History and assessment Diagnostic investigation Treatment

o Give oxygen therapy if the mucous membranes are blue tinged and/ or there is dyspnoea. The prognosis is guarded. Take care not to chill the animal inadvertently whilst it is receiving oxygen.

o Administer warmed parenteral fluids (e.g., lactated ringers) intraperitoneal route preferable, subcutaneous takes longer to be absorbed. Volumes for administration; 10-15ml i/p, 5-10ml s/c in rats and 1-3ml i/p, 1-2 s/c in mice.

o Warm the animals’ environment whether at home or hospitalised (approx 23-26°) take care not to overheat, as they cannot pant or sweat. Ideally monitor body temperature if tolerated

o Hospitalise away from cats and dogs

o Offer enticing foods in addition to the animal’s basic ration (e.g. warmed fruit/ vegetable baby food) also offer some of the usual diet soaked in warm water to increase fluid intake and make consumption easier. Syringe feeding small quantities of warmed foods if not eating voluntarily – high fibre products +/- motility modifiers for chinchillas and guinea pigs.

o Provideanalgesia
o Provide a hide box and additional nesting material
o Onlyisolatetheanimalfromitscompanionsifabsolutelynecessary. 

This is primarily an acquired disorder of decreased motility. It is particularly common in the herbivorous hindgut fermenters (hystricomorph) rodents. See rabbit notes for pathophysiology, clinical features, diagnosis, treatment and prognosis. 

The rodent patient with gastric obstruction may be asymptomatic or have anorexia initially until an acute abdomen rapidly develops (24-48 hours). See rabbit notes for pathophysiology, clinical features, diagnosis, treatment and prognosis. 

Diarrhoea and enteritis 

The PLACE rule”
A guide to antibiotics than can be associated with antibacterial enterotoxaemia, especially if given orally. Therefore avoid, or give with care systemically based on absolute need ( ie culture and sensitivity results) and monitor GI function. Always check species, dose and route from a reputable exotics formulary.

P  penicillins, ampicillin
L  Lincosamides (clindamycin, lincomycin)

A  Aminoglycosides (gentamicin)
C Cephalosporins
E erythromycin, spiromycin 

Very common presenting sign in these species. Clinical signs include nasal discharge, sneezing, dyspnoea, "rattling" respiratory noise, coughing. In rodents a red oculonasal discharge is not blood but a porphyrin-stained secretion from the Harderian gland that occurs with any stress/illness. Both upper and lower respiratory tract disease (URT, LRT) may be seen. Underlying chronic respiratory disease is probably the reason for most anaesthetic deaths in these species. Anorexia and depression will occur in severe cases. See table 2. 

appropriate antibiosis, preferably after culture and sensitivity of nasal swabs or tracheal washes. Supportive treatment is required in severe cases, including oxygen therapy, nebulisation with mucolytics (e.g. N-acetylcysteine, bromhexine), bronchodilators, NSAIDS, vitamin C and antibiotics. Environmental stressors may exacerbate clinical disease and proper cage sanitation to control ammonia levels (a potent respiratory irritant) should also be employed. 

Urolithiasis and cystitis 

Common in guinea pigs. The exact aetiology is unknown but it can be associated with diets high in calcium and oxalate, and bacterial infections (Streptococcus pyogenes, Proteus mirabilis and E.coli). Clinical signs: Dysuria, haematuria, stranguria and generalised depression and collapse if complete obstruction occurs and goes undetected. Large single and multiple small calcui large stones, or a large accumulation of small calculi may be palpable through the body wall, and examination of urine may show the presence of a few small calculi. Radiography provides a definitive diagnosis as the uroliths are usually calcium oxalate, or calcium carbonate, and so are radio-opaque.  

 Cystotomy is indicated to remove the calculi, and antibiotics may be required to control the cystitis. Recurrence is common. In chronic conditions the use of NSAIDS and glucosamines may be beneficial, and ensuring optimum vitamin C levels. Changing to a moderate calcium and low oxalate diet may help. 

Renal Disease 

A common geriatric problem in all species, and should be borne in mind especially when using antibiotics that are renal excreted. Chronic progressive nephropathy is a significant disease in aged rats. Glomerulosclerosis and interstitial fibrosis are histological features. Dietary factors seem to have a role to play in the development of the disease and preventative measures include caloric restriction and feeding a reduced protein ration (4-7%) these will also limit the severity of the disease if it does occur. Clinical signs are polydipsia and marked proteinuria (greater than 10mg/l). Treatment in addition to basic supportive therapy involves feeding a reduced protein intake and administration of anabolic steroids. 

Obese and old guinea pigs especially susceptible as cannot reach anus to eat soft mucus-covered caecal pellets at night, so perineum becomes caked with faeces. Dental disease will also lead to lack of coprophagy and caking of caecotrophs. Guinea pigs are very susceptible to toxic shock and will require supportive therapy. Treatment: Aggressive supportive care (as above), cleansing with an antiseptic solution and removal of maggots, analgesia, antibiosis if large wounds. Dilute insecticidal shampoo can be used or ivermectin to kill any further larvae. Prevention is by frequent examination, fly control and regular clipping/cleaning of perineal region. 

Reported in all species. Severe Trixacarus caviae infestation (mange) in guinea pigs can cause fits. Gerbils have genetic presiposotion.Treat as cat or dog. 

Pregnancy toxaemia/ketoacidosis 

This is mainly seen in guinea pigs. Obese pregnant animals usually affected, as the name suggests, but obese males and non-pregnant females can also succumb. Two forms occur; a toxic form in obese pregnant animals where foetal displacement causes impaired uterine blood supply followed by ischaemia, foetal death and DIC, and a true metabolic form initiated by a stressor such as fasting or transport. Clinical signs are depression, anorexia, abortion, salivation, convulsions, coma and death. Ketones may be detectable in the breath, and ketonuria may be present. Post mortem shows hepatic lipidosis. Treatment involves administration of glucose or dextrose- containing fluids or propylene glycol, corticosteroids and calcium gluconate. Prevention is by avoiding obesity and minimising stress. Caesarean section to remove foetal load to save the dam can be successful. 

The most common cause in guinea pigs is otitis media/interna due to streptococcus infection. Symptoms include head tilt, circling, rolling, nystagmus. Can often see pus at base of ear canal. Medical treatment often unrewarding but in acute cases NSAIDS and antibiotics may be effective. 

Hypovitaminosis C 

Guinea-pigs have and absolute dietary requirement of 10mg/kg of vitamin C, as, like primates, they lack they enzyme L-gluconolactone oxidase necessary to synthesise vitamin C from glucose. Requirements rise to 30 mg/kg in pregnancy or illness. Clinical signs of deficiency occur within 11-14 days of commencing a deficient diet, and can often be vague. Vitamin C is required for collagen synthesis in particular for connective tissue (e.g. heart tissues, to blood vessels). Clinical signs include: Important early cutaneous signs are roughened hair coat, and scaling of the pinnae. Inadequate dietary levels of vitamin C or anorexia will rapidly lead to clinical signs Lethargy, weakness, anorexia, unsteady gait, painful locomotion (due to bleeding into joints), wasting, gingival haemorrhage and loose teeth. Loose foul-smelling faeces are usually present, sometimes with occult blood. Subclinical scurvy often presents as hypersalivation. Untreated scurvy will result in death within two weeks. PM lesions are haemorrhages around joints and in skeletal muscle. Treatment is with 50 - 100 mg/kg daily of vitamin C (ascorbic acid) and is dramatic, with resolution of signs within 7 days. Prevention: Guinea pig foods are usually fortified with vitamin C, but approximately half of the content is oxidised with in 3 months of opening. Exposure to UV light also rapidly degrades vitamin C and contact with metal also degrades vitamin C. Therefore if vitamin C is supplemented in the drinking bottle the bottle should be covered and a new solution made up daily. Foods that contain high levels of vitamin C (ascorbic acid) include kale, parsley, beet greens, chicory, spinach, sweet peppers, broccoli, tomatoes, kiwi, red berries and oranges.