Is this Gout?

Sakai · Aug 15, 2018

Hello, i noticed that Daenys has been moving rather weirdly the last few days but i didnt know why so I just applied a bit of coconut oil to her legs. I had no knowledge about gout prior to this(the nerve of me and my ignorance :banghead:

) but 2 days earlier i noticed some of her fingers were swollen and so i started doing some research. I immediately went and brought Montmorency Tart Cherry Juice Concentrate and gave her 1ml of it. As of now, Im also keeping her hydrated by giving her water via syringe and she would only eat from the veggie slurry I made and drip on her snout.

Ive read about allopurinol, but Im still a bit hesitant as im afraid to give her that without any supervision. What's more i couldnt afford to contact any vet now. We dont have much vet experienced in treating exotic animals here.. There are 2 that are more knowledgeable and experienced with exotic pets but one(whose only means of making appointment is through email) has a full schedule and hasnt gotten back to me yet on the next free slot and the other one is out of the country( i was unable to reach his phone). It's been 2 days since i tried contacting both vets and my worries are only growing. Daenys seems more reluctant to move now and even when she does she seems to be dragging herself. It pains me to see her like that and im feeling so hopeless. I would very much appreciate for any advice on what I can/should do for now :'(

Here are some pics of her

The back legs are still alright so far but the front legs arent looking too good

CooperDragon · Aug 15, 2018

If that has appeared over the last few days, my first guess is that it is swelling to help loosen skin for an oncoming shed. Look for signs of shedding such as lighter colored or dull/waxy skin around the swelling areas. The tart cherry juice won't hurt so you can keep offering that if you want to. You'd need to have a blood test and/or a test of the fluid from the swollen area to confirm gout but I would treat it as swelling from a shed for the time being. If this is the case, the fingers and hands will shed and then return to normal size.

Sakai · Aug 15, 2018

Hello, thank you for replying. I checked for signs of an oncoming shed but I dont see any. The reason why i didnt think of it as shed was because of her movements. She was dragging herself and remains reluctant to move? I may be wrong but I have had her for a year and I've not known a shed to cause this. ? Is this normal?

Drache613 · Aug 16, 2018

Hello,

I am glad to hear you started her on black cherry already, maybe that will help out some.
It is possible it could be an upcoming shed, but with your description of her behavior it is
probably gout developing.
Can you review your tank setup with us, such as the type/brand of UVB, temperatures, the
supplementation & foods offered.
I would go ahead & proactively decrease the protein intake to minimum, around 20-25 insects
weekly. Try to get some greens slurries into her for more oral fluids, if possible.
Where are you located, the US or another country?
Allopurinol is a very routinely given medication which is safe for long term use in reptiles if
given in the proper dosage.

Let us know how she is doing.
Tracie

Sakai · Aug 17, 2018

Drache613":1wz35hwk said:
Hello,

I am glad to hear you started her on black cherry already, maybe that will help out some.
It is possible it could be an upcoming shed, but with your description of her behavior it is
probably gout developing.
Can you review your tank setup with us, such as the type/brand of UVB, temperatures, the
supplementation & foods offered.
I would go ahead & proactively decrease the protein intake to minimum, around 20-25 insects
weekly. Try to get some greens slurries into her for more oral fluids, if possible.
Where are you located, the US or another country?
Allopurinol is a very routinely given medication which is safe for long term use in reptiles if
given in the proper dosage.

Let us know how she is doing.
Tracie

Here is a pic of Daenys' Tank

UVB Brand : ExoTerra 25wReptileUVB150
I was suggested to start investing in an Arcadia T5HO 12% UVB tube and Ive looked but we dont have it here. I dont mind buying it online really but the shipping fee is way beyond my budget =( I once ordered the reptisun 10 and my uncle living in the states was kind enough to pay for me, but when it arrived, the uvb wouldnt work(it went "zap" the moment i flipped the switch and there were some smokes coming out) I can only conclude our country run on different voltages.

Temp : 38-40C basking spot 31C cool side
Supplementations&Food : repashy calcium plus(for every bug meal) & zoomed(once a week) reptivite. Fresh vegetables offered everyday and dubias every 3-4 days(dusted with calcium)
Lately, she wouldnt touch her vegetables, so i have to make her veggie slurries. She used to go crazy whenever there are mangoes or butternut squash/pumpkin served but now she shows no interest even in them.

This is Daenys today.

So i should still continue feeding her dubias? or would crickets be better? (i saw your reply on another post stating that dubias tend to have higher purines.) She is being fed veggie slurries(with calcium plus added), black cherry juice and water everyday now. Also, would she be needing any probiotic? I bought dairy free yogurt just in case. I live in Malaysia by the way

Sakai · Aug 17, 2018

One of the vet was finally able to see Daenys last night. I was unable to go but it was the only time the vet could see her, and I didnt want to delay anymore, so I asked my family for help.

About the veterinarian

Apparently, he's the best known, highly recommended vet for treating exotic animals with 28 years as a veterinarian for the zoo. However, I dont really feel assured as I previously had a rather unpleasant experience with him (I'll explain along the way)

Upon arriving, the vet immediately prescribed potassium permanganate and bathed Daenys in it. Yes, even before asking and checking about her condition. (I heard that 9 out of 10 reptile owners were prescribed the same thing as well.)
Here's what it looks like

Directions: a pinch of the compound. Fill tub with warm water. Stir until light pink/purplish color and make sure compound is completely dissolved.

-Soak for 15-20 mins
-Once a day
-Purpose: detoxification

As long as it's not too concecrated, it isnt harmful he says. He also says it's for both external and internal use(safe for beardie to drink).

Only after soaking (Daenys drank and pooped in the water) did the vet examine her. Im not sure if it was necessary but from the pictures&videos my mum showed me, he was kinda rough.
He did a fecal test and said that she has mite. But aside from prescribing calcium and multivitamin(as medicines), nothing else. He also asked if she was eating well and when my parents told him she wasn't eating much, He gave us a"powder"call dextrose.

Directions:
Multivitamin& calcium
-2 hours interval between each one.
-0.5 ml (for the 1st 3-4 days then 1ml later on)
-2 times a day
-before meal
-after soaking potassium

Dextrose
-one teaspoon. Fill tub with just a little bit of warm water(feet level)
-Leave beardie for an hour in the solution for her to drink / body to absorb.
"Through process of osmosis she gets energy, and then she will have appetite to eat. The next day the area around her legs might be yellowish but soak her in potassium again and it will clear."-quoted by vet. It can be at night when we have time to do so, as long as it is after her medication.

Before my family went I had them request for a blood test for Daenys and inquire about allopurinol, but the vet said there's no lab for blood test in Malaysia and allopurinol can only be given if the condition is determined to be gout. With that said, he wasnt able to confirm if it was indeed gout but he did mention that it could be MBD."Lack of calcium would cause the system to drain calcium from the body,thus resulting in swelling." My parents went home last night without having an exact answer for the cause =(. The vet said to keep feeding her veggies and crickets or dubia, and give her lots of hibiscus flower. He then told my parents to return 3 weeks later to see if the swelling would recede with all the procedure done, and if her legs are still swollen, he will give her another treatment. Personally I didnt like how there was no assurance, cause it sounds like a trial and error diagnosis to me.

I decided not to give her any of the medicine nor bath her in either solutions yet today. I'd like to know what you all think about all these 1st. One of the main reason was because of a past experience with another beardie-Titan. His issue was my 1st post on beardeddragon.org. He was already sick when I got him. And although for very different symptoms, he was prescribed with the exact same stuffs I listed above. (calcium,multivitamin, dextrose and potassium permangante). The problem ,however,was that Titan had to take his medication 3 times a day, and the vet did not mention anything about an interval. Having been instructed to soak daily in potassium permanganate, Titan's color were dulled,

and when I brought him back to the vet some time later, I got scolded for bathing him in a solution too concentrated resulting in Titan's skin being "burnt" but honestly I was always careful with the concentration. Titan died the next day ,after his last visit to the vet.

This is why I am therefore hesitant to follow his instructions blindly once again or to even use the potassium compound until further light can be shed. I'm terribly sorry for such a long post. Thank you to everyone who's willing to take their time to read and share any advice.

Drache613 · Aug 17, 2018

Hello,

I will also be emailing you, but wanted to post on your thread also.
How is she doing this evening/morning?
I have done some research & reading up on the potassium permanganate also. It is used for
soaking for skin ailments etc. However, it is also a dye. Therefore, I really don't think it is
all that safe to be used for such a long term event. If ingested, it can be toxic & since reptiles
are extremely sensitive to toxins, it could be fatal. I don't know if that is what happened to
your little Titan, but, a huge possibility.
The dextrose soaks, are for what purpose? It is a plant fiber & sugar derived from corn. I think
that a lot of soaking may stress her out at this point. Did he treat bearded dragons in the past?
That is a catch 22 then with regards to the blood test. If there isn't any way to do a blood test
& a lab in the country then it is virtually impossible to diagnose gout via a blood test.
Does she seem to like the black cherry juice you got her on now?
As for the Reptisun 10 tube bulb, you are correct. It is USA which runs off of 110V while your
country runs off of 220V. That is what caused the electrical issues. The Arcadia is European
so that would be your best bet if you could get them. You are not able to order those online?

Let us know how Daeny is doing. I hope she wasn't injured by mishandling at the vets.

Tracie

Sakai · Aug 18, 2018

Hello Tracie, thank you.

Daenys is doing alright, basking and eating her veggie slurry. Her finger however is still swollen and she's still limping and has become more sensitive about me touching her fingers.

Yea i wasnt really comfortable about the idea when the vet said to let them (beardies) drink as much as they can while they are soaking, as Ive read a bit about the potassium permanganate online. But i thought the vet would know better :/

The dextrose are to give them energy through oral or body absorption, so they will regain their appetite to eat. At least, that's what the vet told me. Im not sure if you can call that soaking, because the water level needed is only very little(over her feet), but I do agree that 1 hour is just too long, the water would have gotten cold then, which wouldnt be good for her. And yea, as far as I know, he has treated all sorts of exotic animals, that's what he specializes in apparently. He's an exotic animal veterinarian( who used to work for 28 years as a veterinarian for the national zoo).
This is terrible..having no way of knowing if it is indeed gout :'( How can i know then on whether I should reduce her insects intake? Oh, and what about the calcium and multivitamin that he prescribed? Is there a need to give her that? The vet said it could be MBD as well, but there is no sign of her twitching/trembling or anything of the sort.

Daenys is still having 1ml of the tart cherry juice daily and she dosent seem to mind the taste. She would sometimes turn her head away but she'll always lick off every drop on her snout. And I did look up the net for the ArcadiaT5, but the shipping fee is beyond my ability.. sorry :silent:

By the way I read about serrapeptase while looking through similar posts and I really want to ease some of the pain Daenys seems to be in. What is your advice? and are they easily accessible?

Drache613 · Aug 18, 2018

Hello,

There is no true way to determine whether or not it is gout, without a blood test. It could
be metabolic bone disease, but hard to know for sure without a blood test.
Which UVB light are you using now? How often do you take her outside for natural sun &
when you do how long is she exposed to the natural sun?
I understand, international shipping is high, depending on the weight & size of the package.
The liquid calcium should be fine, but can you find out the strength of it? The .5ml is a small
amount but it depends on the strength of the solution. The vitamins probably don't need to
be given more than a couple of times per week so you don't risk the chance of toxicity.
I can get on board with the dextrose soaks but not the permanganate. I am worried about
the toxicity of it, to be honest.
I am sorry her toes & fingers are still swollen. Have they stayed the same or do they seem to
be getting any worse?
Her back legs are very puffy also. Poor girl, I am sure that she is having some joint pain to
where she doesn't want to move. Serrapeptase is very good for helping with inflammation &
joint pain, too.
Keep us posted on how she is doing.

Tracie

Sakai · Aug 19, 2018

Which UVB light are you using now?

UVB Brand : ExoTerra 25wReptileUVB150

How often do you take her outside for natural sun & when you do how long is she exposed to the natural sun?

4-5 days a week in the morning, whenever I can, for about an hour.

The liquid calcium should be fine, but can you find out the strength of it?

I called the vet and asked. This is what he replied " There is no strength,you just need to feed her 0.5ml twice a day before meal for the 1st 3 days and 1ml twice on the 4th day onwards."
The other 2 things I asked about were:
i) potassium permanganate, and he said low concentration is safe even when ingested.(i have no intention of using it though)
ii) serrapaptase (I bought it after reading about it on this forum), and this is what he replied,
"This drug is for the inflammation.
Go on with the therapy I have you for one week and bring these tablets we will evaluate the treatment"
Here is a pic of the serrapaptase i bought

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I weighed her today and she is 502g. Can i know when, how, and how much I should be giving her? There is no side effect to it right?

I can get on board with the dextrose soaks but not the permanganate

Alright, can I know how often would you suggest that I soak her in it?

I am sorry her toes & fingers are still swollen. Have they stayed the same or do they seem to
be getting any worse?

I dont know.. her back legs seemed ok but i think the fronts got worse..?

Im scared and im just so fed up not being able to do anything. Im kinda tempted to get allopurinol but I know I shouldnt unless gout can be determined :'(

As usual, Daenys had tart cherry juice(1ml), veggie slurry (3ml) and some water, except that i gave her 0.5ml of the calcium syrup today before meal. She wouldnt move too much but she would still move away from the basking spot to cool off.

(according to one of your earlier reply)

I would go ahead & proactively decrease the protein intake to minimum, around 20-25 insects
weekly.

Actually, her usual amount of dubias is around 16-20 a week. So should I aim for a lower amount or higher..?

CooperDragon · Aug 20, 2018

That UVB light is OK But low power. It works best between 15-20 cm above the basking area. The output drops off quickly beyond 20 cm so it isn't the best option for large enclosures.

Drache613 · Aug 20, 2018

Hello,

How is your girl doing today?
Were you able to get some of the serrapeptase tablets crushed up for her today? It is a very
useful supplement for pain, joint pain & inflammation. Plus, she can use it long term, without
any side effects.
Has she gotten anymore swelling of the limbs or are they about the same?
I agree, that is a compact/coil light so it wont have a real good UVB spectrum & or reach. I
recommend continuing to take her outside daily for at least 1 hour, if not more when at all
possible.
You can stay with around 20 insects for the week right now, that will be perfectly fine. Keep
us posted on her. I hope she is feeling better soon.

Tracie

Sakai · Aug 20, 2018

CooperDragon":opi4kb36 said:
That UVB light is OK But low power. It works best between 15-20 cm above the basking area. The output drops off quickly beyond 20 cm so it isn't the best option for large enclosures.

I see. But her basking spot is quite close to the UVB light though..

The one Im currenly using is ExoTerra 26w UVB150 but the best I can get is the UVB200. Would that make any difference?

Sakai · Aug 21, 2018

Drache613":15u1xp0j said:
Hello,

How is your girl doing today?
Were you able to get some of the serrapeptase tablets crushed up for her today? It is a very
useful supplement for pain, joint pain & inflammation. Plus, she can use it long term, without
any side effects.
Has she gotten anymore swelling of the limbs or are they about the same?
I agree, that is a compact/coil light so it wont have a real good UVB spectrum & or reach. I
recommend continuing to take her outside daily for at least 1 hour, if not more when at all
possible.
You can stay with around 20 insects for the week right now, that will be perfectly fine. Keep
us posted on her. I hope she is feeling better soon.

Tracie

Hello Tracie, I had the serrapaptase crushed and added it to Daenys' veggie slurry yesterday and I did as you suggested and got superwroms as well. Im not sure but I noticed Daenys has been walking more today! She even showed interest in the superworms and ate 4 on her own!

Has she gotten anymore swelling of the limbs or are they about the same?

Im still not able to tell to be honest, but I think her swelling still looks about the same.

I manage to find another vet and brought Daenys there this morning. I requested for both X-rays and blood test. I was only allow to take a pic of the x-ray though. I shall email them to you later.

The vet seemed to think Daenys has MBD & hypovitaminosis A,noting that her bone density isnt looking good due to lack of calcium.
As for the blood test, I read that I should ask for both Uric acid and CPK levels; however, the vet told me it's very difficult, or rather impossible to check for uric acid levels in bearded dragons. :/ He said he'll call me back 2 days later to let me know about the result.

About the calcium syrup and multivitamin prescribed by the previous vet, this vet told me I can continue to follow the previous instruction given( 0.5ml of each, twice for the 1st 3 days, and 1ml twice on the 4th day onwards) and feed them to Daenys everyday, even for the multivitamin. He said something like it's impossible to overdose on vitamin. He also said I can feed both calcium and vitamin at the same time, as long as the next intake is 6 hours later and it dosent matter if it's before or after meal. Should I feed her both everyday then?

I also told him about the serrapaptase as well but he wasnt so sure about giving them to Daenys. He hasnt heard about giving serrapaptase to reptiles before because if inflammation was the case, they would give ketoprofen or meloxicam.

So, if Daenys does indeed have mbd& hypovitaminosis A, do I still give her the tart cherry juice and serrapaptase? This is her poop today

Having veggie slurry(butternut squash included), tart cherry juice ,calcium syrup and water, is it normal that her poop is watery or even bubbly at this point? And her urate still entirely white, still having a tint of orange, what does this indicate, if not excess calcium?

Thank you!

Sakai · Aug 21, 2018

Sakai":1z5mzzo0 said:
Drache613":1z5mzzo0 said:

Hello,

How is your girl doing today?
Were you able to get some of the serrapeptase tablets crushed up for her today? It is a very
useful supplement for pain, joint pain & inflammation. Plus, she can use it long term, without
any side effects.
Has she gotten anymore swelling of the limbs or are they about the same?
I agree, that is a compact/coil light so it wont have a real good UVB spectrum & or reach. I
recommend continuing to take her outside daily for at least 1 hour, if not more when at all
possible.
You can stay with around 20 insects for the week right now, that will be perfectly fine. Keep
us posted on her. I hope she is feeling better soon.

Tracie

Click to expand...

Hello Tracie, I had the serrapaptase crushed and added it to Daenys' veggie slurry yesterday and I did as you suggested and got superwroms as well. Im not sure but I noticed Daenys has been walking more today! She even showed interest in the superworms and ate 4 on her own!

Has she gotten anymore swelling of the limbs or are they about the same?

Click to expand...

Im still not able to tell to be honest, but I think her swelling still looks about the same.

I manage to find another vet and brought Daenys there this morning. I requested for both X-rays and blood test. I was only allow to take a pic of the x-ray though. I shall email them to you later.

The vet seemed to think Daenys has MBD & hypovitaminosis A,noting that her bone density isnt looking good due to lack of calcium.
As for the blood test, I read that I should ask for both Uric acid and CPK levels; however, the vet told me it's very difficult, or rather impossible to check for uric acid levels in bearded dragons. :/ He said he'll call me back 2 days later to let me know about the result.

About the calcium syrup and multivitamin prescribed by the previous vet, this vet told me I can continue to follow the previous instruction given( 0.5ml of each, twice for the 1st 3 days, and 1ml twice on the 4th day onwards) and feed them to Daenys everyday, even for the multivitamin. He said something like it's impossible to overdose on vitamin but he did advise against dusting calcium powder on insects now that she is taking the calcium syrup to prevent calcium overdose. He also said I can feed both calcium and vitamin at the same time, as long as the next intake is 6 hours later and it dosent matter if it's before or after meal. Should I feed her both everyday then?

I also told him about the serrapaptase as well but he wasnt so sure about giving them to Daenys. He hasnt heard about giving serrapaptase to reptiles before because if inflammation was the case, they would give ketoprofen or meloxicam.

So, if Daenys does indeed have mbd& hypovitaminosis A, do I still give her the tart cherry juice and serrapaptase? This is her poop today

Having veggie slurry(butternut squash included), tart cherry juice ,calcium syrup and water, is it normal that her poop is watery or even bubbly at this point? And her urate still isnt entirely white, still having a tint of orange, what does this indicate, if not excess calcium?

Thank you!

Is this Gout?

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