Gout, MBD, Nurrological, Injury?

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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Fri Oct 20, 2017 2:17 pm

Yay! Well that's progress! That's why you have to stand your ground with doctors in general, it's sad but sometimes you have to make them listen! I'm glad she'll finally be starting the Allopurinol, thank God. Your vet should be able to relate the desired daily dose she wants her to have, and your pharmacist will know what to do. I think your vet didn't quite understand that most reptile and avian vets actually call in prescriptions to human pharmacies pretty much all the time, and the pharmacists are used to compounding the correct liquid doses from tablets or capsules. She's learning too!

Yes, her stools are watery because of all the extra hydration, which is a very good sign, it means her kidneys are getting flushed out.
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Re: Gout, MBD, Nurrological, Injury?

Postby AHBD » Fri Oct 20, 2017 2:40 pm

Yay ! That's good news. :) And her leg DOES look a little bit better there, they don't usually put pressure on a limb if it's in a lot of pain.
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Re: Gout, MBD, Nurrological, Injury?

Postby Drache613 » Fri Oct 20, 2017 11:46 pm

Hello,

Oh poor girl, you still didn't get any allopurinol for her? Hopefully next week. I hope you
don't have to wait too long. So your vet called the pharmacy personally then?
Her leg/knee does look better. The dubias must have had too high of a protein diet so
until her system gets flushed, I would lay low on them.
It seems like a lot of people are having trouble with dubias for some reason.
Let us know how she is doing. Do your best keeping her hydrated & it sounds like you are
right now!

Tracie
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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Sat Oct 21, 2017 5:45 am

Hi Tracie thanks for your response. Yes the vet called the pharmacy last night, I called the pharmacy afterwords and they said I could pick it up today.

Quick question guys, could a severe case of gout cause broken bones? For instance, her toe on her front right foot looks like it is bending back more and more each day. If It bends any further it looks like it will snap, is that possible?

[Click image to enlarge]
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Sat Oct 21, 2017 11:32 am

Wow, it does look like it's bending backwards...is it stuck in that position, like she can't put it back down? Have you tried to gently push it back down to see if it's very stiff or stuck in that position?

Gout won't directly cause her bones to break, no, but I'm assuming that her toe is stuck in that position or is stiff enough to be stuck in that position because of the amount of swelling/fluid in not only the toe but in all of the toes on that foot, and in the foot itself. So it's not the bone that is bending, but the swelling is keeping it in that position...it could also possibly be either swelling in that joint (her "knuckle") or even uric acid crystals built up in that joint that have the toe in that position, but if you gently try to push on her toe and it won't bend at either the "knuckle" joint or in the distal joint in the toe itself, it's just the swelling that is keeping her from bending it back down or at all in any direction.
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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Sat Oct 21, 2017 12:50 pm

Thanks for the response Ellen! I gently tried lowering the finger, the finger goes down but the knuckle does not bend. Their bones, especially the toes, seem so delicate and fragile I'm worried all the pressure and swelling may damage or break the bone.

We finally got out first dose of allopurinol in.👍🏼💃🏻

Here's a picture of the swelling on day one of allopurinol treatment...
[Click image to enlarge]


Here is a pic of her pre gout, hopefully we'll get to our pre gout size soon 🤞I miss those chicken legs! [Click image to enlarge]
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Sat Oct 21, 2017 1:02 pm

Awe, poor girl, I'm so glad she finally started on the Allopurinol. It's quite possible that the swelling could potentially cause her toe or foot to fracture, they are very small and delicate...this is why she should have been give the pain/swelling medication, it really does build up. Have the silkworms arrived yet? The Serapeptase will also help with the swelling...if her foot/toes continue to get worse I'd be calling that vet up and demanding a pain/swelling med, not only to finally make her feel better and comfortable, but to prevent any other problems, she surely doesn't need a hairline fracture somewhere and more pain...
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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Sat Oct 21, 2017 1:52 pm

Yes we finally have everything! Silkworms, allopurinol cherry juice and lots of fluid going on! Oh and some alfalfa powder that's mixed into a greens slurry daily.

Oh god, I can only imagine how difficult it's going to be to get her (dr) to call in a pain meds script now. She's lucky it's a 2 hour ride for me otherwise ide be popping up in the office everyday instead of phoning her. 😂
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Re: Gout, MBD, Nurrological, Injury?

Postby Drache613 » Sat Oct 21, 2017 11:02 pm

Hello Danielle,

Unfortunately, gout causes the digits to bend backwards sometimes. It is directly related to
the joints becoming stiff from the crystallization. The bone isn't broken or shouldn't be but
gout can cause the bones to become weak over time, if not treated simply because their system
may or may not be absorbing calcium properly.
I'm happy to hear she has started on the allopurinol now! I hope he started her on an initially
higher dose of 20mg/kg for a bit, to help get it into her system more quickly.
Does she seem to mind the Alfalfa powder flavor?
Keep us posted on her progress.

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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Sun Oct 22, 2017 3:51 am

Hi Tracie,

Yes, she is getting 1.2 mg and she weighs .06 kilograms.

The first day or so she seemed ok with the greens and alfalfa slurry but I have to force it now. I think she's getting annoyed with me and all the fluids I'm pushing on her 😒 Poor girl.
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Sun Oct 22, 2017 2:03 pm

Poor thing, I'm sure she is annoyed, but hopefully she'll start to feel better soon and then things will get much easier. I wish you lived right next door to that vet, lol...
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Re: Gout, MBD, Nurrological, Injury?

Postby Drache613 » Mon Oct 23, 2017 12:35 am

Hello Danielle,

So sorry, I am sure that she is tired of having to take in extra fluids, foods, etc.
I hope that she starts to feel better soon.
Do you know the strength of the allopurinol, does it say on the bottle by chance? I am sure
she will do fine on it.

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Re: Gout, MBD, Nurrological, Injury?

Postby DanielleGia920 » Mon Oct 23, 2017 5:14 am

Hi Tracie,

Yes it's 10mg/ml and she gets .12 mls.

The dr told me something the other day that I keep thinking about, wondering if anyone knows this to be true. She said to keep the temps up in the bearded dragons viv, even the cool side and overnight. She said uric acid stays in liquid form at higher temperatures and will crystallize at lower colder temperatures. She said, By keeping the temps up we'll try and prevent as much crystallization as possible. That doesn't make much sense to me, uric acid still crystallizes in humans with gout and our body temperature is always 98.6 so how would keeping the cool side at 85 prevent crystallization? I can see that making sense at 300 degrees but at 80 and 90 degrees does it really make a difference? I'm still going to keep her temps up regardless, I'm just dying to know the science behind it.

Thanks for all your help!

Danielle
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Mon Oct 23, 2017 6:04 am

My first thought on that statement about "uric acid crystallizing if your dragon's ambient temperatures are in their normal ranges, but if you bump them up it will prevent this from happening" is that it's total BS, it doesn't make any sense scientifically, at least in my mind, but I could be wrong 😒

I'll get right back to you on this, lol.

Btw, my very first thought was if this isn't true at all, as suspected, all your vet is doing is stressing your poor girl out even more than she already is, which is not good. She has no pain meds so she's very uncomfortable, and your vet wants to make her too hot on top of it? Hmmm....
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Re: Gout, MBD, Nurrological, Injury?

Postby EllenD » Mon Oct 23, 2017 6:20 am

Well, your vet is correct that the solubility of uric acid crystals goes up as temperature goes up, which makes sense, but looking at two different journal articles (dealing with warm-blooded humans) it's impossible to raise the temperature in only the synovial fluids of joints up the at least 20 degrees to make a difference. So as you said, to make any noticeable difference you'd have to bump her temps up way too high ONLY ON HER JOINTS! It's the temperature of the synovial fluid where the saturation of crystals happens, NOT BODY TEMPERATURE! So just because your core temperature goes up means nothing to the formation of crystals in joints...

Bumping her temps up by 5 degrees can't hurt, we do this when they are feeling badly anyway, to try to boost immune systems, etc. So that's not a bad idea. But I don't see any way to bump the temperature in her joints up high enough to increase the solubility of the crystals...
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