Mary Ann Isaksen
From the May/June 1996 Rat & Mouse Gazette
There comes a time in the life of most rats when special nursing care is required. Very ill rats will require the administration of medication, need to be kept warm, and may even need to be hand-fed. Elderly rats may also need this special care and euthanization should not be considered unless the rat is in pain or no longer has a quality life.
HOUSING AND HYGIENE
A moderately sick rat should be left with his cage mates for comfort and companionship. Severely ill rats should be removed from a cage with other rats to lower their stress level. Move a very sick rat into a 10-gallon aquarium and place it where you will be likely to pass by regularly. I prefer to take very sick rats off of all shavings and use old T-shirts or towels as bedding. Change them frequently or the urine buildup will intensify respiratory symptoms.
Rats with severe respiratory disease will quite often get very cold due to low oxygen intake. To keep the rat warm, wrap a heating pad set on low in a towel and place it underneath one side of the aquarium. Do not place it under the entire tank, as your rat needs to be able to have a place to go if he gets too warm. You can also drape a towel over one half of the top of the tank. This will give the rat a dark place to relax in peace and will hold in some of the heat as well. Never put a heating pad in the cage, as your rat could bite into the heating elements and electrocute himself. Make sure the tank, and the room the tank is in, does not get too warm, or the rat may get dehydrated. Seventy to 72 degrees is adequate.
A very sick rat most likely will not be interested in cleaning himself. In fact, it is a good sign when a sick rat once again begins to groom. You can help keep your rat clean by wiping him down with a damp rag. Urine will need to be cleaned off so it does not burn his delicate skin. Use a wet rag to do this, but do not rinse the rat off under the faucet, as this will place an incredible amount of stress on him, which could cause him to become sicker. Sometimes even the sound of running water or a hairdryer will cause undue stress and are not recommended. Your rat needs to be kept as calm as possible during his illness. Use a soft towel to dry him off.
In addition to changing the cloth used for bedding frequently, make sure you clean the cage and any accessories regularly. Use a germicidal cleaner such as Parvosol, or a mild bleach solution. Rinse and dry the tank well before putting your rat back in if using the bleach solution.
Nutrition is a significant factor in good nursing care. Rats will lose weight rapidly while very ill, so finding something your rat will eat is of utmost importance. Offer your rat anything high in fat and food value that he would normally really like. Some suggestions are: avocado, peanut butter spread thinly on a cracker, oatmeal (the instant Maple and Brown Sugar is normally a big hit), eggs (hardboiled and mashed with mayonnaise or scrambled in butter or margarine), baby food (cereals, fruits, dinners, and vanilla custard), bananas, and cooked pasta.
If he is too sick to care about food you will need to hand-feed him. You will need to have some large syringes (no needles) for this. (Don't wait until you need them-- have them on hand if you own a rat!) Good sizes to use for feeding are 3cc, 6cc, and 12cc. I use the 12cc syringes to put the foods in first, since they have a larger opening, making it easier to get the food into it. I then push the food into the smaller syringe from the 12cc syringe. It is too awkward trying to feed with the large syringe; that is why this method is preferable. Try having several different flavors available at one time, so if your rat gets bored with one, you can move on to another and recapture his interest. I normally try filling four 12cc syringes with the following: (1) Avocado mashed with mayonnaise, (2) Mashed banana (you can add a little sugar and vanilla to make it even tastier), (3) A healthy baby food, and (4) Vanilla Custard baby food. I will also keep a 3cc syringe filled with Nutrical. Fill the small syringe from the larger syringe and carefully feed a little bit at a time using the method described for administering liquid medications. Keep a rag or tissues handy as hand-feeding can be messy.
Severely ill rats that need to be hand-fed will also need to be given water by hand. Do not put a bowl of water in your rats cage because he will tip it over and get himself wetopossibly making his illness worse. Instead, mix a teaspoon of sugar into 4 ounces of water and administer as much as he will drink with a small syringe, as often as you can give it to him.
Just as there are special techniques for tricking your child into taking his medication, there are methods to get your rat to take his, too. These methods are in no way as easy as sticking a pill(s) into a piece of cheese and having him gobble it up like a dog will, as rats are not the indiscriminate feeders that dogs are.
Medications may be administered to rats in the drinking water, orally, or can be injected. Treating with antibiotics in the drinking water is fine if your rat is still drinking, but, if he is very ill, he will not drink enough (if at all) to get the required amount of drug into his system.
Liquid medications come in many flavors and are very easy to give if your rat likes the taste. The easiest method of administering liquid medications is to use a 1cc tuberculin syringe without the needle. Fill it with the required dose and pick up your rat in your left hand (if you are right handed) with your thumb and forefinger around his chest, just under his front legs. Turn him towards you resting his hind legs on your chest. Hold his front leg (the side you are administering the meds) in between the ring finger and pinky finger of your right hand (the hand with the syringe) so that he cannot push the syringe away. Lightly push the tip of the syringe into the side of his mouth, behind his teeth and release the medication a little at a time, taking a break between small amounts if it is a large dose. Hold him with his belly facing you until he swallows the liquid. If he refuses to do so and holds it in his mouth, you can lightly rub your thumb on his nose in an upward motion over and over, or lightly blow on his nose until he begins to lick it from his lips.
Very ill rats may need to be given injectable drugs if they refuse to swallow liquid medications, or if the drug prescribed cannot be administered any other way. A drug that can be used subcutaneously (just under the skin) is actually very easy to administer and fear on your part should not keep you from using this method if it is going to save your rat's life. I have found the easiest place to give an injection is in the scruff of the neck. First, make sure you are using a good quality insulin syringe. B-D Ultra-Fine syringes are the best, in my opinion. They are very sharp and are very tiny (28 or 29 gauge) for the comfort of your rat. Fill the syringe with the prescribed dose and make sure the point of the needle is facing down. Place the rat on your lap or sit on the (carpeted) floor and place him in front of you. With the thumb and forefinger of your left hand (if you are right handed), massage the skin on the scruff of the neck. After a brief massage, lift the skin to form a tent. Place the point of the needle against the side of the tented skin and push it through, making sure that it is all the way under the skin and not through both sides or just in the tissue. When you are sure it is, release the medication and remove the needle. A struggling rat may be lifted by the scruff to keep them still enough to give an injection.
Try to discourage your vet from giving you drugs in pill form. It is almost impossible to consistently dose your rat correctly with pills. If each pill is 200 milligrams, and the dosage your rat requires is only 10 mg, of course you could try to pulverize the pill into powder and divide it up into 20 equal size piles, but you still would not be guaranteed a correct dose. The pill contains a buffer in addition to the drug, and it is unlikely that it will be evenly distributed throughout the entire tablet. If you must use this method, you can hide the powder in a tasty food such as avocado, baby food, or Nutrical, but be sure to put it in a small amount of the food or you may not be able to get your rat to eat the entire dose. Be careful not to use things like peanut butter, as even healthy rats can easily choke on a glob of such a thick substance. A sick rat will not likely be cleaning himself so do not try to smear the medicine on his face in the hopes that he will lick it off. Chances are he will rub it off on the cage floor or just leave it there before he will lick it off of himself.
Fluids are as important as antibiotics in the treatment of a sick rat. If your rat is dehydrated, no amount of drug therapy will pull him out of it unless you can get enough fluids back into his body. Very sick rats will quite often refuse to drink water, and, in this case, you will need to administer fluids under the skin.
To check for dehydration, pull the skin of the scruff up and release. Normal skin will bounce back quickly. Skin on a dehydrated rat will go back into place slowly. Older rats may appear to be dehydrated using this method due to loss of skin elasticity, so another good way to determine dehydration is to weigh the rat daily and monitor urine output (you may need keep the rat in a separate cage to monitor urine output). If your rat is not urinating or is urinating very little, chances are he is dehydrated.
You will need to see your vet to obtain sterile fluids (Ringer's Lactate), learn the proper administration method, and discuss the course of treatment, unless you can visit the office three times a day and are willing to pay up to $25 per visit. If your vet is not willing to work with you on something this important, it is time to find another vet.
A large syringe and a large needle (22 gauge) are needed to administer the fluid quickly enough for the comfort of your rat. If you have these and cannot get to your vets office for a consultation, a good base dosage is approximately 35cc per pound daily (10cc to 12cc per pound three times daily).
PAIN AND SURGICAL CARE
If your rat needs surgery, it is a good idea to discuss everything with your vet prior to the procedure so there will be no surprises. Rats cannot vomit, so your vet should not recommend that you fast him prior to surgery, but do not purposely feed your rat treats or large amounts of food, either. Be sure your vet is using an inhalant anesthesia such as Isoflurane or Halothane. These are the safest methods available. Ask your vet to use stainless steel sutures in areas where the rat can easily chew. Staples do not work very well on rats' thin skin and nylon sutures are easily chewed out. Surgical glue can only be used on incisions that do not involve a lot of blood, so do not be disappointed if your vet cannot use this method. If your rat manages to find a way to chew at his incision, the only way you may be able to keep him from reopening his incision is to use an Elizabethan collar. Ask your vet to supply you with one when you take your rat home just in case.
Never give your rat ANY type of drug before taking him in for surgery. You have no idea what your vet may give him, and the combination could be deadly! Let your vet be the one to administer any pain medication to alleviate the pain of a surgical procedure. Speak with your vet about possible aftercare pain medication. Most vets feel that household drugs such as ibuprofen, aspirin, and acetaminophen have no real effect on rat pain due to their high metabolic rate. Heavy duty Opioid Analgesics such as Butorphanol and Morphine administered frequently are considered to be necessary in cases of severe pain. Less severe pain should not be treated with medication at all as the pain ensures that the rat will stay calm and speed the healing process.
Nursing care is all about caring for and helping your little friend get back on his feet again. Spend time with him and give him plenty of love and attention, but do not overdo it; remember, he needs time to rest to allow his body to heal.