Brent - Full Write-Up

Arrival:

Brent arrived in our care after his cage mate tragically passed away, leaving Brent on his own. Brent was still fairly young, his owners thought it would be best for him to go on and find some new friends to prevent him from being lonely, secondary to social isolation.
When Brent arrived, he was showing signs of depression and was very withdrawn. 

Once we were confident he was healthy, we bonded him to our mischief of bucks.

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First Stroke:

Brent had a sudden onset of neurological abnormalities. His symptoms were suggestive of an ischaemic stroke (poss embolic) - we couldn't confirm this without advanced imaging and a neurologist's input. As treatment likely wouldn't have changed regardless of a definitive diagnosis, we decided to try medicinal input first.

An embolic ischaemic stroke only affects the area of the brain in which the blockage of the cerebral vessel perfused. An embolic stroke refers to the blockage of an embolus. Usually, a blockage will occur in an arterial capillary bed. There are several types of emboli, including blood clots, crystals, fat globules, and more. Any emboli can cause a stroke as they travel from its point of origin and through the bloodstream to the brain. Embolic strokes often show severe clinical symptoms suddenly.

Brent was extremely confused as to why he had suddenly gone from "normal" to how he was in the video. Brent was a rat's-rat and was more reserved around people, but he'd suddenly become extremely clingy - likely because he was seeking reassurance and comfort.
His symptoms included early-onset of ataxia, lethargy, dysphagia, headache, and behavioural changes.

We administered a subcutaneous Dexadreson/Dexamethasone Bisodium Phosphate injection for potent and fast-acting inflammatory relief to any irritated tissue. We wanted to see how Brent responded to the medication before making any big decisions.
Although it's undeniably heartbreaking seeing any animal suffering, we believed Brent deserved a chance to fight and recover. The amount a stroke-patient will recover varies significantly depending on the individual. 

We also ensured Brent was introduced to round-the-clock nursing care such as dietary support (especially given dysphagia). In the video, you can see he is enjoying 'Rattus Whiskoff' WUB porridge with added ground maintenance diet, oats, and honey.
We also decided to house Brent in adapted accomodation to reduce the risk of injuries. We also needed to closely monitor Brent.

Brent 24hrs after initial corticosteroid injection:

A few days later:

Continued Management:

As time went on, it was clear Brent's health problems were broader than the stroke. We were sure the stroke was secondary to a larger issue. We decided advanced imaging such as Magnetic Resonance Imaging (MRI) and Computer Tomography (CT) weren't prudent. It was highly unlikely Brent's illness was directly treatable.

Although we didn't opt for further imaging for a definitive diagnosis, we were able to introduce Brent to medicinal and lifestyle management to keep him as healthy as possible for as long as possible.

By now, Brent had been steadily weaned off corticosteroids. Instead, we introduced him to a high dose of Metacam/Meloxicam (NSAID) 1mg:1kg BID. Brent had developed signs of pain, so non-steroidals were particularly useful.

Brent had also developed symptoms of ageing such as slowing down, lack of interest in usual tasks, and more. After conversing with our vet, we decided to introduce Brent to Vivitonin/Propentofylline (Xanthine derivative). Vivitonin has been known to promote healthy blood circulation and reduce the risk of some strokes. The primary actions of Vivitonin consist of increasing blood flow to the heart, central nervous system (CNS), and skeletal muscles. The drug works by inhibiting phosphodiesterase and glial reactivity with specific neuroinflammatory conditions, as well as adenosine transport.

Finally, Brent had experienced gradual weightloss. We ensured Brent had high kcal soft food 'WUB' porridge with added weight maintenance diet. This helped significantly slow down his weight loss. Due to unfortunate circumstances, Brent gained a soft-food-buddy - Einstein - who'd developed a pituitary adenoma (PT).

Passing:

Brent developed a fairly-rapid onset of ataxia and symptoms of severe head-pain. We did a 24hr flush-out of NSAIDs before administering a fast-acting potent subcutaneous Dexadreson/Dexamethasone Bisodium Phosphate injection.

Brent was more coordinated, however, his pain-levels were intractable and he was spending his day hiding his face, he was significantly more reserved, and was demonstrating avoidant behaviour. 

Despite using neuroprotective and derivative medications, Brent had reached a point in which the kindest thing for him was humane euthanasia.

Brent passed away on the 9th of August 2019.