German Giant strange positions, deformed toe, swollen leg.

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Re: German Giant strange positions, deformed toe, swollen le

Postby EllenD » Sun Nov 12, 2017 7:18 am

By the way, pretty much any vet can do a simple blood draw and get the results within a day or two. You don't need a reptile specialist to do simple blood work. Any "exotics" vet that is willing to see a bearded dragon can do the blood draw in 2 minutes and then forward the results to BOTH you and the vet (you absolutely must request that you get the full results before this reptile specialist does). Then you can both make an informed decision TOGETHER. If his Uric Acid level is high then you'll be able to say "Well now we know it's gout caused by the lack of UVB or whatever, and we can start him on Allopurinol and meds for pain and swelling", and if the blood work rules out gout and confirms an infection then you can do a debridement, cultures, and the CORRECT and SPECIFIC antibiotic.

I do have to tell you that if this swelling started back in June, it's very likely gout and not an infection at all, if anything he developed a localized infection secondary to the gout long after the swelling from the gout had already started. Gout can linger for months and months to years without a confirmation because people think it's just a musculoskeletal injury. Infections cannot linger for this long because even a localized, encapsulated infection that bad will pretty quickly spread to the bloodstream and cause lethargy, loss of appetite, and death very quickly. Sepsis doesn't linger. Gout does. And sepsis causes the individual to feel increasingly worse and worse, to the point that they eventually lose consciousness and then worse...
"Dance like nobody's watching..."
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Re: German Giant strange positions, deformed toe, swollen le

Postby kingofnobbys » Sun Nov 12, 2017 7:33 am

GermanGiant3 wrote:I was referred by a trusted friend who has kept Reptiles for a considerable amount of time to take him up to to the Animal Ark Veterinary Hospital. He has an appointment at 2:20PM on Thursday. I will update this thread immediately once he makes it home


You mention
Animal Ark Veterinary Hospital
, googled them , they are a franchised chain of vets in NC, NY & Chicargo. So there will be a lot of reptile vets in easy driving range of where you live , viewtopic.php?f=45&t=234369&p=1803862&hilit=melissa#p1803862
nc list http://www.herpvetconnection.com/nocarol.shtml
ny list http://www.herpvetconnection.com/newyork.shtml
CBDs: Puff (M)(RIP 10Dec2015 @ 3.2 yrs old (aneurism)),Rex (F)(RIP 16Mar2017 @ 4.6 yrs old,Toothless (M)(sudden unexplained death RIP 26Nov2017) @ 2.1 yrs old.Peppa (F) (born 15Nov2015).
EBTSs : George & Mildred (born july 2010).
EWSs : Lucky (M)(wild juvenile), cat attack rescue, fatal SI RIP 21Jul2010.Wriggles (F)(rescued injured),thought she was a big lizard, 7-8 yrs old, died in her sleep, RIP 2Feb2016). Fluffy (F) rescued 14Nov2017 about 4 yrs old . .
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Re: German Giant strange positions, deformed toe, swollen le

Postby EllenD » Sun Nov 12, 2017 8:56 am

kingofnobbys wrote:
GermanGiant3 wrote:I was referred by a trusted friend who has kept Reptiles for a considerable amount of time to take him up to to the Animal Ark Veterinary Hospital. He has an appointment at 2:20PM on Thursday. I will update this thread immediately once he makes it home


You mention
Animal Ark Veterinary Hospital
, googled them , they are a franchised chain of vets in NC, NY & Chicargo. So there will be a lot of reptile vets in easy driving range of where you live , viewtopic.php?f=45&t=234369&p=1803862&hilit=melissa#p1803862
nc list http://www.herpvetconnection.com/nocarol.shtml
ny list http://www.herpvetconnection.com/newyork.shtml



Well, now I feel more comfortable saying that this vet is skipping the normal, routine step of doing a simple blood draw to confirm or rule out both Gout and/or a "systemic infection" and jumping right to surgery under a general as the diagnostic tool. Again, I don't know this vet and I know he came highly recommended to you, but #1) The plan he is following to get a definitive diagnosis makes absolutely no sense at all, and #2) If he works for a veterinary office that is a large chain (much like "Banfield Vets"), they tend to always try to make as much money as they possibly can, and usually they do this by forcing their vets to follow a protocol that is used chain-wide. So typically vets who work for chains like this do not make their own decisions as to what tests to run or what treatment measures to take, they have to follow the corporate protocol....

I think that anyone with any medical experience, reptile experience, bearded dragon experience, or simply has gone through any type of illness or injury themselves or with their children, family, or friends would look at this situation and agree that something is very, very wrong here...I'm all for taking the least-invasive road possible when treating both humans and animals, but I also believe that if more invasive methods need to be taken then you have to take them. But putting a bearded dragon under a general and cutting his body open (I can't call this an "exploratory laparotomy" but he is using this as an "exploratory surgery") in order to come to a diagnosis of either Gout or an infection without first doing very simple, non-invasive, and inexpensive, routine blood work, which itself will result in the very same ending as this "exploratory surgery" will, well this makes absolutely no sense at all, it's taking a lot of unnecessary risks to the dragon's health, which is what is most important to me and to you I believe, and again, in my opinion, you are unfairly being made to make a serious and potentially life-altering or life-threatening decision without having the usual, routine information that most anyone else in this situation would already have...

You cannot make this decision without having the basic, routine information that anyone else would already have had a long time ago. I think had he had a simple blood draw done a long time ago that Pseudogout would have been diagnosed and treatment started, and he'd be well on his way to recovering by now. And again, I'm not talking about doing a needle aspiration to retrieve some of the fluid in his leg and then doing a culture and sensitivity on the fluid retrieved in order to determine whether or not it contains Uric Acid Crystals indicating Gout or bacteria and/or white cells indicating an infection, or both, that is something that I believe should have been done a long time ago too, but forget about trying to convince him to do that, I'm talking about a simple, routine, every-day blood draw that literally takes less than a minute and will get you a diagnosis in a few days, and will cause your little boy no pain, no harm, no long recovery, no risk of complications, and most importantly will get him started on the real treatment he needs. As Tracie has already wisely stated, I too think this is Gout and the 2 unnecessary antibiotics he's already taking is only going to make him much, much worse if it is Gout. But forgetting that, not doing a simple blood panel first before doing what this vet has talked you into doing is so irresponsible and reckless on the part of this vet (not on your part, you are a victim in this just as much as your dragon is) it's really upsetting me, and it's not even my dragon....

I need to thank my lucky stars every day that I've had the same Certified Herp Vet for almost 15 years and the same Certified Avian Vet for the last 6 years that are both independent and that do nothing before talking to me about it and listening to what I'm thinking, and then we come up with an action plan together. I just can't imagine my CRV suggesting a major, exploratory surgery just to simply diagnose what is a very common issue in bearded dragons now, without first doing a blood draw. The blood work would have been done long ago...

I'm so very sorry you're having to deal with this and make this decision, you shouldn't even be having to consider what you are right now without having the basic information anyone else would already have...
"Dance like nobody's watching..."
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Re: German Giant strange positions, deformed toe, swollen le

Postby GermanGiant3 » Sun Nov 12, 2017 12:39 pm

I will be making him an appointment with the vet who saw him originally back around August, and demanding blood-work.

I cannot be completely certain. However, all four extremities appear to be taking on fluid. The front toes seem to be starting to point upward like the back toes do. For the first time ever this morning I found him with a black beard.

He had his baytril and amoxicillin this morning, should I hold off on further antibiotics today and tomorrow until blood work is completed? Also, if it is a possibility of this being gout, should I remove superworms temporarily from his diet?
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Re: German Giant strange positions, deformed toe, swollen le

Postby AHBD » Sun Nov 12, 2017 1:19 pm

Aw, that;s oo bad ! If only the vets had done the bloodwork + needle aspiration they would have known a week ago what they are actually treating. I think that antibiotics can bring on a gout attack in humans, so can stress. So it might be the combo of meds. as well as the stress of taking them. I would def. demand the labwork that you want, this is surely very frustrating for you. Hopefully you'll have more concrete answers + a positive treatment plan soon. Be sue to get lots of water in him esp. now.
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Re: German Giant strange positions, deformed toe, swollen le

Postby Drache613 » Sun Nov 12, 2017 3:00 pm

Hello,

I am sorry that the vet has really misled you & put you on a wild goose chase, trying to find
the problems. I agree, cutting him open to try & figure out whether or not there are uric
acid crystals or infection isn't needed. A blood test can determine white blood cell counts
which are elevated if, there is any infection, or a high uric acid count also.
Yes, please, for now take him off of all of the medications immediately. His limbs are now
worse & I can just about guarantee that his uric acid levels are going to be high. Can you get
some oral fluids into him, along with black cherry juice today to start flushing his body out?
Let us know how he is doing. When are you getting him to your other vet?

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Re: German Giant strange positions, deformed toe, swollen le

Postby GermanGiant3 » Sun Nov 12, 2017 3:31 pm

Drache613 wrote:Hello,

I am sorry that the vet has really misled you & put you on a wild goose chase, trying to find
the problems. I agree, cutting him open to try & figure out whether or not there are uric
acid crystals or infection isn't needed. A blood test can determine white blood cell counts
which are elevated if, there is any infection, or a high uric acid count also.
Yes, please, for now take him off of all of the medications immediately. His limbs are now
worse & I can just about guarantee that his uric acid levels are going to be high. Can you get
some oral fluids into him, along with black cherry juice today to start flushing his body out?
Let us know how he is doing. When are you getting him to your other vet?

Tracie


I cannot be completely certain if his limbs have worsened, but his energy and appetite is very very low today. I do not currently have access to black cherry juice for him, what is the optimal way to mix it if I were to pick some up? Any optimal brands?

As soon as I can get him in for a visit for a blood test I will do it. I will try for tomorrow. His new UVB is on the way. He is awful about drinking water, not an easy one to get fluids into.
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Re: German Giant strange positions, deformed toe, swollen le

Postby Drache613 » Sun Nov 12, 2017 8:43 pm

Hello,

If you can get to a grocery store or general health food store, many will have just straight
cherry juice or black cherry juice. Offhand, Motts possibly, or RKnudsens have it I believe.
I know it's hard getting fluids into him, but you are going to have to find some way to get a
bit into him, he needs them.
His joints are most likely hurting & overall he probably just doesn't feel well. Is his beard
black?
I'm glad his new UVB is on the way, I hope it gets there quickly!

Keep us posted on him.
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Re: German Giant strange positions, deformed toe, swollen le

Postby GermanGiant3 » Sun Nov 12, 2017 9:44 pm

I will call and see the closest time that I can get him in to the other vet. He will be going to the vet that originally x-rayed him and prescribed Baytril, but never recommend surgery. I will request at the least a basic blood panel and hopefully get some answers soon here. Does anything with him at the moment come across as potentially lethal, or do you believe it to be more uncomfortable for him than anything?

Thank you so much for your time. Pablo means the world to me, I will update ASAP
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Re: German Giant strange positions, deformed toe, swollen le

Postby kingofnobbys » Sun Nov 12, 2017 11:29 pm

I hope you can get this vet to do the PROPER diagnostics sampling and tests ASAP and you never go near that $ hungry BS artist at the vet chain ever again.

Sending lots of goodvibes in your dragon's direction and hoping for a proper diagnosis and treatment plan will be forthcoming.
CBDs: Puff (M)(RIP 10Dec2015 @ 3.2 yrs old (aneurism)),Rex (F)(RIP 16Mar2017 @ 4.6 yrs old,Toothless (M)(sudden unexplained death RIP 26Nov2017) @ 2.1 yrs old.Peppa (F) (born 15Nov2015).
EBTSs : George & Mildred (born july 2010).
EWSs : Lucky (M)(wild juvenile), cat attack rescue, fatal SI RIP 21Jul2010.Wriggles (F)(rescued injured),thought she was a big lizard, 7-8 yrs old, died in her sleep, RIP 2Feb2016). Fluffy (F) rescued 14Nov2017 about 4 yrs old . .
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Re: German Giant strange positions, deformed toe, swollen le

Postby GermanGiant3 » Mon Nov 13, 2017 11:03 am

What a day..

I was unable to get Pablo in to the vet that originally saw him, they were unable to do blood work without prior records like that and could not get him in today anyways. I spoke to Dr Spindel again, who has been a vet and treating Beardies and other reptiles/various other animals for 34 years. He was the one who originally suggested surgery on him about 4 days ago. He has been doing a good job of not over-charging me and discounted x-rays and the office visit.

I updated him on everything, explained to him what I thought about surgery and the like. He took an x-ray and discovered something near the back feet where it appears infection or something is creating a small space there. We fully discussed blood testing options and the original plan was to do full blood count, kidney panel etc. We went over potential costs, he mentioned he has seen numerous times high uric acid levels with no gout, low levels with gout etc. He was unable to get enough out of him to send to the lab and the results I waited on there for blood didn't end up coming back since it was such a small sample. :banghead:

However, Pablo is alert and healthy looking right now to the point where his surgery date was crossed out. We spoke at length and he wants him to continue the antibiotics until they are gone, push fluids and keep a side between 90-105 F for him. If 4 weeks or so goes by without a drastic change, he said he would make as minor as possible of incisions and culture the different things he got out of the limbs.

I was considering still picking up black cherry juice. He is alert today, no black beard or anything like that.

Given that he is currently very alert, surgery cancelled etc.. What are the thoughts on antibiotics, black cherry juice along with his new UVB being on the way and very closely monitoring signs of potential gout? Is an antibiotic course if I am rigorous in regards to fluid, food, lighting safe to continue?

I am waiting on the x-rays to be sent to my email and will then post them here.

The vet he saw today that recommended he stay on antibiotics is a Herp Vet Connection listed vet for the NY area. Edward Spindel. http://www.herpvetconnection.com/newyork.shtml
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Re: German Giant strange positions, deformed toe, swollen le

Postby Drache613 » Mon Nov 13, 2017 12:00 pm

Hello,

I am sorry, but I just don't agree with the antibiotic therapy for such a long period of time.
You mentioned that his swelling has gotten worse after he went on the antibiotics.
So, he did a blood test but didn't get enough to do the test? Where did he do the blood
draw, in the caudal vein (tail)? He has no idea what his uric acid levels are without a
blood test diagnosis. Cutting him open to tear up limbs will be not only painful but could
be detrimental too for him to have to recover from, too. I had a rescue dragon years ago
that essentially looked exactly like that, with the swelling, club foot, etc. I put him on
allopurinol & while he was in renal failure when I got him, he did improve some & was with
us for about a year before he passed.
He cannot say for sure he has an infection so I do not agree with just drowning his system
with antibiotics like this, causing more kidney damage.
Where are you located, in the US?

Tracie
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Re: German Giant strange positions, deformed toe, swollen le

Postby GermanGiant3 » Tue Nov 14, 2017 11:00 am

I am still incredibly torn on what to do right now with him. However, I have discovered an area that needs definite immediate improvement. His basking side with just the uvb and other bulb is only about 77-78F and 42 humidity. For the time being I am leaving his not very bright blue night heat lamp on until I figure out a better heat source. For now this raises him to about 83.2 - I know for optimal conditions he needs to be 90-105, but I am uncertain how I can do this given how cold it currently is in my area. Only about 68 degrees in my room. What is the optimal way to increase this?
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Re: German Giant strange positions, deformed toe, swollen le

Postby Juniper » Tue Nov 14, 2017 12:31 pm

If your enclosure has a mesh top and you are losing a lot of heat through it, you can cover part of it (not where the lights are, obviously) to trap more heat inside. I was having the same problem last winter and this raised my cage temps quite a bit. Ceramic heat emitters are the best nighttime heat source because they don't produce any light (even a little light can keep the dragon awake), usually have a dimmer switch so their heat output is adjustable, and won't burn the lizard like a heat pad might. They can also be used during the day in addition to a heat lamp. Under-tank heating pads can also be used, you just have to be really careful that there is enough padding between the hot spot and the dragon that it is only warm, and they won't burn themselves on it.
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Re: German Giant strange positions, deformed toe, swollen le

Postby Drache613 » Tue Nov 14, 2017 10:33 pm

Hello,

I did PM you also. :D How is he doing this evening?
Yes, improper temperatures are not optimal for good health at all. What type of thermometer
are you using, a digital probe, temp gun or a stick on thermometer? He needs a basking spot
of at least 95 to a range of 105. The overnight temps of 65 are ok, but at the moment, since
he isn't feeling all that well, I would recommend a little bit of heating so it stays around 75 but
no warmer than 80.
To increase his basking spot temperatures, you can get a slightly higher wattage of bulb or you
can also use a ceramic heat emitter if there is enough brightness in his tank.

Let us know how he is doing.
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