Ok so Spike had a followup today to check how the biopsy site is healing up and that’s healing well. I’ve also had some questions answered by the vet and will post photos of the q’s and A’s as well as transcribe them here for ease of reading. He has another follow up specifically for the osteomyelitis next month.
1: What effect would this condition have on him?
Osteomyelitis is painful. In severe cases where infection eats through significant amounts of bone jaw fractures may result. He may have difficulty eating if it progresses.
2: what on the X-rays shows the osteomyelitis?
Areas of radiolucency (?) ie. mottling and ‘dark spots’. Vet stated affected area was ‘midline’ tip of jaw at front of snout.
3: I have done some research and found mention of some possibility of “scraping the infection out of the bone”. Is there potential for this in his case?
Spike has no open wounds or stomatitis/periodontitis currently so this has not been reccomended for Spike.
4: I e also found mention of an antibiotic called ‘Baytril’ that seems to be used often for this with success. Would it be worth trying different antibiotics?
Baytril (Ennofloxacin) has poor penetration into the bone than Ceftazadime (injections he is currently on).
5: should I give a probiotic? I have heart this can be beneficial in lon term antibiotic treatment cases.
Gut dysbios is not often seen in reptiles on cedtazadime. Probiotics formulated for humans and mammals often do not contain the same micro flora populations in reptiles so their efficacy is questionable.
6: I’ve heard long term antibiotics can affect the kidneys/liver. Is this a concern and if so is there anything I can do to minimise/manage it? I have heard of milk thistle for liver care.
We would not expect liver/kidney damage with his current medications. However Meloxicam (NSAIDS) has potential to cause kidney problems chronically hence why we are only using this every second day. It is a balance between this and pain relief/quality of life.
7: from what I’ve found in my research with proper treatment the affected dragon often recovers and the infection clears up/shrinks down. Is this a possibility?
Certainly a possibility however even if there is resolution of infection the changes to already affected bone is permanent.
8: if so and he recovers fully/mostly what if any long term effects can there be and how do I manage them?
See above. Management MAY involve feeding softer foods, additional pain relief if needed, assist feeding if he has trouble eating on his own. None of this is required currently.
9: any effect on lifespan?
If there is severe progression preventing his ability to eat etc this can reduce lifespan due to welfare concerns.
10: Given the condition how often should I book him in for dental checkups? (Eg annually, half yearly etc). How frequently should I wipe his teeth over with a q-tip?
Would reccomend 3 monthly checks of dental health and stage dental procedures according to this. May be yearly. Care with a-tips can get fibres caught on teeth, can use sturdy gauze instead.
11: apparently osteomyelitis is usually bacterial in nature. Would it be possible/worth it to attempt to take a swab/sample to test/culture for the specific bacteria strain responsible and tailor treatment to it for maximum success? Sample for testing via needle aspiration?
Certainly a possibility, however for culture of boney infection this required deep FNA (?) of bone. Samples can be hard to obtain.