Septic Arthritis - Leg Amputation

Hi all, my 3yo beardie Smaug has been through a lot... He has fought off 3 different parasites and an infection in his bones, but was left with bad arthritis in his knee joint. I don't know for sure, but my guess is the parasites from the pet store caused the bone infection, which led to permanent damage and arthritis.

My vet put him on meloxidyl for now to help with pain management, but recomended that he should have surgery to fuse the joint together as a longterm solution. Has anyone ever experienced something like this? I'm willing to fuse the joint if it'll stop the pain since he already isn't moving it. I just want to make sure there aren't any other long term options to help.

Smaug is only 3 and in otherwise good health now. His overall bone density is back to normal, he's parasite free, has gained weight back (up to 1.10 lb!) and eating really well. Other than his left leg, he's the healthiest he's ever been. I'd like to help him live a long pain free life.


* I have an xray image, but having trouble uploading on mobile. I'll add it when I get home if I can.
 

CooperDragon

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I'm glad to hear he is bouncing back and is eating well. It sounds like he was in rough shape, poor guy. I haven't read much about arthritis treatment for them. If the doctor has experience with this sort of thing, I'd probably be inclined to defer to their advice. Since he is otherwise healthy and doing well, perhaps there is some kind of physical therapy treatment that could be done before going with a surgical option, which may have risks that aren't worth taking just yet. Perhaps some kind of swimming therapy or other low impact/low stress movement would help.
 

GraphicTortoise

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Original Poster
Update on Smaug...
He was seen by a specialist and we were going to do a fluid tap to see what exactly is going on and what the best longterm treatment is, however the new xrays show some bad deterioration and fragmentation in the joint. The specialist has recommended a full leg amputation.
 

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CooperDragon

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Poor guy, it's too bad that the joints have deteriorated that far. How did the vet think the outcome of the amputation would be? I know that in cases of infection mitigation, they do tend to bounce back pretty well from amputation.
 

GraphicTortoise

Member
Original Poster
Poor guy, it's too bad that the joints have deteriorated that far. How did the vet think the outcome of the amputation would be? I know that in cases of infection mitigation, they do tend to bounce back pretty well from amputation.
We haven't gotten bloodwork back yet, but as long as that comes back normal and the infection isn't cancerous he's expecting him to bounce back with no complications.
 

GraphicTortoise

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We haven't gotten bloodwork back yet, but as long as that comes back normal and the infection isn't cancerous he's expecting him to bounce back with no complications.
My main concern right now is getting the bloodwork back and the recovery process. I haven't really been given many details yet about what to expect after the procedure, but since he's losing his back leg at the hip, I'm concerned about keeping the area clean while it's healing since it'll be pretty close to his vent.

I'm already planning on accommodations for the enclosure so there's less stress when climbing and cutting back on bugs so he doesn't have arthritis issues in the other 3 legs due to extra weight. (He's just a smidge overweight right now)
 

CooperDragon

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Keeping that area clean may be a challenge. Hopefully the wound will close up and heal over quickly so the timeframe for this will be short. You might discuss cleaning options with your vet ahead of time. My vet has suggested using Vetericyn spray in order to disinfect the vent/belly area. This was during parasite treatment, so is a bit of a different situation. I'd imagine your vet will go over routine wound care and cleaning which should help address this issue.

As he heals and adjusts, I'd watch how he moves around and adapts so that you can make adjustments to his environment to accommodate. He is likely to be able to move around pretty well on 1 leg and 2 arms along with using his tail for balance. If not, you might be able to strap some sort of support or wheel system around his hip that would reduce weight on the other limbs, but I wouldn't rush into doing that without first observing how he adapts on his own. That said, I don't have firsthand experience with this and am just trying to think this through and offer an opinion to consider along with advice from the vet and others on the forum.
 

GraphicTortoise

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I appreciate your responses and ideas. Thanks so much! I'll definitely run some of them through with my vet.

I just called about bloodwork and it still isn't back. I really can't do anything but wait until we see the results to be sure he can even have the operation.

I'll definitely continue to update though. I've been poking around looking for full amputation recovery posts, but not a whole lot comes up. I wanna document this so if someone else ends up in the same situation with their beardie, they'll have a place to go to figure out what to do and how to take care of the wound while it's healing.

So far with all the reading I've done these are the things people have suggested to others to help.

Butadiene baths
Manuka honey on the wound with a sterile dressing
Feed silkworms to help with pain and inflammation
Oral meds or injections from the vet
 

Drache613

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Hello,

So sorry your dragon's joints are having trouble! I agree, silkworms are very helpful for pain & inflammation.
You could also try straight serrapeptase (silkworm enzyme) for more concentrated intake, too.
When do you anticipate getting the blood tests back?
They are thinking the infection in his bone/joints could be cancerous or they are not sure?
I hate to hear you would need to amputate the entire leg though, that is very rough.

Let us know how he is doing.
Tracie
 

GraphicTortoise

Member
Original Poster
Hello,

So sorry your dragon's joints are having trouble! I agree, silkworms are very helpful for pain & inflammation.
You could also try straight serrapeptase (silkworm enzyme) for more concentrated intake, too.
When do you anticipate getting the blood tests back?
They are thinking the infection in his bone/joints could be cancerous or they are not sure?
I hate to hear you would need to amputate the entire leg though, that is very rough.

Let us know how he is doing.
Tracie
The bloodwork should be back soon. Definitely before operation. They were supposed to have the results back by now but there was a shipment delay (thanks covid) since they send their tests out.

My vet didn't end up doing the tap to determine what the infection is, just to save time and money, but the xray shows that the "thigh" bone has been infected and fractured near the knee joint which is why he's decided to remove the entire leg in case the infection is still spreading or possibly cancerous. It's also an easier procedure and recovery to remove at the hip joint rather than mid bone. After the operation the vet said I can send the leg to be tested if I want and figure out what was going on in it.

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Drache613

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Hello,

Hopefully the test results get there soon! The shipping has been crazy, I agree, slow in a lot
of areas.
Oh I do understand the reasoning behind amputating that much, it is just very unfortunate. There
are a lot of dragons with missing limbs, or tail, etc that do just fine. I hope any cancer, if any, will
be able to be removed so he wont have any future problems!
How is he doing today?
Keep us posted on him, we are all pulling for him.

Tracie
 

GraphicTortoise

Member
Original Poster
Hello,

Hopefully the test results get there soon! The shipping has been crazy, I agree, slow in a lot
of areas.
Oh I do understand the reasoning behind amputating that much, it is just very unfortunate. There
are a lot of dragons with missing limbs, or tail, etc that do just fine. I hope any cancer, if any, will
be able to be removed so he wont have any future problems!
How is he doing today?
Keep us posted on him, we are all pulling for him.

Tracie
His knee is pretty swollen and he's a little more hesitant to eat because he doesn't want to move around too much due to pain, but he's still eating! Little to no gray in his beard too. He mainly goes gray after climbing and then back to normal while resting. He's also hanging out on the cold side, I'm guessing the heat doesn't feel so good on his knee.

I called the vet again and they finally have bloodwork, but said the vet will talk to me about it tomorrow (amputation day) I'm not totally comfortable with that so I asked for them to email me the results, but haven't gotten them yet. I'm calling again around noon if they still haven't emailed me.
 

GraphicTortoise

Member
Original Poster
So, I finally got the bloodwork!
It doesn't look so good from the summary though...
I'm having my normal vet look at them later today and discuss them with me but that anemia worries me quite a bit...
Outcome
There is mature lymphocytosis and mild azurophilia. These findings can be associated with marked antigenic stimulation and
inflammatory response. Considerations include viral or bacterial infection, marked tissue necrosis or neoplasia. However, an early
lymphoproliferative disease manifests in a similar way and cannot be ruled out. Continued monitoring of the lymphocyte count can be
considered. There is also a moderate non-regenrative anemia. Anemia is attributable to decreased production from a chronic disease is
the most common cause of non-regenerative anemia. Causes for chronic anemia are many and may include infection, chronic exposure
to improper environment and diet, chronic organ failure, toxin exposure, or neoplasia. Correlate with clinical information.
Clinic Notes / Specifics
Moichoir Chemistry
Test Results
ALB 3.7
AST 25
BA 5
BUN 2
CA 14.24
CHOL 180
CL 112.4
CK 350
PHO 2.28
K 3.91
GLU 144.8
NA 149.5
TP 6.7
TRIG 220.6
UA 6.1
LDH 273
PCV 15.6%
WBC 29328
Heterophil Differential 7.1%
Lymphocyte Differential 86.5%
Azurophil differential 3.5%
Monocyte Differential 0%
Basophil Differential 2.8%
Eosinophil Differential 0%
Thrombocyte Adequate
Hemoparasite and inclusion None Seen
RBC Morphology Minimal polychromasia, morphology unremarkable
Clinic Notes / Specifics
Moichoir CBC


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GraphicTortoise

Member
Original Poster
So the specialist vet and my normal vet both agree that Smaug's bloodwork isn't the best, but not bad enough to not do the surgery. They said that they expect everything to go back to normal (minus the leg lol) after he recovers, but since his white blood cell count is high and he's anemic they definitely want to send the leg out now to make sure it isn't cancer.

I've asked probably a billion questions so far, here's everything I know...

I'm dropping him off in the morning and picking him up after the procedure whenever he wakes up. They said he may have to stay overnight if he's really groggy.

Before the procedure he will be sedated and he may need anesthesia during as well. They're giving him a catheter IV too. He's getting his entire left leg amputated at the hip joint. With him being anemic I asked if they have blood for him on standby or a donor dragon... They don't but they said it really isn't necessary since they don't expect much blood loss or any complications with this procedure.

After the procedure he'll be sent home with oral pain meds and antibiotics. He's also getting some iron injections to help with the anemia but I'm having my regular vet administer those (I think he said one every few months but I can't remember for sure) he said the wound will stay uncovered and should be tucked in and "water tight" but the area shouldn't get wet for at least 2 weeks. He said that being close to the vent shouldn't be an issue unless he drags that side through poop in which case I can use a damp cloth or Vetericyn spray to clean the area.

The healing time is anywhere from 4 to 8 weeks and during that time he'll be placed on paper towel substrate. For the first 2 weeks I was told to take out climbing objects, but after that he should be ok to try to climb again. I was also told that upping the temp a little bit (cold side 80-85 instead of 75) is ok to help speed up the healing process. He said no extra probiotics or supplements are needed unless he stops wanting to eat on his own. The sutures could come out during shed while healing, but will probably need removed in 4-6 weeks.

That's everything I know for now. Fingers crossed everything goes well tomorrow!
 

GraphicTortoise

Member
Original Poster
Smaug is a trooper! Surgery went well and he even woke up earlier than expected! Literally 5 minutes after being home, he was walking around and climbed up onto his favorite little log. He even ate a couple roaches!

All his meds start tomorrow.

Ciprofloxacin 100mg/ml Suspension Banana (Per mL)
Give 0.05 ml(s) orally every 48 hours. Protect from light. This is a
compounded medication.

Meloxicam 3mg/mL Suspension Exotics (Per mL) Give 0.08 ml orally once every 24 hours for 14 days.

Iron Dextran 100mg/mL Inj (Per mL) Inject 0.05 ml into the muscle of the front leg once a week for 4 weeks.

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