High phosphorus, uric acid, and calcium

[jarich]

So the fact that the hets are way above any kind of normal range, not to mention degranulated, is normal? How about that the lymphocytes are incredibly low and outside normal ranges? Anisocytosis is often misdiagnosed, but given the polychromasia and other obvious signs of stress, that seems highly unlikely in this case. Hematocrit is outside the range of females of this species, though only just. Basophils are quite low. Though not quite outside the normal range, they are not anything you could characterize as mid range. In other words, taken as a whole there seems little that is normal or mid range about this animal's blood work.

As for the cherry juice, please show me any evidence, even conjectural, that it is effective in reducing the sUA levels in reptiles specifically. I really would love to know of any as this is a common and often deadly disease in reptiles. However, I think that suggesting human remedies with no evidence for efficacy in reptiles detracts from the use of more effective treatments, as it seems to be doing in this case.

 

[Tonja]

I am not going to argue with you on this thread. Sorry but I am not.

 

[Drache613]

Hello,

Jarich, let's remember that this thread is for helping the dragon & the owner. So, in my experience as well as other's who have treated dragons with gout, I can say that I have seen evidence of natural remedies such as cherry juice do very well for them.
I disagree as allopurinol has been & is commonly used for reptiles, long term, successfully. Maybe not as routinely as mammals, but reptiles are not high priority now are they?
The blood values are not really much out of range, it is primarily the uric acid. We don't know how long the levels have been this high, but with the swelling it may have been awhile. At this point, I feel the causes are from several reasons. Who is to say that the levels wont come down? The other counts that are elevated or depressed are likely due to stress from egg development or renal stress. Nutritional deficiencies weigh heavily on a lot of imbalances as well. The SGOT looks good so that is great as far as the liver function. As far as the lymphocytes, they are depressed, but that does happen with malnutition as well as disease, too.
The mentioning of the heterophils does indicate the renal issues, which are very high, I agree. I don't see huge evidence overall of any other large infection going on at the moment.
Most of medicine for reptiles in these cases is experimental because most people don't take their dragons in for gout related problems. Thus no research or treatment is done & it is limited for knowledge.
Why are you insisting on arguing about the type of treatment his dragon is going to get when it's not even your dragon? Since he isn't giving allopurinol yet there's nothing wrong with giving a natural remedy. It has no side effects, plus it tastes good. It's better than doing nothing at all.
I ask that you refrain from being so argumentative here on the board as it doesn't do anyone any good, especially the person we are all just trying to help. Insulting people will get you absolutely nowhere.
I don't want to be forced to send any warnings or close this thread. We are all here to try & help as much as we can & stay positive.

Please update us when you have a chance.

Tracie

 

[jarich]

Hi Tracie,

Im not sure where I have been insulting in anyway, though I have been debating the merit of your's and Tonja's recommended course of action. I do not agree that you are being helpful by suggesting a wait and see approach after a qualified vet specialist has examined the animal, has a better history of the animal, and has recommended what seems like a better course of action even based on what limited evidence we've seen here. I know that it seems like just using cherry juice is a nicer alternative for the keeper since that seems to have no risk, but as this animal is likely in pain and is continuing to suffer, just being nice is not helping anyone. This animal is cycling, cycling causes a sharp rise in many things like serum levels of calcium, phosphorous, uric acid, etc, cherry juice is not going to stop that cycling, and this unhealthy animal will likely not survive the storm of problems its experiencing right now if it is simply left to continue cycling. Its far more likely that its levels will continue as they are, further renal damage will happen, stasis will occur, organs will fail and it will die a slow painful death. You were right when you said this is a young animal that should be relatively able to come back from treatment, but first some of the underlying causes must be addressed. You dont put a bandage over an open wound until you first stop the bleeding. So the best and most helpful course of action would seem to be the surgery. This will immediately remove a major source of these chaotic levels, reduce further stress on the organs, and allow the animal to actually start to recover. No doubt it is risky, yes, but no less risky than just doing nothing. An animal with renal damage and gout will always have issue with any future cycling too, so even if by some amazing miracle it got better with just cherry juice, there will be problems with the next time it cycles, and the next, which could be in just a couple months again.

Its obviously your board, as you are the moderator, but Im saddened by the idea that you would silence an opposing viewpoint simply because I do not agree with you. I have given much evidence in an open and intelligent way. Because I do not agree with allowing the animal to suffer and instead recommend surgery, you would threaten me with censure or shut down the discussion? I too am here to help, and I think you do this OP and their animal harm by going against what their vet has recommended. If this animal could whine like a dog, it would be. If it could complain like an old man, it would be. Simply because it is a reptile that cannot do those things does not make it ok to just wait and see while it suffers quietly.

I will admit I find it somewhat funny. On other boards, I am the one who is seen as being overly nice. I think that in order to help the reptile, we must first reach the keeper, and so must be nice in the way that is communicated. I try to always make sure that I am respectful to any OP in responding to questions in each thread, and I hope I have been here to the OP. It seems the only arguments Ive been in on this forum have not been with anyone new keepers asking questions, but rather the more established owners who are upset that Im new here and disagree with them. Either way, being nice just for the sake of being nice, while the education of the keeper is lost or the animal suffers, seems like it is a step in the wrong direction.
Added by moderator: Your attitude is belittling to anyone that posts and it is obvious that you have a vendetta against Tonja. She can voice her opinion on things just like everyone else is permitted to on this forum!

 

[Drache613]

Hello,

I never said not to do treatment I am in support of trying the allopurinol, also. Geez, I think your mind set for euthanizing is too hasty at the moment.
Since I am not the vet I can't be there to physically do the surgery. Personally, it is up to the owner to make the decisions ultimately not us.
All we can do is make helpful suggestions & let them make the final decision.
Where have we misdirected the keeper in any way here?

I think that her eggs probably should be removed to see if that will help with reducing the uric acid, as well as treating with allopurinol. Automatically putting a young animal down before you know for sure isn't always the best alternative. If that were the case, there would be many owners here on the board that wouldn't have such incredible stories of their dragons who overcame terrible health issues. We would never learn or accomplish anything.
Vets in many cases want to automatically euthanize a dragon with Adeno when most times it isn't necessary. Simply because they don't know enough about it or that they don't know how to treat it is no excuse for just putting an animal down. Of course unless you can see that they are in pain.
I don't quite understand why you aren't willing to try other methods first?
I am definitely not here to misdirect anyone on their treatment.
I am not going to stop offering advice for alternative options to help also. I am simply trying to help with educating, without preaching. I don't honestly see how we haven't helped with suggestions.

Tracie

 

[Tonja]

I am done. I am not going to argue with you, I am not going to let you run me off here. I don't know who you are or where you get that we are suggesting that we said to not have surgery or otherwise. I simply offered an alternative since she does not want to start the meds at this point. You come off as a know it all and try to undermine everything at every turn. You are argumentative and I refuse to play. I am asking you nicely to leave me alone and to stop undermining me everytime I try to help. I do not need yours or anyone elses validation to my help. If I am wrong then one of the mods will let me know. I don't need you to tell me anything when I have excellent resources for helping including the zoologist next door to me. I am done, just leave me alone!

 

[jarich]

First of all, Tonja I thought you were done a while back. I was specifically continuing the conversation here with Tracie, as can be seen by the last post where I started it with "Hi Tracie". She seems to be able to discuss things like this less personally and talk about them more scientifically. Im not interested in arguing with you either, as it is usually just that, an argument instead of a conversation. I do find it curious that you can voice your opinion, but if I try to offer an alternative opinion then I am a "know it all who is undermining everything".

I enjoy having discussions like this with reptile people for many reasons. One is that it allows us to share our collective knowledge with others reading. If we disagree, then another reason I enjoy them is that I have the opportunity to learn as a result. Every time I have a disagreement like these, it focuses my research and reading. If I dont know, Ill ask people more knowledgeable or experienced, then Ill find tons of articles and books to read as well. If I do know, then Ill collect articles and links to post so that it is available for others too. The idea is that we are a community of keepers, so these discussions, and even disagreements, are important to educate and move forward as a group. I am in no way trying to run you off, stress you out or seek you out personally Tonja. However, if you suggest or state things I disagree with, I shouldnt have to feel like I cant voice that different opinion just because your feelings might be hurt that someone disagreed. I have tried to make sure that I am not offensive or insulting at all, and will continue to do so, but disagreeing with you is not offensive. If you look at it objectively, you are the one who is insulting and calling names.

Tracie, Im not sure how you think I suggested euthanasia as anything other than a last resort, but please reread the thread again. I specifically said that only if treatment that would remedy the problem was not going to be offered, only then compassion should be considered in the form of euthanasia. I am the one who brought up treatment with allopurinol as an option. I am the one who has stated three times now (and from the very beginning) that I think that the surgery to remove the eggs should be performed as the best course of action.

However, the only thing you recommended prior to me coming on to dispute it was cherry juice and water. Thats it. Perhaps you wouldve suggested other treatments later, I dont know. But, you swept aside the treatment option a specialist vet gave after interview and examination by saying a better course of action was cherry juice and time. Thats where I think you misdirected the keeper. Now, after we have gone through everything in detail, you agree with me in saying that surgery is the best option. Thats great, but I think we probably scared off the OP long ago unfortunately. Hopefully Im wrong there.

I think its great anytime we can use more natural treatments. Its shocking how often lazy vets will prescribe drugs like antibiotics/antiparasitics without even examining the animal or running any tests. However, suggesting that no other treatment be used for an obviously sick animal than fruit juice is misleading. There are real options here. They arent without risk, but they have a much, much greater chance of success.

 

[Brezzy99]

This isn't a debate jarich. The wonderful people on this site have hands on experience, not just reading a book, dealing with bearded dragons. I, like many others, appreciate the knowledge that they share with us.

 

[jarich]

Like myself, it is obvious that they do have experience, which is great. Its similarly obvious that they are both experienced and well read too. I am glad this forum and the people on it are around to help spread quite a lot of good information. There are some ways that information could improve, just like there are ways my knowledge could improve too. Im not sure why disagreement seems to be taken so personally though.

 

[Drache613]

Hello,

Well, seeing as the vet didn't prescribe allopurinol out of the gate, perhaps she either didn't know about it or didn't have experience with it. Perhaps she may think it's too late for medication, I don't know for sure. Removing the eggs may help but if it over stresses her before the uric acid comes down she may not make it, either.
So I really don't know where I misdirected him, but think the vet should have suggested allopurinol initially & it can be given long term as that what it is designed for. I know about it but I try to give the vets the benefit of the doubt as well. I am not going to just automatically say to give meds immediately if there may be something else going on such as the egg issues, too. Reptiles respond very well to natural remedies sometimes better than to conventional medication. I just think she deserves a chance before just giving up on her.
There are several variables to weigh in on & since I am not there to physically see her it is up to the owner & the vet. I normally recommend allopurinol straight out when it is that high unless the beard is jet black & the eyes are sunken, then it is too late.
They can be treated on meds for years, I have done it successfully. It just depends on circumstances & the situation, that's all.
If the vet wont prescribe it then he will have to get it online without a prescription which will take several weeks. While he is waiting & discussing things, there is no reason why he can't get his dragon started on the fluids & cherry juice. They help immensely as I used that as well along with medication for our boy.

I hope he gives us an update soon on her.

Tracie

 

[jarich]

Thank you, the last couple of posts have been much more in depth and explanatory. Its helpful not just for our communication, but Im sure for those reading the thread too.

As for the allopurinol, yes its difficult to say why it wasnt suggested. Could be either of those you mentioned or some further possibility of damage we arent aware of. There are of course some drawbacks to using any drug, and allopurinol is no different. I know that it does sometimes cause an initial spike in sUA, and perhaps the vet didnt think the dragon could sustain this possibility. Again, hard to say. I would agree the juice and water would be a good idea until such time as the decision is made, but that further, more extensive treatment is necessary and right away.