Okay, here are the blood test results. Vet's office says they ordered the ponazuril, but I don't know how long that will take to arrive. I keep looking at my beardie as I type this. I don't know what to do. I have hope (I'm a optimistic person) that she'll get better, but she currently isn't moving, can't even keep her eyes open. I'm sure she's depressed. She is 95% immobile. Absolutely no function in her arms and can barely lift her head. I can't even see her breathing. She keeps opening her mouth every minute or she makes that hiccup motion. Even when she's sleeping, she has to open her mouth. I don't even know if she is getting sleep at all. I'm literally force-feeding her. I don't know if I should put her down and take her out of her misery or keep trying. Wish I had a crystal ball to see the future. My fiance keeps telling me that we should put her down because there is no improvement - the mouth opening and hiccup motions are what concerns him most. I know it takes time for reptiles to show improvement, and I want to push through and fight with her. I mean, I'm planning on getting a nursing degree . . . this is what I'd do with a human patient - try anything and everything. I'm just under a lot of stress with this whole situation and it doesn't help when my fiance keeps telling me we're basically just extending her suffering. I understand his point of view though. Wish we knew what Fancy Pants wanted.
Okay, thank you for letting me vent.
CBC (Avian and Exotics)
WBC Estimate: 7.5 - 1000/uL
WBC count estimated from smear.
HCT: 44 H (28 - 36) %
RBC Morphology: Normal
Blood Parasite:s None Seen
Heterophils: 65 (34 - 77) %
Absolute Heterophils: 4875 (1698 - 5445) /mL
Toxic Changes: None Seen
Bands: 0 %
Absolute Bands: 0 /mL
Lymphocytes: 24 (5 - 58) %
Absolute Lymphocyt: 1800 (0 - 5512) /mL
Monocytes: 6 H (0 - 2) %
Absolute Monocyte: 450 H (0 - 144) /mL
Eosinophils: 1 (0 - 1) %
Absolute Eosinophi: 75 H (0 - 53) /mL
Basophils: 0 (0 - 4) %
Absolute Basophils: 0 (0 - 279) /mL
Azurophilic Monocyte: 4 %
Absolute Azurophilic: 300
Thrombocyte Estimat: Adequate
04-28-17 Hyperuricemia
04-28-17 GOUT - Arthritic
05-08-17: Final Atadenovirus results - POS.
Tx Plan: Discussed differentials for orthopedic lesions, chronic poor-doing (congenital, infectious,
tox, husbandry); rec cbc/chem to asses ua, electrolytes; rec Ca supplement, DMG for metabolic,
neurological support in interim to lab results. Rec tramadol for pain control. If indeed hyperuricemic, rec allopurinol, fluid therapy, assist-feed; herban renal support/anti-inflam (efa).
Uric acid notably elevated.
- changes in potassium, sodium; Ca
h wnl.
- cbc reveals mild polycythemia, mild monocytosis/eosinophilia
Spoke w/ o re email, photos, description suggest central/peripheral neuro pathology; fecal results
also concerning (mod-high coccidiosis, protozoa); multisystemic signs suggest more insidious ddx
(atadenovirus, septicemia, congenital); rec carnivore care, additional fluids, atadenovirus pcr -
discussed poor long term px, discussed possibility of hosp w/ IO fluids. Discussed quality of life, rec allowing another 5-7 days of tx, recheck to discuss qol, tx options.
05-04-17
3+ coccidia, 2+ entamoeba
- rec tx for coccidia; however TMS, baycox can have adverse effects on the kidneys.
- CC will be looking into ponazuril or toltrazuril for tx
We have ponazuril ordered, will contact o when in.
Positive result. Transmissible, rec closed collection. Prognosis poor
05-09-17: no interest in food, but getting critical care in. o thinks throat appears black.
Discussed above, o to send email re swallowing motion, will look into colloidal silver dose.
1144 SubQ Fluids - OutPatient
2 ml warmed ringers SC
Ova and Parasites with Centrif
Ova & Parasite Positive
Parasite #1 Isospora Oocysts 3+
Coccidia having 2 sporocysts (genus Isospora) are present.
Parasite #2 Entamoeba Cysts 2+
Entamoeba cysts are often noted to be commensal organisms of the GI tract.
Direct Smear Positive
--------------- Ova & Parasite Reporting Scheme ---------------------
The number of eggs or parasites is the number on the entire slide (not
per field) for each parasite reported...
1 seen = 1 egg or parasite seen on entire slide
1+ = 2-to-4 eggs or parasites (few)
2+ = 5-to-10 eggs or parasites (small)
3+ = 11-to-50 eggs or parasites (moderate)
4+ = >50 eggs or parasites (many)
-------------------------------------------------------------------
Parasite #1 Isospora Oocysts 2+
Coccidia having 2 sporocysts (genus Isospora) are present.
Parasite #2 Entamoeba Cysts 1+
Uric acid notably elevated.
- changes in potassium, sodium; Ca
h wnl.
- cbc reveals mild polycythemia, mild monocytosis/eosinophilia
04-29-17 at 4:01p: mild polycythemia, otherwise wnl per carpenters
04-27-17: Acquired from pet store with another beardie. Other beardie has grown
significantly, this one not at all. Fell off a high branch in Feb, taken to vet got rads and showed no
fracture, only swelling. Placed on metacam, better for two days, on third day head shaking and not eating. Once stopped metacam, back to eating. Still had inconsistent appetite and no growth. Trouble walking and drags belly across floor. Defecating but sometimes runny and smaller.
Husbandry: 40gallon tank, carpet bedding, 10.0 UVB output, heat lamp, basking 100-105, low night 70-75, humidity 40%. Diet of greens, crickets and roaches. Get calcium, multivitamins and probiotic. (go)
ABNORMALITIES
General Appearance
BAR; curious, interactive
Integument / Skin
dermis uniform.
Musculoskeletal
mild-mod under conditioning. Multifocal areas of raised, firm swellings associated with stifles, cubital joints,
carpi, tarsi, interphalangeal areas.
Respiratory
nares, choana clear
Digestive
oral cavity unremarkable. caudocoelomic palp wnl
Genitourinary
vent appears normal
Neurologic
diffuse tremor/spastic movement on attempt to ambulate.
Normal Systems: Circulatory, Glandular / LN, Ears, Eyes, Mucous Membranes
DIAGNOSES
Hyperuricemia
GOUT - Arthritic
NOTES
Tx Plan: Discussed differentials for orthopedic lesions, chronic poor-doing (congenital, infectious, tox,husbandry); rec cbc/chem to asses ua, electrolytes; rec Ca supplement, DMG for metabolic,
neurological support in interim to lab results.