Baby BD just diagnosed with MBD (updated 12/07)

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Re: Baby BD just diagnosed with MBD (updated 11/08)

Postby SquirkyTurtle » Sat Nov 23, 2019 5:30 pm

Heya!

Just checking in to see how your little guy is doing since the last update? It's really helped me with our case to read your story and I would love to hear how he's been holding up! :)
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Re: Baby BD just diagnosed with MBD (updated 11/08)

Postby claudiusx » Sat Nov 23, 2019 7:15 pm

Gah,

I'm sorry I don't know how I missed your last update! How is he doing lately?

That difference in the xrays is outstanding! I swear I saw it and I swear I posted, but I guess I didn't! :oops:
Also the weight gain, great sign! :mrgreen:

-Brandon
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Re: Baby BD just diagnosed with MBD (updated 11/24)

Postby skyfishcafe » Sun Nov 24, 2019 1:03 pm

Hi there SquirkyTurtle and Brandon,

Thanks for checking in on us! Alduîn has had his ups and downs, of course. Last week he surprised us by being very alert and mobile -- even starting to "climb" on a small half-log to aid in easier bowel movements. We've checked his weight and he's gone from 28g to about 33g (hard to tell exactly, but for the sake of at least some level of consistency we try to only weigh him after he's pooped). He usually has a pretty good appetite, too, averaging about 27 insects per day since his last appointment. He's shed his face and head and all four legs since the appointment, too.

The last few days, unfortunately, have been pretty down. We might be partly to blame for this; we tried to add some more variety to his diet by introducing butterworms. We also switched from Flukers BSFL to Symton, and he does not seem happy with the changes. We thought he just had a decreased appetite because he was shedding his face at the time, but it's possible his stomach is upset from the new foods as well. We haven't even been able to give him his meds today because he has refused all but a single dubia roach.

All of this is compounded by the fact that I started a new job two weeks ago. I've gone from being home 24/7 to being gone from 0630 to 1800. We have his lights come on at 0500 so we can try and get him his food and meds before we go to work; his lights go off at 2000 but he often sleeps before then. This seems to have affected his elimination timing; he used to defecate every day, but recently it's been closer to every other day. I often worry that he's not getting enough time after eating to digest in the heat, but I don't want to force him to stay awake if he's tired and there's no way I can get home any earlier since my commute is about an hour. I'm also not really sure what to do about water; when he poops, he often releases a lot of water with his otherwise normal (well, calcium-discolored) urates, so I believe he's hydrated well enough... but he always seems SO thirsty when I offer him water from his syringe. Recently he's started just drinking straight out of his bath water. I know the calcium gluconate can be dehydrating, and I know the meloxicam can be tough on the renal system in some cases. We've been using both for 6 weeks now. No signs of dehydration other than always seeming thirsty.

Anyway, we are hopeful for his recovery and, except for the last few rough days, he's definitely in a much better place than he was a month ago! Our next appointment is on the 6th, just under two weeks away. I don't think we'll be doing x-rays this time, but I'll be interested in getting the follow-up assessment from the vet.

Thanks again for your ongoing support!

With kind regards,
Aaron
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Re: Baby BD just diagnosed with MBD (updated 11/25)

Postby skyfishcafe » Mon Nov 25, 2019 5:31 pm

Well, not very good news at all. We took Alduîn for an emergency visit to the vet today because he was continuing to refuse food AND his right arm began to swell significantly more than what was previously explained to us as hypertrophy.

Unfortunately both reptile vets we had seen previously were unavailable for the entire week, so the third and final reptile vet at the clinic saw us. Well, I was driving home from work, so I never actually met the vet -- but my partner said the doctor did a thorough step-by-step chart review in addition to physical inspection. Anyway, the doc suspects the swelling in his front arms is the result of a bacterial infection. She wished she could do a joint tap to find out for sure, but because of his size she was concerned that the procedure would do more harm than good (he's only 32g -- up 14% from his last vet visit on the 8th, but down 3% from a few days ago).

The prescription to fight the infection is intramuscular or subcutaneous injections of 0.06cc ceftazidime every 72 hours. The vet tech explained the process as well as tips she has used with her own bearded dragons, then did the first injection for us as demonstration. It feels horrible to do to the little guy but I know the goal is for it to help him. I have the steadier hands so my partner will hold him while I give the injections.

Since he hasn't been eating, the vet also gave us a log and a trial of Oxbow Critical Care Omnivore. We need to track all his daily stats and give him 0.5cc of the critical care daily in addition to any regular feeding he might do. Luckily for us, I've already been tracking all of his stats (medication times, quantities and types of feeders consumed, elimination times and observations, etc.) in a big spreadsheet, so it won't be much additional work.

Alduîn has also been drinking a LOT of water recently despite not showing other signs of dehydration; his stool are firm and urates are soft, but he passes a large quantity of liquid. The vet suspects the 0.06cc daily dose of calcium gluconate may be too high for him right now, so she advised us to scale back to 0.03cc to allow him to focus on the current fight before re-evaluating the dosage later.

So anyway, here is Alduîn's new regimen:
  • 0.03cc calcium gluconate administered orally every 24 hours (for calcium supplementation)
  • 0.01cc meloxicam adminstered orally every 24 hours (for pain and inflammation management)
  • 0.5cc Critical Care administered orally every 24 hours (for nutrition)
  • 0.06cc ceftazidime administered via intramuscular or subcutaneous injection every 72 hours (antibiotic)
The vet wanted to see us again on the 9th but there was some miscommunication since we already have a follow-up scheduled with our other vet on the 6th. We'll get clarification tomorrow when the vets return to the clinic.

Little Alduîn has had a rough start in life, but I'm convinced that he's not ready to give up yet. We'll just keep doing the best we can.
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Re: Baby BD just diagnosed with MBD (updated 11/25)

Postby claudiusx » Mon Nov 25, 2019 5:50 pm

Hi Aaron,

Darn. I don't know how I feel about the extra meds.

The ceftazidime can cause lack of appetite itself. Although it at least seems like a small enough dose. I'd have to refer to Tracie on that one.

14% in less than a month is quite good! That's about the same (if not a bit more) than the growth I was getting when my dragons were around 20-30g. I wouldn't worry too much about a small drop in weight. A big poo at that age can be enough to drop them a few percentage points.
But the leg is disheartening :( Maybe that's what was causing him to feel unhappy and not want to eat. If so, hopefully the cefta helps.

Probably good to drop the Calcium dose too. How are his urates looking? Are they discolored? or staying white?

-Brandon
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Re: Baby BD just diagnosed with MBD (updated 12/07)

Postby skyfishcafe » Sat Dec 07, 2019 7:07 am

Sorry for failing to reply to your questions, Brandon! Been a bit of a whirlwind here (for mostly non-dragon-related reasons).

Alduîn's urates are mostly white with rare flecks of color from the minerals in the Critical Care (we think). The ceftazidime is definitely not helping his appetite, but thankfully with the addition of the CC he is maintaining his weight. We wish he were growing, but we suspect his compromised immune system is making it harder. We are noticing what we think is pre-shed on his entire body, so that's a good sign. Even more promising is that the swelling in his limbs has gone down considerably; yesterday we saw the vet for a follow-up visit and she said his swelling had reduced by 90%. He's also MUCH more active on most days, and I think he's very happy that we've rearranged our living room furniture so he can bask in the sun on a comfy couch in the early afternoon. Sometimes he'll even run around on all four legs inside his enclosure, exploring the cool side which he has rarely visited due to low mobility.

Here's a photo of Alduîn up on all fours in the bath on Wednesday:

[Click image to enlarge]


You can see how underdeveloped his leg muscles are, and you can also see the "double elbow" appearance caused by the remaining swelling in his front legs. Still, it's so good to see him off his belly!

One thing you can't see in the photo is that he still has the bent-looking wrists. I had hoped it was just an optical illusion caused by the swelling, but the vet suspects it may be a more permanent deformation as a sequela of the MBD. We'll know more when we get a third x-ray taken at his next appointment on December 20th.

Another milestone: he has finally started (apparently) enjoying some turnip greens! He doesn't seem to go out of his way to eat them, but if we dangle a couple strips in front of him he will devour them. I suspect when his appetite has returned he'll eat even more.

Anyway, as for the calcium dosage, Alduîn is still drinking and passing a lot of water even with the lower dosage. The vet considered this for quite a while and ultimately recommended just staying at the lower dosage for now but keeping an eye on him in case his tremors flare up again. We've noticed a shaky leg already this morning, but we're going to monitor over the weekend and check in with the vet on Monday if it's persistent.

And that's the way it is!

With kind regards,
Aaron
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Re: Baby BD just diagnosed with MBD (updated 12/07)

Postby claudiusx » Sat Dec 07, 2019 7:35 am

Hi Aaron,

Well I'll gladly wait around for such a good update as that! He looks great compared to how he first looked. Seems like things are starting to fall into place :) He sure is a fighter.

Him becoming more active will have a great affect on his health and wellbeing too. Plus the start of pre shed, all great signs!

Keep up the great work Aaron!

-Brandon
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P.S. We have lots of pictures ;)
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Re: Baby BD just diagnosed with MBD (updated 12/07)

Postby SquirkyTurtle » Fri Dec 20, 2019 7:44 am

Hey Aaron,

I only just read your update. I'm rooting so hard for your little guy and I'm super happy it's good news on your end. Please keep us updated!
It's scary how many of your symptoms match the symptoms of my little guy but he seems to really be on the way up! :)

I'll keep following this thread!
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Re: Baby BD just diagnosed with MBD (updated 12/07)

Postby claudiusx » Sat Dec 21, 2019 6:37 pm

Hoping for a Christmas update :)
I know it's a busy time of year. Hope all is going well with you all.

-Brandon
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P.S. We have lots of pictures ;)
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