Xander's Battle with Lung Cancer - Full Write Up
Introduction:
We agreed to take on Xander - alongside her 7 friends - as her and another one of her mischief members needed surgery to remove mammary tumours. Their owner was in a difficult situation and wasn't able to have their beloved rats operated on. Their loving owner decided to put their rat's needs before their own.
We've written previous blog posts on the topics:
Xander was a playful, excitable, and friendly doe who loved exploring. She'd always be climbing the ropes in her cage and socializing with her companions.
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Second Mammary Fibroadenoma and Ovariohysterectomy:
It isn't uncommon for mammary tumours to reoccur. Xander developed her second mammary fibroadenoma: a benign encapsulated epithelial tumour of glandular tissue formed on the mammary chain.
Mammary tumours have numerous factors which can cause them to occur: diet, sex, genetics, age, endocrine, and environment.
Studies show that spaying female rats (specifically an ovariectomy: removal of ovaries) can inhibit tumours influenced by prolactin and estrogen hormones.
Diet also plays a large role in tumorigenesis: production/formation of tumour(s). High-calorie diets enhance both mammary and pituitary tumour growth.
As it was Xander's second surgery to remove a mammary fibroadenoma, we decided to have her spayed under the same anesthesia to reduce the chance of further surgeries.
The surgery went smoothly. Xander had her ovaries, uterus, and a mammary fibroadenoma removed.
Unfortunately, despite adequate pain-relief, Xander was fascinated with her ovariohysterectomy surgical site, so she had to wear a buster collar during the early stages of her recovery to prevent damage to the site. Xander was housed in adapted accommodation to reduce the risk of injury and infection.
Fortunately, Xander made a full recovery from her surgery.
Pulmonary Neoplasia:
Xander began displaying a broad range of symptoms:
- Clinical signs of pain: holding ears back, starring coat. Here is a useful document which shows ways rats display pain:
How to calculate pain levels in rats based on grimace scale
- Increased respiratory rate and effort with small subsequent weight loss (-5g).
- Accumulation within eye
Xander was admitted for clinical investigation and radiographs from numerous views.
A clinical investigation ruled out masses within her abdomen and her abdomen was comfortable when palpated. No nasal or ocular discharge. She had increased respiratory noise when Xander woke from inhalant anesthesia that was required for X-rays - inhalant anesthesia can irritate the airways, even in healthy patients. Urinalysis was largely unremarkable with no evidence of a UTI.
X-rays highlighted a clear disparity between each lung - the left showed increased opacity (whiteness) suggestive of fluid and/or inflammation. Her heart appeared normal, and no obvious masses could be seen.
Given the findings, and upon closer inspection of Xander's eye, the vet explained that the 'whiteness' was an accumulation within the eye itself. The accumulation could've been a mass, blood clot, or pus. It was most likely a blood clot formed from hemorrhaging due to increased blood pressure through lung circulation. The eye itself was not painful, even when palpated, therefore no direct treatment was required.
The differential diagnoses were pneumonia, pulmonary edema, heart failure, or pulmonary neoplasia (lung cancer). Unfortunately, the latter was most likely as the other conditions generally affect both lungs.
Despite the poor prognosis, we wanted to attempt to manage some of Xander's symptoms with medication, although we were aware it'd be palliative.
Xander was introduced to Metacam/Meloxicam (NSAID), Frusemide/Furosemide (loop diuretic), and nebulized Baytril/Enrofloxacin (fluoroquinolone antimicrobial agent) suspended in isotonic saline (0.9% NaCl) as some cancers can leave individuals immunocompromised, making them more susceptible to infections.
We knew Xander wouldn't have been with us much longer, but we wanted to make sure she was comfortable during her final weeks of life.
Not overly long after her diagnosis, Xander's quality of life started to worsen. She'd stopped responding to her medication, her pain levels increased, she had a poor lung functional reserve capacity, and her eyes were sinking. We decided to have Xander humanely euthanized to prevent undue suffering.
Cancer is one of the most unforgiving illnesses known to man and cancer had, unfortunately, started to rob Xander of her inquisitive and playful nature.
Xander passed away on 09th June 2019.
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