Nima - Full Write-Up
Nima was an oddball for sure. None the less, we went through a lot together. As Nima's life was full of extraordinary events that really highlight the will to live that some pet rats have, we simply had to write a post dedicated to her life story.
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Arrival:
Nima and her cagemate - Nova - were being given away for free barely 2 minutes away from our home. It seemed silly not to offer them a place within one of our mischiefs here with us.
They were two very happy and healthy girls. Once we were confident they were healthy and had settled in, we bonded them to Shmi, Leia, and Derrick (castrated) (our mischief at the time). Nima went on to have dozens of friends throughout her life!
Opportunistic Infections, Leukemia and Passing:
As the header suggests, Nima had a very sad ending.
Nima struggled from ill-health for the final few weeks of her time with us. We will break it down, as a lot happened in a short space of time.
Closed Pyometra and Bronchopneumonia:
As with most closed pyometras, the patient affected will become very ill - Nima was no exception.
Nima had rapidly developed an increased respiratory rate, dyspnea (laboured breathing), audible respiration without auscultation, piloerection (bristling of hair), displayed signs suggestive pain most prominent around the abdominal area, lethargy, and low body temperature (temperature was 35.5°C from rectal reading - normative body temperature for Norway rats is 38°C).
Nima looking worse-for-wear.
Nima was introduced to oral Baytril/Enrofloxacin (fluoroquinolone antimicrobial agent) and Ronaxan/Doxycycline (tetracycline antimicrobial agent) alongside oral Metacam/Meloxicam (NSAID) and oral Tramadol Hydrochloride (narcotic-like analgesic opioid). We chose to administer orally to increase systemic effects.
Nima was also booked in for an emergency veterinary assessment. Not surprisingly, Nima was admitted. At this point, the prediagnosis was Nima had a closed pyometra - requiring an ovariohysterectomy - and bronchopneumonia.
Nima was given an external heat source and was introduced to oxygen therapy. The veterinarian performed an ultrasound scan, no free fluid could be seen (this can sometimes happen), however, whilst being scanned, a small amount of discharge originating from Nima's vulva was produced.
Despite the added risk given compromised respiratory function, the vet believed it was too risky to leave Nima with a pyometra.
A pyometra is a pus-filled uterus that usually comes in one of two forms; closed, or open.
Due to a closed cervix, Nima was retaining almost all pus within her uterus, therefore, she had a closed pyometra. If pus and secretions are being retained, it can be fatal due to toxins being absorbed into the bloodstream - known as bacteremia. Bacteremia can lead to sepsis and septic shock, both of which carry a guarded prognosis.
We agreed to surgery and, thankfully, Nima's surgery went well. When she returned home, she was housed in solitude in an adapted accomodation to reduce the risk of injury and infection.
For the most part, Nima was able to avoid the use of a buster collar. A common cause for animals messing with their surgical site is pain. We always ensure our animals have sufficient pain relief - especially for the first 72hrs. Sometimes, an animal will mess with the site because, naturally, it feels different. Nima's curiosity was sometimes getting the better of her, so she occasionally required a buster collar, particularly when she was going to briefly be left unsupervised.
Nima showed a lot of post-operative improvements, but she never made a full recovery. Unfortunately, the worst was yet to come.
Leukemia:
Leukemia seems to be one of the illnesses that everyone knows is particularly severe - or at least I have a very negative perception of it, anyway.
Nima fairly suddenly started to develop more severe infections - she had not too long ago battled a closed Pyo and bronchopneumonia. The first infection that occurred was a severe lower-respiratory infection. She was introduced to nebulized Baytril, Ronaxan, Bisolvon/Bromhexine (bronchial mucolytic), Corvental/Theophylline Ph. Eur. (bronchodilator), and Prednisolone/Prednisone (corticosteroid).
At this point, we were concerned about a syndrome known as Murine Mycoplasmosis. MRM is a chronic and progressive disease. As with many chronic respiratory diseases in pet mice and rats, mycoplasma pulmonis is the ubiquitous bacterial pathogen. MRM can be exacerbated and accompanied by other pathogens such as CAR bacillus and Corynebacterium kutscheri. Viral infections also occur such as Sialodacryoadenitis (SDA) and Sendai virus.
MRM can be referred to as either or both of the following; Murine Respiratory Mycoplasmosis, and Murine Genital Mycoplasmosis.
Within a matter of days, Nima developed gross haematuria. We decided to run some basic urinalysis at home to decide the next best move and started to administer the existing prescribed medications orally.
Nima's urine sample demonstrates gross haematuria: blood visible in urine
Urinalysis results:
- Glucose: -tive
- Bilirubin: +
- Ketones: Trace
- Specific Gravity: 1.010
- Blood: +++
- pH: 8.5
- Protein:+++
- Urobilinogen: Normal
- Nitrates: +tive
- Leucocytes: ++
The first thing that is important to note, dipsticks are designed for testing human urine, so always take the results with a pinch of salt.
- The specific gravity reading shows the urine was very dilute. Hyposthenuria (decreased specific gravity) can be indicative of renal failure, polydipsia (excessive fluid intake), acute tubular necrosis, nephritis (inflammation of the kidneys), and other illnesses.
- Haematuria (blood in urine) can have various causes, the most common being urinary tract infections, bladder infections, and kidney infections. Although, more grave causes such as cancers can also be relevant. Microbiologists have previously told us that the dipstick readings for blood when testing animal urine can be "excitable", however, given gross haematuria, we're confident Nima had blood in her urine.
- Proteinuria (protein in urine) can be caused by renal diseases and hypertension (high blood pressure).
- Elevated pH levels (more alkaline than acidic in urine) can be a sign of UTIs and renal illnesses.
- Nitrituria (nitrates in urine) is a sign of UTIs.
- Leucocytes present in urine can be indicative of leucocytosis, which is usually suggestive of UTIs. Leucocyte readings for animals on dipsticks can be shaky and not always accurate, but in some cases, it can be.
Other symptoms:
What made the urinalysis results particularly worrying were Nima's other symptoms. She'd become extremely unwell.
Nima had the following symptoms:
- Dyspnea (laboured breathing) - oxygen was given when required.
- Weightloss - also fed supportive high kcal soft food diet
- Polyuria (increased urination)
- Polydipsia (increased fluid intake)
- Tachypnea (abnormally rapid breathing)
- Tachycardia (increased heart rate)
- Lethargy
- Increased pain levels - was given Tramadol Hydrochloride as she was on corticosteroids
- Opportunistic infections
- Low body temperature
- Developing cachexic (wasting)
The big question - why was she immunocompromised? Nima might have had a form of acute leukemia.
Leukemia is a progressive and malignant cancer. In rats, leukemias most commonly arise from the spleen, whereas in humans, leukemia most commonly arises in the bone marrow.
The most common forms of leukemias in rats are lymphocytic, meaning only lymphocytes are neoplastic.
Another way to categorise leukemias is if they're chronic, or acute.
- Acute leukemias have a rapid onset and progress rather quickly. They're usually harder to manage.
- Chronic leukemias have a much slower onset and progress fairly steadily. Sometimes, you can manage chronic leukemias well with corticosteroids and by managing other health complications that arise due to neoplastic disease.
One thing was clear, Nima wasn't responding well to treatment. In fact, she was only worsening. At the vet appointment, we were all confident Nima was fighting a losing battle. Rather than spending funds on numerous tests, to only have been greeted with the same outcome - humane euthanasia - the vet kindly reassured us it was kinder to let her go now than to put her through more undue suffering.
We agreed.
Nima passed away on the 20th of August 2019.
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