# Malocclusion and PT



## 3pidemic (Feb 22, 2009)

One of my friend's rats that I've been petsitting since Febuary has a PT and is on medication for it. She's been doing better since being put on the meds, but still has her bad days. Luckily for me she loves to take her prednisone and will grab at the dropper for more when you take it away. Well last night my friend came over to visit and see how she was doing. When she went to give Sniffles her medicine last night she noticed that something was weird with her mouth, turns out she now has a malocclusion that she didn't have when I gave her her meds last night. 

Is it possible for a malocclusion to happen this quick or am I just totally blind? I don't think she's fallen or anything to cause trauma to the teeth, but she has been bruxing almost constantly. Could that have caused it?

My friend's set up a vet appointment for when she gets paid Friday to get Sniffles looked at and her teeth trimmed, but is there anything I can do to help make her more comfortable till then? Up untill last night when we noticed it she was doing pretty good with hard/solid foods (she figured out how to use her wrists to hold food really quick), but I'm giving her special soft food feedings now and while she doesn't seem to be showing any signs of pain and her mouth isn't bleeding/infected, it can't be comfortable for her at all. 

I know people on her have dealt with both malocclusion and PTs, but what about in combonation with each other? This is my first malocclusion and my first PT, so I've been researching like crazy, but any words of wisdom would be awesome.


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## ration1802 (Sep 25, 2007)

What are you calling malocclusion? By definition it is a misalignment of the teeth that causes overgrowth as the teeth don't wear down naturally. It is obvious and the effects of it don't happen overnight. An example of malocclusion...


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## 3pidemic (Feb 22, 2009)

Her two bottom teeth have come up inbetween in two top teeth causing them to look like an upside down V. One of her top teeth is also kinn've rubbing the bottom corner of her mouth causing her to look like she's making a Sylvester Stalone face. 

I didn't think that they happened this quick. Maybe they had been growing longer and just finally got to the point where they spilt her top teeth? I've been up her mouth every night for the past couple weeks giving her her medicine and last night was the first night anything looked different than regular rattie teeth. 

I wish the batteries in my camera weren't dead. I might see if she'll tolerate me trying to get a picture with my phone or webcam latter, just for reference.


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## Stace87 (Jun 24, 2008)

Here are some photos of Spike's malocclusion too - might help you compare. 










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Apologies for them all being all over the place and different sizes lol.


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## 3pidemic (Feb 22, 2009)

Sniffle's teeth look like the last picture of Spike's, except with the top having the gap instead of the bottom.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

One of my girls damaged her teeth... she has Seizures, it may have been caused by this, however I think she just had Malocclusion. She got them clipped a few times, burred another, but in the end got all front teeth (4) removed. It would have been unfair to put her through constant operations, and he vets could have easily caught her by clipping her teeth (she had started to wriggle around a lot). I hope this rattie is all right in the end.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

By constant operations, I mean to bur the teeth... which in my opinion is too risky to do when the rat is 'awake'!


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## 3pidemic (Feb 22, 2009)

Siamese said:


> One of my girls damaged her teeth... she has Seizures, it may have been caused by this, however I think she just had Malocclusion. She got them clipped a few times, burred another, but in the end got all front teeth (4) removed. It would have been unfair to put her through constant operations, and he vets could have easily caught her by clipping her teeth (she had started to wriggle around a lot). I hope this rattie is all right in the end.


Both luckily and unluckily for her, because of her pituatary tumor she won't have to go through trimmings for too long. I just hope that it isn't her tumor starting to grow again and causing pressure on her jaws that's causing the issue. She's been doing really well on the meds, but from other people's expierences with PTs that I've read it's just a matter of time before she starts to worse again and I hope this isn't the first sign of her getting worse again. 

Sniffles may not be my rat, but she's the first rattie I ever got to know and means a lot to all of us and her cage mates. We've been putting off considering having her PTS since she hasn't been in any pain and still tries to climb and play as best she can, but if this is the first sign of her getting worse again it may be time to start thinking about it.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

Don't know what to say, I hope that she is a happy girl for whatever time she has left. :'( :-*


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## 3pidemic (Feb 22, 2009)

She's been very happy everything considered. She gets lots of attention (even from strangers!) and tons of treats, half the time I think she believes her medicine is a treat the way she goes at it.


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## Stace87 (Jun 24, 2008)

Siamese said:


> One of my girls damaged her teeth... she has Seizures, it may have been caused by this, however I think she just had Malocclusion. She got them clipped a few times, burred another, but in the end got all front teeth (4) removed. It would have been unfair to put her through constant operations, and he vets could have easily caught her by clipping her teeth (she had started to wriggle around a lot). I hope this rattie is all right in the end.





Siamese said:


> By constant operations, I mean to bur the teeth... which in my opinion is too risky to do when the rat is 'awake'!


Your rat was put under anaesthetic each time the teeth were clipped or burred? If anything, just a whiff of gas is usually all that's necessary to calm them. My Spike with malocclusion has his teeth clipped (not burred) when he's fully awake - I restrain him while the vet trims. He needs them doing approximately every 2 weeks. I usually wrap him tightly in a towel with just his head poking out.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

It was just a whiff of gas yes. The teeth weren't clipped when she was 'under', but she was stressed out by that. Starting to wrap her in a towel is pretty unfair, and every 2 weeks, you are more likely to damage the teeth even more than anything else. If I remember correctly, you posted on another forum your rats toe got caught during teeth clipping?


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## Stace87 (Jun 24, 2008)

Siamese said:


> It was just a whiff of gas yes. The teeth weren't clipped when she was 'under', but she was stressed out by that. Starting to wrap her in a towel is pretty unfair, and every 2 weeks, you are more likely to damage the teeth even more than anything else. If I remember correctly, you posted on another forum your rats toe got caught during teeth clipping?


It was the nail that got nicked and he wasn't wrapped in a towel then. The nail was fine. Wrapping in a towel isn't unfair... it's protecting them and makes the process quicker. If any fracturing does occur during trims, they're always fine again by the time of the next trim. He's been having them done approx every 2 weeks for over a year now (I think) and his teeth are fine. Someone else on this forum has a rat that does, or did, need trims every week - if I remember correctly.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

In my opinion that is way too often and too stressful for the rat, especially if it now at the point he is wrapped in a towel or he may get his nail nicked? That implies he has been putting his hands up and putting up a struggle in order for that to happen, so he is obviously not happy with it. Some rats may just sit and allow it, but I doubt it. Besides, the teeth were removed by the Edinburgh Vet School, so I would rather go by their expert opinion.


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## Stace87 (Jun 24, 2008)

Siamese said:


> In my opinion that is way too often and too stressful for the rat, especially if it now at the point he is wrapped in a towel or he may get his nail nicked? That implies he has been putting his hands up and putting up a struggle in order for that to happen, so he is obviously not happy with it. Some rats may just sit and allow it, but I doubt it. Besides, the teeth were removed by the Edinburgh Vet School, so I would rather go by their expert opinion.


It's not now at the point he is wrapped in a towel or may get his nail nicked. The method of using a towel was already used to restrain him before a nail was nicked as it's quicker and as I already said, it's safer. Spike isn't a rat to sit still very long and be held, but is becoming more cuddly recently as he's getting older. I very much doubt any rat would happily sit still while teeth were trimmed, unless they were extremely ill. If it comes down to a rat having to be wrapped in a towel for a matter of seconds, or teeth growing into the roof of the mouth and causing all sorts of issues - there is no option. Teeth removal isn't something to be taken lightly and isn't a simple procedure. He developed Malocclusion at around 18 months old (roughly) and is now 29-30 months old. 


Any way... good luck with your friends rat 3pidemic. Did you manage to get a photo at all?


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## [x]RaeLovesRats[x] (Feb 7, 2008)

I know it shouldn't be taken lightly. That is why our vet reffered us to the best Vet School around, and I'm pretty sure we can trust they will know how to do the operation. It was earlier this year, and she is fine. Her mouth does not bother her at all. She is happy, healthy, eats, drinks, and unlike if she was getting them clipped does not need to be taken, constantly, to the vets for no *real* reason when she could have got them removed, and did.

Anyway back on topic ( : ) how is the little one doing?


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## Lea (May 15, 2009)

Siamese said:


> She is happy, healthy, eats, drinks, and unlike if she was getting them clipped does not need to be taken, constantly, to the vets for no *real* reason when she could have got them removed, and did.


That's interesting, I didn't know removal was an option. So can she only eat soft food, or food that is already in small pieces?

I would imagine that whether trimming or removal is chosen would have to be evaluated on a case by case basis -- how well a particular rat tolerates trimming vs. long-term effects of removal, etc.


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## ration1802 (Sep 25, 2007)

My girl has a severe case of malocclusion and I am loathe to get them removed unless I am medically forced to. Why? Because I have heard of many stories of rats dying on the table during tooth removal, I have heard of severe bleeding and most vets will not remove the upper and lower incisors in one operations - it often takes 2. Not to mention the risk of abscessing, infection etc. It's too risky. Cj (an old member of this forum) attempted the surgery with one of his girls and if I remember correctly it had to be abandoned because she was bleeding so much.

I trim Fang's teeth at home on a weekly basis. Yes she puts up a fight, she squeaks and protests - but it's in her best interest. It takes about 2 minutes to do and half an hour later she is eating normally and happily. When she was younger she was unable to eat hard food because of her teeth, being with other rats has taught her to manage solid food but if she was to have her incisors removed, like most rats, she would have to go onto a soft diet and possibly be removed from the group for periods of time.

That's my opinion, trim or burr unless you have no other alternative. Some people luck out, some don't. I don't want to risk it


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## lilspaz68 (Feb 24, 2007)

3pidemic,

Can I ask what her symptoms are that you are diagnosing PT? If she has a tumor that can also cause the shift in her jaw (malocclusion) and there are many neural symptoms similar but not the same as PT.


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## 3pidemic (Feb 22, 2009)

Stace87 said:


> Any way... good luck with your friends rat 3pidemic. Did you manage to get a photo at all?


I wasn't able to. My boyfriend wasn't home and even though she loves taking her medicine and will just sit and chill for feedings she doesn't like peopleholding her head still/poking around her mouth, so I couldn't fanangle my phone and her. 



Siamese said:


> Anyway back on topic ( : ) how is the little one doing?


She's doing pretty good. My friend came and picked her up about twenty minutes ago and she's on her way to the vet to get her teeth looked at and get some mommy time. 



lilspaz68 said:


> 3pidemic,
> 
> Can I ask what her symptoms are that you are diagnosing PT? If she has a tumor that can also cause the shift in her jaw (malocclusion) and there are many neural symptoms similar but not the same as PT.


The vet's the one that said she had a PT and after researching it she has all the classic symptoms (inablity to use her hands/clubbing, the head bump thing, one eye bulging out, mobility issues, etc), so we didn't see a point to argue. The fact that she's also improved on the steroids (she can use her hands a little, is a bit more steady on her feet, has more energy) also makes us think he's right.


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## lilspaz68 (Feb 24, 2007)

Ahh yes those are pretty definitive symptoms. I just wanted to make sure. 

Poor little bubbers...


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## 3pidemic (Feb 22, 2009)

Yeah, it's really just a matter of time and making sure she's comfortable. We all honestly thought she would have gone to the bridge before now, but she's a fighter, so we're just making the most of the time we have left.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

> That's interesting, I didn't know removal was an option. So can she only eat soft food, or food that is already in small pieces?


She generally eats soft foods, but she can managed cooked veg, and cucumber/apple/grapes (with no skin) cut into small pieces. She is certainly a very squishy girlie. 



> long-term effects of removal


There have not been any effects with this girl. She was on Metacam and Septrin after the operation but there was no further problems.



> I have heard of severe bleeding and most vets will not remove the upper and lower incisors in one operations - it often takes 2. Not to mention the risk of abscessing, infection etc. It's too risky.


It may be risky, but I'm pretty confident that a Vet School, the best of the best really, will know what they are doing and be completely sure of it. There was not much blood loss. It was done over two operations, her teeth were quite deep, however this was not a problem. As long as the rat is healthy as can be and an all right age, and you are confident with the vet....

When she went to get her teeth removed, they had become a bit black, one was infected, one had half snapped off of it. She had possible infection BEFORE the operation.

I'm confident that it was the right decision for this rattie, I'm not saying that it is for every single rattie though.


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## lilspaz68 (Feb 24, 2007)

I would definitely consider the removal of all incisors myself, but I have a fabulous vet who took in a sick old rat with rotten teeth that the owner wanted PTS. She removed all his incisors (don't forget those molars are there for grinding still) and he lived at the clinic til he was well over 3 years old ;D


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## 3pidemic (Feb 22, 2009)

An update on Sniffles!

She's back from the vet and doing pretty good. She hated the actual trimming and squeaked and squirmed, but I think she's appreciates being more comfortable now. The vet said that for having a PT she's in top shape, all things considered. Her lungs are clear and her heart sounds good. She'll need to go back in a few weeks for another trim or earlier if it looks like she needs it.

Also the whole thing only cost five dollars, no exam fee, nothing extra, just five bucks. My friend was orginally quoted twenty for the trimming, but appearantly the vet is just that awesome.


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## Lea (May 15, 2009)

That's good news.  and a good price too!


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## 3pidemic (Feb 22, 2009)

I didn't believe it when my friend told me. But then again this vet is one of the best town, they even work out payment plans for costly proceedures and such.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

I hope that this girlie is all right? Is she managing to eat okay?



> if she was to have her incisors removed, like most rats, she would have to go onto a soft diet and possibly be removed from the group for periods of time.


Like most rats? Where did you find that information from? My girl does have to eat softer foods, but is this a bad thing? She can have cereals for breakfast (such as Weetabix, baby cereals), and she can manage toast. She can also eat baby foods, as well as as grapes, cucumber, apple, etc. Surely this is better than her teeth looking like this 5 days after trimming (Rations photo): http://i23.photobucket.com/albums/b384/befferoo/Medical bits/Fangteeth0606081.jpg

As even though you may have trimmed them, she could bite into her top or bottom gums/lip as they are all squint. Stace, I read on FR you saying he has problems *eating* (!!!?) after every trim due to bleeding, and also fracturing? I can only imagine the amount of pain these rats suffer.


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## 3pidemic (Feb 22, 2009)

Siamese said:


> I hope that this girlie is all right? Is she managing to eat okay?


She's eating great, hard and soft foods. That's one thing I'm really glad of is that even with all of her health issues lately she's still kept up a healthy appetite. She did lose a lot of weight at the beginning (prior to the teeth issues) due to not being able to coordinate herself while eating, but she gained some of it back before she had to get her teeth trimmed, both from getting some of her ability to use her hands back and hand feedings. Since getting her teeth trimmed we've been letting her eat as much hard food as she wants and supplementing with soft foods (she loves bananas the most).


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## [x]RaeLovesRats[x] (Feb 7, 2008)

Bless her, she sounds like she is fighting this as much as she can :-[


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## ration1802 (Sep 25, 2007)

Siamese said:


> I hope that this girlie is all right? Is she managing to eat okay?
> 
> 
> 
> ...


You have used the wrong picture to prove your point, I'm afraid. That was Fang's teeth 5 days post trim while she was on a soft diet. She was unable to eat any hard food and therefore her teeth got NO wear at all and grew at an incredible rate  Now she is on a hard food diet she is much improved and doesn't need trims as often.

Trimming the teeth themselves does not cause pain. Sometimes, if the rat joggles you can aggrivate the gum but that is easily remedied with some pain killers. I have seen absolutely nothing with my experiences with Fang to show me that she would benefit at this stage with a tooth removal.

Fang is able to eat hard foods immediately after her trim. Spike's problem with eating afterwards isn't something I (or other rat owners I have known) have experienced with malocclused rats.

I understand that you have your personal opinions about this, but what is best suited to you is not best suited to others. I work very closely with my vet regarding Fang's situation; he is a very experienced vet who would be more than happy to remove them if we belived the situation required it. But, for now, it doesn't. I think this discussion is best left for another time and another thread, don't you?

3pidemic - I am glad to hear she's doing well


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## [x]RaeLovesRats[x] (Feb 7, 2008)

"
I understand that you have your personal opinions about this, but what is best suited to you is not best suited to others. "

Yes I do. It isn't what is best suited to me, it is the rats. They come first. Not what is best suited to me. That is why we drove 2 hours to take her to a Vet School (best around, I believe) and get them done really... properly. The difference is that just your local vet is really not ready in my opinion for such a major operation. Our vets are honest, but the main one that saw my girls teeth was pretty sure that it was something the vet school had to see to. And although Fangs appears to have no problems you cannot tell any inner pain that she could hide well.


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## ration1802 (Sep 25, 2007)

Siamese, I appreciate that our opinions differ significantly here but I do not appreciate you insinuating that I would neglect to realise that the trimming caused my rat pain. If I thought for even one moment that trimming her teeth caused prolongued pain then I would get those teeth removed - but nothing in my experience has shown that she is suffering after these trims. If I had another rat in the same situation who any negative signs, I would remove them straight away.

My vet, also, is perfectly capable of performing the operation and has done in the past to many small animals (he has over 20 years of veterinary experience and has a very good knowledge of rats). If your vet was happy to jump in and remove the teeth, that is fine for your rat. But because my vet is happy to hold back and moniter my rats quality of life before risking such an operation does not make him wrong. It is just two sides to the same coin.

If you would like to discuss this further by all means PM me, but I don't think this is appropriate for this thread.


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## lilspaz68 (Feb 24, 2007)

The tooth removal surgery should never be taken lightly, its a difficult surgery on a rat and they often have to go through it twice for top and bottom. I would only have all incisors removed if the rat's teeth needed trimming every few days, but Fang is a happy girl who deals with her trimming well. My vet is also incredibly experienced and will only remove all teeth _when it's warranted and the rat's health is at stake_ but if the teeth only need trims ever 3 weeks or so, and the rat does well afterwards and is still able to eat hard foods then I wouldn't put them through the surgery.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

I really like, and trust, our vet. But she is a very honest vet and if any doubt she will refer us to the vet school. I don't see no matter how amazing a vet is, they can preform a surgery so serious on an animal so small. The vet school are obviously a lot more 'advanced'.


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## lilspaz68 (Feb 24, 2007)

Siamese said:


> I really like, and trust, our vet. But she is a very honest vet and if any doubt she will refer us to the vet school. I don't see no matter how amazing a vet is, they can preform a surgery so serious on an animal so small. The vet school are obviously a lot more 'advanced'.


They are also learning hence the word "school". I will take a vet who has done umpteen of these surgeries on his own over many years of practice than a school.


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## ration1802 (Sep 25, 2007)

> They are also learning hence the word "school". I will take a vet who has done umpteen of these surgeries on his own over many years of practice than a school.


I completely agree. I have access to one of these vet schools where the odd couple of student/trainee vets who are usually on call do know something about rats. HOWEVER, they are also a teaching hospital and are much more likely to take the extreme cases and more risky ones as a matter of fact - because it is a learning experience. Sometimes, they can be reckless.

For example, one of my girls had to be rushed to the Royal Veterinary College on Christmas Eve for an eye removal (the eyeball burst). The vet on call had NO experience with rats and other vets there only had minimal experience between them. They still did the operation, performed well, BUT it was a huge risk that had to be taken. Had I the choice of waiting, I would have waited for my vet to perform it as he has performed many on animals smaller than rats, even.

In my opinion, you lucked out. I still wouldn't advocate the absolute need for a tooth removal, if i were you.


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## Stace87 (Jun 24, 2008)

Siamese said:


> My girl does have to eat softer foods, but is this a bad thing? She can have cereals for breakfast (such as Weetabix, baby cereals), and she can manage toast. She can also eat baby foods, as well as as grapes, cucumber, apple, etc.
> 
> Stace, I read on FR you saying he has problems *eating* (!!!?) after every trim due to bleeding, and also fracturing? I can only imagine the amount of pain these rats suffer.


If she has to eat softer foods, how is that managed so she has constant access to food? I'd have thought the other rats would tuck into what's meant for her.

These rats don't suffer any amount of pain. The problems Spike has eating solid foods for a few days post-trim is most likely due to him getting used to the different alignment. I know someone else whose rat had the same problem post-trim. I add water to their nuggets for a couple of days and all is fine. He can eat that with no issues.

I agree with what has already been said. I wouldn't take a rat to a vet school for any operation (never mind a complicated one) unless it was an only option and was an emergency, like Ration's case.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

Are you saying they use our animals as a learning project? Ha. Sorry, but that's just wrong. They don't. Because the vet scool is also a vets, with a name like any other vets. They care about animals. They made sure we were happy & knew our girl would get the best possibly care. As a matter of fact, we have another girl booked in to see them this week. Thing is, our vet is honest. If even in a slight doubt, she (or other vets at the clinic) will not go ahead with it. I'm not saying your vets are bad, but they are just local vets.


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## zoe9 (Oct 3, 2007)

Siamese said:


> I'm not saying your vets are bad, but they are just local vets.


As opposed to the magical vets at the vet school you mean?

You know it’s a little naive to presume that local vets are somehow inferior to vets at a vet school. Where do you think the local vets learnt how to become vets in the first place?

You cannot also assume all local vets are the same. At my local practise there are three vets. All three do surgery but one is more experienced than the others and he is the one who operates on my rats.

If he refused surgery because he felt there were other treatment options then I would seriously look into those options. I would not assume he wasn't being 'honest' and was only putting off surgery because he wasn't capable of doing it. To suggest that, and please correct me if I'm wrong but that does appear to be what you are suggesting with Rations vet, is, quite frankly, rude and offensive.

Just saying...


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## ration1802 (Sep 25, 2007)

> I'm not saying your vets are bad, but they are just local vets


Then what do you consider my experience with the Royal Veterinary College? They are one of the country's leading veterinary teaching hospitals - aka a vet school - so really, are no different to yours. If they are 'just a local vet' then surely yours are too.

Don't get me wrong, I think it is great that you have access to a good vets (many don't, nor try to find a good vet). BUT, I think Zoe has hit the nail on the head; you are naive to assume that because other vets don't agree with yours, or refuse to jump into things, that they are wrong and somehow inferior.


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## [x]RaeLovesRats[x] (Feb 7, 2008)

The reason it's called a Vet School is because as well as being a vets, students are there learning. They will be there during operations, but they won't just say "ah I'm a bit tired today, student, go operate ok?". The students are there to become qualified vets. And the only vets operating on our animals are qualified vets, or if a student does they most have been training for a while, near qualified, and will be monitored.


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