Respiratory Distress continues - Need more advice please! 2/7/2007 - update belo

[LuvRats2]

I will be taking him to the vet today, just as a heads up before I go further - but I'm not sure how to approach this from here. While I've had sneezy rats before or a rat who has choked on food, this was the first time I've truly had to deal with a rat in respiratory distress.

I would like to know if I handled this correctly, from those of you who have been through it please?

My 4 baby boys I've posted about before - Razz/Tazz/Minx/Munchkin are on doxy/zithro right now. Tazz, Minx and Munchkin are still sneezing after about 4 days now on treatment but I haven't heard it bad in their lungs.

Last night Razz had his sneezing but suddenly hit a bad spot and was HORRIBLE. I could FEEL the mucous buildup in his lungs when he breathed at one point. He was making the 'wuffuh' sound as if congested through his nose and then would end in a violent sneeze 'wheeeeza' thing (I know my explanations may not make sense sorry, it was a very long night with him.)  - I could tell he was 'coughing up' the mucous. At one point the mucous was coming up and he was choking on it and started to dash around panicked. At one point he was laying there mouth agape trying to breathe. I kept a close eye on him and after a couple of mins he got it out.

Here are the steps I took - I had a copy of the rat care booklet so I followed that.

1. Had the steam humidifier in the room already - had that off and on the past few days
2. Took Razz into the bathroom and held him, steaming the bathroom up initially for 10 mins - seemed to help a little
3. 10 mins later another attack - back to the bathroom. Put him in his own little cage with fleece, away from brothers so he could stay calm and not be stressed by outside stuff. Tried to give him a piece of dark chocolate and steam again, he took a bite of the chocolate and then started wheezing/gagging mucous/choking for about 3 minutes.
4. Put a Vicks waterless vaporizor with a Vicks pad in it next to his cage on the bathroom sink. Still was wheezing/gagging/choking and labored breathing, although seemed to be with less frequency after a couple of mins
5. Called Debbie 'the rat lady' and explained things - I was told they needed to try amoxi instead of the zithro/doxy
combo and obviously the immediate concern was to get him out of distress. I put Razz in a tupperware bowl and sprayed primatine mist in there about 3 times, kept him in for about 15 seconds. That seemed to help for about 15/20 minutes.

More steaming, episodes got less frequent and less severe but continued until around 2am this morning.
he seemed to cough up quite a bit of stuff and was able to breathe better/settled down - still sneezing and the occasional 'kachew' wheeze but no where near before. Poor little guy was exhausted. Mommy is pretty darn exhausted too.

So from here, I can try to get him on amoxicillin, get some updated primatine mist spray, what else can I do or ask for at the Vets to prepare if this happens again? Was I OK to wait on taking him to the vet this morning, since I was following the steps above first and eventually he settled down? Please help.

LR2

[eastermonster]

Hi there.  I've been lurking on this site for awhile but haven't registered.  I created an account so I could reply to your email, though.  First of all, I'm sorry to hear about your problem!  I lost my two boys recently after a year long battle with myco and the respitory stuff is not fun.

It sounds like much of what you are doing is good, but I wanted to warn you about the primatine.  I started using this after reading about it online on the Rat Lady's site.  It definitely brought my rats some immediate relief, but I wouldn't advise doing this.  After several days of putting one of my rats in a Tupperware with several spurts of primatine, he began to have cloudy eyes.  At first I thought it was cataracts, but after about 24 hours his eyes crusted over with what looked like horrible pussy scabs.  I rushed him to the vet who told me that primatine has the same effect on the eyes as it does on the bronchial passages, which is to dry them out.  So, essentially he didn't have any tears for several days and his eyelid was scratching his eye everytime he blinked.  We were able to correct this with artificial tears and the vet perscribed prednisone which works as a bronchial dilator.  It's not as immediate as an inhalor, but their lungs improved considerably within a few days. I've heard of people nebulizing with abuterol and a special nebulizor and haven't read about problems with the eyes, so maybe there is something specific to the primatine that is irritating to the eyes.

Also, if your rat does have a myco infection, Baytril and Doxycycline used in conjunction seems to be a pretty common and effective antibiotic treatmet.

Good luck and hang in there.  It's good that you are getting on top of this right away!

[scout]

Good information about the primatine! And I agree that you probably want to continue with the baytril/doxy. It's obviously working if he's clearing crud out of his lungs. You may want to add a bronchodilator to his med coctail, something like theophylline or aminophyline. They're bronchodilators and they'll also help dry up his lungs. I wouldn't rush to try the amoxicillin until you're sure what you're already using isn't helping. Here's my favorite article about treating URIs:

http://ratguide.com/health/lower_respiratory/pneumonia.php

And what you did for emergency measures sounds just fine.

[LuvRats2]

Thanks Eastermonster/Scout - I wanted to post an update and get more feedback please. I'm so new to this and I want to make sure I'm stepping through to help Razz best.

Ok, so I took Razz to the vet first thing this morning - he was sneezing, a little wheezing but when the vet checked him out he was ok/stable. Came home. He started to have a gagging/mucousy fit/wheezing bad again. So I took him right back to the vet. I wasn't aware the difference between full respiratory distress (like if he's heaving sides in and out, etc.) vs. wheezing attacks/respiratory attacks. The vet said she thinks it's an URI - he's still eating, playful
when he's not having an episode, and the episodes come and go - he doesn't constantly make the noises. I got him some baytril to take with his doxy now, I hope that helps.

I also noticed, it gets worse at night, and when he's more active. When he goes to sleep around 1amish and
through the night while he still sneezes and it acts up, it's more subdued. About 6pm it starts to act up more, by
this time it's getting pretty bad.

I got a nebulizer this afternoon also with albuterol and the saline solution mix. I gave him his first nebulizing
session tonight a couple of hours ago - I held him against my chest and let the cool 'steam' with the meds
focus across his nose/face. Question - directing the flow of air and meds at his face is OK, right? Should I go more to the side 'across' his nose, or should I face the flow of air 'toward' his face directly? How often to nebulize??

He's still having wheezing/sneezing/mucous fits tonight again. I"m afraid it's going to be a repeat of last night.

I also picked up a pediatric antihistimine and pediatric cough expectorant. I read somewhere that about .01 cc of expectorant might work on a rat about 4 months old with these symptoms - anyone have experience with an expectorant (only an expectorant also, no decongestant or cough suppressant.)

Should I just watch and wait tonight, and let him work through his 'fit' and steam him again/etc. if he starts
gagging violently/running around trying to breathe? Is there something else I can give him/do beforehand??

Thanks so much for any help,
LR2

[Lise]

I'm definitely not a vet, and really what you should do is call your vet and ask him these questions but...

I wouldn't start giving him any OTC drugs.  You never know how any particular drug will mix with the antibiotics he is already on, and you want them to be able to do their job fully.  I would rely on the antibiotics to do their job.

Directing the air straight at his face is fine.  I used a rubbermaid container and drilled a lot of holes in the top for ventilation and to allow the mist out as well as cutting a hole to place the nebulizer mouthpiece into, and then placed the rat into the chamber with the nebulizer filling it with steam.  That is how you would get the maximum amount into his lungs.  But if he is happy to inhale it straight from the hose then by all means keep doing that.  Also, as for how often you should be doing it that is something once again that you should ask your vet.  When I was using a bronchodilator I was told to nebulize 3 times a day, but I have seen many posts on here by people who were instructed to nebulize once a day.

[WS]

You can hold the mouthpiece (or hose tip) of the nebulizer right up next to the rats face and sort of drift the vapor his way but rats often are scared or put off a little by the coldness of the nebulized medication and unfamiliar smell.  I used to use a nebulizer tent (which I'll describe) but now I hold them and keep putting the mouthpiece by the face... not right in the nose... but close to the face no matter which way they turn their head... I can't describe this well... but I've figured out a way to pet and cuddle so that this isn't a trauma.

Take a small wire travel cage (the smaller the better... your rat will try to get away from the sound of the nebulizer machine and from the smell of the meds)  and  get a cardboard box lid that is deep enough to accommodate the mouthpiece of the nebulizer cup in a hole cut in it.   (You don't need the whole mouthpiece that comes with the nebulizer sets... just the part where the mist comes out is fine)   Prop this box lid against the cage so that the nebulizer set (cup) is upright and making a mist.  Cover the lid and the cage with a towel to hold the mist in during treatment.

Albuterol Sulfate comes in ampules that you'll mix with sterile saline so make sure your vet gave you good instructions on how to do that... it is a very powerful medication that can have serious effects if given too often or in too high a concentration.  I have nebulized 3-4 times a day depending on the weight and age, etc. -- so ask the vet how often you can do the treatments in a 24 hour period.

I generally don't recommend the use of over-the-counter human cold medications at all unless approved by your vet (There are certain classes of medication that your vet may prescribe in the children's formulation --- but this should ONLY be done by your vet.)  -- Cough suppressants and decongestants shouldn't be given. An expectorant agent that thins mucous secretions is something to discuss with the vet--  too much can cause a complication of its own that is dangerous with bronchospasm and with damaged lung tissue (from infection) --etc.  so be sure to check the dose and type with them.  Antihistamines too can be sedating or stimulating and can interact with the Albuterol.


You are taking such good care of little Razz.  Good luck
-- Night-time is a hard time.  Another bit of advice is to keep him very warm and cuddled up with fleece-y cloth and stuff like that. Make sure he is getting plenty of hydration and nutrition too... sometimes when rats have real trouble breathing they have a hard time drinking or eating so you might have to give him some watered down sweet liquids or juice or Ensure. (Milk is not recommended w/ doxycycline in big amounts) ---

[eastermonster]

This is all great advice.  I just want to add that you should keep an eye on Razz's lips and feet.  If they turn blue then he needs to get in for an oxygen treatment ASAP.  This happened a few times with my rats and the O2 helped considerably.  You sound like a great ratmom, and I hope both you and Razz get some rest tonight!