Gout, MBD, Nurrological, Injury?

[DanielleGia920]

Sorry for double post just have a question on the screen. Here's a comparison picture, between the screen on the lid and my window screen.

The window screen seems a little larger compared to the tanks screen, no? And the metal on the lid is extremely thick. I tried widening one of the holes so I could hang something from the lid and I barely good. The metal would barely budge. That lid also blocks out a lot of heat. I used the solar glo, when I first got her 2 months ago, with lid on and her basking temp was 100-110 but the other day when I tried it without the screen her basking temp was 140 and that was with the rock as low as it would go and the lamp as high as it would go. If the lid blocked out that much heat its probably blocking a lot of uvb as well, right? Again, I'm brand new at this and just learning so your input is very much appreciated.

 

[EllenD]

Your lid mesh is pretty typical, I myself don't look at the mesh density, I just go by the rule that "If there is a mesh lid, it's going to block a percentage of the UVB light from the lights, so if you're using a T8 UVB tube you absolutely must mount it under the mesh lid, and if you can mount a 10.0 T5 UVB tube under the mesh lid and be about 11" or so from the basking spot, then do it." The PowerSun MVB just doesn't emit much UVB for an MVB at all, so I would assume that the mesh just compounded that problem. That all being said, you've got it worked out now, the combination of the MegaRay and the 10.0 T5HO under the mesh is an excellent combo. Her bone density looks very good, a little weak in the most distal phalanges, but you can see the tarsal bones in her feet very well, and the rest of her body, skull, and tail look excellent. So I think that pretty much rules any MBD out. Whether the Gout was compounded a bit by the weak UVB light you'll never know, but I personally don't think that the UVB was the cause of the Gout. Either way, what matters now is that #1 your lighting and temps are all correct, which they are, and #2 she's getting tested and treated, which she is...

Did the vet give you their opinion, did they too suspect Gout? I'm so glad they were able to get enough blood to do the blood panel, I think getting a definitive diagnosis at this point is crucial because she needs to get treatment started as soon as possible. Didn't the vet give her any pain medication? I just assumed that the vet would prescribe a medication for the pain and swelling, they typically do, while you are waiting to get the blood work results back. Poor girl, she definitely does look tired and in pain. Gout is extremely painful, I know a few adults who have it, and when they have flare-ups in their feet they can't go to work, they can't even get out of bed, and are usually on a strong narcotic painkiller along with the Gout meds.

I'd do your best to keep giving her the Black Cherry Juice and as much water or Pedialyte as you can get her to drink, she looks dehydrated and Gout is very, very rough on their kidneys, so the more fluids she takes in the better she'll feel. How is her appetite? The stress and lethargy from the trip to the vet and back along with the exam, the x-ray, and especially the blood draw are perfectly normal, I wouldn't expect too much activity from her the rest of tonight, hopefully by tomorrow morning she'll have relaxed from the vet trip. I'm going to let Tracie chime in here soon as far as what else you can do to make her feel better and what would be the best diet for her right now, I know that the Silkworms will help tremendously when they finally ship to you, so that can't happen soon enough, but Tracie may have other tricks up her sleeve that can help her in the meantime.

 

[DanielleGia920]

Thanks Ellen!

No the vet didn't give any pain medication. At first the vet said Sge didn't think it was gout because deka is only 5-6 months old and shes never seen gout in such a young beardie. But after the X-ray she swayed a bit and said it just may be gout and deka would be the youngest beardie she's seen with gout. She also said something about some reptiles not being able to breakdown powder calcium properly which can cause problems. Should I switch to liquid calcium?

The dr mentioned that, she said the bones looked good but when you get to the feet they don't look as great, you can't really seem them. Does that mean the bones aren't as dense, is that why it's not as bright looking in those areas?


Deka will not eat, I don't blame her she's a bit tramautized and defiantly in pain. I noticed this morning that She had gotten worse, she won't walk at all now. Last week she would still walk if I took her out or she would swim when I put her in the bath but she's stopped that completely. I blended some pedialyte with baby arugula, a little bit of collard greens and a dash of calcium, she had about 4 mls of that. She drank 2 mls of water and I gave her a 3mls of reptaid since I can't get her to eat anything. I also bought oxbow carnivore care but I'm guessing I shouldn't give her the extra proteins right now, I probably should've went with the herbivore critical care mix?

Btw, those hand heat warmers work REALLY well. A little too well. I didn't realize how much heat they produce. It was very cold outside this morning, I was so worried she would be freezing so I I put 5 of them along the bottom of the carrier and covered them with a Sherpa pillow. I brought the temp gun with me and checked the temps 15 minutes into the ride, it was 114 degrees in there ? So of course I freaked out, took all but one out and then it was fine! I was so worried she would be cold I over did it! ?

To the previous post, my bulbs are between 4-8 weeks old. 24 inch t5ho light fixture and bulbs is 8 weeks old and the 36 inch is 4 weeks old.

Thanks again guys! Once I get the blood and fecal results back I'll let you know.

 

[DanielleGia920]

Omg just read another post where people replied with length and weight of their beardies and I realized how small she is! One was 12 inches and 250 grams! She weighed in at 60 grams! She's almost 13 inches. That is really underweight right? She has always been very small and I don't know exactly how old she is. I got her 2 months ago from pet store.

So Maybe she's more like 4 months now. Is 60 grams alarmingly small? She has lost a lot of weight in the last week and a half but she was no where near 250 grams. ?

 

[AHBD]

Although she's thin, it's not drastically. A 12" dragon would be obese at 250 grams unless it has part of it's tail missing and is actually a larger dragon.

And I surely was wrong + apologize about the scree, it is the smaller mesh + probably blocks about 35% uvb. It sounds like you have the lights figured out though.

And yikes, the hand warmers are dangerous ! They get up to 160 degrees, good thing you checked the temps, it could have killed her in a short time.

 

[DanielleGia920]

Thanks AHBD! Appreciate the info. I had no idea they got that hot. I know people that work outside and they put them inside their gloves. I figured if we could handle direct contact then it wouldn't be that warm with a thick pillow over it. ? Boy, was I wrong.

 

[Drache613]

Hello,

Wow, the hand warmers really heated it up in there!
I am very surprised they took blood from her, being under 100 grams. I'm sure that they didn't
get a full amount though.
She does look a little dehydrated right now, so, definitely get some extra oral fluids into her to
help out.
You can try mixing some alfalfa powder, spirulina, bee pollen or brewer's yeast & wheat grass
into a slurry with water for help with food intake & purine free protein sources. I haven't read
a label in awhile, for the critical care & herbivore care, but I think they are corn & or soy based.
I would consider getting a liquid calcium to help with absorption. Sometimes they may have a
little bit of trouble absorbing powdered calcium.
I am surprised that the vet didn't give Deka anything for pain. The Serrapeptase is very helpful
for pain relief, so the silkworms should help a lot. When are they supposed to be delivered?

Let us know how she is doing.
Tracie

 

[DanielleGia920]

I was Doing research on gout and came across this article from repashy.

I feed my feeder roaches this exact brand, repashys bug burger Along with flukers cricket diet. Article says that after consuming the bug burger the feeder roaches were dying because they had so much uric acid in them. The professor noted that the roaches survive on a very low protein diet of about 4 percent. The protein was lowered and Bug burger now has a minimum protein content of 14 percent but the flukers high calcium cricket diet has a min crude protein of 20 percent! I have been feeding her roaches on bug burger and flukers since September 9 as her staple. Along with occasional crickets who also get some bug burger and flukers. In an attempt to give her as much protein and nutrients as possible maybe it was just too much and the bugs are overloaded with protein and uric acid? 6 weeks after switching her to roaches and crickets Consuming this high protein diet she's now having these problems. I doubt that's just coincidence.

 

[AHBD]

There is a high likelihood that's what is causing the problem. I had read that before as well and posted it somewhere on another thread here. No one seemed to ever have dragons with gout years ago like there are now, including juveniles but so many owners feed dubias as the staple and probably feeding them a diet which, even when low in protein, can possibly cause this problem. Dubias should only be fed a non protein diet.

Switch their diet ASAP and don't use any of them for a while, possibly a month or more to let them clear their systems of the uric acid. I don't know if that would get rid of high uric acid [ in the roaches ] Mabe someone else knows .

 

[DanielleGia920]

I'm not going to use them. I'll go pick up some new crickets from the pet store.

I believe it would clear the uric acid out of the bugs over time as that was mentioned in the article as well. It said that roaches have a unique way of storing proteins in their systems as a safety measure just incase they can't get food/protein in the future. they store the extra proteins by turning them into uric acid and then they have the ability to turn them back into protein should their protein intake become limited. If they only need 4 percent protein and I was giving them 20 percent protein 24 hours a day they were probably storing all that extra protein as uric acid.

I was thinking that as well AHBD. You look around and companies are making so many different products and pushing gut loads and high protein mixes. They advertise it as something you should be doing to help your reptile but maybe it's over kill especially with roaches, which many people probably don't know. I sure didn't!! Hopefully flushing her system with lots of fluids and giving her feeders that aren't loaded with uric acid will resolve this problem. Still waiting to hear back from the dr with her blood and fecal results!

 

[DanielleGia920]

Just heard from dr. She said Deka has the worst case of gout she has ever seen in a bearded dragon her age. She said she's been consulting all morning with other reptile specialists and they agreed as well that it's not good. Her uric acid level is at 48. She said she has to special order the allopurinol because deka is so small? Once it comes in I can go get it. In addition to gout deka has coccidia and pinworms. I should have known something wasn't right, she was all scales and bones when I bought her and never very active!

I should've taken her for a check up as soon as I brought her home! The dr said she wants to hold off on treating the pinworms and coccidia since the gout is life threatening and that needs to be taken care of first. She said to make sure she stays super hydrated and to keep her temps even the cool side warm. She said she may need surgery in the future to clean the uric crystals from the joints. I'm not so sure about that because we didn't see any crystals in the X-ray. I'm hoping it was caught early enough that it hasn't set into the joints yet. Is that possible?

 

[AHBD]

That sounds very reasonable, good to hear that the Dr. will treat gout first. Hopefully this will be the start of a good prognosis.

 

[DanielleGia920]

Thanks AHBD! I really hope we get a good outcome but I'm starting to think she may not make it. 33 and higher is considered renal falire and she's at 48! Now the dr said the medicine will "hopefully" be in by next week! WHAT!? That's crazy! I have to sit around for the next week and watch her deteriorate and die! Everyday she looks worse and in more pain! The dr said she would like to hospitalize deka for a week and do IV therapy but unfortunately I don't have an extra 600 right now. She didn't mention I had the option of doing sub q treatments at home but I see a lot of other people on here have done them and with success! I just read a post from another case, I believe the beardie absorbed her eggs and it caused problems. That particular beardies uric acid level was at 44 and they treated her with allopurinol and fluid therapy and it resolved. Is it just plain salin that is used or is it a specific IV solution?

 

[EllenD]

Allopurinol is very easy to obtain, it's a very common drug and Tracie can actually figure out the dosing for you and tell you how to prepare it for her...waiting a week to get that medication is absolutely ridiculous, she could have written a prescription to be filled at any pharmacy in the country, and then prepared the correct dosage based on her weight from that, she's ordering it already compounded into the correct dose for her weight, which is ridiculous. I'd actually wait for Tracie to chime in here, she can tell you what milligram prescription is best in order to prepare it for her, and then once you know that I would call the vet back and tell her that you want her to just write a prescription for that milligram pill because you know someone who is a scientist that studies and treats disease in bearded dragons, is very experienced in treating gout in bearded dragons, and who knows exactly how to prepare the correct dosage for her from that milligram pill. And a generic prescription of Allopurinol from a human pharmacy is only going to cost a few dollars, versus the no doubt ridiculously high cost of a special veterinary prepared form that arrives already compounded. You're going to pay big bucks for someone else to do what Tracie can instruct you to do yourself. Plus she needs to get on the medication immediately...

I had never heard anything about the Repashy/commercial bearded dragon food preparations causing this issue in specifically roaches if they are fed theses foods as gut-loading, but it makes perfect sense. If that is actually what caused this in her, it may actually be a good thing, because if so, the source of the uric acid has already been eliminated from her diet, and it's quite possible that the medication may be all she needs to reverse the effects and actually "cure" her, because in this scenario it's not caused by genetics...

I wouldn't think negatively about the uric acid level, the reason it was so high is she was eating those roaches and it was spiking her blood level for sure. I've seen many, many young beardies with uric acid levels in the high 30's and low 40's, and I believe they have all been gout caused by genetics and they are beardies that are now all doing very well, though they all need to take the medication every day for the rest of their lives. In your girl's case it's likely that this isn't the situation. The main thing you need to concentrate on is getting as much hydration in her as possible every single day, because the only thing that would be fatal to her at this point would be kidney failure, and the fluids are the key to preventing that from happening.

Subcutaneous fluid shots are a very good idea, as they act as a kind of "poor man's dialysis", and will most definitely be great for her kidneys and flushing all of that uric acid out of her system. I suspect that when you go for a repeat uric acid blood test after she takes the medication for probably around a month, that her uric acid level will be drastically lower than it is now, it's probably lower now than it was last week when she had the blood taken, as if I remember she was actively eating the roaches at that point, which would definitely spike her blood level of uric acid. So offer her fluids often, and I would definitely ask your vet to show you how to give her subcutaneous fluid shots at home, and the vet should have no problem sending you home with pre-filled syringes ready to go. It's very easy to do, and once you do it once you're good to go.

I know you're extremely worried about her, but I think right now it appears a lot worse than it actually is. I don't like the vet waiting for over a week to order already compounded Allopurinol, that's not cool, but I'm quite pleased that she chose to not worry about the coccidia or the pinworms right now, I don't know what her levels were, but they can live with coccidia and pinworms in their their gastrointestinal tracts for their entire lives without them causing any issues at all. Any symptoms of lethargy, lack of appetite, or anything else that she was having were not related to gastrointestinal parasites, they were due to the pain she's been in from the gout, no doubt at all about that. And putting her on an antiparasitic medication and an antiprotozoan medication right now would be very counterproductive and very detrimental to her recovery from the gout. She should not be on any other medications right now besides the Allopurinol, and I'd also start giving her a probiotic daily as well, I'd start it ASAP so that it's in her system before she starts the Allopurinol. The probiotics will even out her gastrointestinal tract and settle her stomach should the Allopurinol upset it at all. They will also keep her bowel movements regular if they do in fact become effected by the parasites. I would also ask the vet for pain medication for her ASAP, most beardies that I've seen get a prescription pain medication on the day they go in to have the blood test done, usually it's either Metacam or Tramadol, and the beardie's usually perk up quite a bit immediately after they start the pain medication, their appetites increase drastically (who can blame them for not wanting to eat or move when they're in that kind of pain all day long, every day), they start moving around more, they start putting weight back on, and are much more adept to fighting off the gout. Stress caused by the severe, constant pain of Gout causes their immune systems to weaken, and this is most likely the reason that her coccidia and pinworm levels have risen. This is the very first time I've seen the reptile vet not prescribe a prescription pain medication for a dragon with suspected gout, and now that it's been definitively diagnosed there is absolutely no reason for the vet to not put her on a pain medication. I'd insist upon it.

 

[AHBD]

I can't remember, is she taking any hydration orally ? If so, do it several times a day. Whatever you offer via syringe, add a bit of water to it as well as Pedialyte.

As for sub-Q fluids, usually lactated Ringer's or " Reptile Ringer's ".