Medical Corner: Rat Respiratory Disease: The Use of Albuterol Treatments
From the July/August 1999 Rat & Mouse Gazette
For the last 1-1/2 years, I have been using albuterol breathing treatments to help treat my rats with pneumonia. Albuterol is one of the medications used in the treatment of human asthma. I have found this to be very helpful in treating my rats, and have not lost one under age 2-1/2 to respiratory problems since I started using the treatments.
I thought this might be something other rat lovers would be interested in knowing. Just a note of caution though, I do not have any research to back this up, and I am not a vet. My vet could not find any information on the use of albuterol in rats, but due to the extreme need of one of my rats at the time, she gave me a prescription for albuterol to use with my best judgment. I am a registered nurse and have used albuterol in many settings, including pediatrics, and Neonatal intensive care units. I arrived at my treatment plan using the dosage of albuterol frequently prescribed for premature infants.
My first rat to receive an albuterol treatment was Louis, a big Fawn Hooded, sweety boy. We were battling a long-term chronic outer ear infection in Louis, or so we thought. One night (of course at night) Louis started gasping. He got sick very quickly despite being on Baytril and Doxycycline for his ear. I took Louis to the emergency vet clinic, where they tried to convince me to put him to sleep. They ended up giving Louis an injection of Gentamicin and a subcutaneous fluid bolus. I took him home and spent the night in a steamy bathroom with a very sick rat. The next morning I took Louis to my regular vet. She put him in an oxygen cage, started him on Amikacin and gave another fluid bolus. At the end of the day, when I went to see him, Louis looked worse. The vet and I were thinking maybe this really was it. I did not want to give up though without trying everything.
I had brought the nebulizer home from my clinic in anticipation of discussing the breathing treatments with my vet. Even though she did not have any first-hand experience using albuterol treatments in rats, she did a little research, and did not find anything that said the treatments would be contraindicated.
I got the prescription filled and gave Louis a treatment as soon as I got home, at about 5:30pm. I followed the albuterol treatment with a treatment of nebulized Amikacin, an antibiotic. He was a little better at midnight when I repeated the treatments. The next morning was pretty amazing; Louis was eating and drinking and while his breathing was not completely quiet, it was much less labored and he was no longer gasping.
We found out that Louis, unfortunately, had a malignant zimmer gland tumor. This caused his chronic outer ear infection. After his bout with pneumonia, the vet cultured Louisí ear, and it grew pseudomonas. Pseudomonas is a very difficult bacteria to treat and is usually only found in immunocompromised individuals. Iím sure the pseudomonas also caused Louisí pneumonia. Louis died about two months later. Despite having a terminal disease and a chronic infection, Louisí last two months were comfortable and pleasant, I believe, largely due to the nebulizer treatments.
Since that time, I have used albuterol nebulizer treatments with several other rats. All have gone on to live to ripe old ages. The only exception is Sara, who succumbed to a pituitary tumor about five months after her bout with pneumonia.
She was 18-months old when she died.
Iím currently using albuterol treatments on my 40-month old girl Luna. Luna no longer has active infection, but she has significant scarring on her lungs. In December, Luna started having some gasping panic attacks. I started her on twice a day albuterol treatments and the panic attacks have stopped, as has most of her wheezing. Luna loves to sit and have her head scratched, and has come to be pretty accepting of the breathing treatments. I think she knows they help her.
ABOUT THE EQUIPMENT
To do the breathing treatments you need to have a nebulizer machine, tubing and a nebulizer set up. The machine will cost anywhere from $80.00 to $150.00 depending on model and manufacturer. Used machines are frequently available at much lower prices. Another option would be to get a group together to split the cost of the machine. Everyone would need to have their own set-up to avoid cross-contamination, but the set-ups are inexpensive ($3-7). You may need a prescription to get a nebulizer. When I was calling around checking prices, some places said I did need a prescription and some said I didnít, so you will need to ask. The suppliers that said I needed a prescription said they would be happy to accept one from my vet. The equipment is available in medical supply stores and some pharmacies. The nebulizer machines can also be rented. Try to get the type of set-up that has a mouth piece and a hose as opposed to a face mask. The hose makes it a little easier to treat reluctant ratties.
ABOUT THE TREATMENT
You will need a prescription to get the albuterol for the breathing treatment. You do not need a prescription for the saline that the albuterol gets mixed in.
Albuterol is a bronchodialator. That means it works to relax the smooth muscles in the large and branching tubes in the lungs. Albuterol does have some side effects, including increased heart rate, restlessness and tremors. I have never observed any side effects in my rats at the doses I use. If you decide you would like to use albuterol treatment as an adjunct to antibiotic therapy in your rats, you need to discuss it with your vet ahead of time. It will take you a while to obtain the equipment and become comfortable using it. Donít wait until you have a crisis to ask about it.
The dosage that I use is .2 cc of .5% albuterol in 2 cc of saline. I have never done a treatment on a very young rat, but I would probably decrease the dosage to .1cc albuterol in 2cc saline for a rat under 250 grams. I also used this smaller dosage with my old lady Luna. With her lung damage, her heart was already stressed and I thought she would be more at risk for side effects. Please discuss these doses with your vet. As for frequency, I usually do the treatments three times a day. As the rat improves you can decrease the number of treatments per day. I continue to do treatments for two days after breathing is normal.
I will usually begin albuterol treatments on my rats if they develop noisy or labored breathing. I use the treatments as an adjunct, not a replacement to antibiotic therapy.
To do the treatment, plug in the machine. Connect one end of the tubing to the machine and one end to the medicine chamber. Put 2 cc normal saline and .2cc albuterol (or whatever dose your vet has prescribed) into the medicine chamber. Attach the screw-on lid. Attach the t-piece to the screw-on lid. Put aside the mouth piece, you donít need it. Attach the hose to one end of the t-piece, and put a cotton ball in the other end. Now you are ready to start. Flip the switch and direct the end of the hose towards your rats face. The treatment is over when there is no more mist coming out of the hose.
Certain antibiotics can also be used in the nebulizer, chiefly, Amikacin and Gentamicin.Talk to your vet about adding these if your rat does not seem to be responding to conventional antibiotics.
MAKING YOUR RAT COMFORTABLE
Not all rats take kindly to this noisy thing blowing mist in their faces. If your rat is very sick he may not care what you do to him. This was the case with Louis for the first two treatments. When your rat starts to feel better though, or if you are starting treatment earlier in your ratís illness, you may have to get creative. Start by getting as far away from the actual machine as the tubing will allow. I sit on the couch and put the nebulizer on the floor at the other end, this way the noise is somewhat muffled. I think the noise bothers them more than anything else. Try to let your rat find a comfortable spot. Iíve done treatments in funny places; behind a pillow, behind many pillows and in my shirt! Another good trick is to feed your rat some special treats while youíre doing the treatment. If you stroke your rat and talk softly to him he will usually settle in to a comfortable spot and tolerate the rest of the treatment. While doing the treatment, remember to keep the medication chamber upright and keep the hose 1 inch from the rats nose.
I really hope none of you ever has a rat sick enough to need these types of treatments, but it can be a valuable treatment modality for rats with pneumonia. I think one of the things that will propel veterinary medicine to the same levels for our rattie friends, that it is for dogs and cats, is our demand as pet owners for new and better treatments.