Can anyone read these blood work results? Odd vet

Hi everyone,

First post here, long time lurker. Ok, so I have a bit of an issue, my vet just said something that makes me doubt her a lot, and now I don't trust the treatment she suggested or even her conclusion. I saw some people here know how to read blood work results, and I'm hoping someone here can tell me more. I also have a second opinion with a second vet, but he's not available until Thursday, and I literally can't sleep and am shaking while writing this. I'll start at the beginning.

I have 2 beardies, different tanks, can't see each other but are in the same room and can hear each (and smell?) each other. One male was a rescue, been with me 6,5 years, was told he was 5 which would make him 11,5. I guestimate at least 2 when I got him, fully grown, so at least 8,5. Second male is from October 15th 2018 and is 2,5. Both have Arcadia 12% H5 TO bulbs, and Zoomed heat bulbs. Temps are in the high 90"s for my old man, and about a 100 -105 for my younger man. My old man prefers them there, higher bulbs and he stops basking.

Young male went into brumation and started to wake up end of January, got crazy hormonal and fully awake mid to end February. Was clearly triggering my old man, who also got crazy hormonal. A lot of black bearding, window dancing and head bobbing from the both of them ensued. Old man started to eat less, he is still eating, but about 50% of normal, is now lasting about a month. He eats about every other day instead of everyday, and refuses all leafy greens. Assumed hormones. Then I spotted him with a black beard at night while sleeping and someone told me that could indicate liver issues. Freaked me out since my other old male died off kidney failure.

They have calmed down a bit over the past two weeks, no more night time black beards since then, may have even been shadow. So off to the vet we went on the 19th, fecal came back with 2 coccidia found, which they said was too low to treat, blood drawn and examination. Vet thought he was skinny, but he's usually between 495-500 grams, and was now 490. First red flag. She didn't find anything else.

She called yesterday and said blood work showed diminished kidney function, and a low but within range calcium, too high phospheros. Her treatment:

Put him in a bath twice a day so he can absorb water through his vent (this is where not alarm bells but sirens went off in my head).
He's skinny so 5-10 ml of watered down powdered feline force feeding every day (on the phone she said twice a day, maybe she meant 5 ml two times?), the water helps with his kidneys.
Use Calcitat to get his calcium back up. 0,05 ml a day for the first week, and then twice a week (not sure if it's indefinetly, she prescribed a big bottle so I'm guessing yes?)
The extra water is supposed to help his kidneys and would be for the rest of his life as I understood it. She said his spotty eating was due to the start of kidney failure.

Now after the sirens went off after she called him too skinny, and then louder after the absorbing water through vent remark, I started Googling the numbers she gave me over the phone, and now have real doubt about her interpretation of them. As indicated I do already have a second opinion scheduled. But I'm worried, and not sleeping, so I'm hoping for a bit of clarity before that. I'm not sure how to add pictures. But if I can post link, I can put them in a dropbox clone folder and share the link if that helps. But asking around, no one thinks he's skinny. And like I said, he's not that far below what's normal for him.

These are the blood work results (I requested that they'd be mailed to me this morning):

Uric acid: 151 umol/l
Calcium: 3.1 mmol/l
Phosphorus: 2.3 mmol/l
ALT: 77 U/I
AST: 27 U/I
Glucose: 19.2 mmol/l
BUN: 0.6 mmol/l
Albumin (not sure I'm translating this right) : 34 g/l
Total protein: 56 g/l
LDH: 330 U/I
CK: 628 U/I

leucocytes: 6.0 G/I
erythrocytes: 1.7 T/I
Hemoglobin: 13.1 g/dl
hematocrit: 40%

Heterophils: 64 %
Lymphocytes: 25%
Monocytes: 10%
Azurophils: 1%
In absolute numbers:
Basophils: 0 /ul
Eosinophils: 0/ul
Heterophils: 3840 /ul
Lymphocytes: 1500 /ul
Monocytes: 600 /ul
Azurophils: 60 /ul
Atypical cells: 0/ul
anisocytosis: 0
polychromasia: 0

They're expecting more results, but this is all they have right now, vet is on holiday starting today, won't get the rest until she gets back in 2,5 weeks. His treatment plan seems quite exorbitant to me. Assuming she truly believes the water absorbing through the vent myth, that's a LOT of water to give a bearded dragon. Also, I always thought the preffered powdered emergency food was the Oxbow stuff, as they need 80% greens and only 20% protein. On top of calling him skinny when he's not and being adamant he needs force feeding, I started to have real doubts. Now I know Google can be very wrong, hence why I do have a professional second opinion planned, but his phosperos doesnt appear very high at all? Am I wrong? And from a reptile medicine textbook I kinda get the impression that neither is his uric acid?

So, if someone who can reads this stuff, could tell me what they think about these results that would be incredibly helpful. Like I said, I do have a second opinion, but I'm not sleeping or eating well and can't focus. And thursday is so long away. Any and all help and thoughts are truly appreciated from the bottom of my heart.

Saskia

Couple of people on here can read the results and recommend what she thinks - Drache613 our vet tech mod --- I will flag your post shes on at nite --
here is a website for another reptile vet in your area possibly -- I would not feed the feline food she was referring to --
www.arav.org

KarrieRee":j4xk94wf said:

Couple of people on here can read the results and recommend what she thinks - Drache613 our vet tech mod --- I will flag your post shes on at nite --
here is a website for another reptile vet in your area possibly -- I would not feed the feline food she was referring to --
http://www.arav.org

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Thanks, that will be so helpful, thank you so so so much. I haven't picked up the stuff she prescribed yet, and probably won't until at the very least the second vet says I'd need to. But it's so odd, that I'm hesitant to give him any of it until then. I'm usually not one to doubt vets, but I can't ignore the alarm bells here.

I don't have any training in this, but have seen several blood tests over the years and have a vague idea of the typical ranges. The calcium, phosphorus, and uric acid levels all look OK to me. Glucose is a little high, but not by a lot. It looks like the heterophils are a bit high, lymphocytes are low, and monocytes are high. This may indicate that he is fighting off some kind of illness, but I don't know how to interpret beyond that.

I probably wouldn't worry about giving him extra calcium. Offering extra water is good, but don't be forceful with it and let him take what he wants. Just drip some water on his nose and let him lick it up. Stop when he has had enough or doesn't show interest.

His weight sounds OK, and if he hasn't been losing weight I wouldn't worry about it. He is about the same size as my adult dragon.

Since he is still eating on his own, I would just offer as much of a vegetable variety as you can. He will get nutrients from the varied diet. If he stops eating on his own or starts losing weight, you could offer some baby food or make your own slurry out of his salad items. I wouldn't be forceful with it unless his weight starts to decrease a lot, but drip it on his nose (like with the water) and let him lick at it if he is hungry. Stop if it seems to be causing him stress.

I think it may be a good idea to get a second opinion from a different vet.

CooperDragon":10u15nf9 said:

The calcium, phosphorus, and uric acid levels all look OK to me. Glucose is a little high, but not by a lot. It looks like the heterophils are a bit high, lymphocytes are low, and monocytes are high. This may indicate that he is fighting off some kind of illness, but I don't know how to interpret beyond that

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That's very interesting! I kinda came to the same conclusion on the calcium, phosporus and uric acid from Google, but you know... Google. I am going to do not nice things to the vet if he doesn't have diminished kidney function at all, she said he has beginning kidney failure. My other beardie (the one I rescued him with) died from it.

Glucose makes sense. He's not eating his leafy greens, but is eating things like apple, strawberry and red bell pepper. Which are of course sugary, so that might be an explanation. But the signs of some kind of illness are interesting, maybe he has an infection. Or maybe it's just the stress, but that sounds like something.

CooperDragon":10u15nf9 said:

I probably wouldn't worry about giving him extra calcium. Offering extra water is good, but don't be forceful with it and let him take what he wants. Just drip some water on his nose and let him lick it up. Stop when he has had enough or doesn't show interest.

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He's getting his biweekly bath tonight, he usually drinks from the bath. I can always make it a weekly bath. I'm not doing the liquid calcium until after the second vet agrees he'd need it.

CooperDragon":10u15nf9 said:

His weight sounds OK, and if he hasn't been losing weight I wouldn't worry about it. He is about the same size as my adult dragon.

Since he is still eating on his own, I would just offer as much of a vegetable variety as you can. He will get nutrients from the varied diet. If he stops eating on his own or starts losing weight, you could offer some baby food or make your own slurry out of his salad items. I wouldn't be forceful with it unless his weight starts to decrease a lot, but drip it on his nose (like with the water) and let him lick at it if he is hungry. Stop if it seems to be causing him stress.

I think it may be a good idea to get a second opinion from a different vet.

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This was basically my plan before the vet visit. Added with some probiotics. He ate calcium sand before he got to me, and has stomach issues sometimes, always responds well to the Bene-Bac gel stuff. Usually my 'force feeding' style is to annoy him until he takes a bit and then shove in something while he's still chewing. So he's basically eating on his own to prevent aspiration. He did that with water once while in the bath, so I'm careful with force feeding stuff. He's a good boy though, doesn't usually spit it out as long as it's somewhat edible (doesn't work with medication lol).

Appointment for the second opinion (over the phone) has already been made for thursday afternoon. That guy is quite reputable, but is only in once a week, he's half retired. Which is why I asked here, since I'm literally worried sick.

Hello,

Sorry your dragon is giving you grief, they are very good at doing that!
You are positive he is male & not female? Which dragon is having the trouble, the older one?
I agree, the values look pretty well within range. The uric acid levels are a little low. That can
be caused by dehydration, or just a mineral deficiency. The calcium might be just a little bit
high but within range. I do think that the calcium to phosphorus ratio is a little imbalanced but
sometimes that happens when they are not eating as they should be.
The lymphocytes are a little high so he might be fighting a bit of infection. You can keep him a
little warmer overnight to help boost his immune system right now. That can sometimes help
boost them to ward off infections.
The AST which is one of the liver enzyme readings is fine, but the ALT another liver enzyme is
little high which can be caused by disease or sickness/infection, etc.
I don't see any indication, at the moment, of renal failure. Nevertheless, if he is dehydrated or
having any renal issues, you could be proactive & start him on a black or tart cherry juice extract
to help out with that.
Let us know how things are going!

Tracie

Thank you sooooooooooooooo much Tracie. I feels like I can finally breathe, like I can breath deeper now. This is such a relief, it's making me emotional. I really don't know how to thank you!

It's the older male, and yes definitely a male. Not only checked by flashlight, also confirmed by a vet (not this one, she moved away a couple of years ago), and finding sperm plugs. The last one is a dead giveaway, he's a male for sure hahaha. He's generally very healthy, well last few years... he's a rescue. But I was so hurt when the guy I rescued him with died in the fall of 2019, that I feel like I'm hyperfocusing on his health. I'm pretty sure the pandemic doesn't help with that either.

Drache613":1dw2yoit said:

The uric acid levels are a little low. That can be caused by dehydration, or just a mineral deficiency.

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The vet said it was high, from the ranges I found it would indeed be low, and you basically confimed that. That's such a relief, the rescue that passed away died from renal failure. And though I'm not seeing any signs with this guy (his name is Henk btw, you'd pronounce it as Hank), it has made me very worried about something internal we can't see and only notice too late. A mineral deficiency makes sense since he's eating pretty one sided, only eating his favorites. But I'll make his biweekly bath a weekly one, so he can drink if he wants to. But he only drank a little last night. And maybe try a dropper with some water ever once in a while, just to be sure. The pinch test doesn't make me think he's dyhydrated though.

Drache613":1dw2yoit said:

I do think that the calcium to phosphorus ratio is a little imbalanced but sometimes that happens when they are not eating as they should be.

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Exactly, I was pretty much expecting it be off with him not touching his leafy greens basically at all.

Drache613":1dw2yoit said:

The lymphocytes are a little high so he might be fighting a bit of infection. You can keep him a little warmer overnight to help boost his immune system right now. That can sometimes help boost them to ward off infections.
The AST which is one of the liver enzyme readings is fine, but the ALT another liver enzyme is
little high which can be caused by disease or sickness/infection, etc.
I don't see any indication, at the moment, of renal failure. Nevertheless, if he is dehydrated or
having any renal issues, you could be proactive & start him on a black or tart cherry juice extract
to help out with that.

Click to expand...

I'll get a small CHE for the nights if I can find one or otherwise order one. An infection might explain his decreased appetite. Which aside from being hormonal, is basically his only symptom.

If he wasn't dehydrated or having renal issues, would the black cherry juice be harmful? I'm not seeing any signs of either, but if it can't hurt I will give it a go regardless, just to be safe.

Drache613":1dw2yoit said:

Let us know how things are going!

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I'll definitely make sure to update when I have more info. In case anyone finds themselves in a similar situation and stumbles upon the post.

Thank you so so so much!!!!!!

Small update,

I think we can rule out dehydration. He just passed the perfect poop, with the perfect urate too, and some excess fluids. Poop was soft but firm, I squished it in a paper towel, but there was no undigested bugs or other food. Urate was the right kind of white, and also soft and squishy in the right ways. It smelled the horid smell that is supposed to be beardie poop. No odd smells.

He's still not eating much, but I managed to trick him into eating some leafy greens (arugola) yesterday. By hiding it under a thinner than normal slice of apple. After 3 he started to refuse, but then I gave him just the apple and just added the arugola while still chewing, apparently he didn't really mind that and managed to get in a normal amount of what I'd usually give of fruit/greens to leafy greens. I think he took a few pieces of arugola on his own today, but it's difficult to say.

I'm still a bit nervous, but at least able to focus on work thanks to you guys while awaiting Thursday. I can't thank you enough!

That sounds like very good news. Signs of hydration combined with well digested food and proper urate color help to indicate good health.

Major Update:

Just had the second opinion by phone with the second vet. As expected he agreed with you all. No sign of kidney failure, beginning or otherwise. Thinks his values are fine. He did agree with the red and white bloodcel thingies. Although he saw pictures and says that if it were an infection, with those levels he's expect him to behave like a sick beardie and not be his usual self aside from not eating well and the hormonal fits. He also doesn't think he's skinny, he called him well filled out (translated, sounds less awkard in Dutch lol)

His treatment plan, give it two weeks and then do another fecal to rule out the first being a starting coccidia investation. If it's still low or gone away, fine. If not, treat. Weigh him regularly to check if he's losing weight. If not, wait out the hormones. If he does start to lose weight, come by for another examination, but by him this time. Don't give him extra calcium, don't force feed that cat food powder stuff, no extra baths or anything needed. Rule out coccida, and give it time if he's not losing weight (which he doesn't appear to be doing). And of course come by if I get worried anytime. He took his time, gave reference ranges and everything, combined with it being exactly as you all said, I now 100% trust this. He also agreed that if his kidneys were failing she should have prescribed something to bind the uric acid. So the fact she didn't did not make any sense to him. He also had a disapproving hmmmm when told about the vent absorbtion treatment lol. But being she used to work for him, he didn't say anything.

I have added a small 30W CHE to his tank at night, he throws a fit if I leave it on during the day though. If it is an infection, hopefully that'll push his immune system (I asked the vet, he agreed with doing that, said it wouldn't do him harm and might just get him back to normal a bit quicker).

I am going to order some more priobiotics for him on my own. And give him a small treatment of those, since he has stomach issues sometimes, and just want to give his gut a healthy boost when he's not eating well. He's used to that though, I just put a bit of gel on a bug and he eats it that way no issues. So it won't add any stress or anything, and again, is not harmful.

I have never been more relieved in my life and yet so incredibly angry at the same time. I sent the least angry email I could muster to the old vet that the prescribed medication will not be picked up and why. I couldn't help but put just one or two slightly snarky remarks in there, and told them they'll hear from me later. I'll get back to them when I can control my anger a bit better. It's probably a good thing she's on holiday lol.

Now my sweet people, I cannot thank you enough. I would have had a very hard time last week (well a lot harder than it was already) if it weren't for you. I also now don't have his word against hers, but 3 to 1 against her, which is such a comfort. If there's anything I can do for you let me know. Anything I can do, do you feel passionate for a cause I can maybe donate to in your honor or something? THANK YOU SO MUCH!!!!!!

Saskia

Hello Saskia,

It sounds like your vet visit went well & that they were helpful also! I agree, nothing indicates
renal failure right now so that can be ruled at right now.
I think waiting a couple of weeks sounds good. Hopefully his appetite will pick up & he will
start feeling better.
Adding the ceramic heat emitter for him overnight will help keep his system boosted & should
help to ward off any infection if there is one starting.
We are all here to help, as information warriors & educators & are happy to help out! You are
doing a great job getting help for him & researching.

Keep us posted on his progress.

Tracie