is erythromycin the name of the type of antibiotic like doxycycline, or is it the brand name? If not what brand name does it go by? Thanks!
:girly: Jinny, Coco, Shiloh :love:
:rainbow: R.I.P Ratty and Bella, miss your cuddles so much xx
Adopt don't shop :D, millions of animals desperately need a second chance at love; we're all they have :hearts: http://www.abolitionistapproach.com

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Re: Respiratory infection-youngster not responding to treatment

Post by Neotoma » Fri Aug 12, 2011 11:07 am

Brand name for doxycycline is ronaxan. Doxy is a tetracycline antibiotic. I think erythromyacin is something else, it's a macrolide antibiotic, and is the parent compound from which various types ABs have been developed - zithromax for example is derived from it.

Are there any other vets practices near you? This one doesn't sound terribly rat informed...

If you have severe resp symtpoms I'd be unhappy about waiting for swabs etc to try alternative ABs, as rapid treatment can make all the difference in survival, and degree of scarring etc.
Alison and the horde of squish :smileyrat:

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Re: Respiratory infection-youngster not responding to treatment

Post by annc » Fri Aug 12, 2011 4:48 pm

Tylan = tylosin, is related to erythromycin, and also has anti-inflammatory effects.

Is it possible to mix it with some honey, blackcurrant or similar and syringe it in, so she is at least getting something?
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