Gout, MBD, Nurrological, Injury?

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Dragging back leg and not eating as much...

Postby DanielleGia920 » Wed Oct 11, 2017 7:57 am

I've notice since Saturday that my 6 month old bearded dragon Deka has been acting a little lethargic. Her appetite changed and it takes a lot of enticing to get her to eat. She is still eating, but not as much. I bathe her everyday and also give her about 3-4mls of water through dropper per day. She gets calcium without d3 everyday except Wednesday and Saturday, those are the days she gets her herptivite. She has a 36x18x18 tank with a 100watt megaray mercury vapor lamp and two zoo med t5ho strips. The 24 inch strip is right next to MVB and houses a 10.0 reptisun the other 36 inch t5ho runs along the entire back of the tank and houses a 5.0 reptisun. The 5.0 light was only added for additional white light, I didn't want to put another 10.0 because I thought it might be too much UVB. Anyway, I just had this feeling the past few days that something was not right with her but other than her not eating as much and seeming a little lazy nothing else stood out. She has normal bowl movements everyday, last one was about an hour ago. this morning when I woke up I noticed her struggling to get back up on her rock, right after bowl movement. I took her out to see how she would do on the floor, she's usually very active there, and you can see her limping and her foot was bent inwards. I can also feel a little lump on what I would describe as the "knee". Could you still have a bowl movement and be partially impacted? Or does this look like MBD? I purchased her about 2 months ago from a pet store where she was kept inadequately. I removed the top screen this morning so there's nothing filtering out the UVB. I called this morning to bring her in to see a vet but the only reptile vet in this area is on vacation until Sunday. None of the other vets will even see her since they don't do reptiles. Any suggestions on what this could be and what I could do to help? Here's a link to the video of her walking in living room and also trying to get back onto her rock.

Thanks for your help!
Danielle

Walking in living room...
https://youtu.be/gFbJNvCyAMA

Trying to get back onto rock...
https://youtu.be/plAeibMsnvI
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Re: Dragging back leg and not eating as much...

Postby EllenD » Wed Oct 11, 2017 8:28 am

First off, bathing her every day is totally unnecessary as they do not absorb any hydration through their skin or their vents at all, only if they actively drink the water in the bath. If she is drinking 3-4ml of water from a syringe every day and is also eating a healthy diet of mostly live, gut-loaded insects, she's getting all the hydration she needs. Most don't drink at all from a bowl or the bath, and unless she really obviously loves the bath then she only needs one bath a week just to get clean basically. That's just an FYI.

So was she dragging her one leg or did she have the bump prior to this morning? Or I guess I should ask, was she dragging her leg before the bowel movement this morning? To answer you question yes, they absolutely can have an impaction that is pressing on their spinal column and causing partial paralysis of their back legs even if they are still passing small bowel movements, and I would guess it was an impaction except you say she has a lump on her knee? When did you first notice the lump? And is she only dragging the leg with the lump on it, or are both back legs effected?

What substrate do you have in her enclosure? Can you possibly post just a photo of her entire enclosure and showing all the lighting, and then very important is showing a close-up photo of the lump on her leg so we can get an idea of what is going on here. It's very possible that she injured herself somehow in her enclosure, depending on when the lump showed up compared to when she started dragging her leg, and whether or not it's only the leg with the lump, or it's both legs. It could also be the start of gout, which is also why we need to see a close-up photo of the lump.
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Re: Dragging back leg and not eating as much...

Postby EllenD » Wed Oct 11, 2017 8:41 am

I just watched the entire first video, I think it cut out early the first time I watched it, I saw you pointing out how her left leg is a bit swollen compared to the right leg, and that you can feel a little lump on her left knee, but it's not really visible.

I can't tell because she's definitely walking oddly, but is her right leg moving normally? It seems as though she's definitely favoring the left leg, but I can't tell if the right leg is effected as well, I don't think so though.

I don't think it's an impaction at all, I think either she injured her left leg somehow inside her enclosure when you weren't looking, either she fell off of something or she got it stuck on something (I can't tell because you don't show her entire enclosure, but does she have one of those green, mesh hammocks by chance?), or she may have the start of gout. If her appetite and activity levels have been effected recently, and now this lump and swelling has just started in her left leg, it's very likely gout. I'll wait until other reply to get their opinions, but she definitely should be seen by an experienced reptile vet with bearded dragon experience, make sure of that. She's large enough for blood work to be done, that will diagnose the gout or rule it out. An x-ray will show an injury to the leg, but they don't always show the crystals accumulating from gout in the joints, and some vets will just take an x-ray, see no uric acid crystals on the flat x-ray, and then just call it a muscular-skeletal injury and then prescribe Metacam for the pain and swelling without doing a blood panel to show her uric acid level and her CPK level, which will definitively diagnose or rule out gout. So blood work is a must. If you see any swelling in her other legs, feet, joints, etc. then it's definitely a gout situation.

Again, I'll wait for other opinions before prescribing anything to do at home until you can get her to a reptile vet.
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Re: Dragging back leg and not eating as much...

Postby DanielleGia920 » Wed Oct 11, 2017 9:20 am

Thanks for your response!


[Click image to enlarge]
.
Here's her enclosure

Here's a picture of her knee but you can't see anything. I only starting feeling around because of the dragging and it felt somewhat different than the other leg. I don't know if it's always been like that. It kind of sounds/feels "creeky" when I try To extend the leg. Bump maybe a bad choice of words. It feels like the bond has an indentation in the middle. So it goes inwards and then back up.
[Click image to enlarge]


I think both of the back legs seem off, it's hard to tell. She doesn't seem to want to use either of them. I did notice two days ago some jerky back leg movement but I figured it was from the shedding. Both of her back legs just shed the last few days.

I just went up to her to feel her belly and I can feel something hard just before her leg begins. I messaged it lightly and When I touched it she jumped. Wvertime I walk to her tank her toes keep tremble on her back leg, the same side where I can feel the hard bump in belly. That's her right side. [Click image to enlarge]
.

If it was impaction what could I do to try and relieve it? No solids, a little olive oil, canned pumpkin and warm soaks?

Thanks again for your help!
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Re: Dragging back leg and not eating as much...

Postby EllenD » Wed Oct 11, 2017 9:55 am

Your best to get a jar of prune baby food to use as a base, empty it into a microwave safe container, add 3 tablespoons of plain, canned pumpkin, and some water or unflavored pedialyte to thin it so you can use it in an oral syringe or eye dropper. You can add a drop of oil too. Mix very well, microwave for a minute, mix very well again, then fill the syringe and test it on your wrist, like a baby bottle. You want it warm, not hot.

You can try dripping it on his snout and over his lips to see if he'll lick it off, but you want to get between 1ml-2ml at the least in him to make a difference. So if you have to, insert the tip of the syringe gently under his upper lip on the side of his mouth, back towards his ear. Then slowly slide the tip of the syringe towards the tip of his snout in the middle of his mouth, keeping it under his upper lip the entire time. When it gets to the tip of his snout he will automatically open his mouth, then you can gently push out a good sized drop of the laxative slurry into his mouth, let him swallow it, then start over and keep repeating the process until you get 2ml in him. Then let him bask under his lights for a good 2 hours, then try an warmer than average bath, giving him gentle, circular tummy rubs starting under his right armpit, and going down the right side of his stomach and then in towards his vent. Repeat the tummy rubs while he's soaking in the warm water a few times, and encourage him to swim around in the warm water if he can, or you can passively make him swim, gently moving his back legs back and forth, which encourages a bowel movement.
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Re: Dragging back leg and not eating as much...

Postby DanielleGia920 » Wed Oct 11, 2017 10:28 am

Your the best! I just did a warm bath and rubbed his belly. His back legs seem fine in the bath, he can swim but they aren't 100 percent because he couldn't climb up my arm which he would normally do. He started a bowl movement but it was small and then he stopped. I'm going to run to the store now to pick up the baby prune food, canned pumpkin and pedialyte.

Thank you very much! Will keep you posted!

Danielle
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Re: Dragging back leg and not eating as much...

Postby DanielleGia920 » Wed Oct 11, 2017 1:03 pm

I did the slurry. I got about 2.5 ml in, probably a little less since it was dripping from her chin and all over her face 😱She wasn't very happy with me but hopefully we can get things moving. Going to let her bask now then we'll try the bath. Thank you again!
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Re: Dragging back leg and not eating as much...

Postby EllenD » Wed Oct 11, 2017 1:07 pm

It sounds very much like an impaction now, sometimes they'll even throw a black beard in the middle of straining to go because it hurts so much. Definitely get the laxative slurries in her and in a couple of hours try a bath again. Remember, when she's in the bath let her soak for a couple of minutes, then try to encourage her to swim by moving her around throughout the water, usually they'll take off then. Typically if they're really impacted they need to move their back ends around to get things moving, and then they will suddenly just stop and start straining.
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Re: Dragging back leg and not eating as much...

Postby DanielleGia920 » Fri Oct 13, 2017 7:12 am

SHe has been going to the bathroom everyday so I guess I was wrong. This was her bowel movement this morning, with that we can rule out even a partial impaction correct?[Click image to enlarge]


After much research since I didn't know much about gout in reptiles, in guessing you were right with your fist assumption. It's her back right leg that she is not using and that's the leg that looks swollen and now her foot as well seems swollen...[Click image to enlarge]


She is not moving around her viv, she stays in the same spot all day and sleeps there as well. I also noticed her left front foot has a finger that doesn't curve normally like the others. It sticks straight out.

The only reptile vet in this area is away until Sunday. Could this possibly be MBD? Is there anything I can do in the meantime to alleviate the swelling and help her walk and feel better?

Here's a side by side comparison of her from last week to now. You can see a dramatic difference, she looks ill. [Click image to enlarge]


The thing I felt on her side, that I thought was an impaction is still there but I'm thinking it's just bone? [Click image to enlarge]
not sure if you can see it there, it's right where my finger is pointing. Would that be her ribs? Do they go down that far?

Thanks for your help and advice,
Danielle
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Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Fri Oct 13, 2017 11:53 am

My 6 month old bearded dragon has been having trouble with back leg since Wednesday. We've ruled out impaction, she's had normal bowl movements everyday. She is limping and not using her back right leg. The leg also seems swollen as does the foot.[Click image to enlarge]
[Click image to enlarge]
She is not moving from her rock she sits in the same spot all day and all night! If I take her out she does make an attempt to walk back to her viv, so she can walk/limp but chooses not to. I also noticed her front left toe is sticking straight out instead of curved like the rest of them.[Click image to enlarge]
The back left foot also looks awkward to me, she tucks it in towards the body instead of out like it normally is. [Click image to enlarge]
[Click image to enlarge]
Ive done so much research but that just makes me more confused. Could it be gout, MBD, something neurological, I don't know. Btw she's on repticarpet in a 36x18 viv with a megaray MVB and a 36 inch T5h0 Reptisun 10.0. Her diet consists of dubais, Phoenix worms, hornworms, crickets, mealworms, small supers (under 1 inch) mustard greens collard greens and squash with calcium and herptivite dustings. She looks like she is ill or in pain. Here Is a comparison picture, the first pic was taken today and the other was taken last week. You can see the difference in her...[Click image to enlarge]


Also the half of her tail has a weird pinkish tint to it and she isn't eating like she used to. That just changed this week along with everything else. [Click image to enlarge]


I tried calling a reptile vet but the only one in my area is on vacation until Sunday. Anyone have any suggestions on what I can do to help with the swelling and the pain she seems to be in. Or what exactly is happening to my poor girl? 😞
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Fri Oct 13, 2017 1:21 pm

First off, I think the tail tint is just a shed coming on. I wouldn't worry about that right now unless it turns pitch black or shrivels up, but again I'm pretty sure that's just a shed coming.

So her back right foot and leg did end up swelling up? And she still has the lump on her other back leg if I recall? I'm going to assume now, just like I mentioned before, that she probably has gout. I'm basing this on the swelling, the lump on her knee joint, and the fact that she is obviously in ACUTE pain. You're husbandry has always been good and her diet/calcium supplementing has always been good, so that usually rules out MBD, as does the great amount of ACUTE pain that she is acting like she's in. MBD typically will not cause them to seem like they are in pain, nor does it stop them from trying to move, they still try to move normally, they just end up walking oddly and usually flipping over onto their backs often. It does not look like MBD to me at all, nor does it look like a Vitamin B1 deficiency or any type of neurological issue. She hasn't had any tremors or twitching as far as I know either, is that correct? If not, then I'm pretty sure it's most likely the start of gout. The good news is that it's completely treatable, but she does need to get to an experienced reptile vet that has a lot of experience with bearded dragons, not an exotics vet who doesn't have experience with bearded dragons or with gout. Gout is unfortunately becoming very common is young bearded dragons, so any experienced or certified reptile specialist vet will be familiar with the signs and symptoms of gout in bearded dragons, as well as what tests need to be run to positively diagnose gout, and how to treat it successfully. So if you have to drive a few hours one way to get to an experienced reptile vet then that's what you need to do, trust me it is sooooooooo well worth the drive. Gout is a disease that once you get it diagnosed and start treatment, which by the way is a daily dose of the medication Allopurinol, which is not at all expensive, as well as pain management, and once you get it under control, you don't need to be running back to the vet all the time to treat it.

An experienced reptile vet should do both an x-ray and blood work to diagnose or rule out gout, and these 2 tests will also diagnose and rule out a host of other conditions, like an infection, a muscular-skeletal injury, nutritional deficiencies and the diseases and conditions they cause like MBD and Vitamin B1 deficiency, etc. DO NOT JUST SETTLE FOR AN X-RAY!!!! SHE'S LARGE ENOUGH TO HAVE A SIMPLE BLOOD DRAW TAKEN TO RUN A FULL BLOOD WORK PANEL, AND THIS IS THE ONLY WAY TO DEFINITIVELY DIAGNOSE GOUT!!! I'm telling you this because a lot of "exotics" vets, general vets, or vets that don't know anything about gout in reptiles will often first take an x-ray, and when they don't see any Uric Acid Crystals in the dragon's joints (which is most likely the bump in her left knee, but they don't always or even often show up on a regular x-ray), they automatically rule out gout the problem, then they just prescribe a medication for pain and swelling and probably a totally unnecessary antibiotic (how do they know they have an infection without blood work?) and send you home, telling you it's just an injury and she'll be fine after a week or two. Then the poor dragon just suffers and suffers, deteriorates, the unnecessary antibiotic makes them even more sick, and instead of getting a jump on treating the gout, the gout is now so bad it's breaking down their muscles and the poor dragon can't even move. So yes, you want an x-ray, but you also must insist upon blood work to check her Uric Acid and her CPK, those are the two levels that usually diagnose gout, and also you want to know her blood cell counts. And always ask them for a copy of the blood work results to be emailed to you immediately when they get them.

Until you can get her to the reptile specialist, there are a few things you can do to help her feel better. Tracie, one of the moderators here, is an expert on Gout in dragons, so hopefully she sees your post soon and chimes in with her recommendations, as well as whether or not she agrees with me on a diagnosis of gout. The usual things that help relieve some of the swelling and pain of gout are #1) Giving her Black Cherry or Tart Cherry Juice or Extract, whichever you can find. Usually you can find Black Cherry and Tart Cherry Juice at most health-food stores, as well as grocery stores that have a large organic and natural foods section, like Wegmans, Whole Foods, Harris Teeter, Trader Joe's, etc. If you give her a few ml of the Black Cherry Juice or Tart Cherry Juice every day it should help to relieve some of the swelling and pain. #2) It's extremely important that you keep her very well hydrated every single day, as gout is very hard on their kidneys. As the uric acid builds up in her body, the kidneys go into overdrive trying to get rid of it, and this can result in kidney damage. So the more fluids she takes in to flush out the Uric Acid the better. So if she drinks out of a bowl make sure she has a bowl of water at all times, if she drinks during a bath be sure to bath her every day, and if she does neither then you'll need to give her a 2-3ml of water or unflavored Pedialyte a few times a day. You can drip the water or Pedialyte on her nose and let her lick it off, and if that doesn't work you'll have to use the syringe forced-fluids method, which is really easy actually.

If you fill the oral syringe with either the water or unflavored Pedialyte first, and this is also how you give her the Black Cherry or Tart Cherry Juice, then use the tip of the oral syringe and insert it under her upper lip at the side of her mouth back towards her ear. Once you have the tip of the oral syringe under her upper lip on the side of her mouth back by her ear, slowly slide the tip of the syringe up towards the tip of her snout, keeping the tip of the oral syringe under her upper lip the entire time you're sliding up towards the tip of her snout. Once the tip of the oral syringe reaches the tip of her snout, she will automatically open her mouth, I don't know why they all do this but they all do, lol. Be sure to have your thumb on the oral syringe plunger the entire time, so that when the tip of the oral syringe reaches the tip of her snout, you're ready to VERY GENTLY push a small amount of the Cherry Juice/Water/Pedialyte into her mouth. You don't want to push a lot of liquid into her mouth at one time, or "shoot" it quickly or forcefully into her mouth, as you don't want her to aspirate it. Once you do this a few times you'll be able to judge it easily. Let her swallow the liquid, then just start over again, inserting the tip of the oral syringe under her upper lip, on the side of her mouth, back towards her ear...just keep doing this until you get the necessary amount of fluids in her. Works very well, and is not at all stressful for the dragon or for you as a lot of other methods are.

The other thing that really helps a lot with relieving the pain and swelling of gout is a supplement called Serrapeptase. Serrapeptase is a naturally-occurring enzyme that is a wonderful anti-imflammatory and pain reliever, and people with beardies that have gout swear by it. You can either order a bottle of Serrapeptase capsules online (pretty inexpensive) that you can open up and dump out the powder and then give her the correct dose, which Tracie can help you with, or you can order her live Silkworms and simply feed them to her as her live feeder insects. Silkworms contain a large amount of Serrapeptase inside the inner-lining of their intestines, and they are a very healthy feeding for bearded dragons anyway. So either way, Serrapeptase is a must for a beardie with gout.

Tracie can make her recommendations and give you her advice when she sees this, like I said, she's the gout expert. What I do know is that most beardies who are first being diagnosed with gout and are experiencing a lot of pain and swelling to the point where they can't move, seem to do very well once they are put on the appropriate dose of Allopurinol. She'll have to be on it for the rest of her life most likely, but as I said it's a very inexpensive prescription drug, and people often take it for a variety of reasons, but gout and kidney stones are the most common, and it's available in a cheap generic form.
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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Fri Oct 13, 2017 1:52 pm

Thank you so much Ellen! Ok, so X-ray and bloodwork checking for uric acid, cpk and blood cell count needed. For the swelling I'll go get some Cherry extract, serrapeptase capsules, silkworms and also make sure she's hydrated. I did see another reptile vet on herpvetconnection.com about an hour from me and in the comments they mentioned "dr just loves bearded dragons" I guess I can assume that means he knows a thing or two about them, hopefully. 🤔 I'll call them and see if they are experience with them.


You have been so helpful thank you for taking the time and helping me. How exactly do I keep her warm while transporting her to the vet. It's been chilly by me the past few days, rainy, damp, and in the 50s. I don't wanna stress her out to bad. Is a box with a blanket and the heat on in the car good enough?

One last thing, as for the hard spot I though I felt in her stomach the other day. It's still there but I can feel it on both sides. Could this just be her ribs? Picture isn't the greatestt but you can kind of see the protrusion exactly where my thumb is. [Click image to enlarge]
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Fri Oct 13, 2017 2:22 pm

Yep, that's her bottom rib on both sides. When you said that the other day I figured it was either a rib or her pelvic bones, that's a really common thing to feel and freak out about, so it's always better to ask than to worry about it.

Yes, I'd give that reptile vet's office a call ASAP and definitely ask about his experience with bearded dragons. I'd go ahead and tell them that after consulting with a few experienced bearded dragon owners that a diagnosis of Gout is suspected, and that you're expecting to get both an x-ray and a blood panel done to check her Uric Acid level, her CPK level, and also to rule out an infection. This is a good idea to do anyway if she's never had a baseline blood panel done before, as the blood panel will include all of the most commonly run levels, which should all be normal except her Uric Acid and CPK level, so you'll have her normal baseline blood level results to compare to if she has any other problems in the future. Something else to mention about the CPK level, this is basically a level that indicates that her skeletal muscle is being broken down, which is highly indicative of Gout. Now any experienced reptile vet will know how to read her blood test results, but this is why I absolutely recommend getting a copy of all test results, including her x-ray, emailed to you as soon as they get them, because if there is any doubt about whether or not she simply has some type of bacterial infection based on an elevated white blood cell count, we can help you differentiate between Gout and a bacterial infection, or both. There was a frustrated beardie owner on here a couple of months ago who's beardie definitely had gout, and was diagnosed as having Gout, but the beardie also had an elevated White Blood Cell count in addition to a high CPK level, which is normal and does not indicate a bacterial infection, but rather just their body basically "attacking the gout" as a simple explanation. So this poor beardie was prescribed a strong, broad-spectrum antibiotic for like a month daily, which was totally unnecessary and was only causing the poor dragon to lose a ton or weight because it was upsetting her stomach...so it's just better to let multiple eyes look at the results and always keep a copy. As I said, and experienced reptile vet will know the difference and it won't be a problem, which is why the hour drive is well worth it. A lot of people don't realize that in the United States, in order for a vet to call themselves an "exotics vet", all that is required is that the vet wants to call themselves an "exotics vet" and is willing to see "exotic" pets, meaning anything that isn't a dog or a cat. That's it. It simply means the vet is willing to see reptiles, birds, rodents, etc. It involves absolutely no education, no experience, and no special license or certification. Where as a vet that is either a "Certified Reptile Vet" or a "Reptile Specialist" indicates that this vet has additional education, training, much reptile experience, and if they are "Certified" they actually took reptile specialty board certification tests. So any vet can call themselves an "exotics vet" in the United States, even one who is 26 years old and just graduated from veterinary medical school, and has never treated a reptile or a bird in his life. Scary :shock:

As far as taking him to the vet in the cold, he should be fine if you warm up the car first, and then put him in a carrier or a little tank with towels or blankets in and around him, and a blanket covering the carrier or tank while walking outside to the car. Once in the car you can uncover the carrier or tank, and she'll be fine. A lot of people also put some of those "Hot Hands" pocket warmers you can buy at like Dick's Sporting Goods and probably at Walmart as well, back in the hunting and fishing gear section. They put a couple of the "Hot Hands", wrapped inside a towel, underneath and around their beardies inside the carrier or tank. Works like a charm when it's really cold out.
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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Fri Oct 13, 2017 4:17 pm

Ok thank you so much for the explanation and knowledge. I really appreciate it. Will keep you posted!

Danielle
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Re: Gout, MBD, Nurrological, Injury?

Postby Drache613 » Fri Oct 13, 2017 9:30 pm

Hello Danielle,

So sorry your little one appears to have gout. Your setup is really good, along with the diet,
supplementation, etc. I have a few questions for you, if that's ok.
Which brand of calcium are you using, it does not have D3 in it, correct? The Reptivite has
D3 in it I believe as well as calcium & synthetic vitamin A which could be causing some
oversupplementation issues. For now, I would cease use of the Reptivite right now & cut the
calcium to 3 times per week at the moment.
The Megaray MVB, how close is that mounted to your girl? The tube T5 bulbs, are how close
to her & are they mounted underneath of or on top of the screen? They are the 5 or the 10
strength? Can you post pictures of your tank, to show the lighting placement?
I have had the opportunity of testing an older Megaray recently & it emitted pretty well for
being around a year old. Have you tested your Megaray?
It doesn't appear to be metabolic bone disease. Gout can develop for a few reasons & is in
two forms. Pseudo gout which is very common, is usually caused by oversupplementation or
improper supplementation & lighting. This can be treated with meds initially but should 100%
reverse itself & they can go off of the meds within months most of the time. Visceral gout is
more serious & is caused from a multitude of things such as genetics, but is also caused from
poor husbandry & dehydration.
Unfortunately, there is a tremendous amount of inbreeding with bearded dragons that I feel,
is utterly ruining their hardiness & long term health.
Does your girl weigh at least 100 grams I hope? As Ellen suggested, a blood test is the very best
way to determine gout, just by the uric acid levels alone. It looks highly suspicious with the
way the swelling is looking to me. They can & do recover from gout, but it absolutely has to be
caught in early stages to give them the best chance.
The X-rays can help determine gout as well, but, are not always 100% accurate on view. It all
depends on the composition of the crystallization as to how it shows on image.
If you can, try to start on the black cherry extract, either powder or juice, as soon as you can.
I can help as much as possible. Do you have a vet in mind?


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