Is this Gout?

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Is this Gout?

Postby ewarwoowar » Mon Dec 24, 2018 2:24 pm

My beardy had a blood test recently as he had permanent stress marks, black beard, low appetite and lethargy (usual sick beardy symptoms). The results came back with elevated uric acid levels at 1282 umol/L or 21mg/dL as well as slightly elevated calcium and total protein.

We’ve since had him put on allopurinol and he’s currently on a greens only diet for the course of the treatment. The cause of his uric acid was most likely a high protein diet as we tended to let him eat more bugs than salad as that's what he prefers. We've since corrected this and got him onto a more salad diet.

I know that uric acid leads to gout but to me he doesn’t look like he has any swelling or physical differences but I’m worried he’s in serious pain. He will be back at the vets for a follow up blood test at the end of the treatment in 2.5 weeks and I’m going to ask for an x ray to specifically check for gout but in the mean time, I wondered if anyone with experience of gout notices any swelling in his limbs? He’s my first and only BD so I have nothing to compare to other than online photos and it all looks okay. I'm probably going to book him in sooner for an x ray just to be certain.

Please ignore the toes on his left front foot. These were actually injuries from when he was a baby at the pet store with 15 other babies and he’s had those since we got him 9 years ago. His front legs are the ones I’m a bit wary of as they look chubby but at the same time they look exactly the same amount of chubby. He also has full movement in all his legs and walks on all four when chasing food down, I can provide a video of flexibility if it helps. Every photo of the front legs make them look different so I'll take more tomorrow of when he's basking and standing up.

Thank you in advance!

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Re: Is this Gout?

Postby Drache613 » Mon Dec 24, 2018 11:07 pm

Hello,

So sorry your dragon is having some trouble! I do have experience with gout. This sounds like
a form of gout, but hopefully not visceral gout. Those uric acid levels are very high though, so
I am glad to hear the vet did prescribe allopurinol for your boy. Depending on the levels, I'm not
sure that such a short treatment period will be enough to knock the levels down enough.
I do see some puffiness on the forearms though so I highly recommend staying with the treatment
right now, until those levels come down to at least 5mg/dl.
He may be feeling some discomfort with those levels because the uric acid will cause some joint
capsule irritation. Are his urates hard or soft?
I would also recommend giving extra oral fluids daily to help flush the system out too.
What type & brand of UVB are you using?

Let us know how he is doing.
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Re: Is this Gout?

Postby ewarwoowar » Tue Dec 25, 2018 2:21 am

Hi Tracie,

Thank you for commenting.

I've just calculated the length of treatment and it will be 0.6ml twice a day for 25 days. He will then have another blood test to check if it has helped. I've read that it's not possible to cure gout so we are hoping for the best.

His urate yesterday wasn't solid but wasn't entirely liquid. I have a photo from Saturday that I will upload soon. He was treated for flaggelates before the blood test as his poops were runny but his samples have come back clear since and no longer runny poops.

Here are his tank specs:

- 4x2x2 feet
- Arcadia T5 12% d3+ 34"
- Arcadia 75w Halogen basking bulb on a thermostat. 42-45c directly below the bulb. Around 35-40C around the bulb area

Basking area UVI ranges from 3.5-4 UVI maximum and drops of to 1-2 on the sides of the basking area then he has areas of 1UVI and 0UVI. If he is directly under the basking lamp then he has 42-45C and 3.5UVI which is ample.

Diet is now just varied salad which is below. They are UK names so some names are different to US:

- Spring Greens
- Pak Choy
- Bell Pepper
- Butternut squash
- Carrot
- Basil
- Mint
- Sugar Snap Pears
- Pea Shoots

Protein is off the menu at the moment to allow his kidneys to rest but his insect menu was:

- Dubia Roaches
- Silkworms (when we had time to grow them)
- Occasional Locusts
- Phoenix worms/Calci worms

Lastly, we have tried providing him black cherry concentrate and water but he is refusing to take it. I think he's associated the syringes to medicine :(

Thanks,
Ed
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Re: Is this Gout?

Postby RockyTurner » Mon Jan 28, 2019 11:40 pm

Hello Ed. I am the mom of a beardie girl who is only a little over 1 year old. Only a few months after I got her she couldn’t walk on a swollen front foot. After taking her to the exotic vet twice with multiple swollen feet and toes, she was diagnosed with gout. She has been on Allopurinol every day ever since. She has to have a perminant low protein diet- no Dubai’s, they are very high in protein. She is having a flare up right now, so she is on Metacam which is a pain reliever/anti inflammatory.
It is amazing that you have had your dragon so long. His little ankles do look a little puffy to me, but I don’t know what his feet normally look like. We have a beardie without gout, so I am able to look at his feet and realize how swollen Roxy’s are.
Did you ever get anymore answers? How is your boy?
Shann Roxy’s Mom
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Re: Is this Gout?

Postby Drache613 » Fri Feb 01, 2019 6:37 am

Hello,

Yes, please do let us know how your boy is doing. We have been seeing so many gout cases
now, it is very unfortunate.
The tank size & the setup sounds very good for him. Be sure he can get about 10 inches or so
from the tube bulb for the best UVB exposure. Is the basking bulb directly beside or alongside
of the tube Arcadia T5 bulb?


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Re: Is this Gout?

Postby ewarwoowar » Fri Feb 01, 2019 6:44 am

Hi All,

Charmander has an appointment at 5:30PM for a follow up bloodtest as the medication is now over.

Subsequently, he has decided to start brumating as of 11th January but we must wake him to take him to the vets as it is more important. We may attempt to not let him return to brumation if his results as still not good and he requires further medication.

We are still yet to know if it is actually gout so this evening we will request an Xray on his joints to check for uric acid crystal build up.

His basking bulb is in the corner at one end of his UVB so he is able to get heat and UVB at the same time with peak UVI of around 4UVI.

I'll update you with the results and thanks for your comments.

Many Thanks,
Ed
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Re: Is this Gout?

Postby RockyTurner » Fri Feb 01, 2019 7:30 am

I am so glad that Charmander is going to see the vet. The brumating with gout is a tough thing, if that’s what it is. I thought my girl was going into brumation and I talked to the vet about managing it if she did.
Praying for your little guy🙏
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Re: Is this Gout?

Postby ewarwoowar » Fri Feb 01, 2019 11:16 am

We just returned from the vets and Charmander has had a follow up blood test with results due mid next week.

He has perked up drastically after we woke him up from his dark tank (Lights out and covered for brumation). We had noticed his eyes were open more the last few days so I think he was start to wake up. He's in bed now but we will return his lights to normal as of tomorrow and offer him some fresh vegetables.

We had an x ray done around middle to end of December 2018 which was when he started medication. The vet pulled the x ray out from then so we could review his joints for any tophi (Urid acid crystals). The x ray "looks" fine and there seems to be no visible build up in the x ray albeit one of his legs is covered by his head and his back left leg is out of shot. If we had noticed anything obvious then we would have requested another one done today. You may notice a darker patch in one of his lungs, the reason we had an x ray done back in December was because he aspirated a small amount of medicine and the vet has said this dark patch was most likely the small amount of liquid - he hasn't had any issues since then other than having a little cough for a few hours that evening (We laid him head down when he slept that night as we read it can help the liquid come out).

Note - His front left toes were injured when he was a baby at the pet shop as he was kept with 15 other not very well looked after beardies. The x ray makes it seem like he has an issue with 2 of his toes when in fact one of them was bitten off and one of them healed funny with a little "bobble" on the end.

The vet checked his joints and they all move fine and she can't feel any obvious tophi build ups with her fingers but he could still have gout without the tophi build up. Fingers crossed that we caught it early enough that it has not done any lasting damage. Because his front legs are equal in size, X ray looks okay, joint movement is okay and he walks fine then we have agreed that he just has a case of "chunky front legs"....

Thanks everyone for your thoughts and I will update again once the results are back :D

Here are the xrays:
https://www.beardeddragon.org/useruploa ... _large.jpg
https://www.beardeddragon.org/useruploa ... _large.jpg
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Re: Is this Gout?

Postby Drache613 » Fri Feb 01, 2019 2:45 pm

Hello Ed,

Great, let us know how the vet visit goes. I am anxious to hear whether or not his uric acid
levels have improved or not & I'm sure you are as well.
Perfect, they always seem to choose the greatest time for brumation, don't they? The x-rays
look good, those are from today?
It sounds like he is doing good & possibly waking up some out of his little brumation phase.
The UVI readings sound fine so he should be getting adequate UVB exposure.

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Re: Is this Gout?

Postby ewarwoowar » Wed Feb 13, 2019 9:10 am

Hi Everyone,

We received Charmander's results back and his uric acid levels have dropped to good levels. They are now 84 umol/L or 1.41mg/dL which is well within normal levels! :blob5:

The blood work did show some sign of infection somewhere so he has having a more thorough bloodtest (Not sure of the difference, yet) this Friday to work out the best antibiotics for the infection.

His mood is very varied at the moment. He has woken from brumation and only eaten very little over the last 1.5 weeks so hopefully this new treatment he receives next week for the infection will help further. He's walking and moving okay so I'm keeping my fingers crossed we caught the uric acid levels early enough that they didn't cause any lasting damage to him.

Thanks,
Ed
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Re: Is this Gout?

Postby Leiissha » Wed Feb 13, 2019 7:18 pm

What is the gray patch on your beardies tail? Mine has something similar and I'm trying to find some answers. Thanks.
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Re: Is this Gout?

Postby RockyTurner » Wed Feb 13, 2019 10:06 pm

I am so glad to hear that Charmander’s uric acid level is good. Please let us know when you find out more about the infection. My girl with gout just had her blood work checked, and it came back showing that she had infection in her white blood cells. Very confusing, but she is on antibiotics.
I hope that Charmander starts feeling more lively every day. He is very lucky to have parents who want to take great care of him.❤️
Oh, the grey patch on the tail looks like remaining shed to me.
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Re: Is this Gout?

Postby ewarwoowar » Wed Feb 13, 2019 10:31 pm

Leiissha wrote:What is the gray patch on your beardies tail? Mine has something similar and I'm trying to find some answers. Thanks.

This is just an area getting ready to shed, one day you will wake up and it will be peeling off :) nothing to worry about.

RockyTurner, I think charmanders blood work also showed a issue with his white blood cells and that's why we are going back. I'll update once we know more..

Fingers crossed for both of our dragons!
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Re: Is this Gout?

Postby RockyTurner » Thu Feb 14, 2019 7:29 am

Thank you! And Amen!🙏
I also looked back and saw that Charmander showed elevated calcium.... when Roxy’s white blood cells were found to be infected, her bloodwork also showed high calcium and normal uric acid.?.?
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Re: Is this Gout?

Postby Drache613 » Thu Feb 14, 2019 11:50 am

Hello,

That is great news Charmander's uric acid levels are now normal. The 1.4mg/dl is a good level.
It came down pretty quickly so hopefulfly there isn't any kidney damage that was sustained. They
are pretty hardy & can take a good deal of stress.
The whitish discoloration is likely just shedding!

In times of stress, their white counts can always do strange things, while the other blood count
levels remain relatively stable.
Thanks for the terrific update.

Tracie
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