Making sense of blood panels

[SqueakstheTiger]

So about a month ago I took my 2 year old male beardie Frank to the vet because he was eating less, pooping less, and being lethargic. He'd already came out of brumation around February and had been fine for a little while(super active to the point of demanding to be let out daily as soon as someone got home, healthy appetite).

So the vet did a blood panel and determined that he was fighting an infection. They prescribed .2 CCs enrofloxacin 30 mg/ml for 18 days. I've been doing that as well as giving him acidophilus+ mixed with carnivore and critical care daily. I took him in for a blood recheck on Tuesday and just got an email with the results today. The vet notes stated that the white blood cell distribution is now within normal limits. Plan is to finish out antibiotics (today is the last day I give him the antibiotics) and wait about 1 week after to see how he responds. If still not normal they can test for atadenovirus as well as a radiograph to look for other potential problems.

Here's both blood panels (the first values are from Tuesday 6/14 and the second are from 5/22)

Hematology
____________6/14 - 5/22
Hematocrit 39.0 % - 36.0 %
WBC 10 K/µL - 6.5 K/µL
% Heterophil 43.0 % - 9.0 %
% Heterophil Band 0.0 % - 0.0%
% Lymphocyte 35.0 % - 81.0 %
% Monocyte 0.0 % - 0.0 %
% Azurophil 15.0 % - 6.0%
% Eosinophil 4.0 % - 0.0 %
% Basophil 3.0 % - 4.0 %
Heterophil 4,300 /uL - 585 /uL
Heterophil Bands 0 /uL - 0 /uL
Lymphocyte 3.5 K/µL - 5.265 K/µL
Monocyte 0 K/µL - 0 K/µL
Azurophil 1.5 K/µL - 0.39 K/µL
Eosinophil 0.4 K/µL - 0 K/µL
Basophil 0.3 K/µL - 0.26 K/µL
Thrombocytes ADEQUATE - ADEQUATE
Blood Parasites NO PARASITES SEEN - NO PARASITES SEEN
Remarks CELLS DO NOT APPEAR TOXIC OR REACTIVE - FEW REACTIVE LYMPHS PRESENT, FEW REACTIVE MONOCYTES/AZUROPHILS PRESENT, HETEROPHILS APPEAR SLIGHTLY TOXIC

Chemistry
____________6/14 - 5/22
Glucose 263 mg/dL - 182 mg/dL
Uric Acid 1.2 mg/dL - 1.7 mg/dL
Phosphorus 3.0 mg/dL - 3.3 mg/dL
Calcium 10.1 mg/dL - 11.3 mg/dL
Sodium 155 mmol/L - 158 mmol/L
Potassium 7.1 mmol/L - 4.1 mmol/L
Total Protein 4.4 g/dL - 5.2 g/dL
Albumin 2.2 g/dL - 2.8 g/dL
Globulin 2.2 g/dL - 2.4 g/dL
Alb:Glob Ratio 1.0 - 1.2
ALT 7 U/L - 10 U/L
AST 48 U/L - 12 U/L
ALP 59 U/L - 81 U/L
LDH 1,921 U/L - 645 U/L
Cholesterol 142 mg/dL - 166 mg/dL
Creatine Kinase 6,213 U/L - 726 U/L

There is no range included. I tried looking up ranges on my own, but being the anxious person that I am, this only served to confuse and cause worry. It would be awesome if I could get a more experienced eye to look at these and maybe help me to make sense of it all.

 

[AHBD]

Hi there....one of the mods. ,Tracie [ username Drache613 ] will probably be on later, if not you can p.m. her. She can decipher Frank's blood panels for you.

 

[Drache613]

Hello,

Can you quickly run over your tank setup for us, such as the type & brand of UVB, supplementation & the temperatures?
I will review the blood tests for you, to be sure nothing else is going on. Today was the last day for the antibiotic? Is he maintaining his weight too?

Tracie

 

[SqueakstheTiger]

Cage is a 5ftx2ftx2ft wood tank, lined with paper towels. It has a cave, a half log, a branch, and a rock.

-Lights:
1 x Arcadia D3+ T-5 34 Inch 39 Watt 12% Desert UVB w/hood
1 x Arcadia Natural Sunlight T8 Bulbs 2% UVB 18 Watt 24"
1 x Philips duramax 65w flood
1 X CHE 100w on a dimmer for supplemental heat

-Temps
Cool side has an ambient temp of between 80-85F
Warm side has an ambient temp of between 90-95F
Two basking spots, one can get up to 110-112F, the other 102-105F

-Supplements
Liquid multivitamin concentrate with D3, diluted 1:5 and liquid calcium glubionate 23mg/ml
I give about .5 CC of the multivitamin and .05 CC of the calcium about once a week

Frank currently weighs 523g and has remained at within 523-525g. He gets either a bath or syringe of water about once or so a week, depending on which he'll allow. I've been leaving a plate of greens in his cage daily, consisting of mainly collards and cilantro, because that turned out to be the winning combo that he will more often go after. He's been refusing all bugs for almost a month, the last one he ate was a horned worm. I figured this weekend I'd go pick up a cup of supers and see if he might start eating.

 

[Drache613]

Hello,

Perfect setup, no problem there. He has great lighting!
So he gets calcium once a week? He should get calcium 3 or so times per week though. His blood test isn't bad though.
I can tell in the second blood test reading that he has an infection possibly, due to the elevated lymphocyte levels. They are not much higher than the normal ranges which are 54-76 so the infection is mild & should be knocked out easily.
His calcium & phosphorus levels are fine, no issues there. I did notice the AST levels were improved on the 2nd test too, which the ranges are 23-50. The AST enzymes are for liver readings.
The uric acid levels are a bit low on both tests as well. The normal ranges are 3-10 but usually 4 or so is a good range. He could have been dehydrated, or maybe he is missing a vitamin or mineral.
His kidneys don't appear to be having any trouble.
Based on those tests whatever infection he had should be able to be treated easily.
How is he doing today?
Everything else looks pretty good. If you need a more detailed analysis, let me know.
I hope he is doing better.

Tracie

 

[SqueakstheTiger]

Yesterday he spent the entire day in his cave. This morning he's still in his cave, but I'll take him out later for a bath and to give him his calcium/multivitamin/acidophilus+. I'll up his water intake to see if that helps any as well.

Thank you for your input.

 

[Drache613]

Hello,

How is he doing today?
Do you think he may be trying to brumate possibly? Some dragons do brumate during the late spring to early summer.
Is his beard a normal color or is it darker than usual?

Keep us posted on him. Let me know if you need more help with the blood test results.

Tracie

 

[SqueakstheTiger]

I cleaned his cage today and had him out for a bit. The only supplement he'd accept was the calcium, and he would not take any water. When I checked on him right before his lights went off, he had some black beard going on. He went through brumation in January, finished up with it around February. The vet said it's possible he might be trying to go into brumation again.

 

[Drache613]

Hello,

If he only brumated for a month or so, it is very possible he is trying to slow down again. I think some are on Australian time as they want to brumate during our summers.
Does he black beard when he is resting or sleeping or just when you get him out or disturb him?

Tracie

 

[SqueakstheTiger]

Black beard's when he's resting. I thought it was the medicine he was taking not jiving well with his stomach, because he would black beard an hour or two after I would give him the medicine. But he's been off the medicine for two days now and he still black beard's a little bit.

 

[SqueakstheTiger]

Just thought I would give you an update. Frank had not left his cage since Sunday until I brought him out to try and give him some water, which he stubbornly refused to drink any of it. I weighed him and either my scale is off, or he lost 8 grams. The vet said the next step would be to do xrays and test for Atadenovirus.

He's had coccidia, pin worms, bacterial infection, this latest infection. For the past two years I've had him, I think he's eaten/drank/acted normal for maybe a few months out of that. I keep being told I'm doing stuff right, but I'm thinking I must not be cut out for reptiles.

 

[Drache613]

Hello,

I am sorry he is still having some type of issue! I do think an adeno test would be a good idea then right now.
You don't think the meds have been the cause of his black beard then? Have you also tried getting some slurries into him even if he is stubborn? You can try chicken & turkey baby food mixed with squash or sweet potatoes & drip it onto the end of his nose to see if he licks any of that off.
If he has lost some weight, he could still have a slight infection of some type. His fecal has cleared up now, correct?

Tracie

 

[SqueakstheTiger]

I do think the meds were the cause of the black beard, since this is the first time he's been prescribed enrofloxacin. And now that I think about it, it does make sense that he would still black beard a day or so after. My brain's just all over the place trying to figure out what could be going on. He didn't black beard at all today when I took him out, which is a plus.
He had a fecal done and that was clean. Plus the recent blood test which the vet said was good. I'll pick up some baby food tomorrow and see how he does with that, and schedule the adeno test for next week.
Thank you so much for the advice and support. This is so frustrating for me; I just want Frank to be happy, healthy, and back to scarfing food and demanding play time.