Liver issues — next steps/quality of life?

[Blueathena623]

Trying to keep this short(er). This past winter I noticed my bearded dragon (currently 1.5 years old) eating less and was more sluggish, and then barely eating at all, but I thought it was brumation. In April I noticed a swollen toe and then he had blood in his stool. Look him to the vet asap, and the dx was mild MBD (husbandry issue, since fixed) And was given parasite medication. Started syringe feeding of critical care. Still blood and not eating after two weeks, fecal test indicated coccidia count of 9, was started on Albon, completed that, later fecal test indicated no parasites. No more blood, but still not eating/needing to be syringe-fed, but follow-up X-ray showed good bone density. Took him to another vet for a blood test, everything came back good except for very high liver enzymes (but not indicative of fatty liver) and on the higher side of normal white blood cells. He is currently on milk thistle extract and marbofloxacin. The vet says that the next step would be a liver biopsy, but she and I talked about how that would be beyond my budget (plus a round trip time of almost 10 hours). He is still being syringe-fed critical care.

My question is, if this medication doesn’t work (and it’s been 1.5 weeks and I haven’t seen any change), how do you decide quality of life? He does not like being syringe fed, but both vets have commented that he doesn’t even look sick. He’s always just kinda preferred to just chill, so it’s not like he’s gone from this super active, happy lizard to something else. But he won’t eat (and believe me, I have tried all foods). Per the vets instruction I’ve tried not feeding him critical care for a few days (3) to see if he would eat food, and he didn’t.

I don’t want to put him down because he’s my buddy, but is it fair to him? I feel like I’m torturing him every time I feed him. Can liver issues heal over time?

 

[BuddyBeardedDragon]

I am so sorry about what is happening to your beardie. My bearded dragon is 2 and hasn't experienced many issues. However, when I last went on holiday for about 3 weeks, I had to bring him to a friend of mine who is a vet to pet sit him. When he was with her, he wouldn't eat any vegetables and hardly any bugs. I am suspecting it is because he was stressed in his new environment. Maybe your beardie is stressed about all his trips to the vet and that is why he won't eat? Also, when my bearded dragon won't eat vegetables, sometimes I push it around his plate and he eats it. My bearded dragon also prefers to eat leaves rather than vegetables.
Hope this was helpful!

 

[KarrieRee]

Trying to keep this short(er). This past winter I noticed my bearded dragon (currently 1.5 years old) eating less and was more sluggish, and then barely eating at all, but I thought it was brumation. In April I noticed a swollen toe and then he had blood in his stool. Look him to the vet asap, and the dx was mild MBD (husbandry issue, since fixed) And was given parasite medication. Started syringe feeding of critical care. Still blood and not eating after two weeks, fecal test indicated coccidia count of 9, was started on Albon, completed that, later fecal test indicated no parasites. No more blood, but still not eating/needing to be syringe-fed, but follow-up X-ray showed good bone density. Took him to another vet for a blood test, everything came back good except for very high liver enzymes (but not indicative of fatty liver) and on the higher side of normal white blood cells. He is currently on milk thistle extract and marbofloxacin. The vet says that the next step would be a liver biopsy, but she and I talked about how that would be beyond my budget (plus a round trip time of almost 10 hours). He is still being syringe-fed critical care.

My question is, if this medication doesn’t work (and it’s been 1.5 weeks and I haven’t seen any change), how do you decide quality of life? He does not like being syringe fed, but both vets have commented that he doesn’t even look sick. He’s always just kinda preferred to just chill, so it’s not like he’s gone from this super active, happy lizard to something else. But he won’t eat (and believe me, I have tried all foods). Per the vets instruction I’ve tried not feeding him critical care for a few days (3) to see if he would eat food, and he didn’t.

I don’t want to put him down because he’s my buddy, but is it fair to him? I feel like I’m torturing him every time I feed him. Can liver issues heal over time?

I am going to flag your post to Tracie the vet tech on the board -- if you have any office visits blood work please post them -- also go over the surface basking temps and how your getting them and the UVB your using-- are you feeding any worms or insects besides the critical care ?
@Drache613

 

[Blueathena623]

I am going to flag your post to Tracie the vet tech on the board -- if you have any office visits blood work please post them -- also go over the surface basking temps and how your getting them and the UVB your using-- are you feeding any worms or insects besides the critical care ?
@Drache613

Currently he is in a 40 gallon tank only because his other tank is a much larger bioactive enclosure that I knew I would not be able to sanitize as much as necessary when we started dealing with the parasites. I was just thinking about how I need to go ahead and ditch the substrate in his big tank, fully sanitize, and get him back in there . . . but then there was some blood in his poop this morning, so I don’t even Know what could be going on. In the 40 gallon he has an Arcadia 12% 24 inch light that hangs from the inside that is 12 inches from his basking spot, but maybe that is too low? Not super happy with his temps – currently 80 degrees on the cool side, 97 on the hot side as measured by a temp gun. Current substrate is paper towels.

Since he stopped eating back and the end of April I have offered dubias, crickets, super worms, and even wax worms to tempt him, and nada. For his veggies, he’s always loved collards, and if I can roll up a bit of a leaf and tuck it in the side of his mouth he will eat it, but he won’t go and eat the greens himself.

 

[Blueathena623]

Sorry, his test results:
everything came back normal except his liver enzymes and white blood count
liver enzymes
ALT — 61
AST — 277
A Phosphorus — 455

 

[KarrieRee]

Currently he is in a 40 gallon tank only because his other tank is a much larger bioactive enclosure that I knew I would not be able to sanitize as much as necessary when we started dealing with the parasites. I was just thinking about how I need to go ahead and ditch the substrate in his big tank, fully sanitize, and get him back in there . . . but then there was some blood in his poop this morning, so I don’t even Know what could be going on. In the 40 gallon he has an Arcadia 12% 24 inch light that hangs from the inside that is 12 inches from his basking spot, but maybe that is too low? Not super happy with his temps – currently 80 degrees on the cool side, 97 on the hot side as measured by a temp gun. Current substrate is paper towels.

Since he stopped eating back and the end of April I have offered dubias, crickets, super worms, and even wax worms to tempt him, and nada. For his veggies, he’s always loved collards, and if I can roll up a bit of a leaf and tuck it in the side of his mouth he will eat it, but he won’t go and eat the greens himself.

Your UVB is of good height -- what is the surface basking temp? I am thinking if the ambient is 97 depending on the height of the bulb it should be atleast 6 inches its over 97-- a digital probe thermometer would give a better accurate temp-- I am flagging Tracie again -- his big tank is a 120 gallon ? Zen Habitats sells a black mat to fit the 120 gallon tank - you can look into that if you want or some textured NON adhesive shelf liner would work as well
@Drache613

 

[Blueathena623]

Your UVB is of good height -- what is the surface basking temp? I am thinking if the ambient is 97 depending on the height of the bulb it should be atleast 6 inches its over 97-- a digital probe thermometer would give a better accurate temp-- I am flagging Tracie again -- his big tank is a 120 gallon ? Zen Habitats sells a black mat to fit the 120 gallon tank - you can look into that if you want or some textured NON adhesive shelf liner would work as well
@Drache613

Yes, his real tank is a 120 from Zen Habitat. The temp on his basking area just read at 99, 150W basking bulb, I use one of the IR thermometers where you point and shoot. I can totally see how the smaller, kinda sparse cage could be stressing him out, and I want to move him back into his real cage, but now I’m second guessing myself because of the bit of blood in his stool this morning — it’s a lot easier to steam clean a glass 40 gallon than a 120. Although I’m also wondering if the blood could be because he is having some very loose stool because of the antibiotics (although I do add probiotics to his critical care)?

 

[KarrieRee]

Yes, his real tank is a 120 from Zen Habitat. The temp on his basking area just read at 99, 150W basking bulb, I use one of the IR thermometers where you point and shoot. I can totally see how the smaller, kinda sparse cage could be stressing him out, and I want to move him back into his real cage, but now I’m second guessing myself because of the bit of blood in his stool this morning — it’s a lot easier to steam clean a glass 40 gallon than a 120. Although I’m also wondering if the blood could be because he is having some very loose stool because of the antibiotics (although I do add probiotics to his critical care)?

Let's see what Tracie says

 

[Drache613]

Hello,

Sorry to hear your dragon is having some trouble. Definitely post some bloodtest copies if you happen
to have them or can get them, so I can take a look at them.
Liver cells can regenerate if they are not too far gone or diseased. The MIlk thistle should really help out,
& can be used long term if needed.
The best thing to do is to focus on a healthy low fat & moderate protein diet.
Be sure to keep him a little warmer overnight, to help boost his system. Usually 75 to 80F is adequate
for overnight warmth.
Which antibiotic is he on, the Marboflaxin? You can add probiotics separately, with just a little bit of water
later in the day so it doesn't have to compete with food or medication.
Do you have pictures of him you could post?

Tracie

 

[Blueathena623]

Hello,

Sorry to hear your dragon is having some trouble. Definitely post some bloodtest copies if you happen
to have them or can get them, so I can take a look at them.
Liver cells can regenerate if they are not too far gone or diseased. The MIlk thistle should really help out,
& can be used long term if needed.
The best thing to do is to focus on a healthy low fat & moderate protein diet.
Be sure to keep him a little warmer overnight, to help boost his system. Usually 75 to 80F is adequate
for overnight warmth.
Which antibiotic is he on, the Marboflaxin? You can add probiotics separately, with just a little bit of water
later in the day so it doesn't have to compete with food or medication.
Do you have pictures of him you could post?

Traci

Here is my buddy. I’m concerned with excess fluid in his abdomen, maybe ascitis from the liver issues, although neither of the vets commented on it.

Currently he eats the omnivore critical care, but I have been giving him his meds as the same time as his food (which has the probiotic, so I’m going to start giving them at separate times.

these were the lab results the vet gave me:
everything came back normal except his liver enzymes and white blood count
liver enzymes
ALT — 61
AST — 277
A Phosphorus — 455

 

[Drache613]

Hello,

Thanks for posting those results.
Did they test him for adeno virus? That can cause liver issues as well as fluid retention in the belly,
also.
The AST levels are a bit elevated. How is he doing with the omnivore care, how much do you give?
Yes, the probiotics should be given separately, so they don't have to compete against each other.
Did you mention if you were giving him any milk thistle extract right now?

Tracie

 

[Cuttlefishh]

Beardies have a very slow metabolism, so it will take defintiely longer than a few weeks to heal the liver. If he's not black bearding or showing distress I'd give the conservative treatments/meds a shot. It could take a few months to be honest before you see a lot of improvement. If he's not eating I'd continue to assist feed and maybe continue to have the vet monitor blood levels periodically.

 

[Drache613]

Hello,

Please keep us updated on how he is doing. We are all pulling for him
to have a full recovery.

Tracie

 

[Blueathena623]

Hello,

Thanks for posting those results.
Did they test him for adeno virus? That can cause liver issues as well as fluid retention in the belly,
also.
The AST levels are a bit elevated. How is he doing with the omnivore care, how much do you give?
Yes, the probiotics should be given separately, so they don't have to compete against each other.
Did you mention if you were giving him any milk thistle extract right now?

Tracie

I am giving him milk thistle, and i just ordered some more from your shop.

 

[Drache613]

Hello,

Ok, great! I hope it is helping him out. Let me know if you have any questions.

Tracie