Gout likely, advice needed

EricaBee

Member
We rescued our Eva a couple of weeks ago from a less than ideal home. Prior to her living with us I have almost no information on her husbandry or diet.

She came with an enclosure, 29x11, suitable for babies and small juveniles. She is ready to upgrade I believe, however please forgive me in being hesitant to do so as I don’t believe she has long with us due to gout.

My question actually has more to do with timing, and is it common for this to happen so rapidly?

Saturday 4/23 - happy happy! Eating like crazy, zooming around the house, alert, gaping. Happy!

We came home from an evening event to find her cage trashed. Salad everywhere.

Sunday 4/24 - alert but not very hungry. Tried dubia both morning and evening but no interest. Also didn’t touch salad.

Monday 4/25 - not hungry in the morning, took outside for some real sunshine (was over 80 that day) and noticed her back right leg wasn’t working quite right. Concerned with her lack of eating and MBD, contacted vet.

Tuesday 4/26 - interest in food came back but walking was getting worse. I would have to put roaches right in front of her to get her to eat.

Wednesday 4/27 - vet day! Vet did X-rays to confirm that there was no MBD, said she is 101g, and that the inside of her mouth is pale. Said underweight and dehydrated. Laid out a plan of daily baths, water via syringe, and continue feeding as is. Eating normal but still not walking. Would walk a very short distance to hunt a roach but if it got too far she would stop. Also took fecal sample (waiting on results)

Thursday 4/28 - noticed front left arm was swollen. Went back over photos taken over the week and saw it was normal until this point. Upon closer inspection the back leg ankles were also swollen, but the arm was definitely the worst.

Friday 4/29 - read about gout online and am convinced this is the issue. Did not feed dubias at all as it says protein will make it worse. At this point it was too late in the day to get ahold of the vet.

Today I ran out and got her some tart Cherry extract capsules and mixed a little with butternut squash baby food. She ate maybe one bite of her salad and I wanted to make sure she got some in her.

Is it typical for it to go from no symptoms to euthanasia likely in less than 5 days? It seems so fast!

FAQ:

Enclosure - 29W x 11d x 18h

Basking - 105-115 (she will gape so I don’t think it’s too cold but not all the time so probably not too hot either)

Lighting - reptisun 10.8 T8, the lid of the tank is wide mesh but we also cut holes in the mesh under the bulb. This bulb was replaced Tuesday, as I am not sure how long it has been used by her prior owner, and it has previously been on a finer mesh lid, which we replaced.

Substrate - linoleum, was to be replaced with slate tile when she upgraded to a larger tank. Her entire setup was to be temporary, intended to upgrade this weekend, but are holding.

Food - dubia roaches from ABDragons, fed flukers orange crystals and carrots. Salads are various greens (collard, mustard) as well as carrots, apples, grapes, although not all at the same time. (Grapes or apples for example)

Getting her to drink water is tough. She won’t drink in the bath or from a bowl. I drip water on her nose and that is hit or miss if she will take it, but we try as often as we can.

I know that realistically that euthanasia is probably coming this week, but I am so heartbroken because we just got her and she is so sweet. I have had beardies before and have never even heard of gout!

I really thought we could rehab her but it seems likely that this was already going on before we rescued her :(

I am attaching two photos, one from Monday and one from today.
 

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KarrieRee

BD.org Sicko
Beardie name(s)
Hiccup he is 4 and Blaze is 2
We rescued our Eva a couple of weeks ago from a less than ideal home. Prior to her living with us I have almost no information on her husbandry or diet.

She came with an enclosure, 29x11, suitable for babies and small juveniles. She is ready to upgrade I believe, however please forgive me in being hesitant to do so as I don’t believe she has long with us due to gout.

My question actually has more to do with timing, and is it common for this to happen so rapidly?

Saturday 4/23 - happy happy! Eating like crazy, zooming around the house, alert, gaping. Happy!

We came home from an evening event to find her cage trashed. Salad everywhere.

Sunday 4/24 - alert but not very hungry. Tried dubia both morning and evening but no interest. Also didn’t touch salad.

Monday 4/25 - not hungry in the morning, took outside for some real sunshine (was over 80 that day) and noticed her back right leg wasn’t working quite right. Concerned with her lack of eating and MBD, contacted vet.

Tuesday 4/26 - interest in food came back but walking was getting worse. I would have to put roaches right in front of her to get her to eat.

Wednesday 4/27 - vet day! Vet did X-rays to confirm that there was no MBD, said she is 101g, and that the inside of her mouth is pale. Said underweight and dehydrated. Laid out a plan of daily baths, water via syringe, and continue feeding as is. Eating normal but still not walking. Would walk a very short distance to hunt a roach but if it got too far she would stop. Also took fecal sample (waiting on results)

Thursday 4/28 - noticed front left arm was swollen. Went back over photos taken over the week and saw it was normal until this point. Upon closer inspection the back leg ankles were also swollen, but the arm was definitely the worst.

Friday 4/29 - read about gout online and am convinced this is the issue. Did not feed dubias at all as it says protein will make it worse. At this point it was too late in the day to get ahold of the vet.

Today I ran out and got her some tart Cherry extract capsules and mixed a little with butternut squash baby food. She ate maybe one bite of her salad and I wanted to make sure she got some in her.

Is it typical for it to go from no symptoms to euthanasia likely in less than 5 days? It seems so fast!

FAQ:

Enclosure - 29W x 11d x 18h

Basking - 105-115 (she will gape so I don’t think it’s too cold but not all the time so probably not too hot either)

Lighting - reptisun 10.8 T8, the lid of the tank is wide mesh but we also cut holes in the mesh under the bulb. This bulb was replaced Tuesday, as I am not sure how long it has been used by her prior owner, and it has previously been on a finer mesh lid, which we replaced.

Substrate - linoleum, was to be replaced with slate tile when she upgraded to a larger tank. Her entire setup was to be temporary, intended to upgrade this weekend, but are holding.

Food - dubia roaches from ABDragons, fed flukers orange crystals and carrots. Salads are various greens (collard, mustard) as well as carrots, apples, grapes, although not all at the same time. (Grapes or apples for example)

Getting her to drink water is tough. She won’t drink in the bath or from a bowl. I drip water on her nose and that is hit or miss if she will take it, but we try as often as we can.

I know that realistically that euthanasia is probably coming this week, but I am so heartbroken because we just got her and she is so sweet. I have had beardies before and have never even heard of gout!

I really thought we could rehab her but it seems likely that this was already going on before we rescued her :(

I am attaching two photos, one from Monday and one from today.
Please do not euthanize if she is eating and basking- a blood test would need to be done to determine uric acid levels for gout- they can put her on allopurinol for that- if she does have gout get her some bsfl or silk worms or both- the T 8 needs to be replaced as soon as you can those bulbs expire in 6 months I recommend 5 - distance should be 6-8 inches directly above the basking decor-unobstructed- extremely important especially w/ gout- please upgrade her tank to a 75-120 gallon tank- please get her surface basking temps down to 95-100 w/ a digital probe thermometer-
 

EricaBee

Member
Original Poster
My main question is if it’s normal for gout to come on so quickly. Also, what is Psuedogout and would it show on the X-ray she received on Wednesday? I am just trying to learn more about the conditions before our vet opens on Monday, when she can get the blood work. He had mentioned last week he wanted to do blood work if she didn’t perk up soon. At that time she was less lethargic but still struggling to walk.

The T8 bulb is 4 days old, and the mesh was removed under where it rests. (We can’t go without mesh entirely as we do have cats) We were told not to get a T5 yet as the tank is shallow and a T5 may be too powerful until we upgrade to a taller enclosure. If she can have a good quality of life, I intend to replace her entire enclosure / setup ASAP. However, right now our financial priority will be the veterinary care, especially as she can not actually walk well.

I promise I do not want to euthanize her. We have only had her a couple of weeks but we already love her. But everything I had read stressed how painful it is for them, and how hard it is for juveniles.

I will look into those other lower protein insects, I was very concerned about how to keep her growing without the protein that may be hurting her.
 

EricaBee

Member
Original Poster
Just adding a copy of her x-ray to the thread.
 

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KarrieRee

BD.org Sicko
Beardie name(s)
Hiccup he is 4 and Blaze is 2
My main question is if it’s normal for gout to come on so quickly. Also, what is Psuedogout and would it show on the X-ray she received on Wednesday? I am just trying to learn more about the conditions before our vet opens on Monday, when she can get the blood work. He had mentioned last week he wanted to do blood work if she didn’t perk up soon. At that time she was less lethargic but still struggling to walk.

The T8 bulb is 4 days old, and the mesh was removed under where it rests. (We can’t go without mesh entirely as we do have cats) We were told not to get a T5 yet as the tank is shallow and a T5 may be too powerful until we upgrade to a taller enclosure. If she can have a good quality of life, I intend to replace her entire enclosure / setup ASAP. However, right now our financial priority will be the veterinary care, especially as she can not actually walk well.

I promise I do not want to euthanize her. We have only had her a couple of weeks but we already love her. But everything I had read stressed how painful it is for them, and how hard it is for juveniles.

I will look into those other lower protein insects, I was very concerned about how to keep her growing without the protein that may be hurting her.
The 29x11 is too small and yes for what the tank is now a T 5 would be too strong please make sure your distance for the UVB is directly over the basking decor 6-8 inches -- you need to talk to Tracie our vet tech about the gout issue -- I am flagging post shes on late at night
@Drache613
 

EricaBee

Member
Original Poster
The 29x11 is too small and yes for what the tank is now a T 5 would be too strong please make sure your distance for the UVB is directly over the basking decor 6-8 inches -- you need to talk to Tracie our vet tech about the gout issue -- I am flagging post shes on late at night
@Drache613
I just realized I never posted her age or size! She’s a very small juvenile, that’s why I was under the impression that she would automatically have a poor prognosis. (Her exact age is unknown but vet said her joints haven’t fused yet so she’s still very young)

And yes, we do plan to upgrade the size of her tank, if the vet indicates that he believes she can be stabilized.

I included a photo of her from the vets to show her size, you can see the very very beginning of the arm swelling here, it barely shows on her X-ray.
 

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Drache613

BD.org Sicko
Staff member
Moderator
Hello,

I hate to see such a youngster developing gout like this. Geez, she isn't even full grown yet! The
previous care definitely was not good. Also genetics do play a role in health problems, too.
Definitely avoid dubias because they are naturally high in uric acid. For protein, you can use crickets,
silkworms, or even calcium worms. I realize that she isn't full grown, but keeping her insect protein at
a minimum right now is crucial.
I am hoping she has just developed pseudo gout, which is essentially secondary gout caused by poor
or non existent UVB, lack of calcium & malabsorption issues. It can cause renal issues. Also, gout
conditions can be caused by improper temperatures, too.
Since the swelling has come on rather quickly, her system is likely having some trouble. I would at this
time recommend a blood test, if the vet is comfortable & trained to do one. It would be helpful to know
the uric acid levels, as a baseline. Most of the time, gout develops more slowly so I am inclined to
think it is more along the lines of secondary gout because of poor care. I just hope her kidneys aren't
damaged too badly. A lot of vets are quick to put them down but I feel many times they give up too
fast or soon. Reptiles can recover with work, but it does take time. She is young so I would give her
a chance & try to get her going in the right direction. Her joints probably hurt if there is tophi (built up
uric acid crystallization) in or around the joints which make it harder for her to get around.
Depending on the composition of the uric acid, gout crystals may or may not be visible on x-rays. They
can be made up of either monosodium urate or calcium pyrophosphate but it is usually easier to see the
calcium content than the sodium. That's why a blood test would be helpful.
The x-rays look fine as far as the bone alignment. The internal areas look a bit odd, but that could just
be the resonance or contrast of lighting.
The black/tart cherry extract is helpful so do give that daily. You can give it straight or diluted for her.
You can consider some liquid serrapeptase which is silkworm enzyme, to help with pain & inflammation.
It is safe for long term use & also good for overall health, too.
Hopefully the vet will prescribe allopurinol for her to help break up the uric acid.

Let us know how she is doing.
Tracie
 

EricaBee

Member
Original Poster
Just a quick update with some shots from yesterday and today. The swelling does appear to be going down. Still calling the vet tomorrow but we have a little more hope that we can make her feel better.

She still isn’t walking much, and when she does it’s slow/clumsy and she has to rest after a short distance, but she’s eating and bright eyed. Enjoying her soaks in warm water to help with any pain / swelling.

I can update after the vet visit, hopefully tomorrow.
 

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Drache613

BD.org Sicko
Staff member
Moderator
Hello,

She looks very sweet. I hope she is feeling better. I'm sure that it's hard on her to get around with
the swelling, with the pain on & around the joints.
Hopefully she enjoyed her warm baths. Let us know how the vet visit goes!

Tracie
 

EricaBee

Member
Original Poster
Just an update - I talked to the vet yesterday requesting to bring her in for bloodwork but they had to have the vet call me about her fecal results before they'd schedule anything, in case it changed things. they couldn't see the results, only that it was positive for something.

He called this morning and her fecal was positive for coccidia, which doesn't surprise me considering her level of care at her last home.

He also said we can go in today for bloodwork but it's going to be sort of on-call, and we have to wait for them to have a break in their day to see her. So I'm waiting around to take her in.

As for how she's doing, her appetite is great, she's eating her salads well and I mix her critical care in with .5ML of baby food so it has some flavor that she likes. That's also helping her get in a lot of water. She's getting twice daily soaks in warm water, and she's still getting the tart cherry extract.

She's walking more, and better, but still lays down shortly after she starts going. Of course is that because she's in pain, or because she's just made it to her destination? It's hard to say.

I will update again once we get bloodwork results back. I'm also including a photo from last Friday (left) and today (right) to show the progress we've made.
 

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EricaBee

Member
Original Poster
Just waiting on bloodwork results, vet said it'd be 24-48 hours. He said he felt that she was a lot stronger than when he held her last week when we were in originally and that she even tried to fight them a bit when they were taking blood. Lot different from just laying there last week! After we got home she hung out in her tank a bit but when I took her out for cuddles she was zooming all over me and the chair we were sitting in. So I think she's feeling better.

I don't know what the blood tests will reveal, he mentioned we should know both calcium and uric acid levels, so hopefully we know one way or the other. I think he was somewhat surprised that I knew anything at all about gout and uric acid and pseudo-gout. When he called to tell me about the coccidia he inferred that she may not make it, but I think he was basing that off of her condition last Wednesday, he seemed a lot more confident after seeing her today. Swelling hasn't come back in her joints, although I can see it's not 100% gone in a few areas. The improvement is drastic though compared to where she was last week, and that's without any meds at all, just hydration, twice daily soaks and cherry extract.

Once we get the results from the blood test I can figure out what kind of feeder insects she can have. I saw that BSFL is high in calcium, which may be problematic if she's got pseudo-gout, and I haven't found silkworms locally just yet. (And feel free to correct me if their high calcium content won't matter if she's got pseudo-gout, I'm not very well versed in either type, and I'm still woefully confused)

Her prior owner had a lot to do with a good bit of this, and I know we should have never given him money for her, but we knew that if we didn't, she'd die there. Would they have noticed her limbs swelling? Would they have cared? They told us when we came to get her that "dragons don't need water" so no wonder she was so dehydrated. She was SO skinny, her little arms were like twigs. She was SO happy to have the dubias, I had no idea they could hurt her with too much protein. =\
 

EricaBee

Member
Original Poster
Updates galore here:

Eva is feeling SO MUCH better. Eating better, walking better, the only swelling left on her body is her left right ankle and even that's so so so much better.

Her bloodwork results came back, and while it looks like she doesn't have gout, she does have elevated glucose. He said that this can be indicative of gastric neuroendocrine carcinoma which is obviously a death sentence.

However, her glucose was not extremely high, and she had eaten that morning, about 3 hours before bloodwork, and part of her breakfast was EmerAid Omnivore, and the first ingredient is Glucose Sugar Solids. So it's certainly possible that she has cancer, however it's less likely due to the fact that she is getting better, not worse.

So right now we're just going to keep doing what we're doing. Hydration, good foods, snuggles, and playtime.

One question I do have, even though her uric acid and calcium levels are fine, I'm a little gunshy to go back to dubias, but I also know that crickets can carry coccidia, which we are already going to be battling once those meds come in. Any ideas other than the BSFL? Or should she be ok on the dubias? Because we don't actually know WHAT caused her swollen joints in the first place I don't know what I should be mindful of feeding her.

I'm attaching her bloodwork results (the pertinent parts anyway, it's a huge report) if anyone wants to offer any thoughts on this blood sugar stuff.
 

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KarrieRee

BD.org Sicko
Beardie name(s)
Hiccup he is 4 and Blaze is 2
Updates galore here:

Eva is feeling SO MUCH better. Eating better, walking better, the only swelling left on her body is her left right ankle and even that's so so so much better.

Her bloodwork results came back, and while it looks like she doesn't have gout, she does have elevated glucose. He said that this can be indicative of gastric neuroendocrine carcinoma which is obviously a death sentence.

However, her glucose was not extremely high, and she had eaten that morning, about 3 hours before bloodwork, and part of her breakfast was EmerAid Omnivore, and the first ingredient is Glucose Sugar Solids. So it's certainly possible that she has cancer, however it's less likely due to the fact that she is getting better, not worse.

So right now we're just going to keep doing what we're doing. Hydration, good foods, snuggles, and playtime.

One question I do have, even though her uric acid and calcium levels are fine, I'm a little gunshy to go back to dubias, but I also know that crickets can carry coccidia, which we are already going to be battling once those meds come in. Any ideas other than the BSFL? Or should she be ok on the dubias? Because we don't actually know WHAT caused her swollen joints in the first place I don't know what I should be mindful of feeding her.

I'm attaching her bloodwork results (the pertinent parts anyway, it's a huge report) if anyone wants to offer any thoughts on this blood sugar stuff.
Silkworms
 

Drache613

BD.org Sicko
Staff member
Moderator
Hello,

That is great Eva is feeling a lot better. So no gout, very interesting. Since her glucose level is
elevated her liver might be having a bit of a hard time. Did the vet suggest anything to be given
to her? Maybe milk thistle or lactulose would help out her liver right now.
The uric acid levels are pretty normal. Maybe go easy on the dubias for awhile until all of the
swelling goes down. They are naturally high in uric acid which might contribute to it some.
Even though calcium levels are normal, it doesn't mean that she might not be having a little bit
of trouble with calcium absorption or D3 production. Since her previous care probably wasn't the
greatest, I imagine her system just needs to balance out some. It will in time, with better care from
you!
Let us know how she is doing.

Tracie
 
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