Gout, MBD, Nurrological, Injury?

Ohhh ok! Thanks so much Ellen! I've heard of laser treamtements, I believe it's laser, on bearded dragons to break up the crystals. I guess the heat, directly on the joint, dissolves them. So bumping the temps in her viv a few degrees is doing absolutely nothing lol that's what I figured. She stays on her basking rock 24/7, since she's not very mobile, which is 105 during the day and 85 at night. Should I let it drop lower at night? Is that too warm to get a good night sleep?

Yes, the laser treatments directly on the joints where the crystals are present seems to work very well if there are crystals left that the Allopurinol does not break up (the formation of uric acid crystals in the joints is completely dependent on the saturation of the synovial fluid that fills the joint by the uric acid, and Allopurinol is excellent at lowering that saturation). I would think that yes, the laser treatment directly on the crystals and/or the joint itself is raising the temperature of the synovial fluid of the joint, but if the crystals are that bad, at that point there isn't much fluid left to heat up. It's all about lowering the saturation of the synovial fluid by the crystals.

I think her temps are high enough, 105 on the basking spot is hot enough, bumping it up to 110 is not going to make a difference on the crystals in her joints, especially now that she is taking the Allopurinol, after a week or two of taking the Allopurinol you will start to see serious improvement, and I would be afraid of needlessly raising her temps up to that range because you certainly don't want to stress her out any more than she already is...85 at night is very hot, and again, I don't think it's necessary at all. If she was suffering from something like an upper respiratory infection or some type of infection then yes, keeping her nighttime temp up high is beneficial. But she has gout, and is already in pain and really uncomfortable and exhausted, so having her nighttime temp up to 85 is only going to make her even more uncomfortable and disrupt her sleep...

Are you using a nighttime heat source, like a CHE or a heat mat? I would try a night without her temps being so high, see if you can get her nighttime temps down in at least the 70-75 range, I think you'll find that she will sleep much, much more soundly, be much more rested the next day, and have more energy. Keeping her nighttime temps up to 85 isn't helping dissipate the UA crystals in her joints, the Allopurinol is. I think restful, comfortable sleep in cool temps is going to be very beneficial to her along with the Allopurinol and the Serrapeptase from the Silkworms...by the way, is she eating the Silkworms? I'd try to give her a couple an hour or two before lights out for bed, the hit of Serrapeptase a couple of hours before bedtime may really help her sleep more comfortably and peacefully too...

Ok thanks again Ellen. Yes I've been using a CHE at night. I'll shut it off tonight, inside temps are in the 70s. Yes she's eating the silkworms. I'll give it to her a couple hours before lights out.

Thanks have a nice night!

Danielle

One more question lol ? I read, with regards to gout in humans, that you should never start allopurinol during an active flare up. ? Why is that? Is it because the allopurinol starts to break down the uric acid and that's extremely painful?

Hello Danielle,

OK, so she is receiving .12ml, correct? If that is the case, that will be 20mg/kg for her which
is fine for now.
It's different for reptiles with gout. It really doesn't matter when you give the allopurinol,
during an outbreak, or not. Either way, it needs to be started & it will be somewhat painful
during either phase.
As far as the uric acid crystallization, it is the long term issues which cause crystallization.
They are not able to properly excrete uric acid on a normal basis if kept too cool for long
periods of time. Of course, there are other reasons for gout development, too.
Reptiles cannot stay hot all of the time, it will stress them too much. The crystallization or
literal crystals irritate the joints & damages the joint capsules so laser treatments may or
may not do a lot of good. It depends on the severity of buildup. If the crystals haven't had
time to harden or buildup much then a treatment like that may be beneficial. The dissolving
of them is through the medication & flushing out the system which decreases the blood serum
levels of uric acid. The allopurinol simply decreases the amount of uric acid production by inhibiting the actions of xanthine oxidase.
Sometimes it takes weeks to see any type of results from medications, but it varies from each
case as each reptile is unique. I am really hoping that she is feeling better!

Tracie

Thank you Tracie for all the information, it's very much appreciated.

Deka on day 4 of allopurinol... ?


The back right leg looks pretty bad, toes are curling.

Day 5 on Allopurinol...


Back right leg looks horrible.

Yeah it's swollen, but only 5 days on the Allopurinol is typically not enough to see outward results, unfortunately it typically takes around 2 weeks to actually see a difference. The Allopurinol lowers the concentration of Uric Acid in their blood, but the saturation of the synovial fluid in their joints by Uric Acid has to be lowered to see a visible difference, that's why it takes a while.

Are the Silkworms making her feel at all better? The Serapeptase usually at the very least helps them to feel a bit more comfortable.

It doesn't seem like she's feeling any better and she absolutely hates the medicine. For a bearded dragon that hasn't moved in over a week, she can put up one hell of a fight when it's time to take medicine. It has gotten progressively worse over the past several days. I figured it would take a while to correct, if ever, but I didn't realize it was going to get worse and worse each day. I thought taking the medicine would possible halt any further swelling/deposits but it's spreading like wild fire. The scales on the knee are not even touching anymore, her lower leg is so swollen that I could see the white from underneath the leg, when standing above her. If her uric acid level was at 48 last week, and she wasn't half as bad then, I wonder how high it is now.

Poor girl, I don't have any advice but I'm really sorry she's going through this. Hopefully the meds. will do what they're supposed to do and hopefully it's not anything else going on.

This does not sound good at all to me, it definitely does take a while for Allopurinol to start showing positive effects, as I've gone through this with many people when they first start giving it to them and are expecting immediate results...but I don't recall things suddenly getting this bad as far as the swelling and such after 5+ days on the Allopurinol...

Did you and Tracie go over the dose she is on? I know Tracie would need her weight and the percentage of the Allopurinol, and the dosage, I can't help you with this one, but it might be worth going over with Tracie just to be sure your vet got the dosage correct for her...

What has her diet been like for the last week? I know you got rid of the roaches amped-up on protein, but what has she been eating daily? And are you still giving her a lot of water or Pedialyte throughout the day? You definitely want to keep doing that to keep her kidneys flushed out...I'm just trying to touch on anything I can think of off the top of my head...Tracie will chime in soon I'm sure, I'm going to do a little research and I'll get back to you...

Thanks guys for the reply!

Yes Tracie said it was correct.

She is getting about 6 crickets, several Phoenix worms, 2 small supers (cut in half), and a couple silkies daily. She won't touch her greens so she gets a baby arugula and pedialye slurrie (5mls) daily. I give her water every couple hours through syringe and a bath everyday, sometimes she drinks from it most of the time she does not. Should I try replacing some of the live food with something like reptaid. Would that hurt or help? Does that have less purine than live food?

I know there isn't anything else I can do at this point, I appreciate all the info everyone has given me. This site has been extremely helpful! I'll keep updating her progress with hope that it will help someone else in the future.

Thanks again everyone!

Danielle

You may want to switch to alfalfa or some other source of protein, as Tracie has discussed, she may just not be able to handle the live protein right now. I wish the vet would have prescribed an anti-inflammatory/pain med, I've honestly never helped someone through this process when their dragon hadn't been put on one, so I can't help but wonder if that's why I've never seen one keep getting worse like this, especially with the horrible swelling. Like I'm thinking this is normal if they aren't given medicinal help for the swelling and pain...

That could very much be it. I called the dr twice, she's stopped returning my phone calls. Guess I would have to bring her back in and give the dr. another $500 to get a return phone call. ?‍

I give her alfalfa powder in her greens slurry every morning.

Day 6

Hello Danielle,

I am so sorry! The allopurinol dose is correct & it will be awhile with uric acid levels of that
height to decrease.
The vet should have reviewed the diet with you more, with a better direction. The alfalfa has
great purine free protein so that should be given daily, in a greens slurry.
This is becoming a huge issue here that I am seeing with regards to feed that insects receive.
Thanks for posting the Flukers label. The insects are what they eat literally. Unfortunately,
90% of all corn & soy products in the US are genetically modified which does damage to the GI
tract in humans as well as animals. I have done a few experiments with the crickets & supers
that we fed a regular chicken feed for dry feed. They were dying & we couldn't figure out why.
This was quite awhile back, but we did research on gmo, etc & figured we should knock it out
of the insects' diet. Our colonies flourished on organic chicken feed.
Too many if not all of the commercially produced feeds for insects are genetically modified so
that can also cause complications with the insects, thus, your reptile, too.
What I am going to recommend is to go strictly with silkworms for now, along with either baby
food squash or sweet potatoes or freshly cooked/pureed with the alfalfa, & other vitamins, etc
to get her system cleaned out.
Another agent that is oftentimes used in combination with the allopurinol for pain & inflammatory
relief is Colchicine. It can be used often & cycled.
Basically that uric acid level has got to come down before her kidneys fail on her.

Let us know how she is doing.
Tracie