Keeping my girl comfortable during her last days with edema

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Keeping my girl comfortable during her last days with edema

Postby voyagerrr » Sat Apr 12, 2014 6:22 am

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Hi everyone, this is my first post here after being referred from r/beardeddragons. I'm excited to join this thriving community!


We've known for a while that Tawny has had kidney problems, probably due to adenovirus, which is causing her tummy to fill up with fluid. She was adopted last August from a family that had her in a tiny tank, only feeding her 5 or so crickets a day. She looked like a skinny crab when we got her. She had signs of mbd, but we thought she was doing better when her belly started to look chubby. However, around that time, I saw a beardie with similar symptoms on r/beardeddragons and suspected she had the same problem.

She's been to the vet multiple times since, had a fecal, etc., and is taking alopurinol and milk thistle for her kidneys now. However, we always knew the outlook wasn't good, and now it seems that her health has finally started to decline. She has become more lethargic of late, and has had less of an appetite. For now, we're concentrating on keeping her as comfy as possible, but my plan was to put her to sleep when she starts looking miserable or stops eating her roaches.

My primary concern now is keeping her comfortable and knowing when to go to the vet to put her to sleep. Do you have any advice about how we can make her last days as easy as possible? When should we go to the vet for the last time?

Here are some pics.

I love my log! http://imgur.com/y0pY3cy)

Sleepy girl http://imgur.com/KjTHgfT

Why you do this to mee??http://imgur.com/dC3aLoq

Passed out on her favorite blanket http://imgur.com/b4VmgBT
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Re: Keeping my girl comfortable during her last days with ed

Postby Taterbug » Sat Apr 12, 2014 6:35 am

The poor thing, she is lucky she found someone to love her and care for her in her ill health. She looks like a sweetheart.

The best you can do it provide her an ideal setup, and a little stress as possible. It sounds like you have been. It's a tough and personal decision to let go, my advice is to try to consider her quality of life from her point of view. Reptiles are very hard to read, unfortunately. In my experience you sort of just, know it's time as long as you are thinking about her welfare and what is the kindest thing to her. For me it it was when it crossed from supportive care, to just keeping the animal alive.
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Re: Keeping my girl comfortable during her last days with ed

Postby voyagerrr » Sat Apr 12, 2014 6:42 am

Thanks for your advice! When you say switching to keeping her alive, do you mean like feeding things like repti-boost after she's stopped eating on her own?
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Re: Keeping my girl comfortable during her last days with ed

Postby Taterbug » Sat Apr 12, 2014 6:53 am

Sort of, basically life support. Like I said, it's a deeply personal choice to know what the line is, since things like assist feeding can help convalescing animals and aren't by default a problem.

My first dragon was a rescue, so had more supportive care than a healthy dragon, like your girl. But the he suffered an injury to his back and was paralyzed. He couldn't poop on his own anymore and refused assist/force feeding (spit it out), his mobility was very limited and he couldn't bask or thermoregulate very well. I couldn't in good conscience keep him going like that. At some point my hope for his recovery was outweighed by his discomfort and poor health.

I'm sorry you are faced with this situation, it's never an easy one and rarely clear cut.
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Re: Keeping my girl comfortable during her last days with ed

Postby Drache613 » Sat Apr 12, 2014 9:02 pm

Hello,

Oh I am sorry to hear about Tawny. Overall she looks good, I was surprised. You have done a great job with her. How old is she?
She is lethargic more than normal? Is her beard darker than usual?
How long has she been on the allopurinol & milk thistle?
Just keeping her stress free as suggested does wonders for her. How much has her eating slown down?

The Adenovirus causes a multitude of issues. How is her liver, has it become enlarged or do you know?
The milk thistle should help out with the liver.
It is hard to know when to let them go, but in your heart, you will know. She will let you know.
Could there possibly be anything else causing the swelling in the belly, such as eggs?
Are you using the Reptisun 10 tube bulb for her with regular calcium since she had signs of metabolic bone disease?
I am sorry you are both going through this. She looks so sweet, too.

Keep us posted on her.

Tracie
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Re: Keeping my girl comfortable during her last days with ed

Postby voyagerrr » Mon Apr 14, 2014 8:19 am

Hi Tracie, thanks for your questions.

When we adopted her, we were told that she was 2 years old, and that was 3/4 a year ago, so she's almost 3. She has been slightly more lethargic than usual, although yesterday she ran after her roaches with gusto. She has not been eating her vegetables as much lately. She is not very interested in butternut squash, which was previously her favorite. I'm not sure if that's due to her health problems, or because I made the mistake of feeding her her medicine by injecting it into a blackberry every night. After that, she was less interested in her boring old veggies. I would say her interest in insects has not decreased but her interest in veggies has. She used to eat squash out of my hand eagerly, but now she turns her nose up at it. We stopped feeding her blackberries probably 2-3 weeks ago. She has been on allopurinol for maybe 6 weeks, at .1 (ml I think?), and I've been giving her milk thistle and also bee pollen for about 2 weeks, a sprinkle on her greens. She hasn't been blackbearding at all.

I'm not sure exactly what is going on with her kidneys or liver, except that her blood test came back and her uric acid levels were maybe 3-4x higher than what is normal. I don't think it could be eggs, since the vet did an xray and didn't see any. Here's her xray from about 2 1/2 months ago. http://imgur.com/MvDJb3A

She has a reptisun 10.0 in a t8 (I think, the stronger one) fixture. She also has calcium with D3 that I dust on her roaches. Here's a picture of the sweetheart from last night: http://imgur.com/faOZAe4

Thanks for your time Tracie!
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Re: Keeping my girl comfortable during her last days with ed

Postby Drache613 » Wed Apr 16, 2014 12:53 pm

Hello,

She looks happy in the picture. If she isn't black bearding any, then I don't think she is in any discomfort. Is there any swelling of hands or limbs visible?
I don't see any eggs on the x-ray, either. Her bones look fine as well.
It is possible she lost some interest in the veggies & fruit when she recognized the meds inside of them. That can happen.
What is the strength of the allopurinol, do you know, since she is getting .1ml daily. What is her weight?
Definitely continue with the milk thistle for liver help & try to get 2-4mls of fluid into her for help with her kidneys. The bee pollen is excellent as well.
When was she tested for Adeno?
Were other levels ok on the blood test that they determined? Do you have a copy of the blood tests I could see?

I think you are doing great with her, she is very lucky to have such a wondeful mom looking out after her.

Tracie
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Re: Keeping my girl comfortable during her last days with ed

Postby voyagerrr » Thu Apr 24, 2014 8:07 am

Hi Tracie, I'm sorry it took me so long to respond, I've had a busy past week!
Tawny seems to be doing a lot better. I thought she was going to pass away last week, but she seems back to her normal self, only a little bit clumsy because of all the added weight of the fluid. The allopurinol is 100 mg/mL. I am not sure what her weight is, but when I go to the vet next time to get more medication for her, I'll ask them to print out her weight and all of her blood tests results. She wasn't tested for adenovirus, the vet basically said that it wouldn't make a difference knowing if she had it or not because there is nothing we can do about it if she does.
What is the timeline for edema? I mean, how long have you seen beardies live with it and at what stage do they start to decline?

Thank you so much for taking the time to answer all of my questions. I really appreciate having someone with your expertise to talk to, as my vet wasn't all that experienced with edema in beardies.

-Rose
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Re: Keeping my girl comfortable during her last days with ed

Postby Drache613 » Sun Apr 27, 2014 5:39 pm

Hello Rose,

How is your girl doing?
That is great news Tawny seems to be doing better now. Has she pulled any water weight?
The dose of .1ml seems to be ok, was it dosed for her weight? The 100mg/ml is a strong solution.
There are a lot of things that can be done for adeno positive for immune support, etc. Edema can be caused by so many factors that it's hard to put a time table on it.
I have read that the kidneys function normally even with up to three quarters of them being damaged. I would say that once the kidneys fail & are no longer able to excrete any uric acid at all you will see decline.
That could be quite a while depending on her strength, spirit & overall health. She is young so she does have that going for her.
You can try dandelion greens/root for a natural diuretic effect for her to help with water weight.


I do hope that she is feeling better! Keep us posted on her.

Tracie
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Re: Keeping my girl comfortable during her last days with ed

Postby voyagerrr » Tue May 13, 2014 12:57 pm

Hi Tracie,
Tawny seems to be doing just fine. She's eating dandelion greens happily and is still running after her roaches. On Sunday, she was hyper, scratching at her glass and running around all around the house when I let her out. I think she's looking for a boyfriend since she wasn't blackbearding and it's that time of year! I just picked up her lab report. I took pictures since I have no idea what I'm looking at:

http://imgur.com/93gWHjz
http://imgur.com/Qv69yK5

I don't know if the dose of allopurinol was dosed for her weight or not. I am also not sure about fluctuations in her weight. I need to get a scale for her. She does look about the same, though it's hard to tell.

Thanks for all your help!
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Re: Keeping my girl comfortable during her last days with ed

Postby Drache613 » Tue May 13, 2014 10:01 pm

Hello,

Wow that is great to hear Tawny is running around so much right now.
How long ago were those blood tests done?
The uric acid is very high, indeed. Thanks for posting those.
I am glad to hear she is eating her greens & taking some roaches, too. Are you getting extra water into her?
I would think that the allopurinol should be dosed for her weight, I hope.
Does she have any swelling of the hands, toes, etc right now? I couldn't see any areas that were swollen.

Let us know how she is doing.
Tracie
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Re: Keeping my girl comfortable during her last days with ed

Postby voyagerrr » Wed May 14, 2014 1:19 pm

Hi Tracie,

I think the blood tests were done in February. I've been giving her a bath every day. Is this a suitable way to give her extra water, or should I also get it directly in her mouth? I am concerned about hurting her teeth on a syringe.
She doesn't have any swelling other than in her belly.

Here she is outside just the other day. http://imgur.com/JfNGUUE
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Re: Keeping my girl comfortable during her last days with ed

Postby Drache613 » Fri May 16, 2014 9:23 pm

Hello,

She looks happy outside in the sunshine! :D
Giving a daily bath is good for hydration. While she is in the bath you can swirl the water around to see if she will start drinking. A lot of times they will, with moving water.
It sounds like she is doing pretty well, overall. Is she eating well too?

Tracie
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Re: Keeping my girl comfortable during her last days with ed

Postby Esther19 » Thu Jun 19, 2014 8:39 pm

How is Tawny doing?
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Re: Keeping my girl comfortable during her last days with ed

Postby Drache613 » Wed Jun 25, 2014 9:53 pm

Hello,

Just wondering how Tawny was going lately? Update us on her when you can. :D

Tracie
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