# URI not responding to antibiotics



## Dan203 (Jul 10, 2014)

So about 3 weeks ago Zeeky started getting a little bit of crackle in his breathing. I had some Baytril on hand (22.7mg/ml liquid) so I started him on a round of 10mg/kg (600g = .27ml). He was on that for a week and didn't seem to be getting better so I took him to the vet. She recommended that we try Orbax instead since he had responded to that in the past (he had never been on Baytril before) she also gave me a script Doxycycline so I could add that in combo if he wasn't getting better after a few days. 

I gave him the Orbax for 2 days but he seemed like he was geting worse, not better, so I had the Doxy filled and started giving him that too. I continued with that for 3 more days but again he seemed to be getting worse not better. So in a bit of a panic I switched back to the Baytril but continued the Doxy. After a few days he still wasn't getting better so I bumped his dose up a little to .3ml. After a couple days of that he still wasn't getting better so I bumped it again to .33ml and then finally again this morning to .39ml which is 15mg/kg which is the max recommended on ratguide. 

If he doesn't respond to this what is my next step? Are there any other antibiotic combos he might respond to if these aren't working? Could this be something other then a URI? Can they get colds? He had sort of a cronic URI when he was younger but after a strong round of Orbax he never got one again, until now. 

He sounds horrible. When he's sleeping there is constant crackle/wheezing sound and when he's out for free time it's almost constant but every now and then he'll sneeze and it'll clear up for a minute.

I've tried taking him into the steamy bathroom a few times, but that didn't seem to help. I also put a humidifier in their room but that doesn't seem to be helping either. I've tried to get him to snif Vicks Vapor Rub, thinking it might help him breath a little better, but he wont smell it long enough for it to do any good.

What are my options here? Ratguide says something about a nebulizer. Is that one of those machine people use for asthma? If so where would I even get one and how would I get him to breath the vapors?


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## Dan203 (Jul 10, 2014)

Been doing some reading and there seem to be a lot of people who say that a Batril/Zithro combo will work when Baytil/Doxy does not. I've scheduled an appointment with my vet on Thursday (soonest they could do) so I can get the Zithro. I also found out my mother has an extra nebulizer, and I watched some videos on YouTube showing how to do it, so if the Zithro doesn't work I guess that will be the next step


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## Miss_Rattie (Jul 5, 2016)

I am having the same problem at the moment with my rat Reg. Baytril alone hasn't worked and also in combination with doxy. I tried increasing the doses to the maximum for his weight and there was no improvement over 2-3 weeks. His symptoms have always been very mild and limited to squeaky breathing, which gets worse in the evening. His lungs don't sound too bad, but Reg is over 2 1/2 and so I don't want the URI to progress to something worse as I guess that his immune system is not as good as it was.

So after my next vet visit, I tried azithro and doxy. This did seem to help a little bit, but Reg still had symptoms. Again I tried different doses and gradually increased to the maximum.

I went to the vet 3-4 weeks ago and the most promising combination so far is Sulfatrim with doxy. Sulfatrim is supposed to work best against secondary infections and not against mycoplasma, but combined with doxy it seemed to help. Reg's breathing is still a bit noisy and yesterday the vet gave me Karidox to try with the Sulfatrim. Apparently Karodox is very similar to doxy but permeates the tissues better. This is only the second day of the new combo so I don't know the outcome. The only issue with Sulfatrim is that I think that it must taste pretty bad as sometimes Reg is reluctant to eat it - even mixed in lots of chocolate spread.

So, I would be prepared to experiment with different combinations but the Sulfatrim/doxy combo could be worth mentioning to your vet. Good luck!


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## Dan203 (Jul 10, 2014)

From what I've read in other threads you're suppose to combine Zithro with Baytril, not Doxy. I'm pretty sure I read the same for Sulfatrim. The Baytril keeps the myco at bay while the others work on secondary infections. Perhap you should try one of those combos if you still have some Baytril left.


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## TheBoys (Jul 20, 2016)

I've never used a nebulizer, instead what we did for my rat was we were prescribed an albuterol inhaler and just cut a 2 liter pop bottle big enough on one side for him to go in there and then close it up behind him and spray the inhaler in his face. We did this as well as the Baytril and it seemed to clear him up pretty fast.


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## Dan203 (Jul 10, 2014)

The vet said she did not think the infection was in his lungs and agreed that we should try the Zithromax first before resorting to the nebulizer. She said that even if we did do the nebulizer we should probably skip the albuterol part of it and just do the Gentocin because the albuterol is for the lungs. 

Does anyone know what the exact combo dose for Zithro and Baytril should be? Should I do the max for both? Max for Baytril is 15mg/kg and max for Zithro is 8mg/lb according to ratguide. Not sure if I should start with such a massive dose though.


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## lilspaz68 (Feb 24, 2007)

You can.do 10-20mg/kg for zithromax but keep.15 mg/kg for the baytril.


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## Dan203 (Jul 10, 2014)

The dosing she wrote on the script for the Zithro works out to be 13mg/kg so I'll just start with that.


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## Dan203 (Jul 10, 2014)

The Zithro/Baytril combo seems to be working. Zeeky sounds clear for the first time in almost a month. 

This forum is awesome! I never would have known that this combo was even a thing if not for this forum. You guys are a whealth of knowledge and I really appreciate it.


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## Dan203 (Jul 10, 2014)

So Zeeky sounded mostly clear on this combinaton for the last two weeks but the last day or so I've noticed the rattling coming back. I know the healthguide page says that you can keep giving it for another 2 weeks, once a day instead of twice, if needed, but is that going to work if his symptoms are returning while he's already on it?


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## Dan203 (Jul 10, 2014)

Anyone?


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## Miss_Rattie (Jul 5, 2016)

I would consider the Sulfatrim with doxy or baytril. I had the same issue that Doxy/azithro seemed to work for 3-4 weeks then the symptoms started to return. I didn't try either in combination with baytril, as my boy Reggie had already seemed to stop responding to it.

Reg has been on sulfatrim/doxy for 3-4 weeks now. His breathing is still a bit squeaky in the evenings but this is definitely the best combo that I have tried. The only issue is the taste and it can be a bit tricky to get down them.


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## Asteria (Jul 6, 2016)

I am treating a younger rat who came into my care recently (3-4 weeks old) for a respiratory infection. Most antibiotics that are safe for younger rats aren't as effective or fast as Baytril, so my vet suggested using a nebulizer on top of his medication and it's really helped to clear him up. If you have access to one, it's worth a try.


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## Gribouilli (Dec 25, 2015)

Asteria said:


> I am treating a younger rat who came into my care recently (3-4 weeks old) for a respiratory infection. Most antibiotics that are safe for younger rats aren't as effective or fast as Baytril, so my vet suggested using a nebulizer on top of his medication and it's really helped to clear him up. If you have access to one, it's worth a try.


What med do you put in the nebulizer?


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## Dan203 (Jul 10, 2014)

I switched to the once a day zithro for zeeky on Friday and he already sounds worse. Is it OK to go back to twice a day or should I switch to something else?


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## Gribouilli (Dec 25, 2015)

Did your rat get X-RAYS of his lungs yet?


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## Dan203 (Jul 10, 2014)

No. the vet said it didn't sound like it was in his lungs, but offered to do xrays. I declined at the time because I wanted to see how these new meds worked first. Do you think I should take him back to get some xrays? 

I probably wont be able to get an appointment until wed-thurs. until then should I go back to twice a day for the zithro?


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## Gribouilli (Dec 25, 2015)

Yes I would do XRays, just to make sure you aren't dealing with an abscess or tumor in his lungs. I read you tried quite a few antibiotics/antibiotics combo...usually if an antibiotic(s) is going to work you would see an improvement (even if it is a small one) within three days- doesn't seem like it is what you had. So what had he been on the last three days now and at what my mg/ml?


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## Gribouilli (Dec 25, 2015)

I'm assuming you aren't using anything at all scented around your rat, right? How do you wash their fleece liners? in another post we discussed how fleece liners were useless for ammonia control, and ammonia hurt the lining of the lungs making respiratory flare ups much more likely. What kind of cage do you have?


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## Dan203 (Jul 10, 2014)

The Baytril/Zithro combo did work. There was a huge improvement. But not 100% recovery. After the first two weeks on that combo he still has a little bit of the crackling nose sometimes. So, as directed by the health guide, I refilled the zithro but have only been giving it to him once a day instead of twice a day for the last 2 days. Now the noise seems to be returning. My question is should I bump the zithro back to twice a day for the remainder of the two weeks? Or should I take him back to the vet so we could get xrays and maybe try something else?

As for doses he's on the max for both... 15/mg per kg of each.


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## Gribouilli (Dec 25, 2015)

If the baytril/zithro wirked I would do that again: same schedule and same dose. Do it for 1 month this time. What mg/kg were you using for both the baytril and the Zithromax?


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## Gribouilli (Dec 25, 2015)

3 hours after the antibiotics give you rat some probiotics. Kefir has lots of probiotics (more than yogurt) and is 99% lactose free as many rats are lactose intolerant. Get the plain kefir, and smash a little banana it it for the prebiotic FOS. There's something in the flavored kefir that none of my rats like. You can also use a human casuals probiotics on top of his veggies or mix in baby oat meal cereals...


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## Gribouilli (Dec 25, 2015)

Antibiotics fight most of the bacteria causing the disease, but ultimately it is the body's immune system that will win the battle, that is why probiotics are so important. Most of the immune system starts in the guts with the good good bacteria (probiotics), and the antibiotics kill both the harmful bacteria and the good probiotics that are so important for a good immune system.


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## Dan203 (Jul 10, 2014)

Ok that's what I wanted to know. If it was safe to keep giving him the zithro twice a day for two more weeks. The health guide says do two weeks twice a day and two weeks once a day if needed. I switched to once a day on Friday and it seems to be coming back so I would rather keep going with twice a day if it's safe.

I do give them Kefir every other day like you suggested in another thread a while back. They seem to like the flavored stuff ok. My local store doesn't seem to carry plain.


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## Dan203 (Jul 10, 2014)

Crap he's getting worse. The Zithro seemed to be effective at first but apparently it wasn't enough to knock it out and now it's coming back despite him being on Zithro/Byatril.

I called my vet to see if I could get an appointment for the end of the week, just so I could give it a couple more days, but she is booked up all days except today and she's on vacation next week. So I took the appointment. It's in about an hour. I'm going to ask about the Sulfatrim and the stuff I need for the nebulizer. I'm also going to get her to do the chest xrays just to see if it's pneumonia.


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## Gribouilli (Dec 25, 2015)

Good luck. I hope you get some answers. Ask if there is any abscesses or tumor in his lungs- which should show on the XRays. Let us know, I hope it goes well.


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## Dan203 (Jul 10, 2014)

The XRay showed two bright areas in his right lung. One was in the normal low front typical of pnemonia but the other was high and to the back. But she couldn't definitively say if that was pneumonia or something else. She said it could be infection, a tumor, or even scaring from a previous infection. It wasn't real obvious just brighter then it should have been. So for now we're just continuing with the antibiotics. She gave me some of the SulfaTrim but said I should continue with the Zithro for another week and only switch if I'm sure it's not working.

At this point I've got on hand, or refills available, for pretty much every antibiotic available. So which combo would you suggest I try next if the zithro/baytril doesn't work? I have access to doxy, amoxy, zithro, sulfa, baytril and orbax. I also have a standing order at the vet for the Gentocin that I can put in a nebulizer if needed.


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## Miss_Rattie (Jul 5, 2016)

I would definitely give the sulfatrim/doxy a try. My rat is over 2 1/2 years old and I know that azithro can be less successful in older rats, but the sulfatrim/doxy combo has been good so far.

Reg is 600g and is on 2.5 mg doxy twice a day. The sulfatrim is a liquid and I give him 0.15 ml twice per day. I am away from home at the moment and so unfortunately can't check the concentration, but it is a ready-made suspension.


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## Dan203 (Jul 10, 2014)

I'll give the zithro two more days. If he doesn't improve I'll switch to the other combo and see how that goes.


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## Dan203 (Jul 10, 2014)

The Baytril/Zithro combo didn't work so I switched to the doxy/sulfa combo. I hope it works. He sounded so much better on the zithro at first, but then it stopped working and he just kept getting worse.


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## Gribouilli (Dec 25, 2015)

Oftentimes rats who feel better on antibiotics at first but don't respond afterwards have something like an abscess or tumor in their lungs...The XRays weren't conclusive about that, right? It also could be that your rats need antibiotics deliver via nebulizatuon. Obviously keep giving the antibiotics you were given by your vet. How many days does he get better before getting worse on new antibiotics?


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## Dan203 (Jul 10, 2014)

I tried several different combos. He never got better until I did Baytril/Zithro. He was almost normal, but then after two weeks I dropped him to once a day and it started to come back. I switched back to twice a day after just two days, but at that point it was too late and he just progressively got worse. He never really responded to the baytril anyway so I'm hoping the doxy/sulfa combo works. If not then nebulizer is next.


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## Miss_Rattie (Jul 5, 2016)

Good luck with the doxy/sulfa. My rat has been on it now for about 5 weeks and I am very pleased with the combo - his breathing is rarely totally silent, but the vet has said there could be some lung damage that is causing it, from him having respiratory issues for the past six months or so. He is well over 2 1/2 years old and so his immune system is probably not the best. I don't know whether doxy/sulfa will cure the URI but as long as it is kept in check and doesn't progress further then I will be happy.

I had a rat who was on doxy/baytril for two years, from six months of age, until she died. I don't think the URI was ever really cured as she did intermittently have mild symptoms, but the combo did stop any progression and I never had any issues with resistance. I just had to increase the dose if she put on weight.


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## Dan203 (Jul 10, 2014)

He really hates the sulfa. I'm trying o find something to mix it with to hide the taste but so far every time has been a struggle. The doxy is fine becuase I tried them seperate and he ate the doxy no problem. So the sulfa must taste terrible.


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## Gribouilli (Dec 25, 2015)

Torani syrups are usually well liked. I used flavored syrups like almond, vanilla, and caramel in the last with great success. Put a little peanut butter or Nutella on the opening of the syringe and some higher that the rat can't lick off but still smell it so as to encourage the rat to continue licking out all the medicine


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## Andromeda (Apr 28, 2016)

One of my boys is on Baytril right now for a mild URI, and he hated the taste of the meds. After struggling with him the first day, I took a small (like, 1/8th of a slice) piece of banana, mashed it up, and mixed it with the meds. Have not had a problem since. He practically grabs the dish out of my hands now. xP


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## Miss_Rattie (Jul 5, 2016)

I use a mixture of Nutella, chocolate baby food and golden syrup (1 spoon of each) and keep it chilled in the fridge. This has been a great success for the Sulfatrim but I do have to use about half a teaspoon of the mix to dilute it enough so that poor Reggie doesn't have to suffer the taste. If he won't have it, then I mix in a bit more of the mixture and it usually works well and he is getting his full dose.

I tasted the sulfatrim for an idea of how much I needed to dilute to hide the flavour and it is vile :-(


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## Dan203 (Jul 10, 2014)

Most meds, even Baytril, I can just mix with a little bit of apple cinnamon baby food and all my boys will lap it up. With the zithro that didn't work so I had to mix it with a tiny bit of peanut butter and then mix that with some apple banana flavored baby rice cereal. Then Zeeky would eat it. Even that didn't work with the sulfa. What I found that does work... Reeses peanut butter ice cream topping. It's basically liquid peanut butter. Don't even need very much and he'll mow it down. 

I use a small ceramic guacamole bowl to mix these things and then let them lick it right out of the bowl. If they leave any in there I scrape it with my finger and have them lick my finger. It works great. Although I do wonder how much antibiotic I've been exposed to absorbing through my finger. I asked my doctor about it once and he said it was insignificant.


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## Dan203 (Jul 10, 2014)

Man it's been 4 days on the sulfa/doxy combo and he really doesn't sound any better.  

I'm giving him the max dose of the sulfa according to rat guide (30mg/kg) but a mid level dose for the doxy. (5mg/kg) The rat guide does say that up to 10mg/kg can be give in chronic cases. Should I bump the doxy dosing? Or should I give it a couple more days?

I'm still bummed that the baytril/zithro worked at first and then stopped. I was hoping he'd be better by now.


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## Gribouilli (Dec 25, 2015)

Personally, I would increase the doxy. You could try the antibiotics in a nebulizer, but it could very well be a tumor or abscess too- with tumors/abscesses, antibiotics often work at first and then stop working Keep giving him probiotics 3+ hours after the antibiotics. So sorry your rat is still sick, it is so stressful I know.


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## Dan203 (Jul 10, 2014)

The only reason I don't think it's a cyst or tumor in his lung is because the noise seems to be mostly coming from his nose. And every now and then he'll get a good sneeze out and he'll stop making the noise for like 30 seconds. It doesn't seem like that would be the case with a cyst or tumor. Now the X-ray did show something in his lungs, but I don't think that's the primary cause of the noise he's making. It just seems to be a nasty URI of some kind that's not reaponding to anti-biotics for some reason.

Are there any other combos I could try? Or could I add baytril back into the mix so it's doxy, sulfa and baytril? Or maybe doxy, zithro and baytril? I tried the baytril/zithro after he had been on doxy/baytril for a couple weeks, so maybe the original baytril/doxy beat back something and the baytril/zithro beat back something else but the original thing came back after I stopped the doxy?

Oh and during all this he's still been pretty active and he gained some weight between vet visits so he's obviously not having trouble eating or going down the two stories to get food. (I keep their food on the bottom of a DCN and they mostly sleep at the very top) He's just really crackly when he sniffs/breathes.


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## Dan203 (Jul 10, 2014)

Here I made a short video. The mic on my iPad isn't great so it sounds a little different in the video then it does in real life, but you can get an idea. 

https://youtu.be/ToO9gzj-buY


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## Gribouilli (Dec 25, 2015)

You could try baytril/doxy in the AM and Zithromax in the PM or vice versa. I watched the video and it is typical URI. You didn't try Gentamicin yet, right? Here is a list of all antibiotics that can be used in rats and how they treat different symptoms...http://www.rmca.org/Articles/dchart.htm


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## Dan203 (Jul 10, 2014)

No I have not tried Gentamicin. That's the one they put in the nebulizer right?

I also just noticed something about the Zithro... it has a 10 day expiration! I ASSumed it was 14 like the doxy and continued to give it to him for 4 days past the expiration. That could be why he rebounded. He was expired meds twice a day for 4 days then when I did refill it I dropped him to once a day for 3 more days before bumping him back up to twice a day. Although I did give it 5 days on the new batch twice a day and he seemed to be getting worse, so maybe the expired zithro didn't matter. 

Is zithro/doxy a viable combo? I have some Orbax which is like Baytril but only given once a day. So I could try Orbax/doxy in the morning and doxy/zithro in the evening. Although I should probably stick with the current regemen for at least a week before I give up on it. It's only been 6 days and he does sound slightly less loud then he did last Friday when I started this combo. 

My vet will be back from vacation next week, so I may call on Monday and see if I can get some of that nebulizer stuff. My Mom has an extra nebulizer she said I could borrow. (she has COPD)


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## Gribouilli (Dec 25, 2015)

If you see any results at all in an antibiotics or antibiotics combo, don't stop using it for at least two weeks. If the results are slow or not good enough, you can add another antibiotics. It is only when there is no progress at all or the rats is getting worse that you can change antibiotics.


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## Dan203 (Jul 10, 2014)

I gave him the Zithro for two weeks and it seemed to be working. But his symptoms returned when I started him on the once a day dose. I bumped hm back to rwice a day after 3 days but they didn't get better again, so after 5 more days I switched him to the sulfa/doxy combo. But now I discovered I screwed up the expiration on the zithro and gave it to him in that first round for 4 days past it's expiration. So those four days, plus the 3 days of only once a day, may be what caused the resistance and why it didn't work any more when I bumped him back up to twice a day. I should have paid attention to the expiration and kept going with twice a day when I knew he wasn't 100%. But I was worried about causing some long term issue with over medicating him. Turns out I may have done just that doing what I did.

I also have been kind of impatient with some of the other meds. I originally gave him BayTril for almost two weeks and it wasn't working so I took him to the vet and requested some Orbax instead, since he had responded to that when he was younger. I only gave him that for 4 days and he started sounding worse so I switched back to the BayTril and added doxy. I did that for a little over a week and he wasn't getting better so I took him back to the vet and got the zithro. I gave hime a zithro/baytril combo and after a few days he sounded way better so I thought all was good. But then at the end of the two weeks he wasn't quite 100% and that story is what I outlined above. Last Friday is when I switched to the sulfa/doxy combo. He sounds about the same right now, maybe ever so slightly quieter, but not much especially when he's sleeping. (it's a constant noise when he's sleeping) 

I feel really bad that I can't help him. I'm going to talk to the vet on Monday when she returns from vacation and see if I can get the Gentamicin for the nebulizer. If that doesn't work I'm not sure what else to try. There are a few other's listed on that site you linked to, but we're just stabbing in dark here. 

Have you had any success with other combos, or individual meds, after the ones I've tried have failed?


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## Dan203 (Jul 10, 2014)

I'm not sure if he's just having a good day or if he's turned a corner but Zeeky sounds significantly quieter today then he did yesterday. Maybe he's finally starting to kick this thing. <fingers crossed>


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## thepumpkinrat (Oct 30, 2016)

If he doesn't respond well to the new med combo, you could have your vet do a cytology of his nasal discharge to make sure it's mycoplasma and not strep (or any other weird rattie illnesses) The swabbing works even if doesn't look like there's any discharge. They usually just use a cotton swab on their noses, get a slide and identify the bacteria that's causing the issue. I know that they can get some form of strep, but honestly it's probably just an annoying case of mycoplasma. One of my boys just had one done a few days ago, it was an extra $50 but spared my conscience to know 100% what was causing his illness. 
Good luck with your lil guy ;D


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## Dan203 (Jul 10, 2014)

The first thing I tried when this started was a two week run of baytril, max dose. He didn't improve at all so I'm pretty sure it's not myco. His best response was to Zithro, which isn't effective against myco at all, but that suddenly stopped working after a little misstep on my part (read above). Now he's on a sulfa/doxy combo. Doxy dose have some minor effect on myco, but it's more for secondary infections. Myco could be playing a small part here, but I believe there is something else at work here that's causing the major symptoms.


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## Gribouilli (Dec 25, 2015)

I believe I mentioned it before, but you could try amoxicillin which is for bacteria other than mycoplasma, that is if you know it isn't a tumor or abscesses. Even if there are tumors or abscesses, you can still try amoxicillin but it won't help. I'm so sorry you're having such a hard time helping your rat. You're are truly doing your best here.


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## Dan203 (Jul 10, 2014)

He actually seems to be getting a little better. The last two days hes been making a lot less noise. It's still there, but it kind of comes and goes rather then being constant like before. It's only been a few days since I bumped his doxy dose, maybe that's what made the difference.


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## Miss_Rattie (Jul 5, 2016)

Good luck with the sulfa/doxy combo. I would certainly persevere with it a bit longer unless your rat is getting worse. I did find that it took a few days to kick in when I started to give it to Reggie.

Reg is still doing well on this combo after a few weeks and I have managed to cut his dose down from twice to once a day, which is good as he hates it!


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## Dan203 (Jul 10, 2014)

He does seem to be doing better. He's not 100%, but better. I may still ask the vet for some of the stuff you put in the nebulizer to help him along, but as a supliment to the existing combo. 

Yeah the sulfa must taste terrible. I tried mixing it with a bunch of stuff and Zeeky wouldn't take it. The only thing I found that works is mixing it with a little bit of Resses peanut butter ice cream topping, which is basically liquid peanut butter. The doxy I just mix with a little bit of apple baby food and he loves it.


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## Gribouilli (Dec 25, 2015)

That's great news. Continue at the higher dose range and don't stop for at least 30 days. Hopefully you get all of it this time. Remember to give him probiotics and fresh food that boost his immune system. Ultimately it his the immune system that will win the battle, the antibiotics are just helping (a lot).


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## Dan203 (Jul 10, 2014)

Any specific fresh foods? I have been giving him the keifer every other day so hopefully that's enough probiotics.


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