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Many years ago, when I was a student at Bristol University Vet School, a wise professor used to tell us, “When you hear hoof beats, think of horses, but don’t forget the zebra”. Another professor might say, “Common Conditions Happen Commonly”, but I think the zebra quote is more memorable.
The point is, when we see an animal exhibiting clinical problems, we shouldn’t leap to the conclusion that it has a weird, exotic disease, without ruling out the more common, and therefore more likely, causes first.
I was reminded of the phrase recently when presented with Honey, a beautiful, grey and white fancy rat. Honey had had very itchy skin on and off for a while, and as a result had raw, bald patches on her side and her tail. She had been treated for skin parasites, but to no avail, and there was concern that the skin problems might be a sign of something more sinister under the surface, for example lymphoma. I hadn’t seen Honey before, so I could take a step back and look at her itchy skin with fresh eyes. In general, what would be the most common cause of itching, after parasites, in a domestic animal? Could this actually be an allergy?
Honey’s owner and I looked at the evidence. It was unlikely to be an infectious problem, as the rat who shared Honey’s cage wasn’t itchy. And as for more sinister issues, well Honey was actually pretty healthy apart from her itchy skin; she was bright, active and eating well, and hadn’t lost any weight.
So we gave Honey an injection of short acting steroids, which can “damp down” hypersensitivity reactions, to see if the itching stopped. It did! So we continued the steroid treatment with tablets (most rats are really good at taking tablets if you mush them into a bit of chocolate mousse or peanut butter!), and aloe vera jelly applied to the sore patches.
Next was to try and work out what Honey was sensitive to. This is a real needle – in – a – haystack problem, and we face it regularly with itchy cats and dogs. Allergens can be in anything that we eat, anything that we inhale, or anything that we touch, so the possibilities are almost endless. In dogs and cats we can do blood tests or intradermal skin tests to identify individual or groups of allergens, but these aren’t available for rats (for one thing, rats are so tiny we’d struggle to get a big enough volume of blood or area of skin to test!)
Honey’s owner was already using “hypoallergenic” bedding, which was helpful as I have found wood shavings, hay and straw to cause hypersensitivity reactions in rats in the past. But when she stopped using disinfectant to clean the cage, Honey’s itching didn’t return even when the course of steroids we had given her finished. There was nothing wrong with using the disinfectant, it was one designed for use in small pet accommodation, and it was being used correctly; it’s just that Honey was allergic to it. Honey’s owner now just uses hot water to clean the cage and furniture.
Honey now sports a beautiful glossy coat, and although she scratches herself a little more than her ratty friend, she has been off medication for several weeks. It’s unlikely that she is only hypersensitive to the disinfectant, so other things she comes across may set off little reactions. But now her owner knows to keep aloe vera jelly handy in case a scab starts to form, and we can prescribe a short course or steroids occasionally as needed.
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