Shmi - Full Write-up

Shmi was very popular amongst some of our followers. She had a larger than life personality, and there are many names we can think of to describe her that wouldn't be appropriate for this blog-setting. Despite her troublesome nature, we loved her a lot.

You can follow us on social media: Facebook, Instagram, and Twitter

You can donate to us via our Paypal and our Amazon Wishlist

For other enquiries, please email: bacchusresidents@outlook.com

Arrival:

We'd recently rescued a Mother and Daughter duo of Manx (tailless) rats from Hamster Haven (rescue) - Leia (daughter) and Padme (mother). Tailless rats are a controversial topic amongst rat experts. In our opinion, tailless rats shouldn't be deliberately produced. Due to their deformities, tailless rats usually require adapted-housing.

Padme was much older than Leia. We knew Leia would need companionship in the future when her mother passed away. We searched for does in need of a home. We stumbled across someone needing to rehome two young female rats. They had an accidental litter due to a renowned pet shop incorrectly sexing their rats. 

Rey and Shmi:

Shmi and Rey were two very mischievous, cheeky rats. Once we'd ruled out any underlying health issues, we bonded them to Padme and Leia. All of the girls were happy to meet each other.

Rehabilitating Derrick:

A long-time had passed, Padme and Rey had sadly passed away due to health issues. Shmi and Leia remained the best of friends.

We'd rescued a traumatised buck, Derrick.
Unfortunately, Derrick was unable to live with other males. The horrendous bullying from his previous cage mate, Dennis, had left him traumatised.
After his castration, Derrick was still extremely aggressive towards other bucks. We decided to try and bond him with our two does, Leia and Shmi. It was going to be a challenge to help Derrick overcome his psychological trauma.

Derrick's body language showed aggression and insecurity despite Shmi being far away.

At first, we weren't convinced it was going to work. Derrick was still aggressive towards the girls - we wrote a previous post about bonding Derrick to the does. 

Derrick displaying normal body language

Surprisingly, Shmi was phenomenal with Derrick, it was absolutely fascinating to see. Shmi understood and respected Derricks boundaries. She showed awareness of Derrick's fears and encouraged him to trust rats again. Without Shmi's help, we doubt Derrick would've trusted rats again.

Development of CRD:

Chronic respiratory diseases are common amongst pet rodents - particularly mice, rats, guinea pigs, and rarely degus. Shmi is the rat who is responsible for the change in how we treat and manage respiratory diseases.

Initial Management:

The veterinarian thought Shmi had potential allergies/sensitivities and inflammatory pulmonary changes. The vet prescribed subcutaneous Dexafort/Dexamethasone (corticosteroid) injection QW. Shmi improved short-term, but once the steroid wore off, her symptoms came back.
We stopped keeping rats on Fitch paper bedding and swapped to a cardboard bedding for respiratory issues. We also tightened prophylactics.

Our vet was reluctant to prescribe Dexamethasone long-term. 
Dexamethasone is an Endocrine hormone. Corticosteroids are divided into two main classes; glucocorticoid and mineralocorticoid. 
Dexamethasone is classified as a glucocorticoid due to its high glucocorticoid activity and low mineralocorticoid activity.
Glucocorticoids can be described as a synthetic analogue of adrenalcortico hormones, and are involved in a range of physiological processes.

Long-term usage of glucocorticoids can trigger atrophy of the adrenal cortex. 
Corticosteroids are naturally produced by the adrenal gland. With additional synthetic hormones (Dexamethasone) circulating the body, the adrenal cortex may stop releasing its own hormones - adrenocorticotropic (ACTH) and glucocorticoid.

Even if Dexamethasone was used as Shmi's only form of medicinal management of chronic respiratory disease (although Dexamethasone has been shown to reduce plasma leakage, resolve mycoplasma-induced inflammation, and reduce the number of mycoplasma organisms when used as an only therapy) it could've had very severe and potentially fatal consequences in later life.

Nebulising:

The exotic specialists recommended purchasing a nebuliser.

Nebulising turns certain medications into a breathable mist that can be inhaled to the lungs and is a more direct approach than other therapies. Shmi showed improvements from daily nebulisation therapy with F10 antiseptic solution. Shmi was steadily weaned off Dexamethasone. 

Shmi was later prescribed nebulized: 

• Bisolvon: Containing active ingredient Bromhexine. Bromhexine is a bronchial mucolytic. It facilitates the removal of mucus by thinning bronchial secretions.
• Corvental: Containing active ingredient Theophylline Ph. Eur - dimethylxanthine. Theophylline has numerous therapeutic effects. One of which is bronchodilatory effects and β2-agonist, but there can be side effects. Bronchodilators work by dilating the bronchi and bronchioles, therefore improving airflow and decreasing resistance in the airways, which can improve shortness of breath.

Respiratory Infections:

Shmi suffered from reoccurring upper and lower respiratory infections throughout her life as a result of living with CRD.

Shmi's clinical symptoms worsened, and she started sneezing blood. Shmi had an upper-respiratory infection. Although nebulising mostly targets the lower-airways, the vet prescribed nebulized Ronaxan/Doxycycline (tetracycline antimicrobial agent) and Baytril/Enrofloxacin (fluoroquinolone antimicrobial agent) for a minimum of 2-weeks. Shmi was also prescribed oral Metacam/Meloxicam (NSAID) 1mg:1kg QD.

The antibiotic course was extended to 30-days.

Broccoli fishing to cool down during a heat-wave in 2018.

As the months went on, Shmi suffered from numerous relapses. Shmi's diagnosis was expanded on. Shmi was suffering from mycoplasmosis: an infectious disease caused by pathogenic mycoplasma-organisms.

Nearly all pet rats and mice host a species-specific organism - Mycoplasma pulmonis. It's often found in the respiratory epithelium

Mycoplasma are a molecule-size genus of bacteria that lack a cell wall. Instead, they're enclosed by a cell membrane. They belong to a family containing over 95 different species of mycoplasma - mycoplasmataceae.

Shmi's mycoplasmosis progressed as she aged. In later life, we'd have classed Shmi's disease as an advanced, complex respiratory disease.

Preserving Life:

Shmi's suffered a severe relapse and it was unlikely we'd fully control her respiratory disease. We were preserving life. She required intensive medicinal intervention to manage her symptoms.

Stage 1 of Palliative Care:

Shmi finished a 30-day course of Enrofloxacin and Doxycycline for a respiratory infection. Unfortunately, Shmi's infection quickly reoccured after antibiotics were discontinued.

Shmi was prescribed a 44-day course of antibiotics. Enrofloxacin used in combination with Doxycycline is more effective at tackling mycoplasma-induced infections. She was also prescribed Bisolvon and Corvental.  

Shmi developed a rapidly increasing respiratory effort and respiratory rate. The vet prescribed nebulized Prednisolone/Prednisone (glucocorticoid). Due to an increasing resp rate and effort, Shmi had subsequent weight-loss. We introduced Shmi to a high kcal weight-gain 'WUB' porridge.

Neoplasias (Mammary Fibroadenoma):

Shmi developed two mammary fibroadenomas on her mammary chain. Given Shmi's old age and compromised respiratory function, surgery was not an option. Fortunately, the tumours were benign and didn't bother Shmi.

Stage 2 of Palliative Care:

Shmi continued to show symptoms of increased pulmonary inflammation. Shmi was introduced to subcutaneous Dexadreson/Dexamethasone Bisodium phosphate injections. We decided injections were more beneficial than nebulised steroids as she required potent, fast-acting inflammatory relief. Prednisolone was discontinued.

Given Shmi's compromised respiratory function, despite the risk of respiratory arrest under anaesthesia, the vet required radiographs, additional insight would be beneficial. The vet wanted to check for pulmonary neoplasia and/or abscesses and lesions.

X-Rays highlighted excessive fluid on Shmi's lungs. There are numerous causes for fluid on the lungs. In Shmi's case, the cause was most likely a chronic and unmanaged respiratory infection.

Stage 3 of Palliative Care:

Shmi's infection wasn't responding to the current antibiotics, and the chronic infection was causing irreversible damage to Shmi's lungs. Mycoplasma are never fully eradicated, making prolonged antibiotic therapy difficult. 

We were faced with an ethical dilemma; did we opt for humane euthanasia, or try to manage Shmi with two different antibiotics used for management of unresponsive advanced lung and respiratory infections.

Shmi was resilient and had a remarkable will to live. We decided to allow her to fight and trial her with 2 off-licence antimicrobial agents:

• Gentamicin Sulfate: Gentmacin belongs to the Aminoglycoside class of antibiotics. Aminoglycosides can tackle mycoplasma infections. When nebulized, there has been no evidence of toxicity even when used long-term. Gentamicin was prescribed TID.
• Azithromycin: Azithromycin belongs to the Macrolides class of antibiotics. Macrolides can tackle mycoplasma infections. We administered Azithromycin orally, BID for 2 weeks, then QD for two weeks, and then discontinued. When used long-term, Azithromycin can cause superinfections. Limited response in older rats with chronic health issues has been documented.

The new antibiotics were prescribed alongside already existing treatment.

Shmi was also given hydration-support due to becoming dehydrated otherwise. As Shmi was now reliant on soft high kcal porridges, we introduced Shmi to a ground weight-maintenance, honey, and PolyAid emergency nutrition to her porridge. 

Passing:

Opting to humanely euthanise Shmi was incredibly difficult. Shmi wanted to fight, but her body was failing her. She failed to respond to long-term aggressive medicinal intervention and prophylactics. Her disease was unmanageable, and we decided it was kindest for Shmi to be humanely euthanised to prevent undue suffering.

Shmi passed away on the 8th of February 2019.