We saw the vet, got some fluids and meds, and were sent home with 5 days of medication.
Injections administered: sub-q fluids, Meloxicam (5mg/ml Bymg), and Metoclopramide (5mg/ml per MG)
Take-home: Metacam 1.5mg/ml given .25ml twice a day for 5 days, Cisapride 10mg/ml given .04ml twice a day)
Fergie hasn't really improved since then....she has eaten no pellets yet today, and fights a lot on the critical care (I guess it's a good sign she still fights, right?) She ate her lettuce with breakfast but left behind bell pepper which is unlike her. She's eaten some hay, and some dried corn husks, but no real food. After I had her out of the cage for 15 minutes on the vibrating pad, she demanded a reward for her patience. I held the bowl of bell pepper out and she took 2 (cut small, like chopped that you'd put in a recipe), but has only nibbled the edges and left them there. She's puffed up and her abdomen seems about the same size as yesterday, not smaller.
I left a message for the vet asking how soon we should see results with the medication - In some cases I heard 2-3 days? I am verifying with Dr. Nakamura. Do you guys have any guidance or anecdotes?
Also I saw on some of the bloat articles & threads the over-the-counter gas medication for children. I forgot the name now so I'll go look that back up. But that's safe to add with the above medications, right?
I think I may have been part of the problem because I mixed in some pureed pumpkin with her critical care to make it more appealing. For a bowl of critical care I would add maybe a tablespoon or two of pumpkin, and then a lot of water. The change in her diet and added fiber/carbs could have upset her and created this issue so now i feel terrible. A lot of people seem to use that in their CC but I won't use it going forward. I'll revert to what I used to do, which was blend bell pepper, lettuce and cilantro into water and use that suspension to mix her critical care. It gets the flavor in there so she fights less, and is in line with her regular diet. I stopped by the store today for fresh veggies and blended the "juice' and then froze it in 1/4 cup amounts so I can pull them out and defrost as I make a new batch of CC every day or two.
Hopefully you would clear this with Dr. Nakamura first. I don't know if any organs might be fragile. I am hoping she can get over this. Please do not blame yourself. It is always hard to know exactly what causes bloat - and once it has occured, it is more likely to recur.
They did x-rays and on top of all this she also seems to have gunky lungs, so we got Baytril added to the mix. It also showed the gas had moved from stomach to the cecum which was good, at least it was moving along, but she was still pretty bloated. So we've been using the massaging pad and she's OK with that. I've been putting her on it ~15 minutes of every hour when possible (only did it once during the night, so both of us could get some rest), and working from home yesterday and today to keep an eye on her.
I am happy to report this morning she had a big pile of beans in her cage (separated for now to monitor food, poo, etc). I've never been so happy to see a poo pyramid, ha! And she wheeked quietly twice this morning as my husband was sweeping the cage, because she knew breakfast was coming. We are thrilled!!!
Also for the gentle massage we did discuss that with Nakamura and Dr. Blackwolf at Adobe, both said it's good. You don't dig in, just a gentle pressure if they can tolerate it. The pictures shared in the post are really helpful, thanks for sharing!
She just kept deteriorating and her weight kept dropping. She fought really hard against critical care and would spit out as much as she could (~ half) of what little I could get in her mouth. So back to the vet we went. She spent all day hunched in a ball near the hay rack or in the corner of the cage, not in her usual spots, and her breathing kept having really scary patches. So 2 days before Baytril ended we saw the vet again.
New x-rays show her lungs are worse than before, not better. They think it's either pneumonia or lung cancer. She's too weak right now to be anesthetized for an aspiration to see if we can get a culture or determine if it's lung cancer. If it's cancer we could skip the antibiotics and any potential side effects and just keep her comfortable. But if it's an infection we can treat it more specifically.
So, given that wasn't an option for her in her current state, we settled on TMS instead of Baytrill and she's on a 3 week course to start with. We will re-check in 3 weeks unless she gets worse before then. Her right lunch is completely fully of gunk, her left is about half full. She just looks so miserable but then when I pet her or give veggies, she perks up, the lgiht comes back into her eyes, and she's totally "Fergie". So I don't know what to do...I feel bad she's so miserable for a significant chunk of each day but then she rebounds when I interact with her so I don't feel she's ready to say goodbye yet.
I don't know how we got here, and frankly I'm pretty upset. We've been to the vet weekly for the past months, thousands of dollars in vet bills (especially with her cage-mate Astrid also having some concerns lately and a small surgery), several x-rays. How could they not have found this sooner? I brought up my concerns about her breathing repeatedly. But I'm trying not to focus on that - people make mistakes, things can be missed, etc. But it's frustrating to feel we've let her down and not focus on what else could have been done to prevent getting to this level of deterioration.
Anyway here are her x-rays, I circled the lungs. The white cloudy part is all the infection/cancer (orange), and the black part is air. (green circled area). Obviously they should be primarily black and full of air but they aren't. I'll also link to a video of her labored breathing, because it was kinda hard for me to find examples of that when I was researching.
<a data-flickr-embed="true" href="
She continues cisopride to help with any potential tummy upset from the antibiotics and to help alleviate the remaining gas in her system, she has metacam 2x/day for 5 days then as needed, and TMS for 3 weeks with new chest x-rays to reevaluate then. Until then the doctor recommended avoiding syringe feeding to reduce the stress on her so she doesn't further tax her lungs, and to monitor her weight daily. She was maintaining at 835 for several days so I stopped weighing her daily. 4 days later when I weighed her during cage clean she'd drop to 755g.
I am just so exhausted fro mall of this, and so sad to watch her suffer, but I'm hoping she'll pull through...
And if you'd like the xray added permanently to your thread, I can do so and remove the miscellaneous text.
Excellent, thanks Kimera!
@Lynx - thanks. I'll try that on her chest and see if it helps. It's been 6 days so far, so I don't expect big changes, but she still spends most of the day with her face pressed to the side of the cage and puffed out :( She did have a good day on Friday, sniffing around, sleeping in her usual cozy cave, and standing up on the edge of the cage begging for food even when it wasn't breakfast/dinner time. So it made me really happy and I hoped she was improving but today was a bad day. So, we'll see.
She keeps dropping weight, down to 709 today, so I started syringe feeding her again. Thankfully she didn't fight this time, so I am very grateful for that and will keep it up. It's so hard to balance "don't stress her out" and "don't let her lose weight" when they totally conflicted!
Emailed our vet, and recommended sticking with TMS and cisopride, and adding back in the metacam. Also going to pick up bene-bac to add to the mix, which he approved.
Question: He called this 'walking pneumonia' which from what I can gather via forum research and a bit of Google searching today is the Mycoplasma noted. I read through various threads for ~2 hours today and over and over it seems oral doxycycline or a g-named medicine administered by nebulizer are the only real solutions to true mycoplasma.
Fergie had a nasal culture this summer which was negative for anything (though, again, mycoplasma on the forums seems to indicate a false negative may be common). She had blood work done in the past couple of weeks and nothing came up - but I'm not sure if they tested for mycoplasma which it was noted by Lana is the only way to truly diagnose it in rats.
Also noted that myco is slow progressing; Fergie was a bit lethargic all summer and has coughed more, but we went to the vet repeatedly and were assured she was healthy. Kicking myself not for letting my fear of being "that mom" get in the way of pushing for more answers. After reading so much today I feel pretty convinced she had this all along and it's been festering and I could have done so much more to help her.
So I guess my questions are
1) Is it common to be on antibiotics for 7+ days with no discernible improvement?
2) Has anyone had success using TMS for myco? I saw plenty of references to bactirm/baytril, but didn't see TMS noted.
3) How was mcyo diagnosed for you? Our vet seems to have based it off of symptoms and lack of improvement after Baytril and her summer round of antibiotics when they initially diagnosed her with Rhinitus. [/list]
All of us are running a bit ragged over here from all of the care for Fergie, and cage mate Astrid (separate issue - lump on her face), on top of work demands and travel lately. I feel so bad for her, I just want to see her running around being a diva again.
I think I'm going to go to another vet for a 2nd opinion. I called the rescue and got guidance on other good vets they've used, as I've only used Adobe Animal Hospital to date and want to go somewhere truly independent for a 2nd opinion.
Fergie also leans a lot to one side to alleviate the pressure from the bloating - one side of her tummy is more swollen than the other, and she doesn't lean on the foot on the swollen side. So now the foot she leans to looks weird and is also developing sores.
I made an appt with Nakamura for Friday to look at her foot and get some wipes, and to ask more questions about the improvement and myco. My gut just keeps telling me we need to be doing something else but it's also hard to second guess someone who is so well known and respected, and I don't want to offend him. But I just feel like this isn't the right course so I need to get a second opinion to make myself feel better about either course of action - either pushing back harder on him, or feeling better about following the current guidance.
It's tough being a piggy servant!
The odd thing is her left foot was cold when I touched it, but her right foot with the sores was normal warmth. Given that she's OK with me touching it though, I'll try adding in some gentle massage to her ever growing list of special needs! Thanks for the advice, I hadn't thought of it but it makes sense.