Sunday, May 18, 2014
Twice in One Week: Bela Diagnosed with a Lung Tumor
On Friday, Bela went in for her second recheck for a respiratory infection. I had caught it early and brought her in three weeks ago at the first sign. We treated her aggressively with Baytril and Doxycycline. At her one week recheck, she was much improved. The second week of treatment, she was fine. The third week, her symptoms returned - this time, worse and persistent, despite still taking the antibiotics.
After listening to her lungs, the vet decided an x-ray was necessary. When she returned with Bela, she had bad news for me. For the second time in one week, I had brought in a rat for a respiratory infection, only to find out we were dealing with a lung tumor.
You can imagine how surprised and heartbroken I was to get this very same diagnosis, not once, but twice in just a three day period. Bela's tumor is less advanced than Casper's and she likely has more time, since it was caught earlier. We are treating with a steroid (Prednisolone), plus doxycycline to prevent secondary infections, since the steroid weakens the immune system. We also decided to try the same for Casper, although his tumor is more advanced and the steroid is something of a Hail Mary pass.
How Common Are Lung Tumors? Should We Do More X-Rays?
The shock of having two lung tumors diagnosed in one week got me thinking. I had always thought this was not a very common problem. I knew it could happen, but it is not the first thing I would suspect when a rat comes down with respiratory symptoms. I have now had three rats diagnosed with this problem - each time it was caught on an x-ray. It makes me wonder how often this is missed because no x-ray was performed. It made me wonder about Mystery, who passed from chronic respiratory problems. After a while the meds didn't help. Had we done an x-ray, would we have found a tumor there, as well?
My experience is making me wonder if we shouldn't do x-rays more often. Not for those initial mild symptoms that are treated effectively without much fuss. But maybe for those rats who have frequent recurring respiratory symptoms. Maybe for those who stop responding to the antibiotics. Maybe, before we go to all the stops with various meds and trying this and that, we should do an x-ray.
Bela's initial diagnosis of respiratory infection was, in fact, correct. However, the respiratory infection had occurred secondary to the tumor. When given meds, the respiratory infection cleared up rather quickly, but because it was just a secondary problem, the root cause being the tumor, the symptoms returned and the meds were powerless to help.
X-rays always make me cringe because I know they come with a cost. But with Bela, I am thankful that we did it early. Catching a tumor at this stage has saved me several recheck visits, along with more antibiotics and higher dosages of those meds. Doing the x-ray early actually saved me quite a bit of money, and early diagnosis means there is a chance that the steroids will stall the tumor growth and we will get more time. I also am prepared for what will inevitably be coming.
Don't Skip the Vet
This diagnosis is a reminder of why it is in our rats' best interest to NOT throw antibiotics willy nilly at every wheezy rat, but instead, to see a vet when they become ill. I know there is a whole community of rat lovers who will treat respiratory infections at home without the guidance of a vet. I know there are ways to get prescription medications illegally online or to use medications meant for a different species in an off-label way, or to just save leftover medications to try to treat yourself. I choose not to go this route. Everyone must make up their own mind, but these are some of my reasons, and if they influence others, that is great, and if not, at least you go into it aware of what is at stake.
Risks to You and Your Rat
Home treatment without the guidance of a vet carries risks. You are at risk of using meds that have expired, that are unsafe, or even not what is advertised. You are at risk of making an error in the dosage calculations. Some medications are safe for some rats but not for others. For example, Baytril is unsafe for rats under 4 months old because it can cause cartilage problems. Vets are better educated in these special cases. Most of all, you are at risk of treating for the wrong thing or with the wrong medication. While you are doing that, your rat is getting sicker; his prognosis, worse. When you finally do see a vet, it will cost you more money and will be harder to treat. We always assume that respiratory symptoms are caused by respiratory infections. But as I have seen, that is not always the case, and even when it is, respiratory infections are opportunistic infections that often crop up secondary to another health problem. For example, Pirate developed a respiratory infection secondary to salmonella poisoning. Treating the secondary problem doesn't do much good if you don't treat the source. Treating yourself and getting something wrong is a waste of money that will only lead to spending more money down the road, risking the health of your rat as the actual problem goes untreated for longer.
The other thing to keep in mind is that rampant consumer use of antibiotics without the guidance of a vet leads to antibiotic resistance down the road. I have seen this already happen in the bird world, where many antibiotics are legally available for consumer use. Many of the broad-spectrum antibiotics carried by pet bird suppliers now have absolutely no effect on anything. They have been overused and misused by too many people over too long a period, and everything out there is resistant to them.
To replace these now useless antibiotics, pet bird supply vendors are starting to carry more potent antibiotics, and one of those is Baytril (intended for use in chickens, but sold by pigeon supply stores, and now pet bird suppliers, and marketed to pet birds). This concerns me. When consumers use antibiotics, there is inevitably a large portion of the public who use them incorrectly. They will use them for the wrong thing. They will use the wrong dosage. They will use it for the wrong period of time - stopping after symptoms resolve or stopping when it doesn't seem to be working. They will use it too often, when not even needed. It is not uncommon for a rat to be a little sneezy just because of environment (allergies, new home sneezes, dusty bedding). The more available antibiotics are to consumers, the more consumers will throw an antibiotic at every little dry sneeze. They will use it preventively or as a quarantine measure. You may not be that person, but you can bet than there are many out there who are, and they spoil it for everyone. The bird community has proven it to be true. It would be nice if everyone was as knowledgeable as a vet with regard to diagnosis, dosages, and proper use. Unfortunately, even when we have mastered the latter two, the first will always be trumped by an experienced vet, and many, many people will get all three wrong.
The Emergency Vet Fund
I know it happens sometimes where people end up in tight situations where they just cannot afford a vet, and then they feel they have to resort to home treatment. I never have any advice for this situation. The truth is, if you are truly in that spot (no money to be had anywhere, no credit, nothing to sell, no way to earn money, no one to borrow from), it is too late. It does no good at that point to say, "Well, you should have done XYZ" because we can't go back in time and fix it now. Instead, I offer advice for everyone not in that situation today, with the hope that there will be fewer people in that position tomorrow: Start an emergency vet fund now, even if you don't have rats yet - in fact, that is when you should start the fund - before you have rats. Fund it generously. Never borrow from that fund . . . ever! Remember it is an EMERGENCY vet fund - don't use it if you don't have to - pay your vet bills from your regular budget if that is an option. Replenish that fund in a timely manner before it is needed again. Apply for Care Credit if there is a chance you ever might need it, so that you can finance a vet appointment now and pay it off gradually should the need arise. The only good solution for this problem is to take steps now to make sure you never have that problem. It is like the movie War Games: The only way to win is not to play. Unfortunately, if you don't take those steps before they are needed, it is too late once you end up there.