• DON’T PANIC

i. Heat — most critically ill small mammals benefit from assistance with heat regulation.

The best form of heating is an infra-red lamp suspended above the cage, which will disperse the heat evenly. Hot water bottles, or in an emergency a latex/rubber glove filled with hot water, are also useful but will need to be refilled with hot water every hour or so. A desk lamp over the cage may also work but you must shield the animal from the light (see below). Heat pads, such as those sold for reptiles, are useful but may not provide enough heat for mammals.

ii. Light — patients usually do best in situations where ambient light sources are dimmed/unobtrusive.

Most small animals are naturally accustomed to low-light conditions and may be over-stimulated if there is too much light, which will encourage them to move around and expend more energy than may be good for them.

iii. Quiet — It is important not to disturb ill animals as to do so can increase their anxiety levels and waste valuable energy reserves.

iv. Immediate environment — Place the affected individual in a small container with warm bedding. Clean, non-dusty materials such as shredded paper should be used.

The ideal container would be made of wood, to maximise insulation, with perhaps a grille on top to allow the infra-red light to penetrate (if used) and the air to circulate, and perhaps a viewing panel on the side, so that animal does not need to be unduly disturbed for observation. If this is not available, a shoebox is ideal (providing the animal does not escape!). Containers made from other materials may not insulate so well. The best form of bedding is shredded paper or shredded newspaper which is bulky, retains the heat well and allows air to circulate, as well as being absorbent.

v. Nursing — Discharges and exudates from eyes/ears/rear end etc. should be bathed with warm saline (1 teaspoon salt to 1 pint water) using cotton wool.

It is especially important to keep the airways clear, as small animals will become distressed and/or dehydrate if they have to breathe through the mouth. If diarrhoea is present, it is important to clean and dry this off regularly as if allowed to remain wet, it can reduce the body temperature. Gentle, regular cleaning of any discharges will most definitely make the patient feel better and more comfortable.

vi. Fluids — where patients can still swallow, attempts should be made to syringe warm glucose solution by mouth (3 teaspoons glucose powder to 1 pint warm water). Maximum 1ml for mice, 2ml for hamsters, 5ml for rats at any one time.

Honey may be substituted (similar proportions) if glucose is not available, but the water will need to be hotter for it to dissove. Make sure the solution has cooled to “baby-bottle” temperature before use. The best way to give fluids is through a syringe. Leave the needle on but snap off about half of the needle (and the sharp tip) with pliers. This will give you an ideal way to administer the fluids to small creatures as the needle can be easily inserted into tiny mouths. The frequency of giving fluids should be limited to 3-5 times a day; any more than this and it may be counterproductive in terms of added stress. Give less frequently if the animal appears distressed.

Specific Problems

a) Bleeding — pressure (using a wad of dampened tissue or cotton wool) should be applied to the area if possible. Most animals will cease to bleed after a few minutes if this is performed and the animal is not permitted to dislodge the clot which forms.

Bitten toes may bleed profusely. Dip the toe in either potassium permanganate (available from the vet - can be messy!) or cornflour, to stop the bleeding. With any type of bleeding, stay calm and remember that it *always* looks far worse than it is - “a little bit of blood goes a long way.”

b) Seizures — care must be taken in handling animals when they are suffering from such episodes. Not only are they more likely to injure themselves, they are far more likely to bite their handler through a combination of disorientation, fear and lack of conscious control over their body movements. More forceful restraint than would usually be used may be required. Warmth, and especially darkness should be attended to (see iii above).

Some causes of seizures in rats can be liver problems, or a tumour in the brain or spine. Be very cautious when handling rats who are in a siezure: they are highly likely to bite. See illustration (right) for a way to firmly handle a rat which is likely to bite. Grasping the rat around the head will prevent this. Most seizures last from 30 seconds to 1 minute; if they last longer, brain damage may be a possibility afterwards. The seizures may be recurrent. Put the animal into a small closed container as described above, with plenty of extra bedding to prevent the animal from injuring itself during convulsions. It is highly important to keep the animal in the dark, as light may trigger further seizures. Do not use any of the nursing techniques as described above, but seek veterinary help as soon as possible.

c) Skeletal Injuries — falls etc. leading to damage to limbs etc. SHOULD NOT BE DISTURBED. If there is no evidence of bleeding, the patient should be given supportive treatment until it can be assessed by a veterinary surgeon. Spinal injuries unfortunately carry a poor prognosis, but again, do not attempt to interfere unless absolutely necessary.

Broken limbs rarely result in haemorrhage in small animals. Do not attempt to splint or bandage a broken limb, but keep the animal isolated in a well-padded container and take it to the vet as soon as possible.

d) Respiratory Distress — breathing difficulties, regardless of cause are always significant and professional assessment/diagnosis should be sought ASAP.

Clean any discharges as described above, to keep the airways clear. For animals already undergoing treatment for respiratory illness, steaming may help immensely. Place the animal in a small wire cage on a table. Find a large container (a cardboard box, for instance) and place over the cage, but allow 1/3 to 1/2 to overhang the end of the table. Then boil a kettle under the open end of the box, at the edge of the table. (illustration below)

e) Diarrhoea — prompt attendance at veterinary clinic to instigate therapy is required. Avoid green vegetables and allow full access to fresh water.

Withhold solid food, but administer fluids (glucose or honey solution) as directed in the Nursing section, to prevent dehydration.

f) Urinary Bleeding — again, any discoloration of the urine or foul smelling urine should prompt a visit to a veterinary surgeon to obtain an assessment and treatment.

It can be hard to differentiate between bleeding from the vulva or penis and bleeding from the urinary tract. Common causes are cystitis, but may also be stones, or a tumour. There is no correlation that cranberry juice will help animals with cystitis as human forms of cystitis usually have different causes. In animals it may be bacterial but could also be something more sinister like a uterine infection.

a) Open Wounds/Removed stitches — Cover the area if possible. For rats, making a body bandage from the foot of a pair of tights [US = panty hose] is possible (cut holes for legs, head and tail). A good idea may be to have a ready-prepared body bandage like this in your first-aid kit. Using superglue or veterinary wound glue is not recommended unless it is on a recently-done operation wound, as infection could then be sealed in.

Additional notes by Sue Brown
A product called Nu-Skin (made by Germolene and available over the counter in pharmacies) is available in some countries (UK and Australia — USA not sure). It is a type of skin varnish designed for [human] wounds, which dries and provides a barrier which allows the wound to breathe but keeps it waterproof and sealed. Some vets are using several coats of this on small animal surgical scars, as the animals seem more interested in trying to get this off than in the stitches. It should be applied *before* the animal has recovered from the anaesthetic, as it is said to “sting”. However it could be used in an emergency to deter a rat/small animal from biting its stitches further, or to keep a wound covered until it can be re-stitched by a vet.

Other techniques used by other vets: one rat owner reports that her vet gave the rat some “fake” stitches to “worry” in a more accessible place following a caesarian operation, hoping this would distract the rat from the real wound. In this case however, the rat was a good girl and left all the stitches alone anyway!

b) Flushing out & cleaning abcesses — use the saline solution described above, using a syringe. Aerosol of sterile contact lens saline can also be used; it is the same dilution, and the pressure can flush out abcesses well. Hibiscrub can be used at a dilution of 1:100. Do not use hydrogen peroxide or other fluids. Some abcesses can also be drawn of pus using a syringe before flushing.

The Lee Lecture

Inspiration for this article came from Lee, a small black rex buck rat owned by Lora Colver, who died in December 2001 following an acute illness. Lee was nursed through the night by Lora until veterinary help could be sought, with moral support provided by Sue on IRC, and the idea that rat owners could be given special training to nurse rats (and thereby improve their chances of staying alive long enough to see a vet) was born.