Mystery illness with GI, work in progress

[DorgEndo]

Hopefully in 5 days or so I will have an answer, but I thought I would put this up before the weekend.

Devlyn has been having a mystery illness since June this year. Overall she is acting fine. Stable weight. Active and basking. Good appetite. Happy coloring. The symptom is loose and watery stools, basically a water poop with a formed white urate. There is only distress around when she poops, she runs from the poop and seems to hold poop in until she gets time out of the enclosure (when she can hold it). Stool sample in late June was clear of parasites, none seen.

So we monitored her and I increased Bene-bac, alternating with Bee pollen. Once per week for each.

Symptoms continued so we got bloodwork. Azurophilic monocytes were off the charts high, indicative of a chronic infection. We got a new fecal smear earlier this month, also negative. No parasites of any sort seen.

Her vet suspects she may have a bacterial infection. We are calling it gastroenteritis right now. A culture is in the works from her stool which we will get in 5 days or so. With the veteran's blessing I have upgraded her to human probiotics. It is hard to measure exactly how much she eats and what falls down. My estimate is she is getting 2.5 Billion CFUs (colony forming unit) for her weekly serving of probiotics. 70/30 percent split of Lactobacillus/Bifidobacterium strands. Suspended in potato starch and acacia root powder. I dislike the reptilian probiotics have no measurement for CFUs. What good is Bene-bac if I don't know what is really in it? I could try calling them or something...

Anyway. Poor Devlyn is overall okay but with a mystery intestinal issue. She can't seem to fight it off herself and needs some help. This is not brumation because she will not brumate until October.

 

[AHBD]

I hope you get some answers and I hope that Devlyn continues to be unbothered by it. If it were gastroentiritis it would probably affect her behavior, in humans + mammals it causes nausea and sometimes vomiting so it's good that she's not visibly in discomfort like that. What does she normally eat + drink ?

 

[DorgEndo]

I offer filtered water with water conditioner by Zoomed in it. I am not sure if she has drank anything this year. Her water dish goes in the dishwasher once a week

Arugula, orange bell peppers, red clover, and mustard greens have been her favorites lately with Johnny jump up flowers. Dubia roaches and hornworms. Food dish changed daily and I wash the dish every day hand or dishwasher. Plain calcium more than D3 weekly, Exo terra multivitamin weekly, bee pollen weekly, probiotic weekly. Devlyn is weird, if we do Calcium more than 1-2 weekly she has gotten the start of hypercalcemia...we do less calcium than typical.

Weight 423g at Vet, I get about 424g at home, this is the higher end of where I want her weight, she needed to poo when she was weighed. 4 years old female.

Ca : P ratios 11.1 : 4.3 = 2.58 : 1

14% UVB by Arcadia with reflector, Arcadia daylight LED strip, 150 watt heat lamp plain reptile light, and Vivarium electronics 120 watt radiant heat panel for ambient heat. 240+ gallon enclosure 50" wide, 27" depth, 44" height. 18"-30" most often where she basks for UVB.

ITEM	Devlyn's value	Normal value	Unit
WBC estimate	13.7	2.8-14.6	1000/uL
HCT	42	23-39	%
RBC morphology	Normal	Normal	na
Blood parasites	None seen	None seen	na
Heterophils	61	na	%
Absolute heterophils	8357	1146-6238	/µL
Toxic changes	None seen	None seen	na
Bands	0	na	%
Absolute bands	0	na	/µL
Lymphocytes	15	na	%
Absolute lymphocytes	2055	363-8172	/µL
Monocytes	1	na	%
Absolute monocytes	137	10-1078	/µL
Eosinophils	0	na	%
Absolute eosinophils	0	3-364	/µL
Basophils	5	na	%
Absolute basophils	685	13-820	/µL
Azurophilic monocytes	18	na	%
Absolute azurophilic monocytes	2466	5-1540	/µL
Thrombocyte estimate	Increased	?	Platelet count reflects the minimum number due to platelet clumping
Total protein	4.7	3.3-7.3	g/dL
Albumin	2.7	1.5-3.7	g/dL
Globulin	2	1.3-3.9	g/dL
SGOT(AST)	34	3-75	IU/L
BUN	2	1-4	mg/dL
Phosphorus	4.3	2.3-9.4	mg/dL
Glucose	167	129-293	mg/dL
Calcium	11.1	6.8-22.7	mg/dL
Sodium	154	143-173	mEq/L
Potassium	4.5	2.6-6.1	mEq/L
Chloride	115	103-145	mEq/L
CPK	795	17-3421	IU/L
Uric acid	3.8	1.2-8.4	mg/dL

Sample conditions: Hemolysis 2+ No significant interference

 

[DorgEndo]

Rage! A few months ago I posted about how teeny mouse were coming into the house. Because my beloved kitty passed. I was worried about the mice and Devlyn and I was raging right!

The vet identified 3 bacteria typically associated with rodents. Saying this is an infection usually seen only in person that get live fed rodents or are fed wild rodents. I did get new cats this year because I don't know what itty bitty hole the teeny mice are using to get into the house. House inspector had us seal areas but they still get in somewhere. Devlyn probably licked up a mouse poo running around the house. Or maybe a mouse did get in her house and poop inside and I didn't see it. Filthy rodents! It's the only thing that makes sense. The timing works out for infection period, incubation, then symptoms.

Devlyn needs to be on 2 Antibiotics. Flagyl for 5 days and another (just forgot the name) for 14 days.

I asked the vet to email me the full report so I have the names of the bacteria. Or if they forget I'll get the report when I pick up the medicine after work.

Now I have to force feed Devlyn antibiotics and she is going to hate it...

 

[DorgEndo]

Oh and the bacteria are considered zootonic and highly infectious so I'll have to set up her house as a hospital setting for cleaning

 

[AHBD]

Oh no, poor Devlyn ! Good on your vet for quick I.D. on the cause and in prescribing the proper meds. that will hopefully get rid of the problem.

 

[DorgEndo]

Oh no, poor Devlyn ! Good on your vet for quick I.D. on the cause and in prescribing the proper meds. that will hopefully get rid of the problem.

Got the report. Abundant growth of 3 different strains of bacteria

1. Pseudomonas Aeruginosa
2. Klebsiella Species
3. Citrobacter Freundii

I honestly know nothing about these bacteria. If anyone else has tackled them please share!

Treatment plan is Flagyl for 5 days (0.15mL), and Baytril for 14 days (0.2mL). I will add 0.2mL water treated with reptile conditioner as long as she is on antibiotics.

 

[DorgEndo]

For anyone wondering...

Devlyn is handling the medicine well so far. This is day 2 of meds. Good appetite still. I ordered BSFL from dubiaroaches . com but they sent wax worms by mistake. So she got wax worms as a treat after the meds. I'm keeping her heat higher at night. The radiant heat panel is staying on full force at night. I'm worried about her calories even though it's likely fine. She is a good weight.

 

[AHBD]

Good that you have insurance, those bills are stacking up ! It's good to have the heat up a little more at night but nothing high, 80-82 would be O.K but not more than that.

 

[DorgEndo]

Depending on where she is she is warmer or cooler. The highest spot gets to 84°F overnight. She choose that spot one night. She choose it so that's the important thing to me. She mostly stayed lower, and thus cooler.

Most of her house is 80° F or less in her hides. The heat panel really is a gentle even heat. It's one of those you can put your hand directly on it and it will not burn you.

Devlyn is figuring out my timing and crawling into her hide during the day when I want to give her medicine. Even before I grab anything, she just does the math I guess and goes to hide. I want her to wake up about 2 hours so she is warm, so she gets warm then hides.

I can get her easy enough, just funny she figured out my plan so quick

 

[DorgEndo]

I got a funny update, sorta. Since I work in a clinic we had an internal medicine intern who is specializing in infectious disease. So I got to ask him about the terrible trio affecting Devlyn.

As the infection is in the GI tract whether the exposure was from food, soil, or any way contamination would enter her mouth what should protect a person (or dragon) is the pH of the stomach acid. In humans these bacteria are generally not a GI concern unless the patient is taking medication to reduce stomach acid pH, s/p a bariatric procedure, or any number of immunosuppressant conditions which would leave a patient more vulnerable.

This conversation lead me to think a few things.

Is the stomach pH for bearded dragons sufficient to kill these bacteria?

As temperature changes and Devlyn's thermal performance curve changes could this affect her stomach pH?

Could seasonal hormonal changes, i.e. getting closer to brumation, effect stomach pH?

Devlyn has always been a problem eater. She doesn't eat in the morning. She doesn't eat during the day. Most of her meals are only when I feed her after work. Barely making the 4 hour window before lights out. This consistent late eating, which I have tried hard to change, made her more susceptible to opportunist infection?

I still think the sprouts or mice could have been a contamination factor. I don't mop the floors much because the robo vacuum keeps things looking well. Guess I need to mop the kitchen more since Devlyn licks everything (as a dragon should)

End random thoughts for now

 

[AHBD]

That is interesting. It is possible that those bacteria are simply tolerated in beardies as a lot of other organisms are. I doubt her eating habits are a factor.

 

[xp29]

If you read on beardies intelligence A LOT of sites say they are lower intelligent animals. I call B. S. It sounds like she is clearly trying to evade taking medication. My beardies get insanely jealous if they see me with one of the others. I had one that would let herself outside and let herself back inside. I say all that is abundant proof of intelligence!!!!!

 

[DorgEndo]

If you read on beardies intelligence A LOT of sites say they are lower intelligent animals. I call B. S. It sounds like she is clearly trying to evade taking medication. My beardies get insanely jealous if they see me with one of the others. I had one that would let herself outside and let herself back inside. I say all that is abundant proof of intelligence!!!!!

Absolutely! Beardies can definitely "do the math" and put together things. Try alternative options towards the desired outcome.

Today Devlyn successfully evaded the grab from her log. However, I was then able to grab her from the other end when she moved. I had been lifting her up and pulling her out the larger log entry, the other side has two smaller holes. Also, she had positioned herself so the scales were against the grain from how I had been lifting her out

I set her down to crawl back into her log. Giving me the over the shoulder stink eye

 

[xp29]

Lol, if beardies grew into the size of their attitudes they would be the size of mythological dragons