Gout!

[ctwoo]

Hello everyone, I am writing to ask for some advice regarding gout.
My bearded dragon confirmed gout when he was just 3-month old. He has to allopurinol for more than 9 months then.
He got better after that and did the blood test, everything was normal. Swollen legs and hands remain a bit, but he can walk normally.

He stopped allopurinol for all 3 months.
Now, he is around 1 year old and 9 months.
I find one of his arms swollen again. I took him to the vet, and did the blood test the ua figure is normal.
The vet also took some samples from the swollen arm to do the aerobe and facultative anaerobe test.
Nothing found.... My Vet guesses the swollen is crystal due to gout.
My Vet said sometimes gout won't show in the blood test.
Is it possible?

Here are his pictures.


Last vet visit, my vet only asked me to give him allopurinol in the long term though the blood test was normal.
Can allopurinol be taken in the long term? Is it harmful?
He only eats around 6-7 dubia roaches in 1 week.
Not willing to eat his salad. Only have one or two bites a day.

Any gout special care advice for me, please?

 

[KarrieRee]

Hello everyone, I am writing to ask for some advice regarding gout.
My bearded dragon confirmed gout when he was just 3-month old. He has to allopurinol for more than 9 months then.
He got better after that and did the blood test, everything was normal. Swollen legs and hands remain a bit, but he can walk normally.

He stopped allopurinol for all 3 months.
Now, he is around 1 year old and 9 months.
I find one of his arms swollen again. I took him to the vet, and did the blood test the ua figure is normal.
The vet also took some samples from the swollen arm to do the aerobe and facultative anaerobe test.
Nothing found.... My Vet guesses the swollen is crystal due to gout.
My Vet said sometimes gout won't show in the blood test.
Is it possible?

Here are his pictures.


Last vet visit, my vet only asked me to give him allopurinol in the long term though the blood test was normal.
Can allopurinol be taken in the long term? Is it harmful?
He only eats around 6-7 dubia roaches in 1 week.
Not willing to eat his salad. Only have one or two bites a day.

Any gout special care advice for me, please?

Please get him off the roaches --- this is more than likely the culprit for the gout--- as far as I know you can take allopurinol long term- I am diabetic and am taking it -- high uric acid levels are cause of gout and are found in the blood test - please post the blood test if you have them and Tracie can advise on this - but please get him off the roaches and feed a different staple feeder like crickets BSFL or silk worms

 

[xp29]

The issue with the dubias is feeding them protein, they store it as uric acid the way we do fat. You literally have to starve them for weeks to cause them to use it as energy. Only feed your dubias greens and veggies (the one you intend to feed your beardie) baby dubias need protein to live and grow, breeders need it to breed successfully, feeder sized dubias should not be given any protein what so ever.

 

[ctwoo]

I researched online saw some people said crickets are worse than Dubai roaches as they contain more purine than roaches. Is that not correct?

Can they just eat vegetables without any bugs?

 

[Drache613]

Hello,

So sorry your boy is battling gout. If he had true visceral gout, then he should be kept on Allopurinol for life, to help manage any renal damage he has. It is a good medication, designed for long term use so if used in proper doses, it is safe for long term use.
What you are seeing now, on or around the joint area is called tophi which is built up uric acid crystallization. If you have a copy of the blood test please post it. I am just wondering what the vet means by the uric acid levels being normal.
Have you started him on black or tart cherry juice extract to help with the kidneys?
As far as the insect intake, they do benefit from protein but do keep it low to moderate in intake. The crickets are lower in uric acid than dubias. Silkworms are very good also. You can try some alfalfa leaf powder or timothy hay powder for good non purine sources of protein. It is hard to get them to eat their greens but keep trying to encourage him to eat them.
Gout can be very elusive & hard to diagnose. It isn't always visible on x-rays, but it depends on the composition of the crystals as to whether or not they are visible.
However, blood tests should reveal uric acid levels which is very helpful.

Tracie

 

[ctwoo]

thanks for all the advice!!!
here is his blood test result

 

[xp29]

thanks for all the advice!!!
here is his blood test result

@Drache613 is on late at night so it may be a while before she responds.

 

[Drache613]

Hello,

Thanks for posting his blood test results. Everything looks pretty good. The uric acid levels are in range. I would like to see them slightly lower but they are ok. These results are from this past January correct?
The blood serum levels are likely increasing which is what is causing the tophi build up again. I would encourage the continuation of the Allopurinol if your vet will prescribe it again. Also, starting on the black or tart cherry juice extract can help too.
Let me know if your vet wont prescribe it for him.

Tracie

 

[ctwoo]

He is 450g
My vet give me two tablets of 100mg mixed with 5ml water.
And me to give him 0.28ml every day.

 

[ctwoo]

black or tart cherry juice extract...
The one for human ok?

Is it OK for me to starving him if he is not eat the vegetables?
I do 3 days salad, 1 day bugs (3-5 bugs), 2 days slas, 1 day bugs.

But he usually leaves all the salad untouched.....

 

[Drache613]

Hello,

That dose should be fine, it is on the lower end, of
a little over 10mg/kg. You could bump it to 0.3ML
for a little more of a boost.
So to confirm, you mixed up 100mgs of Allopurinol
with 5MLS of water, correct?
The black or tart cherry juice extract for humans is
perfectly fine.
They are very stubborn about not eating their greens.
You can withhold insects short term, but definitely
don't starve him too much so he doesn't stress. It
may help him start to eat more greens.
Let us know how he is doing.

Tracie

 

[ctwoo]

No, she asked me to mix 5mls water with 2 tablets of 100mgs of Allopurinol

 

[Drache613]

Hello,

Ok, so 200 mgs of Allopurinol mixed with 5 mls of water.
Great, the dose of .28ML is fine, it is slightly over 20mg/
kg which is the recommended amount.
How is he doing today?

Tracie