Some Things You Should Know About Antibiotics

I want you to know what I know because too many times I hear scary things come from peoples' mouths, like:

• "Oh, I had XYZ antibiotic in the fridge that I had leftover from treating my child's illness/my illness/my last sick rat's illness so I started my rat on that."

• "I found these pills in my grandmother's medicine cabinet. Can't I just use that?"

• "I found fish tetracycline at the pet store, how much should I give? Half of a capsule?"

• "I found fish tetracycline at the pet store and gave my rat a couple of doses of that and now he's better."

• "My vet sent me home with Sulfa-something-or-other. It's been two days and the rat's not getting better so I stopped."

• "My rat's been on Baytril for 2 months now and he hasn't really improved much at all in the past 6 weeks. Should I just put him down?"

• "Well, my vet sent us home with steroids and the dose seemed too low so I tripled it and it seemed to help at first but now my rat's getting worse."

• "I believe in a shotgun technique: Just give them everything in high doses. One of them is bound to work!"

And I know that all of these comments were, at some point, backed by good intention, but it is important that we understand why our good intentions aren't, in fact, always good.

What I know:

• Most mixed suspensions become useless after 7-14 days. Antibiotics are chemicals. If you mix dry chemicals with water (or whatever) they tend to react. If they react, it changes their form. If their form has changed, they will not work the same way that they worked when the mixture was fresh. Therefore: If you pull some suspension out of storage and give it to your rat to treat his illness, you're probably, in fact, just struggling to get him to swallow something that will either do nothing or cause your rat harm.

  Of course this isn't always the case but there is one way to know for sure: Find the expiry, check the bottle. Some suspensions are OK until they expire. Others have a short shelf-life once they've been suspended.

• While I am likely one of the first to question expiration dates, and while I know that in some cases, you do have a little leeway, and in some instances it's just that much of an emergency, if the drug in question is 3 months past-due, chances are, it's either not going to work or it will cause your rat harm. We can assume that the contents of most of Grandmother's medicine cabinet is way past that 3 month expiry margin.

• Fishbiotics (and Birdbiotics) - I'm absolutely not against them and I'm sure that they're the same as or very close to whatever it is that you'd get from your vet. My problem is with the measuring. You see a vet and they give you a nice suspension and tell you to give an amount based on your rat's weight at a given frequency for a specified amount of time. That calculated dosage is a precise, based on a rat's weight and decided upon based on a rat's metabolism, dose. "Half" of a capsule, or partitioned amounts of a capsule, or "a pinch" are not precise calculated amounts based on what their rat needs. In fact, most of the people asking, when asked how many milligrams the capsule is, don't even know how to respond. And that means they haven't a clue as to how much they're giving.

  Let's just switch this to an example: You have 1 liter of vodka at your disposal. You want to knock yourself out because you're not feeling well (or whatever). Not knowing how much you need to drink to obliterate yourself, you ask a friend. You don't tell your friend what the Proof of the vodka is and you don't tell your friend how big the bottle of vodka is. Your friend assumes it's a 750 ml bottle and tells you to drink a third of it. You, my friend, are going to become seriously ill. Your liver is going to want to find a new body and fast. You're going to surpass the point of obliteration and be finding yourself draped along the side of your toilet bowl.

  You just can't do things like that! Antibiotics work much in the same way. Antibiotics, like alcohol, are perceived by our bodies as toxins and our liver processes those toxins. So don't assume that whatever random amount of antibiotics you choose to give your rat is harmless. If it's too much, you could be poisoning him. If it's too little, you could be promoting bacterial resistance.

• A couple of doses of antibiotics aren't going to resolve a problem. If it does, legitimately, seem to resolve the problem, the problem either wasn't as bad as you thought it was, or the problem wasn't what you thought it was. The only thing you've proven or witnessed is the miracle of chance. By just giving a couple of doses of some antibiotic, however, you have increased the likelihood of bacterial resistance.

  What usually happens with rats is that, because they are animals of prey, they effectively hide infections for a prolonged period of time and by the time you realize there's a problem, the infection is pretty advanced. You then treat the infection and after a short period of time, assuming the dosage is high enough and frequent enough to tend, effectively, to the problem at hand, the rat feels a little better and is able to go back to his previous more cheerful demeanor: The one where he's effectively hiding an infection that you're not actually seeing.

  Just remember that rat's can't say (and won't say) "I'm not feeling well." You have to assume that if the doctor says 7 days that's the minimum time you're going to need to treat the infection. Even then, doubt. If the last 3 of the 7 days wasn't a succession of "good days" for your rat, the problem has not been "cured" - you need to go back to your vet and let him/her know that so you can continue with the antibiotics until the infection is completely resolved.

• This is tied in with the above concept. If your vet, who has seen your rat and who has pieced together the information he has - information acquired from experience, from research, and from the exhibited symptoms - says that your rat needs 10 days on sulfa (or whatever), do the 10 days of the sulfa.

  I picked the sulfa example intentionally: It's generally slow to work but when it does work, it works very well (when being used to target something it tends to). If you assume that every antibiotic is going to respond in the same manner and in the same amount of time, you're simply not going to go anywhere. And if you decide something's not working fast enough and drop it without consulting your veterinarian, you could be contributing to bacterial resistance. The last thing you want to do is make that stuff that's making your rat feel unwell stronger!

  Of course, if you have doubts, you should contact your vet: He/she should be able to tell you to have a little patience or to give up and try something else. Vets may not know everything there is to know about rats, but they do have a considerably better knowledge of antibiotic function than we do. But the vet does need your input: A lot of it is guess work based on probability. If something's not working as you expect it should, you have to discuss that with your rat's vet.

• Not sure why, but I hear this a lot: The antibiotic hasn't been working for some extended amount of time - the rat hasn't improved for some extended amount of time - and yet the person continues to fight, day in and day out, with their rat in attempts to get the antibiotic down his/her throat.

  This makes absolutely, 100%, no sense. Think about it.

  We can't always predict how an antibiotic will work in a given situation. You've got some knowns: "It's probably myco." But you have so many unknowns as well. The mycoplasma present served to suppress the rat's immune system then secondary infections took hold. When treating a respiratory infection, the vet can't very well swab out the lung to send off for a culture so she/he has to guess as to what bacteria, besides myco, is present. And then she/he has to choose an antibiotic that will have some effect on that presumed bacteria.

  You can expect, usually, that in 4 days you'll see some improvement. If you don't, you need to contact the vet. If you don't, it could be that the dosage being given is too low. If you don't, it could be that the antibiotic that was chosen simply has no effect on the bacteria present. Your vet will know if she/he started with a lower dose. Vets do that to decrease future chances of bacterial resistance. Your vet will know if she/he prescribed the higher dose which should work but isn't.

  You can also expect, usually, that the secondary infection isn't limited to one bacterium. As such, you may see great improvement in the first, second, and maybe even third week of treatment, but after that, if you've reached some point of stagnation where the rat isn't 100% better, but he's not getting any worse either, chances are, other bacteria are present that the antibiotic you're using isn't tending to.

  And if that is the case, you need to consult with your vet to explore other options. Believe it or not, there are antibiotics other than doxycycline and baytril.

• Reassessing a vet's orders and doing whatever you feel like doing because, in your experience, giving more Baytril than the vet prescribed actually resolved one instance of an illness in one rat and so, therefore, giving more prednisone should have the same positive effect, doesn't always work (and it's not always the best thing to do).

  While most recommended dosages for antibiotics have a minimum recommended and maximum recommended amount, and while the maximum recommended amount is generally more effective for older rats, for rats with pneumonia, or for rats who seem to be perpetually ill and received the lower doses in the past, giving the maximum dosage of every drug just to "play it safe" isn't a good thing.

  Which is why I specifically chose the prednisone example. Many people are unaware that there is any difference between a steroid and an antibiotic (or any other type of drug for that matter). This is, again, why we see a vet: she/he knows these things.

  If you take some rule you've applied to the efficacy of one substance, based on your experience, and apply it to another, it's not going to have the same result because they're not the same thing. In the prednisone example, it is a steroid. If being used long-term, lower is in fact better. Or, specifically, the lowest functional dose. Giving higher doses just hastens the supression of the immune system which, in turn, hastens your rat's demise.

• The shotgun thing. This makes me cringe. A friend of mine pointed this out to me and I had to scrape my eyeballs off of the monitor. Poor rat!

  All drugs - alcohol, steroids, diuretics, bronchodilators, antibiotics - are toxins. And this "shotgun" concept basically involves giving two or three kinds of antibiotics, plus a bronchodilator, plus a steroid, and if you're up to it, a diuretic for fun...and all at the highest recommended dosages with the hope that some drug or combination of drugs therein will do something to resolve the problem. Sure, you're bound to, at least temporarily, resolve the issue by trying everything at once. But if that rat is young, you're going to encounter a similar issue in the future and you're not going to know what worked (if he even makes it that far). If the rat's old, it'll be about time to carve out the grave stone and bury his vital organs for, if he survives, he's going to be one damaged little man.

  And it just doesn't make sense. Your vet will listen and observe. If you're dealing with a gasping rat and his lungs aren't filled with fluid, the bronchodilator will work. But it doesn't need to be given in the highest dose possible. If you're dealing with a gasping rat and his lungs are filled with fluid, the bronchodilator will do little to nothing to help, regardless of what excessive heart-attack instigating dosage you use, because you can widen the bronchial airways all you want: If the rat is drowning in fluid, he's still not going to be able to comfortably breathe. So you would, instead, use a steroid or a diuretic -- OR being the key word.

  Your vet then makes an educated guess as to whether this fluid accumulation is the result of a severe infection or if the fluid accumulation is the result of heart problems. If heart problems, the diuretic is the best choice but only if the rat isn't severely dehydrated. If the fluid is the result of a severe infection, the steroid would be the better gamble but only in lower doses and for a short period of time. Steroids suppress the immune system and with such an advanced infection, prolonged use of a steroid will, in fact, only hurt. Of course, short term, it may consolidate enough of the fluid present to alleviate the stress involved with breathing allowing the rat to maintain enough calm to allot what little energy he has to fighting the infection itself.

  Ditto with the high-doses-of-every-antibiotic-known-to-mankind. Some antibiotics do counter other antibiotics. The best example is doxy and baytril. Doxy is bacteriostatic, baytril is bactericidal. Using both together counters their efficacy. Fortunately, in rats, what is lost in combining the two, is greatly outweighed by the gain of their cumulative effect. But that doesn't apply to all antibiotics. Causing the antibiotics, albeit unwittingly, to cancel each other out, does nothing but put added stress on the rat's liver and kidneys.

What? Bacterial resistance?

Bacterial resistance is a very scary thing. Before antibiotics were discovered, many sick and injured people died because their immune response alone wasn't good enough to fend off some bacterial infections. But most of us do have (and most rats do have) very effective immune systems. Our immune systems must be permitted to play their important role in the treatment of the foreign bodies we are exposed to.

When antibiotics were discovered, they became the miracle cure. People were randomly taking antibiotics to treat everything - even the smallest of things. Now they, and their offspring, are finding themselves in a bit of a pinch. More antibiotics were synthesized in the meantime, but, for them, finding one that works is so challenging that, while they lie in the bed at the hospital, as they finally find one that does work, the infection is so far advanced that the chances of them coming out of it alive, are nil.

The reason for this is bacterial resistance. The antibiotic should tend to the bacteria present. The doctors have cultured it and sent it out to a lab for confirmation. But yet no antibiotic seems to do anything to the bacteria because somehow the bacteria has changed in some manner that permits it to survive in the presence of that which is supposed to kill it. It has adapted, and adapted well, to a life in the presence of that antibiotic.

So...

1. What antibiotic you choose does matter.

There are two general categories of antibiotics. There are bactericidal antibiotics and bacteriostatic antibiotics. Bactericidal antibiotics attack, directly, the bacteria present. Bacteriostatic antibiotics inhibit the replication cycle of the bacteria.

Every antibiotic has its own specialty. Just as there are many species of rat genus (e.g. Rattus norvegicus, Rattus rattus), there are many species (e.g. the "norvegicus," the "rattus" bits) of bacteria. Some antibiotics, though "broad spectrum," may only have an effect on a portion of a particular genus (e.g. "Rattus") - they'll only have an effect on a handful of bacterial species (e.g. "norvegicus," "rattus"). Some antibiotics tend to 'most' "Gram negative" bacteria while others tend to 'most' "Gram positive" bacteria. Some may even tend to both Gram negative and Gram positive bacteria but only a handful of select species within each genus.

Or, an example: Let's say there's a wigglebiotic that inhibits motility. It does so by disabling the function of fins. You attempt to use this wigglebiotic on your rat because you want him to stop his kicking and wiggling. Giving him this wigglebiotic, however, does nothing: He doesn't have fins!

Quite often we can assume that a certain type of bacteria will be found in a given location. This is why, when you see your vet, he'll give you doxycycline or baytril for a respiratory problem, a sulfa for a urinary tract problem, and amoxicillin for an ear problem. Some of these antibiotics work well for treating other problems in rats however you make a best guess using the most logical choice, and if that fails, you try the next most logical choice.

But randomly guessing serves no purpose other than to increase the chances that, when you use that particular antibiotic again for something it should work well for, it will not work.

These poor sops we call scientists and researchers spend a good deal of time and money to find out what the lowest possible amount is that can be given that will still get the job done. They also find out what the caps are on those substances - how much will kill a rat (literally). It's bad enough that all these lab rats suffer and die for our convenience of this knowledge. There is absolutely no need for you to test this same information out on your rat by giving random amounts. More is not always better. Less and fluctuating amounts can contribute to resistance.

These poor sops also try to determine half lives of the substances they study. They draw a lot of blood to find out how much of the substances maintain themselves in good concentration in the rat's blood and for how long. Some antibiotics need to be given every 12 hours to be present, in a functional concentration. Others have longer-term effects.

The poor sops also study how long the substances need to be given in order to get the job done. But of all of these factors, this varies the most because the "job" varies. If treating pneumonia, you'll be giving an antibiotic longer term. If treating something considerably more mild, the antibiotic will be given shorter-term.

If, in treating pneumonia, you stop too early, you increase the chances of promoting bacterial resistance: The surviving bacteria, not yet all removed from the rat's lungs will replicate and since they survived thus far, their offspring will be stronger than the bacteria you were originally treating.

If, in treating a more mild infection, you treat for too long, you risk having that antibiotic not work as effectively (or at all) the next time your rat becomes sick. The longer you use an antibiotic, the longer the body has to treat it as a toxin, to be prepared for it as a toxin, and, because it is treated as a toxin, to become, essentially, ignored by your body (going back to the alcohol thing: The more you drink and the more frequently you drink, the more you must drink in order to feel the obliterating effects of the alcohol).

ARGH! That's it? I've made it through this entire lengthy page and you still haven't told me how much, how often, and for how long!

Right: See your vet and keep the lines of communication open and you will find that your rat can improve a considerable amount.

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Disclaimer: There are many non-sarcastic accounts and tips on the web regarding rat care. This is not one of them. These are merely accounts of our experiences with rats, our perceptions of these experiences, where we've failed and where we've succeeded. These accounts are here for two purposes:

1) To entertain.

  Remember! Your rat is not a science project, he is your friend!