High levels in blood work?

[beardielove10]

Hey everyone, I got a call from my exotic vet that just got results back for Sheldon's blood work. Sheldon is 6 years old and like everyone else's beardie, he's my baby. He has a reptisun 10.0 uvb fluourescent bulb and a halogen 90 watt heat light about 8 inches above basking spot. (He likes his heat levels lower). The vet wants me to bathe him daily for the next three weeks and then come back to recheck his blood levels and see if anything changes.

The vet is worried about 1. Genetic issue 2. Dehydration or 3. Kidney/liver disease. He hasn't ever shown these concerns before so I'm pretty worried and thought I would ask for some advice on here. I did ask the vet to email a scan of the blood work results to me so I can attach it when I receive it. For now, I was told his Uric Acid is 6 when the normal is 1.8-4. His CPK is 12,848 when the normal level is between 175-1,450.

Any advice or ideas about this? I'm very concerned about my boy!

Here is the link to view a scan of the results:
https://ibb.co/bDeSx6

Thank you!

 

[CooperDragon]

None of that looks too out of whack to my untrained eye. If the vet is concerned about the BUN or uric acid levels, extra hydration is a good idea. If he enjoys baths and drinks from them, that's a good way to provide some extra hydration. They aren't worth the stress if he doesn't like them though. A good way to get them to drink (if they want to) is to drip water on their nose using a dropper or plastic syringe. They will instinctively lick the water as it's dripped on their nose. Some extra fluids may help flush out his kidneys and bring those levels down a bit (although they don't seem significantly high to me).

 

[Drache613]

Hello,

I agree, the values don't look too bad. The Uric acid is a little elevated, but hopefully that is
just due to possible dehydration issues & not early gout signs.
The AST (liver enzymes) though were elevated. What type of diet is he on?
A daily bath is ok, as long he doesn't mind one. A lot of dragons would get stressed by a daily
bath but if he drinks from one, then that would be alright.
The CPK levels will elevate many times, simply from a tail stick because of stress of pain. Those
readings aren't always a good indicator of stress, trauma/injury or disease.
What prompted you to take him into the vets?

Tracie

 

[beardielove10]

Hello,

Thank you both for the replies. It is good to hear it's not as terrible as I was told. Sheldon has a diet of greens and fruits and once every other week he may have protein. I will admit, ever since his incident in 2015 where he had trouble breathing he doesn't eat like he used to and doesn't eat greens as willingly. I have had to trick him into eating them by stuffing some in his mouth as he is chewing a blueberry or carrot peel (for example). So I did express my concern about his nutrition levels because of that and the vet gave me critical care to offer when he doesn't eat as many greens as I would like. He seems to like it. He doesn't seem lethargic or anything, he is still active and alert. I brought him into the vet for his annual checkup and blood work was a part of it

Thanks again for all your help. I want as much advice/knowledge as I can get! I told Sheldon he better live until 12 and made him promise ?

 

[EllenD]

I agree, that blood work looks like nothing at all wrong except he's a bit too dehydrated and his electrolytes are a bit out of whack/low, which will effect every one of those blood levels slightly. Your exotic vet needs to not recommend baths for hydration though, bearded dragons do not absorb any usable hydration/electrolytes at all through their vents, their skin, or any other way other than through their mouths and directly into their GI tracts for absorption into the blood, just like us. That was a myth that unfortunately caught on a long time ago, but it has been proven over and over again that they have the same type of hydration absorption process as most other reptiles, birds, mammals, etc. do. And also, the baths can stress them out to the point that it actually can effect their health in an additional negative way, especially in hot water that will actually cause the moisture to be drawn out of their skin/scales, just like it does us when we get out of a warm bath and don't put on lotion. If he actively drinks water through his mouth while he's in a bath, then once every couple of days is fine, but if he doesn't ever drink water through his mouth in the bath then it's not going to help him at all. Because most general and "exotics" vets aren't really educated in reptile physiology at all, they seem to tend to repeat what they hear.

If he'll lick water/Pedialyte off of his snout when you drip it on him, then I recommend doing this several times throughout the day, every day, and using Pedialyte is even better because it's full of electrolytes to help his fluid balance to regulate. I've seen a bunch of people recommending either Pedialyte or "Sugar Free Gatorade", but I just saw an article yesterday in a Herpetology Journal in my Certified Reptile Vet's Office that said to never give any type of Gatorade to a reptile that is dehydrated, even the Sugar Free Gatorade, because the sodium content is way too high for their body to handle, and it effects the saline content of their cells in a very negative way, causing even more dehydration. My Certified Reptile Vet agreed with me yesterday when I asked him, he said he only ever recommends or uses Pedialyte because it's made purposely to be low sodium, low sugar for babies.

If he will drink standing water from a bowl, I recommend keeping one in his tank, and mixing in some unflavored Pedialyte with the water. If he won't drink standing water at all, or he won't lick water droplets off of his snout (they really have no innate concept of "standing water" since they get most all of their hydration in their natural desert habitat from the live creatures they eat and from the vegetation they eat), then you'll need to either try to increase his greens/veggie consumption (this is where giving him a little high-water content lettuce mixed in with his nutritious greens is okay), and maybe order some Phoenix Worms/BSFL/Nutrigrubs (all the same thing), they are like a very healthy wax worm that is very high in fluid content compared to other live insects, or order some hornworms and give him one of those every other day or so...

 

[Drache613]

Hello,

You could be proactive & start him on some black cherry or tart cherry juice daily for awhile,
just to help flush out his system, along with extra oral fluids. Be sure he eats some vegetation
as much as you can, just to help with hydration & minerals, etc.
Have you ever had him tested for Adeno, since it seems to cause liver issues? I am looking at
the AST levels as well as uric acid levels. You could also start him on milk thistle or some
serrapeptase to help with his liver, too.
Silkworms are great sources of serrapeptase also & are low in fat.

Let us know how he is doing.
Tracie

 

[EllenD]

Hello,

You could be proactive & start him on some black cherry or tart cherry juice daily for awhile,
just to help flush out his system, along with extra oral fluids. Be sure he eats some vegetation
as much as you can, just to help with hydration & minerals, etc.
Have you ever had him tested for Adeno, since it seems to cause liver issues? I am looking at
the AST levels as well as uric acid levels. You could also start him on milk thistle or some
serrapeptase to help with his liver, too.
Silkworms are great sources of serrapeptase also & are low in fat.

Let us know how he is doing.
Tracie

Tracie, just for my own curiosity, do you suspect Gout based on that UA level? Or do you think that the UA and AST levels are due to dehydration? I'm asking for my own education on the subject, as I'm so used to seeing dragons with active Gout having levels that are just sky-high, rather than them being extremely borderline, such as these are...Do you suspect his levels will normalize with adequate hydration, or do think this will require intervention with a medication? I've no reference for how borderline cases like this usually end up...thanks.

 

[Drache613]

Hello,

How are things going with your dragon tonight?
I don't really suspect gout, but an increasing uric acid level can lead to gout like syptoms
& ultimately kidney damage if left untreated or not remedied. Dehydration or infections
can also cause spikes in uric acid also. So, early on, reviewing the diet, fluid intake, etc
is crucial. I would say though that 6, is a cause for some concern & needs to be gotten
down before the blood starts to become more saturated leaving the kidneys more taxed.
A lot of times, it is relatively easy to get them back down if it is just dehydration or some
other variable. No medication is needed quite yet, just fluid therapy & maybe a lower
protein intake for a short bit.

Tracie

 

[CooperDragon]

I've seen uric acid spikes like that (and BUN) with my guys. The vet just recommends increasing fluids and re-testing in a few weeks just as was the case here. With Darwin, the results went back to normal in the next test and he just needs a little more hydration than most do to keep his levels normal.

 

[beardielove10]

Hi all,

I apologize for the delay in response as the holiday has made my days hectic lately. Sheldon is doing well just his typical self..although I will say that he does seem more energetic and is pooping more now that I force critical care. He is not eating on his own I suspect due to laziness so I've been feeding him watered down critical care through a syringe once every two days. I know this might be his brumation period so I wasn't sure if feeding him daily was realistic. How you suggest going about the milk thistle supplement and tart cherry juice? Do I buy a milk thistle supplement? Also, how do you suggest giving oral fluids? (I mean how many ccs a day).

Interesting questions that were brought up. I do worry about his health (especially only being at age 6) being that his Uric is so high but I'm really hoping it is just due to dehydration. I appreciate all feedback, help, and time all of you have taken out to respond to this thread. You have no idea how much it means to Shel Bell and I. We want to be sure he will live a long healthy life! So thank you thank you from the bottom of our hearts! ?

 

[CooperDragon]

I haven't used milk thistle so I'm not sure on that. For water, I just fill a dropper or plastic syringe with water and drip it on the nose for them to lick up. If they ignore the drops after a few min I stop. If they are thirsty they usually start licking it up and will turn their head or run away when they've had enough.