# Loss of balance, possible head tilt



## Dan203 (Jul 10, 2014)

Buddy seems to be more clumsy then usual lately. Also when he walks he seems to sort of lean to one side a drift that direction a little. From what I can find one of the possible causes is an inner ear infection. I'm currently giving one of my other boys doxycycling for a URI and have some extra so I've put Buddy on it too. How long should it take to see results? Should I also give him some of the baby ibuprofen I have to help with inflammation? He's my oldest boy, and my favorite, so I'm really worried about him and want him to get better ASAP. 

I know there are other reasons for this condition, like pituitary tumors or brain tumors. Are those completely incurable? Even if money is no object? How exactly are they diagnosed? Xray?


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## smoteymote (May 28, 2016)

While I fully believe you should check into all the other conditions you listed I do have one that might be the case. Is he running into things at all when he walks around or poorly estimating jumps and such? A few years ago my friend's boy started to go blind and because it was only in one eye he'd always end up drifting towards the better eye. He bobbled his head a lot as well and became incredibly clumsy. He still lived to a ripe old age though - just had some trouble navigating! We just made sure the area was safe for him to romp and he was good!

Of course, it could easily be an inner ear infection or something else, so you should check everything out. But also get his eyes looked at too!


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## Dan203 (Jul 10, 2014)

I'm taking him to the vet this week regardless so I'll have his eyes checked. He has dark ruby eyes and I know they're a little more prone to vision issues. 

But I'm not real optomistic that's it. He also seems to have balance issues. Like falling over when he's scratching, he's fallen off the table a few times. (small end table only about 2' off the ground, so no injury) And last noght he fell from the second level of the DCN. That's a big drop, but he seems uninjured.

He's relatively active, and seems to be eating and drinkng ok so I don't think he's deathly ill but something is up.


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## futureshadows (Jul 9, 2015)

I have experienced two cases of headtilts.
I have one rat who once had an ear infection and now has a permanent headtilt. She started off kind of unsteady, but now she climbs and jumps as well as her sisters. 

I had another rat who had a stroke and slowly lost use of her limbs. She started off clumsy and falling off the side of the levels/cage, then eventually lost use of her legs and couldn't even eat anymore. I had her put down. It was a sad way to go.


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## Gribouilli (Dec 25, 2015)

You were right to start him right away on doxy as a head tilt due to an ear infection can be permanent if not treated soon enough. He will have to stay on doxy for 3 weeks now. If you stop it before that it will get worse. As far as Sri g an import event I would say 3-5 days. Pituitary tumors can't be cured but there are meds that can shrink them and add months of quality life.


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## Dan203 (Jul 10, 2014)

Went to vet. She looked in his ear and saw no sign of infection, but said it's possible it's inner ear. She gave me some prednisolone to help with the inflamation and hopefully the vertigo. She really counldn't say for sure if this was an infection or a tumor. She said the only way to know for sure would be to get a CT which costs $2,500 and is 5 hours away. 

We did some other basic tests, like wheel barrel and she looked for jitter in his eyes, and those seemed normal so he has no advanced signs of a tumor. But that doesn't mean it's not one.

I showed her the page on Rat Guide about pituitary tumors and she said she could get me some Bromocriptine if I wanted, but she had never heard of it and had no idea how to administer it. Is that something I should get right away? Or should I wait until the doxy/steroid course is done?


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## Dan203 (Jul 10, 2014)

Man I hope the steroids help. He's really messed up. Just constantly tipping over and walking sideways. 

Otherwise he seems ok though. He's still eating and drinking and is relatively active even though I kind of wish he'd take it easy and heal.


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## LoveOurBabies (Feb 20, 2016)

If possible, I'd try and make his cage one level. My wife and I did this for our girly. I have a lot up about her. I don't know enough about ratties to say what's going on, what meds to use (she was put on Baytril and Prednisone), etc. but I just wanted to mention the 'one level' thing. Falling was a big worry for me, until we did that. She can barely walk, now, wobbly if anything 'upright' and so her cage bottom is lined with lots of cloth, and I'm trying to make padded walls, but she doesn't want them.

I wish your baby a quick recovery, and good health all around.


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## lilspaz68 (Feb 24, 2007)

Can you get us a video? I have seen PT so many times that I see the tiny things you might not mention in your description, like the way a paw stays clubbed as they turn, the tiny head movements etc. 

Are his eyes bright or dull and confused, this is a starting point for determining PT vs inner infection/anything else. Is he able to grasp food items in his paws equally well or not at all?

As for bromocriptine, I am using it right now and have had many unsuccessful and successful cases with it. This one looks like its going to be very successful. Signs of PT a week and a half ago. Had her on bromo, not a lot of change, she missed a dose (I had forgotten to mix it up that day) and she declined rapidly. I gave her dexamethasone orally and came home to a very changed girl. Then I had to wait to see if the dex wearing off would make her regress but no, shes improving daily and is almost completely back to normal. These are the best results with bromocriptine but if you do decide you are dealing with PT, its sooo worth it to try. The only downside is that bromo only works on the most common type of PT's called prolactinoma's. So if there's absolutely no response then you can try or continue steroid therapy. which gives you more of a reprieve than a real treatment. It still can have some lovely results and give you your baby back for longer.

If its inner ear infection, I would definitely look into adding baytril or zithromax to the treatment along with the doxy. The pred will help with inflammation which is good.


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## Dan203 (Jul 10, 2014)

If it is a PT how important is it to get him on the bromocriptine right away? Are their negatives to giving that to him if it's not a PT? Can he take it along with the steroids and antibiotics? Or should we wait until the course of steroids is over and go from there?


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## Dan203 (Jul 10, 2014)

Here is a video...

https://youtu.be/Du0qDyhayPU

He seems to hold the food ok, but does keep his one paw up when he turns. That's the oposite paw of the tilt.

Also just before this he was really scratching at the ear that is on the side of the tilt. Really digging in there


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## lilspaz68 (Feb 24, 2007)

It looks and sounds a LOT more like inner ear infection. A good combo of abs, and the steroids should kick this infection's butt.


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## Dan203 (Jul 10, 2014)

Really? Wow that's good to hear. I really hope you're right.


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## Dan203 (Jul 10, 2014)

So how soon should we see results on the steroids? 

When I first posted this thread I had just noticed the symptoms. He was a little off balance and had a slight head tilt. I started giving him doxycycling right away. (that was last Sunday night) I took him to the vet on Wednesday and by then he was pretty bad. The head tilt was pretty pronounced and he was really unstable. He's now been on the doxy/steriod combo for 3 1/2 days and if anything he's slight worse then he was during the vet visit. This morning I started giving him a doxy/baytril combo just in case the doxy alone wasn't working. I don't have much baytril, and it's actually intended for my other boy Ollie, but I've got enough for about a week each. I'll have to go back to vet and tell her what I'm doing so I can get more. (hopefully she's not mad) 

Is my assumption correct that if it is an infection, and the doxy is not working on the infection, then the steroids wont help because the infection will still be causing inflamation? Or should the steroids be working even if the infection is raging? I know steroids can actually cause infections to get worse, could that be why we're not seeing an improvement?

My main concern here is that if it is a tumor I want to get him on the tumor meds ASAP. I don't want to waste time treating him for an infection if that's not the issue. So how soon should I expect to see an improvement from all this if it is an infection? And at what point should I assume it's not an infection and start treating it as a tumor?


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## lilspaz68 (Feb 24, 2007)

I wouldn't consider doxy alone enough of an antibiotic to cure inner ear infection, baytril alone maybe but not doxy. Considering you just started using baytril I would also consider this the start of his Real treatment, and he should act less dizzy and more bright in 4-5 days. The steroids will work on the inflammation but you need the abs to kill the infection and effect the cure. if your vet won't give you more baytril, you can order online if you are in the U.S. 

if you want, post another video, and I can look for signs of PT again. There are classic symptoms and there are symptoms that vary amongst rats. Classic symptoms are clubbed paws, inability to grasp with front paws (don't worry about eating one-handed or bracing arms on floor...this is an older rat thing to do). They usually brux more than usual, head bump when you stroke over their head, don't seem to realize that there are edges (loss of edge behavior) and unlike a healthy rat who stops at the edge of a bed or desk, will continue and tumble off of it. They seem lighter than normal, more limp. their eyes may seem confused and dull, they may even act blind and slow. Your rat in the last video is very quick and accurate with getting those treats. There are more symptoms but those are the usual ones.


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## Dan203 (Jul 10, 2014)

He seems like maybe he's slightly better this morning. He's sill disoriented, but he didn't lisp quite as much to the side when I picked him up or seem quite as confused. Maybe the baytril is working. Or maybe I'm just seeing what I want to see. I really want him to get better. I hate seeing him like this.


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## Gribouilli (Dec 25, 2015)

How many days ago did you start Baytril? Did you stop giving him the doxy? If yes, how many days was he on doxy? What is the concentration (mg/ml) of baytril, your rat's weight, and his dosage?


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## Dan203 (Jul 10, 2014)

I started giving him the Baytril yesterday. He just had his 4th dose. I figured the dose base on what I was giving Ollie. Ollie weighs 520g and is getting .23ml, Buddy only weighs 440 so I'm giving him .19ml. He's still on the doxy. I'm giving him .5ml of that and it's 25mg/5ml.


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## Dan203 (Jul 10, 2014)

I was being too optomistic this morning. He's not getting better, if anything he's worse. Now he's falling over just walking. He's really disoriented. I feel so bad. I don't know what to do. None of this seems to be helping him. 

Anyone have any advice on what I can do to help him? Is there any medication to help with the vertigo? Is there anything else that can be done? His initial 5 days of the steroid are done tomorrow, then I cut him back to just one dose a day. If that was doing anything at all to help him it's about to get cut in half. 

I'm starting to get skeptical that this is an infection. If it's a tumor is it safe to put him on that anti-tumor med while he's still on the antibiotics and the steroids?


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## lilspaz68 (Feb 24, 2007)

You can definitely *try* the bromocriptine but it's not often a PT doesn't respond to steroids but does to bromo.What is the concentration of your baytril? This can tell us if the dose is adequate since we have a weight now. For inner ear infection it's best to use a combo of antibiotics like baytril/doxycycline, baytril/clavamox, baytril/amoxi etc

You also may want to increase your doxy to 10 mg/kg and a dose of 0.88 ml twice a day. I am so not a fan of vets handing out low concentration antibiotics like 5 mg/ml doxy.


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## Dan203 (Jul 10, 2014)

The baytril is the injectible kind, so 22.7mg/ml

Is it common for a PT to progress this quickly? It's only been a week and he's gone from just barely noticable symptoms to barely able to stand without falling over.


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## lilspaz68 (Feb 24, 2007)

Dan203 said:


> The baytril is the injectible kind, so 22.7mg/ml
> 
> Is it common for a PT to progress this quickly? It's only been a week and he's gone from just barely noticable symptoms to barely able to stand without falling over.


Yes it can happen quite fast. Does he lie on his side with his legs sticking out stiffly when he does fall?


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## Dan203 (Jul 10, 2014)

He falls over on his side, but his legs don't seem stiff. When I pick him up he freaks out a little. He's kind of on his side and he seems to get really anxious and struggles.


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## Dan203 (Jul 10, 2014)

It's weird I've watched a few videos of rats with PTs and they seem to lose control of their front paws. Buddy still seems to be able to eat OK and hold food. He's just really off balance. He does seem to club one of his paws when he's standing/lying, but he still has controll of it. What's weird is his balance seems to be much worse then the ones I saw in the videos. He's basically just tipping over all the time.


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## Gribouilli (Dec 25, 2015)

I would increase the doxy and Baytril. Look on RatGuide and increase it to 70-80% of the max recommended dose and see if there are any ameliorations. Reading your description, I believe it is an ear infection and not PT, but I haven't seen your rat so can't be sure.


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## lilspaz68 (Feb 24, 2007)

Can you get us another video? The inability to grasp is a symptom of PT that is universal so its unlikely. is he acting manic at all?


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## Dan203 (Jul 10, 2014)

Yes he seems a bit manic. Like moving faster then normal, reacting to touch more violently, and his eyes are wider then normal. 

Why what's that a symptom of?


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## lilspaz68 (Feb 24, 2007)

Sometimes perfectly normal rats get inner ear infection and develop these manic behaviors which often stay even after the infection is cured. These rats can range from just being super energetic and doing things like running big looping circles over and over. Some wave their head around, others do both. I saw a tiny bit of the manic when he was going to grab his treat in the first video.


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## Dan203 (Jul 10, 2014)

He seems like he's improving. He's very active this morning and while he's still off balance he's not quite as unstable as he was Sunday night. Maybe the higher doses of the antibiotics are working. I bumped him to the max on both the Baytril and the doxy, so if it's an infection then that should definitely knock it out.


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## Gribouilli (Dec 25, 2015)

Dan203 said:


> He seems like he's improving. He's very active this morning and while he's still off balance he's not quite as unstable as he was Sunday night. Maybe the higher doses of the antibiotics are working. I bumped him to the max on both the Baytril and the doxy, so if it's an infection then that should definitely knock it out.


It's great. Make sure he is on the highest dose for at least 2 weeks. Check RatGuide not sure how long it is recomnended, maybe it is more than two weeks. After 5 days on the highest doses you will know for sure. After 3 days you should see good improvement.


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## Dan203 (Jul 10, 2014)

Rat guide says 1-3 weeks. 

So how much improvement can we expect? I know it says that after an infection like this the tilt can be permanent. How much should his balance improve even if the tilt doesn't go away completely?


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## lilspaz68 (Feb 24, 2007)

The tilt isn't really causing the imbalance, its the actual infection causing inner ear disturbances, dizziness and pain. Once the actual infection is cured (keep him on the high dose antibiotics for 3-4 weeks as inner ear infections can be persistent) then he will adapt to his slightly different world and gain confidence in his mobility again. He will be fine


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## lilspaz68 (Feb 24, 2007)

This boy Fred came to me in terrible shape, and would sleep spooning his brother to keep the world still. Fred lived to past 3 years old



















This boy was more recent...my lovely Jax. He arrived in terrible shape from his inner ear infection, completely unable to stand at all and he was a baby at the time. He was my worst case ever and it actually took him a year to get the confidence up to try to climb anything. he was a timid guy and would flail when off of a surface but ended up bounding and racing around in big loopy circles with mad kisses to my face in between them. 

Arrival










Happy and healthy and tilty


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## Dan203 (Jul 10, 2014)

Buddy kind of looks like Fred. Just always on the verge of tipping over. In fact maybe not even that bad. 

You've given me a lot of hope here. I've been very upset about this over the last week to the point of losing sleep. I'm really glad that this may very well just be an infection and Buddy could stay with us a long while still.


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## Dan203 (Jul 10, 2014)

So it's been a week since I started the BayTril and Buddy still isn't really improving. He seemed like maybe he was getting a little better the last couple days, but then last night he seemed worse. He was really disoriented. Really wide stance when walking/standing, really falling over when picked up, etc... It was a bit discouraging. 

Should we be seeing a marked improvement by now? If it is just an infection how long should it take for him to regain his balance? I know the head tilt may not go away, but he should still regain his balance and stop tipping over right? 

He's at the end of the round of steroids. I know steroids can make infections worse, so if this is an infection should we stop those? I have some children's ibprofen, so maybe I should try giving him some of that instead to help with any inner ear swelling? Or should I consider giving him another round of the steroid?


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## Dan203 (Jul 10, 2014)

I think I was freaking out a bit. Over the last couple days Buddy seems to be getting better. His head tilt has lessened a bit and he's not leaning as much when he walks. He's still off balance, especially when you pick him up, but he does seem to be improving or at the very least adapting.


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## Gribouilli (Dec 25, 2015)

Please remind us why he is on steroids (if still on now). I'm happy he is doing better. How many more weeks of antibiotics do you have?


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## Dan203 (Jul 10, 2014)

He was on steroids because at first we weren't sure if it was an infection or a tumor and the vet said that if it was a tumor the steroids would slow it down and if it was an infection it would help with the inflamation which causes the vertigo. 

Today is suppose to be his last dose of the every other day wind down, but I'm thinking about skipping it because he's doing better and I don't want him to regress at all.

He's only been on the baytril for 10 days so I've got a ways to go on that.


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## lilspaz68 (Feb 24, 2007)

I am glad to hear he's improving. What is your tapering or weaning off schedule?


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## Dan203 (Jul 10, 2014)

It was 5 days twice a day, 5 days once a day and then 5 days every other day. Although I'm not 100% clear if that last part should be 5 doses over 10 days or 3 doses over 5 days. I assumed the later, but maybe that's wrong.


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## Dan203 (Jul 10, 2014)

Man I gave him the one last dose of steroids and he seemed to get worse. It seems to have set him back several days. 

Lilspaz68 - in your experience how long does it take for them to regain their balance once you start giving them the antibiotics? It's been almost two weeks, and while he may be a little better, he's still really off. Is it possible for the infection to be cleared up and for him to still be messed up? If so is there anything else I can do to help him stabilize?


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## Dan203 (Jul 10, 2014)

Any advice here? He's not getting better as quickly as I thought he would and I want to know if I should worry, or maybe get different meds, or if I should be patient and give him more time?


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## Gribouilli (Dec 25, 2015)

Is he only on Baytril for an antibiotic? Is yes I would add an other antibiotic like Baytril AND doxy. Other possible combination here:http://ratguide.com/health/auricle_ear/otitis_media_otitis_interna_labyrinthitis.php


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## Gribouilli (Dec 25, 2015)

I would add a second antibiotic asap or switch one of the two antibiotics if you were already giving him two antibiotics, I would give two antibiotics also.


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## Dan203 (Jul 10, 2014)

He's on baytril and doxy already. I've been giving him 10mg/kg of each, twice a day, for two weeks now. He was on doxy only for about a week before I gave him the baytril. What other combination should I go with? You seem to have experience with this from your pictures, how quickly did your boys start to respond to the antibiotics? I'd say best case he's responded slightly, worst case he hasn't changed at all but hasn't gotten any worse from when I first started giving them to him. 

Other then the head tilt and imbalance he's pretty active and still seems to be eating ok. I've been monitoring his weight and it has not changed in the last 3 weeks. He also still seems to use both hands when eating, so I'm pretty confident it's not a PT. But could it be something else? Something other then an infection? 

I still have a bunch of the steroids so I coul give him another round, but I worry about those because he did seem to be getting better and then regressed a bit after the final dose of his last round. And I keep finding conflicting information on whether or not it's good to give steroids while he has an infection. 

One more question... With this tilt is the infected ear the one pointing up or the one pointing down?


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## Dan203 (Jul 10, 2014)

Here are a couple of videos that show how he moves and how off balance he is...

https://youtu.be/SISoNwA3gW8

https://youtu.be/WA4urSfPDoc


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## Dan203 (Jul 10, 2014)

If the infection clears but the head tilt is permenant will he always have balance issues?


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## Prince (Jun 17, 2016)

Even with the worst tilts, most rats learn to move around just as well as they did before their tilt. 
My old rat, Oreo developed a head tilt after having a stroke. It took a few weeks, but eventually he learned how to balance and do normal rat things again. Rats typically learn and adapt very quickly. 
As long as he's still acting okay, I wouldn't worry about a tilt from a previous infection.


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## lilspaz68 (Feb 24, 2007)

The infection is what is causing the balance issues, once that's cleared he'll do great


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## lilspaz68 (Feb 24, 2007)

I just saw the videos, he does still have a lot of hesitation. I would continue the bay/doxy for another 1-2 weeks and see how he is then? The steroid won't do much of anything anymore as any inflammation would be gone by now that the pred could help.


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## Dan203 (Jul 10, 2014)

Just a little update. Buddy is getting a little better each day. He's still got the tilt, but it's not terrible, and he's regained a lot of his balance. He's able to climb up on stuff a lot better, although he's still more cautious coming down. But he's not just randomly falling over any more or rolling to his back when I pick him up, which is a big improvement. I'm going to continue with the antibiotics for a couple more weeks just to be sure he's over the hump with the infection, but I'm happy to see that he's finally making lasting improvements in his balance. His fur also looks better. For a while there it was a bit shabby, probably because he wasn't able to groom himself properly. It looks more well kempt now. 

Thank you all for your advice and support. Buddy is my heart rat and it really upset me to see him like this and to think he might have a tumor. I'm glad that it wasn't and I look forward to having more time with him going forward,


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## lilspaz68 (Feb 24, 2007)

Fantastic update Dan!!!


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## Gribouilli (Dec 25, 2015)

I'm happy for Buddy and you! Many rats need to be on antibiotics their whole life so better to give him a few extra weeks of antibiotics on top of what's recommended, just in case he needs them a little longer. He made great progress and you did wonderful for your little friend


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