Pandora - Full Write-up

Pandora was very special to us because we knew how much she was loved in her previous home. Quite often, we see owners who see them as "just a rat", or worse. It's always lovely to meet people who love their animals and treat them as a live being and as someone who is part of the family.

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Arrival:

Panda came into our care with her 7 mischief members. Unfortunately, her owner could no longer care for them due to unforeseen circumstances. 

2 of her companions required surgery to remove mammary fibroadenomas, and 4 rats had chronic respiratory diseases.

Pandora was the woman in charge. She made the rules and even kept the neutered bucks in line.

Mammary Fibroadenoma:

Mammary tumours are common with pet rats. We weren't surprised when Pandora developed a fibroadenoma in her mid-to-senior years. We booked her in to have the tumour surgically removed.

The surgery went well. The surgeon removed the tumour and Pandora handled the anaesthesia well. Despite adequate post-operative pain-relief, Pandora was determined to meddle with the surgical site. Pandora needed to wear a buster collar in solitary amended accommodation to minimalise the risk of injury and infection.

Pandora made a quick recovery and was able to return to her usual surroundings alongside her companions.

Oesophageal Blockages:

This section may contain content that some readers may find upsetting; themes of choking, paralysis, pain, and death.

Pandora's final battle required intensive and round-the-clock care.

We discovered Pandora listless and presenting symptoms such as sialorrhea (excessively drooling) containing small amounts of blood, high-scoring pain-levels based on grimace scale developed for rats, increased resp rate and effort, difficulty breathing/mouth-breathing/gasping, and decreased glucose levels. We suspected Pandora had an oesophageal blockage. Basically, she was choking.

Rats are anatomically different from humans. 

A rats diaphragm is a thoracic muscular layer that separates the start of the abdominal cavity. Their oesophagus pierces their diaphragm at the natural fissure which passes between the thorax and the abdomen. The structure is referred to as a hiatus and plays a role in moving food from the mouth to the stomach. 
A rats oesophagus is long and narrow. There are powerful muscular valves inside both ends of a rat's stomach. The valve opening between the oesophagus and the stomach is known as the cardiac sphincter. Their oesophagus doesn't have the muscular strength to independently overcome their cardiac sphincter, which would be required for vomiting when truly choking. 

Rats also seem to lack a vomiting-reflex on a neurological level.

As owners, our first, understandable instinct when we see our pet rat choking would be to try and help them. This can be unhelpful and can even worsen the situation. Due to the arrangement of rats throat, true choking is rare and we don't need to intervene until then.

Pandora was truly choking and required our assistance to clear the blockage. We started with 'flinging' which is a technique that uses centrifugal forces to try and dislodge the blockage. Flinging should only be performed if a rat's respiration is highly, or completely compromised.

"Hold your rat firmly around the neck with one hand, and by the base of the tail with the other to hold them securely. Make sure there are no objects within an arm's length. Lift the rat overhead and bring them down in a rapid arc, so that at the end of the path they're tail up and head down. This can be repeated 3-4 times, then give the rat a rest, check their breathing, and see if anything is visible in the mouth. This is extremely effective in dislodging objects in the throat. However, don't use this procedure if your rat can breathe, or you might make it worse."(Debbie Ducommun, Rat Health Care)

Taken from NERS: First aid for rats. 

We also tried to suck the blockage clear - yes, it's as gross as it sounds. Medicinal intervention included a short-duration subcutaneous Dexadreson/Dexamethasone bisodium phosphate (corticosteroid) injection. 

We managed to clear the blockage but Pandora had aspirated some fluid and continued to show symptoms of severe pain. We believed she'd caused some damage the back of her throat 

The following day, Pandora was introduced to Metacam/Meloxicam 1.5mg:1kg QD, Tramadol (analgesic opioid pain-relief) TID, and frequent syringe feeding. 

The veterinarian was reluctant anaesthetize Pandora to try and see the extent of damage caused. The inhalant anaesthesia was risky, they could've caused more damage, and it probably wouldn't have changed the outcome anyway.

Pandora after being bathed, she'd become messy from the syringe feeds.

Over the next 5 days, Pandora showed a lot of improvements. She had started to eat independently and was in less pain.

Unfortunately, Pandora suddenly deteriorated. She'd developed facial abnormalities and grave muscle weakness. Our veterinarian wanted us to monitor her closely throughout the night.

We had alarms set so we could frequently check on her. On the 5am night check, we decided it was necessary to administer another dose of Dexadreson subcutaneously. Pandora was choking (not truly choking this time) and had moderate-wet respiratory noise. We stayed with her until morning, and she was rushed into the vets as soon as they opened.

Pandora was comforted.

Based on Pandora's now rapidly worsening condition, the vet believed Pandora either had a brain tumour causing neurological disturbances, or a rare condition called Myasthenia Gravis, although there is little literature regarding the disease affecting rats.

Myasthenia Gravis is a chronic autoimmune neuromuscular disease which disrupts communication between the nerves and muscles. It causes a broad range of symptoms such as difficulty swallowing, facial abnormalities, grave muscle weakness, and sometimes severe breathing.

Regardless of the exact cause, the prognosis was equally as poor with each scenario. It was decided Pandora's quality of life was irretrievable, and we decided to have her humanely euthanised. We didn't opt for further tests as we didn't believe it was fair to prolong her suffering. 

Pandora passed away on the 3rd of April 2019.