Please Help: Diagnosed with Fatty Liver Disease

Hi all!

I've spent quite a bit of time lurking on these forums, but I could use some pointers here. My dragon, Stella, is just about a year old, and had been acting pretty oddly recently. I originally thought it might be because her UV light (reptisun 10.0 tube) was starting to burn out, so I replaced it. Then I noticed her tank temperatures were a little lower than they should be at night, and have since started using a ceramic heat emitter. Her tank is a bit small for her (30 gallon breeder), and I am currently shopping around for a 75 gallon. I've fed her dubias for the majority of her life, until early in the summer. For about 3 months, she refused all feeders except for super worms. I know that I shouldn't have bought into it, but I was scared she would starve herself if she didn't eat something, so I gave her what she would eat. For the past month or so, she's been eating only crickets. She still was acting a bit strange, so I figured it couldn't hurt to take her to the vet. Her beard had been a bit saggy, and her appetite is next to nothing.

I'm somewhat concerned with the dependability of this vet's word, as she didn't ask me anything about Stella's husbandry. She asked me tank temperatures, but no mention of a UVB light, what substrate, etc. She proceeded to conduct a very quick visual examination, and said she wanted to run some tests. She weighed in at 640g. They took blood and her liver function came back as abnormal. She said she likely had fatty liver disease, and gave subcutaneous fluid injections, in addition to B12 injections, and prescribed thyrotab, a lactulose solution, and levocarnitine. Now, since the her treatment was based off of the blood test results, I am not particularly concerned about it, but I wanted to see if there were any differing opinions on here, and whether or not there is anything more I can do for her.

I'm concerned that I've monumentally screwed up as a pet owner, and I guess I'm looking for reassurance that my little girl will be alright...

Setup:
Reptisun 10.0 tube
100 w basking bulb
100w CHE
repticarpet
temps: 104 F and 73 F (day) 84 F and 69 F (night)


Thanks for your time.

She is still pretty young so I think she has a good shot to bounce back. Did the vet notice anything else out of line with the bloodwork? That is usually a pretty good test for systems function. She seems a bit heavy for her age but could you post a photo of her? That will help give a better idea of if she is just a large dragon or is overweight. You can help her liver by moving her toward a mostly vegetarian diet. At her age and size she should probably only be getting one or two bug meals per week anyway. Try offering her a salad with a balance of veges every day and try to get her into the habit of eating that. It may take some tough love at first and just hold off on the bugs until she gets hungry and starts in on the salad (within reason). Keep track of her weight and offer drops of water on her nose to give her extra hydration if she wants it. I suggest referencing this list for salad ideas http://www.beautifuldragons.com/Nutrition.html Offer 2-3 items in each salad and just rotate depending on what looks fresh at the store. Once she settles into a healthy diet, her overall health should start to improve.

CooperDragon":1d2lqzxl said:

She is still pretty young so I think she has a good shot to bounce back. Did the vet notice anything else out of line with the bloodwork? That is usually a pretty good test for systems function. She seems a bit heavy for her age but could you post a photo of her? That will help give a better idea of if she is just a large dragon or is overweight. You can help her liver by moving her toward a mostly vegetarian diet. At her age and size she should probably only be getting one or two bug meals per week anyway. Try offering her a salad with a balance of veges every day and try to get her into the habit of eating that. It may take some tough love at first and just hold off on the bugs until she gets hungry and starts in on the salad (within reason). Keep track of her weight and offer drops of water on her nose to give her extra hydration if she wants it. I suggest referencing this list for salad ideas http://www.beautifuldragons.com/Nutrition.html Offer 2-3 items in each salad and just rotate depending on what looks fresh at the store. Once she settles into a healthy diet, her overall health should start to improve.

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I heard some utterances of high calcium levels from the back, but she did not bring that to my attention directly. I offer her green squash, collards, and mustard greens daily, and the occasional bell peppers and apple. Sometimes I'll feed her by hand and she's more inclined to eat them then, but aside from that she largely ignores her greens bowl. She gets a bath 3-4 times a week and I offer her water from a dropper daily.

here are some recent photos of her:

https://imgur.com/a/qkcuN

That all sounds good. Keep hand feeding her if she prefers that. My guy likes that too. She does look quite overweight so I would focus on bringing her weight down with a combination of diet and exercise. If you have a safe area for her out of the tank, give her some time to roam around the house. You could set up a portable basking light so she can return to it to warm up as she's out and about.

Hello,

The carnitine should really help her out, it is great for fat burning.
As suggested, gradually get her eating more of a vegetable based diet as opposed to mostly
bugs. Go slowly so the body doesn't release to much fat too quickly.
Plenty of exercise & a lower fat diet should help reverse any liver damage. She is young so
I am sure she will recover well.

Let us know how she is doing.
Tracie

CooperDragon":243wafza said:

That all sounds good. Keep hand feeding her if she prefers that. My guy likes that too. She does look quite overweight so I would focus on bringing her weight down with a combination of diet and exercise. If you have a safe area for her out of the tank, give her some time to roam around the house. You could set up a portable basking light so she can return to it to warm up as she's out and about.

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Great idea, will definitely do that so she can spend more time out.

Drache613":243wafza said:

Hello,

The carnitine should really help her out, it is great for fat burning.
As suggested, gradually get her eating more of a vegetable based diet as opposed to mostly
bugs. Go slowly so the body doesn't release to much fat too quickly.
Plenty of exercise & a lower fat diet should help reverse any liver damage. She is young so
I am sure she will recover well.

Let us know how she is doing.
Tracie

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Since she got back from the vet (which was Wednesday), she’s only eaten two crickets, and nothing else. I’m not sure if the meds have any effect on appetite, but she isn’t willing to jump down from her hammock to chase them. Aside from when she just got back from the vet and hid under her carpet, she hasn’t really left her basking spot unless I move her. She seems fine running around my house, so I’m not really sure what to make of it.

Did you happen to get a copy of her blood work results? If so , can you post them here? And if you didn't get a copy of them, if you call the vet office they can email them to you, and then you can just post them here for us to take a look at, so we can get the full picture of what is going on with her. It's good that you always get a copy of EVERYTHING the vet does at each appointment, all the test results, a list of the medications she was put on and the dosages of each, etc. It's your right as her owner. See if you can get them to email them to you...I'm sure it is a bit of FLD, based on her weight, which she should have no problem recovering from at her age, but it's good to know the entire story...

Also, have you ever tried BSFL as a live insect feeder? If she likes worms then that might be the way to go, they are extremely healthy and high in fluid content...

Also, you can cut back on the baths weekly, unless she actually enjoys them. Otherwise, the stress isn't good for her, and unless she is actively drinking the water in the bath through her mouth, they are not hydrating her at all. They do not absorb hydration through their vents or skin, at least not any of significance, only through their mouths like us. So if she likes the baths or she does actively drink the water during a bath then that's okay, but otherwise one bath a week for cleanliness is more than enough.

EllenD":2sxjpr23 said:

Did you happen to get a copy of her blood work results? If so , can you post them here? And if you didn't get a copy of them, if you call the vet office they can email them to you, and then you can just post them here for us to take a look at, so we can get the full picture of what is going on with her. It's good that you always get a copy of EVERYTHING the vet does at each appointment, all the test results, a list of the medications she was put on and the dosages of each, etc. It's your right as her owner. See if you can get them to email them to you...I'm sure it is a bit of FLD, based on her weight, which she should have no problem recovering from at her age, but it's good to know the entire story...

Also, have you ever tried BSFL as a live insect feeder? If she likes worms then that might be the way to go, they are extremely healthy and high in fluid content...

Also, you can cut back on the baths weekly, unless she actually enjoys them. Otherwise, the stress isn't good for her, and unless she is actively drinking the water in the bath through her mouth, they are not hydrating her at all. They do not absorb hydration through their vents or skin, at least not any of significance, only through their mouths like us. So if she likes the baths or she does actively drink the water during a bath then that's okay, but otherwise one bath a week for cleanliness is more than enough.

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She really does love her bath time, so it’s more for her entertainment than anything lol. She used to eat Phoenix worms, which I understood to be BFSL, but she hasn’t had any for at least 9 months, I may see if she’s interested in them again. Thanks!!

As for the blood work, I just recieves results today:
https://imgur.com/a/ouPA8

Hello,

Did the do a complete blood count, or just a hematology report? I didn't see liver or kidney counts, or protein & calcium levels.
I do see that the white counts are elevated which would indicate infection or at least stress. I assume the AST levels were elevated?
The treatment sounds fine, for fatty liver right now.
How is she doing today? If she enjoys her baths, it's fine to give them frequently, making sure she is good & dry by her bedtime.

Let us know how she is doing.
Tracie

Drache613":289ekt5w said:

Hello,

Did the do a complete blood count, or just a hematology report? I didn't see liver or kidney counts, or protein & calcium levels.
I do see that the white counts are elevated which would indicate infection or at least stress. I assume the AST levels were elevated?
The treatment sounds fine, for fatty liver right now.
How is she doing today? If she enjoys her baths, it's fine to give them frequently, making sure she is good & dry by her bedtime.

Let us know how she is doing.
Tracie

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They told me that they would need to send the remainder of her sample to another lab, which I would normally not have had any issue with, however I couldn’t afford to do that at the time. The results I’ve posted here are the tests they were able to run in house. She is really hating having to take her meds, though she seems a bit more active today than days past. We are making sure to try to get her exercising, especially swimming around during her bath time. She definitely seems hesitant of me when I get her out now, which I assume is because of feeding her her medication.

Hello,

Oh I see, so they don't have a lab to do the rest of the blood work, or they went ahead & ran
it for you to let you know the liver enzyme counts?
I am sure she is tired of her meds. Just take your time with her & hopefully she will learn to
tolerate it better, poor thing.
If she is swimming around in her bath, then that is good for her. That will give her some
exercise.
I hope she is doing well today!

Tracie

Yes, if she likes her bath then by all means, indulge her! Most Dragons don't like them at all and get very stressed out and just spend the entire time trying to get out, so you're lucky in that respect, lol.

If you happen to get the rest of the testing sent out, let us know the results, as Tracie said it does look like the start of FLD, and possibly an infection of some kind, though I doubt it, their WBC's tend to get slighting elevated due to the overall stress of an illness or health issue, and that's what it looks like to me too.

The reason I suggested the BSFL (yes, they are also called Phoenix Worms, NutriGrubs, ReptiWorms, and CalciWorms, lol, they are just different "brand names" depending on where you buy them from) is because not only have I fed them as my main staple feeder for over 15 years with no health issues at all (and I also have pretty much always "supplemented" the BSFL with 1-2 Superworms too, no issues at all), but because they are high in calcium and other vitamins and minerals, high in hydration, low in fat, and high in "healthy" protein, meaning that their protein content is not high in purine, as in crickets and especially most species of roaches. Purine-based protein is what causes a lot of the cases of Gout in Beardies, because a lot of the cricket and roach vendors feed their insects what is easy and cheap, and high in purine based protein, usually, yes, Dog Food. They just dump in bags of cheap Dog Food for their roaches and crickets to eat, rather than feeding them healthy, fresh greens, veggies, fruits, and lean protein. The other source of purine-based protein that a lot of vendors and even reptile owners feed their live crickets and roaches are any and all of the "Commercial" feeder-insect feeds, like the "Cricket and Roach Chows" and such. It's basically Dog Food, lol. So reptile owners read the nutritional analysis of the "Roach Feeds" available at the pet stores, see that it's extremely high in protein, and they think that this is a good thing for their growing reptile...then the reptile ends up with Gout, or ends up overweight and with FLD, etc. So the BSFL are also recommended for young Beardies with Gout who need to drastically lower their purine-based protein intake, but still need lots of insect protein every day because they are still growing, and even adults, who I believe in still feeding live insect protein once a day as well, in addition to their fresh salads, albeit in much smaller quantities.

So the BSFL are a healthy source of live insect protein that will not only keep her healthy, but will no doubt drastically lower her percentage of body fat and help quite bit with the FLD. The cheapest place I've found in the US to order them from is www.dubiaroaches.com, I get 1,000 size large for $23 shipped from them, and then from www.symtonbsf.com, 1,000 size large from them is about $32 shipped. Obviously you can order less than 1,000, but always order the size large, do not bother with the smalls or mediums, as they tend to need to eat more BSFL in general than they do any other feeder insects, and since they are soft-bodied, even small babies and juveniles can handle the size large BSFL.

Hello,

How is your girl doing today, any improvements?
I hope she is active & eating for you. Let us know how things are going with her.

Tracie

Drache613":2adam0g0 said:

Hello,

How is your girl doing today, any improvements?
I hope she is active & eating for you. Let us know how things are going with her.

Tracie

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She seems alright, though she is still not interested in eating anything. The vet emailed me saying she wanted to give her an antibiotic due to to the high white blood cell count, so I have another appointment tomorrow to do that and have her reweighed. She's been puffing her beard a lot compared to how often she usually does. She used to only puff at me when I would put her leash on or if she wanted to go somewhere that she wasn't allowed, but now she will randomly or if someone is approaching her cage. I'm not sure if that has anything to do with stress or anything. We found a way we can agree on getting her meds in her, which involves dissolving her meds in pedialyte and letting her drink it.

Update: It’s been nearly a month since her treatment has begun, and she is noticeably losing weight. I am a bit concerned, as she is continually ignoring her crickets. I have some BSFL in the mail, and she ate a rather large hornworm yesterday, but aside from that and some greens every few days she is largely ignoring food. She seems alert and will run around when I put her on the floor, but she isn’t moving around much in her tank either. She perked up substantially after she got an antibiotic shot a few weeks ago. The vet said they usually do 3 rounds of shots but wanted to wait and see if she improved. Do you guys think I should go back and get the other two?

Edit: I should add that she recently began shedding her belly, back, and face