Septic Arthritis - Leg Amputation

GraphicTortoise

Member
Original Poster
So.... some bad news.
Smaug got another xray on his swollen arm. The vet had a radiologist confirm that there's progression of infection in his hand.

We're doing a tap next week to determine the best treatment since antibiotics aren't working. He's been on cipro since his amputation in November (which is doing great, he just got his stitches out!) and the xrays between October and now show progression in the front arm.

Obviously a second amputation isn't an option, so my vet is doing some research on a couple experimental options. One was injecting a more concentrated antibiotic into the joint, and the other was a little more complicated and I can't recall since it was discussed over the phone.

I'm hoping to find a grant that can help out since we're going into uncharted territories, but we're having no luck finding anything on a small scale. Most of them require multiple reptiles being studied.

Hopefully the experimental options work. If not I'll just have to make him as comfortable as possible because I refuse to go through with another amputation. The vet agrees that he probably wouldn't do well with a stump and a missing leg. Quality of life definitely comes into play if it gets to that point.
 

AHBD

BD.org Sicko
Sorry to hear about this turn of events, how is Smaug getting around ? How many injections did he have ? The swelling may be from the injections and also from being off balance with his missing leg and having to walk with more stress/pressure on that side. I'd go easy on all further treatment, sometimes less is more , especially when the Dr.s don't know the cause + have no real answers. Continued aggressive treatment , medicines and vet visits can sometimes add to the problem by increasing stress. How is his mobility + appetite ?
 

GraphicTortoise

Member
Original Poster
Sorry to hear about this turn of events, how is Smaug getting around ? How many injections did he have ? The swelling may be from the injections and also from being off balance with his missing leg and having to walk with more stress/pressure on that side. I'd go easy on all further treatment, sometimes less is more , especially when the Dr.s don't know the cause + have no real answers. Continued aggressive treatment , medicines and vet visits can sometimes add to the problem by increasing stress. How is his mobility + appetite ?
He only had the 4 injections, 2 in each arm, and is no longer getting them (stopped 2 weeks ago). After confirmation from the radiologist, the swelling is definitely from progressing infection in the wrist joint.

The weird thing is, the arms look different, but measure the same around even though one clearly looks swollen.

The current plan is to stop antibiotics since they aren't helping, and then get a sample of the joint fluid tested next week to determine the best course of action. If nothing can be done then I'll make him as comfortable as possible and that'll be that, but I want to try to stop this before it gets worse if possible.

Smaug is eating, walking (without dragging), and even climbing on his own with no problems. He honestly seems healthy other than the swollen arm. He's still using the arm just fine, but he does favor it a bit and was quick to pull it towards him while the vet was examining it.
 

AHBD

BD.org Sicko
I'm glad that Smaug is doing well, animals don't comprehend when a body part is removed and so if they feel good they go on about their business like he is doing. :) So far he has a strong will to keep going and in that way he's doing well. Hopefully everything will turn out for the best without too much interference after all is said + done and Smaug will keep on plugging along.
 

GraphicTortoise

Member
Original Poster
I'm glad that Smaug is doing well, animals don't comprehend when a body part is removed and so if they feel good they go on about their business like he is doing. :) So far he has a strong will to keep going and in that way he's doing well. Hopefully everything will turn out for the best without too much interference after all is said + done and Smaug will keep on plugging along.
The best case is that we clear the infection in his arm with no further damage using the best treatment option based on the cytology results. Worst case is that he can't be treated and is put on pain management with frequent quality of life checks. I really hope it doesn't come down to that, but either way he'll still have a least a few good years left, if not more.
 

GraphicTortoise

Member
Original Poster
Update on smaug:

His cytology came back confirming the infection in his right hand to be Staphylococcus schleriferi, this is what the vet emailed me...

-"His joint fluid culture finalized today, and a single bacterial organism grew in culture. The bacteria grown is a Staphylococcus schleriferi that is resistant to a variety of antibiotics including those that Smaug has received previously. The good news is that it is sensitive to two antibiotics that I'd like to try. The first is amikacin. I would plan to perform a single infusion of amikacin into the right carpal joint to get a higher concentration of antibitoic directly to the site of infection in hopes that this can help clear the infection without the need for surgery. The second antibiotic would be chloramphenicol. Chloramphenicol is a great antibiotic for Staph species, and it penetrates into the joint fluid well compared to many other antibiotics. The only caution with chloramphenical is that while reptiles tend to do very well with this antibiotic, it is something where people need to take precautions when handling it. I recommend that anyone handling this antibiotic wear gloves and wash their hands thoroughly after giving it to their pet. There is a very small portion of the human population that has a reaction to this medication leading toa blood disorder. This risk is quite low and practicing good hygiene helps to prevent accidental exposure.

The joint injection of amikacin can be performed while Smaug is awake. I would plan to give him an injection of an opioid pain medication prior to the joint infusion to ensure he is comfortable, and I do not anticipate the need for sedation in this circumstance.

The chloramphenicol can be called into a compounding pharmacy and shipped directly to your home. The plan would be to give this medication for 30 days."-

So finally some good news. This infection has a chance of being stopped! I'm going to speak with my vet tomorrow, but I think chloramphenical will only be used if the amikacin doesn't work since there are clearly some risks involved with it. I'll continue to update on smaug's condition. Right now he's doing well other than the little bit of swelling in his hand. He's alert, active, and eating like normal.
 

CooperDragon

BD.org Sicko
Staff member
Moderator
That's good news. It always helps to have identified the strain that is causing the infection to be able to do targeted treatment. I hope the medication works and treatment goes well. It sounds like your vet is very good.
 

GraphicTortoise

Member
Original Poster
Smaug got his antibiotic injection yesterday and is doing well today. He starts his 30 days of oral chloramphenical next week, and then a recheck to see if he has improved.

Luckily chloramphenical poses no known risks to reptiles, but I'll have to wear gloves and be extra cautious since contact with humans has a chance of causing a rare blood disorder. Smaug's daily dosage is obviously very tiny, but I'd rather be safe and cautious than sorry.
 

GraphicTortoise

Member
Original Poster
Update on smaug:

He just finished his last dose of antibiotics and is due for a recheck in his front arm. It still looks a little swollen, but that could just be whatever permanent damage was done. Despite it looking a tad swollen, he seems to be using that arm just fine. Fingers crossed! I'll be scheduling his appointment this week.

Smaug is eating well, alert, active, and climbing just like he did when he had all 4 legs! His stitches are out and his scab finally shed off. 😊

I'll attach a pic of my guy hanging out by the window. He absolutely loves looking outside.
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GraphicTortoise

Member
Original Poster
I think this is my final update on Smaug for this thread...

After his followup vet appointment I received an email with the radiologist's confirmation of not only no progression, but improvement of his front right arm. I think it's finally safe to say Smaug beat septic arthritis! I'm overjoyed to hear the good news! The arm still looks swollen, but my vet did a mobility test and Smaug had no issues or signs of pain. He'll get regular vet visits every 6-12 months to monitor his arm, but as long as there's no signs of pain or new swelling, he won't need any more medicine.

I really hope that by sharing this, it'll help other beardie owners out there. Most posts about septic arthritis usually don't end well, but Smaug is proof that Septic arthritis isn't a death sentence. It's definitely a difficult and rather expensive battle, but I'm glad my boy is finally healthy and able to enjoy life!

Thanks everyone for your support and advice, I really appreciated it and definitely needed it through all of this!

A smug pic of my guy, right after he pooped in the car. He knew he was going to the vet lol.

Screenshot_20220307-184323_Drive.jpg

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