How severe is this impaction? (x-ray picture)

[CooperDragon]

Poor girl. Do you know if Pet Emergency Center has anyone on staff (especially after hours) with bearded dragon experience?

 

[AHBD]

Poor little Meryl.....I agree with Cooper, you only want an experienced reptile vet. Were you able to set her up under a heat lamp for the day with a nice hot basking area ? By the way, because of where you live, you can take her out when it's sunny and above 75 so she can get the best UVB in the world from the sun. Try taking her out for 45 minutes a day, and the rest of the time indoors make sure she has enough heat. I'm so sorry she's going through this, and I know you're confused + super worried about what to do. If you go to a new vet, show them the X-ray but don't tell them what the other vet said. That way you can hear what THEY say without getting an opinion based on the previous suggestion. Best wishes to you + Meryl !

 

[CooperDragon]

I just checked their site and it seems that they do support reptiles. I'd still call and double check that they have someone available with bearded dragon experience though. Interesting setup they have - its ONLY open overnight and on weekends/holidays.

 

[CathyJ]

I called the emergency vet and their reptile expert was not on staff.

I am going back to the vet tomorrow for the surgery. My lizard is just not keeping any food down and I am too scared to take her off any medications.

I tried calling other reptile vets to get a second opinion and there is just no one else in my area. The only other reptile vet I could get ahold of told me the one I went to is the best available at the moment and he basically just told me "if X said that then I believe her". The only other person who is more professional supposedly is 2 hrs from my location.

I don't think I have a choice with this one. The damage has already been done and it looks like this surgery is the only option I have. Both vets told me that if she is vomiting it most likely means that she is completely obstructed and we only have so much time to act.

I hope everything goes okay, I will try to update everyone on the results.

 

[AHBD]

Yes, I completely understand Cathy, you want to do what you feel in your gut is the right thing. I'm sure everyone here is wishing the best for her. Get better Meryl !!

 

[Drache613]

Hello Cathy,

I am so sorry you have been misdirected by your prior vet.
As everyone has stated, probably one of the most important things affecting their health is lighting & supplementation. The UVB is extremely crucial in helping their body regulate 25 Hydroxy levels via the parietal eye from UVB exposure. One problem could also be from malabsorption of the calcium. When you give calcium & they don't receive any UVB to help the body convert it & absorb it then that can cause issues over time.
I do see the swelling in the forearms but not in the back legs/feet area.
So the gout may not be renal related per say but more nutritionally induced & could be controlled & cured pretty quickly with the correct lighting.
Do you know how much allopurinol & colchicine she is getting? The colchicine could & does cause stomach upset in too large of doses. Usually the allopurinol doesn't though.
I would keep the basking temperatures to a range of 95-105 as 116 is a bit to high & that can expedite dehydration. I agree, I would discontinue the laxative as that can cause upset stomach.
Actually, the uric acid isn't as high as I had anticipated but over 10mg/dl which is enough to cause swelling. The calcium is relatively normal, surprisingly but an ionized calcium test would reveal D3 levels & help determine absorption issues.
So you are going to opt for surgery then?
There is a Dr. Marc Kramer in Miami but not sure if he is still at the Dixie Highway Exotics practice though. He is terrific & so caring, too. Here is a site to contact him:

http://www.avianexotic.com/facility.php


Please let us know how she is doing.

Tracie

 

[CathyJ]

it is very confusing going to the vet and then coming on here and reading what you guys have to say. I dropped my dragon off this morning for a blood test to see if anything has been improving. She has a pretty hard lump in her stomach and like you guys said, that could be due to calcium problems and UV lighting but is the vomiting a very severe symptom? When we got to the vet she had stuff coming out of her nose which had not been happening at all at my house. The vet open her mouth and she just had a pool of reddish liquid in her throat. The vet told me that she looked a lot worse, she is still under weight. she told me that she might not even survive the surgery and was worried about possible kidneyfailure. the blood test says her uric acid level is 15 when it should be under 5 so my vet said that was very alarming. She also told me that bearded dragons rarely get past the age of 10 so that her age was a huge factor

 

[CathyJ]

sorry, I am on my phone so its hard for me to include everything. The medicine that starts with AC she is getting a pretty big dose of, I think it was. 0.64cc. The one that starts with an A is the lesser dose of 0.32cc.

if the surgery might kill her, should I just bring her home and try to get her to keep food down? I just don't want her to suffer

 

[CathyJ]

The medicine that starts with a C***
larger dose one

 

[AHBD]

Hi Cathy....again, I'm so sorry that this is happening and my thoughts are with you whatever you do. It IS hard to decide, you don't want her to suffer, and I'm sure that money is not the big issue but you don't want to spend many $100's or $1,000 or more if there's little chance that she'll survive. Whatever you feel is best is what you should do. She is an older dragon, you have taken good care of her to live so long....a few live to be 11-12, even 13 but that's pretty much the high end of how long they live.

If you bring her home + keep her warm, [ about 100 in the basking spot, 85 in the coolest cool area since she's sick ] without giving any meds. but offering a bit of water + baby food mixed she might get settled a bit. At this point it's a very hard thing to decide, because either way she may not make it. The stuff coming from her nose is likely from having vomited.

I still think that if she was pooing before you took her in , then the vomiting may be just from upset stomach from the meds. Maybe just try to keep her comfortable if you want to see if she'll make it. Where there's life there's hope. Oh, are the meds. that you're referencing the Allopurinol + the Colchicine ?

 

[CathyJ]

Yea, I am referencing the meds. One that starts with A and one that starts with C because I dont remember how to spell them really.

So I've decided I want nothing more to do with that vet and brought the dragon home... Honestly surgery was not an option in her condition.. The vet took a blood test and said her urates had gone UP since last time so clearly whatever she suggested wasn't working. Personally, I think the urates might be high because she's basically dehydrated and starving. She is so underweight right now.
Anyway, she seems to be acting normal thus far.. On the ride home she gave me a small poop and then kept trying but nothing came out.

I just gave her a bath outside so she could be in the sun (97C bath, she was 100C when I took a temp with my lasergun thermometer) and she must be trying to pass something big because she pushed and pushed for 10 minutes straight and gave up. Her butt didn't look so good..
http://i.imgur.com/CxqljLO.jpg
http://i.imgur.com/18pUCOA.jpg
http://i.imgur.com/lBZ2EqD.jpg

I was VERY scared of prolapse and I once heard that if you keep it lubed up alright it should decrease the chances of it getting stuck. I got a Q-tip dipped in some mineral oil and gently oiled up her cloaca. I stuck it in maybe 0.5" just to help a bit hopefully. So far it doesn't look like prolapse but that poop she tried to do really loosened the skin around her bum..
http://i.imgur.com/ounN2q1.jpg

She's sitting regularly now but there's no way she's comfortable..

I gave her a syringe with squash+water+juiced collards+mineral oil and so far she's kept it down.

I had called a vet in marathon, FL who is supposedly the best in the area for reptiles.. I spoke with a Dr Shaun(sp) and explained the situation and he said that maybe if I were to change medications I should just give her the Allopurinol and the laxatives to help her pass. I also made an appointment for next monday so hopefully she'll be ok until then.

So what I was thinking is maybe keeping the Allopurinol (but maybe just once a day), replace the laxative I have now with mineral oil, maybe keep the omega3 oil because why not, and cut out the Colchicine and Hydromet(painkiller) as some people suggested.

I remember someone saying something about cherry extract (I'll try to go back and find that). Should I also add that in? Or will we be overwhelming her you think?

Thanks again guys I am grateful for all the advice.. I really hope everything goes well.. This has been an emotional rollercoaster for me.

 

[AHBD]

Can you remember the last time she had a meal [ before this small mixture you just gave her ? ] Because if she's on the laxative she may have the urge to push even if there's nothing there. And try to think back, it was when you first posted you mentioned that she was still going, some poos were normal + some were small.....that's why I didn't think she was impacted, but I am not 100% sure. She is thin, but doesn't look too bad. Hopefully she'll keep her little meal down. Do you have her set up with a heat lamp ?

It's good that you had her out in the sun for a bit, too.

 

[CathyJ]

By the way, Tracie, I tried to get ahold of Dr Kramer but he no longer works at the office. The staff member gave me his new number but no one answered and I was too frantic to wait for a callback.

 

[CathyJ]

Yea I think it's a hornworm.. The one that she managed to poop out was one out of TWO that I gave her that day. I bet its a huge honking leftover..

The poop she did manage(today) had some cricket parts (wings) but previous to the vet visits one of her poops had a TON of little cricket pieces (but it was a big poop that was mostly a good texture) and her throwup had completely undigested crickets..

I suspect when it's not the hornworm giving her trouble, its little cricket parts.

I got her under her heat lamp but I will probably be taking her back outside in a bit. I was just really scared when she started pushing and pushing and I sort of wanted her to stop.
I also got my UB light today, its a 10.0 UVB reptisun (zoomed)
http://ecx.images-amazon.com/images/I/814uenkzJxL._SY355_.jpg

I think I found it on this website, I forgot.

I actually have a long housing for a UVB that requires a long bulb but they didn't have the size. I wanted to go to another store to try and find that one but for now she has the mini one.

 

[CathyJ]

Sorry I think I answered your question wrong. You asked what I had fed her BEFORE this one mixture? It was yesterday. I gave it with the medicines and she threw all those up + crickets from a day before.

So basically yesterday she threw up what I tried to give her and today she ate nothing, she was at the vets all day basically.