Swollen Leg and Foot

[kingofnobbys]

Hey Jenny,
I'm glad you have the tart cherry juice coming!

I'm unsure if this plays a direct impact on his gout situation (I have to imagine it does), but his uvb exposure is much too low. Those compact/coil bulbs are already pretty weak, but that 13w uvb light is not doing much for him. I'd recommend getting a 26w coil right away, or if you have the means/money to upgrade to a reptisun 10.0 t5 and fixture, I'd do that sooner than later.

The coil bulbs at a 26w above screen only put off rays about 6" from the source, meaning he'd need to stay 6" from that light at all time to benefit. With yours being a 13w I'd have to imagine that he'd need to be half that distance, or 3", to get any use from the bulb. Even a reptisun 10.0 t8 mounted above screen is 6-8" for benefits, where a t5 tube brings that to about 12" to benefit, huge difference. It's also worth noting those coil bulbs and t8 bulbs need to be replaced every 6 months as the uvb it puts off diminishes, whereas a t5 bulb is once a year. Food for thought.

It's possible his weak uvb exposure is making it difficult to process his nutrients correctly, resulting in gout.

Ok. I actually think I may have misspoken. My other dragon actually has the coil light. Elliot does have the 10.0 Reptisun as it came with the aquarium, which I bought in February. I will add a picture of it so you can see... I will also purchase a stronger ubv bulb asap. If you can give me any more info I'd appreciate it.

<<< is the reptisun 10.0 a T8 or a T5 tube , and is it in a reflector hood ? and is it mounted ontop or under the mesh lid ?
<<< how long each day are the lights on ?

Jenny

I'm not sure if it's a T8 ot T5 tube. I tried to look on the package, but I couldn't figure it out. His lights remain on usually 15-18 hours a day. <<< a regular plug in domestic timer (need not be fancy) to regulate the photoperiod at say 16 hrs would be excellent money
It is a dome that sits on top of the mesh lid.And I believe it is a reflector hood I checked into the other hoods you spoke of, but I think I should take him in the vet, his front legs seem to be swelling as well. He's not moving around much and I'm definitely worried.

<<< OK , it's a compact , definitely needs
>> to either go into a horizontal NanoHood UNDER THE LID , make sure it's a 26W globe , these are better mounted horizontally in a hood than vertically in a dome , spreads the UVA and UVB out better. I use these to very good effect in my full size tanks (BTs) and rearing tubs (beardies) and they are an excellent solution - PT2224 model = http://www.exo-terra.com/en/products/compact_top.php , ensure beardie can get inside 8 inches from the globe and nanohood (it effectively doubles the UVA and UVB from a compact).
or
>> EVEN better a T5 reflector hood and 10%uvb -12%uvb (Zoo Med or Arcadia or Exo Terra) T5 tube.

Seems the issues are more dietary than anything (see Tracy's post) .... I'd say back to the vet or at least a call to ask what they are going prescribe , explain your hard financial situation to them , some vets will forgo fees and just charge you at cost for meds (this has happened here with some people too).

 

[kingofnobbys]

He never has, but the coloration and markings were like looking at his back. Seeing the face they are super different. Here's him in a hat to cheer you up!

$430 is steep, but your dragon's health and comfort is totally dependent on getting some medication quick, especially if it's spreading. Is there a way to wave the xray? I'm unsure if this would help much regarding gout, the bloodwork should be most necessary

Had you let this worsen , you could easily have doubled and doubled it again as these things don't get better with home remedies.

Maybe a GoFundMe online fund raising - I'm sure there folks here who will be happy to help out financially ( you wont be the first , and it doesn't take very many donations to get together a few hundred dollars ) , or maybe ask if the vet will line up a payment scheme where you can spread the costs over a few months.

Personally , as someone who is retired and on an a very limited income who has to be very careful about how money is spent , and who has been known to spend $800 on emergency vets fees for major surgery for Puff and wound up with nothing - as Puff died in recovery from surgical complications (excessive blood loss --> heart failure) I can relate to your situation. And Puff had his surgery only a few weeks before Xmas - so you can imagine what my Xmas was like that year.

At least you are working and don't have to spend money you'll never be able to replace.
I had to raid my retirement savings - I valued and loved Puff so much that the money was to me a secondary issue - I wanted to try to help my Puff, I was told he would surely die without urgent surgery.

I'm sure you can budget around this - maybe spend less on social stuff for a while. I'm sure you love your beardie enough to forgo some things in aspects of your life for a while.

 

[mygirlz]

Hello Jenny,

Sorry I didn't get on sooner & am glad you went with just the bloodwork.
I agree, the fluorescent compact/coil you are using needs to be changed out to a long tube bulb, mounted underneath of the screen for maximum exposure.
The values look pretty good, the glucose is normal & the calcium to phosphorus ratio is good as well.
I hate to tell you but the uric acid is too high, unfortunately. That is the primary reason why he has this marked swelling. Most of the time, swelling begins at or around an 8-10mg/dl level.
I highly recommend getting them to prescribe him allopurinol. Will your vet be willing to do so?
Luckily, the AST (liver enzymes) are good, so his liver is in good shape. If you get him started on treatment immediately he will have a very good chance of becoming healthy again.

Let us know how Elliot is doing.

Tracie

The doc said something about a combination medication. I'll let you know the actual name of it when she prescribes it. I asked about getting a prescription. She's waiting for the whole blood panel to come back today before she gives me anything. I received my tart cherry juice yesterday. I gave Elliot 1ml via syringe and he nearly ate the plastic....lol. He absolutely loved it! It is concentrated, so I'm worried I may need to dilute it. I'll definitely keep you posted!!!

 

[mygirlz]

Update on Elliot:

Doc says his lymphocyte count is high and she wants to put Elliot on an antibiotic as well, I've stressed that I'm concerned about it harming the kidneys. She's assured me it will not. She wants to put him on allopurinol and cultuzine (sp?) combo as well. I'm not sure which antibiotic she's​ prescribing at the moment but is is a common (human) antibiotic. Any opinions are welcome.

Jenny

 

[Drache613]

Hello Jenny,

Hm, not sure he should go on an antibiotic with uric acid levels that high. The lymphocyte count is likely high due to inflammation being caused by the gout & secondary symptoms.
Are you referring to colchicine combined with allopurinol? If so, that is a great combination. The colchicine is an anti-inflammatory med which is used frequently with allopurinol.
I am glad Elliot liked his tart cherry juice. You don't need to dilute it though if he likes it. Or you can slightly if you would like, but full strength should be fine.
Tetracycline or Azithromycin or Zithromax would be ok, but I am still not sure he needs it at the moment.
Let us know how he is doing.

Tracie

 

[mygirlz]

Hello Jenny,

Hm, not sure he should go on an antibiotic with uric acid levels that high. The lymphocyte count is likely high due to inflammation being caused by the gout & secondary symptoms.
Are you referring to colchicine combined with allopurinol? If so, that is a great combination. The colchicine is an anti-inflammatory med which is used frequently with allopurinol.
I am glad Elliot liked his tart cherry juice. You don't need to dilute it though if he likes it. Or you can slightly if you would like, but full strength should be fine.
Tetracycline or Azithromycin or Zithromax would be ok, but I am still not sure he needs it at the moment.
Let us know how he is doing.

Tracie

Yes. Colchicine/allopurinol is the combination that doc wants to put him on. You don't think I need to put him on an antibiotic? How long should I wait to give him the antibiotic?
I have to pick up the prescription tomorrow. I sure hope this helps.

 

[Drache613]

Hello,

I am just not thrilled about him being placed on an antibiotic. Maybe you should give it a couple of weeks of him being on the allopurinol & colchicine combination first to see if the lymphocyte levels fall on their own. It is unlikely he has an infection, just inflammation & stress.
Keep him as hydrated as you can.
What type of dietary changes are you making?

Tracie

 

[mygirlz]

Hello,

I am just not thrilled about him being placed on an antibiotic. Maybe you should give it a couple of weeks of him being on the allopurinol & colchicine combination first to see if the lymphocyte levels fall on their own. It is unlikely he has an infection, just inflammation & stress.
Keep him as hydrated as you can.
What type of dietary changes are you making?

Tracie

That was a question I forgot to ask. So the doc doesn't think that crickets are the "right" kind of protein to cause this issue. He has been given fruits and vegetables and a few crickets a day. Nothing close to what he was eating previously. I considered getting the alpha meal, but I'm not sure where to purchase it. I'm giving him the 1ml of tart cherry concentrate as well. Do you have more suggestions?

Jenny

 

[mygirlz]

Sulfamethoxazole??? Avoid prolonged exposure to natural or artificial sunlight?!!? He's a ?. He needs uvb. So I'll start him on the compound but wait on the antibiotic?

Jenny

 

[Drache613]

Hello Jenny,

Yes, wait on the Sulfa based drug right now, I just don't think he needs it.
Go ahead & start him on the allopurinol & colchicine. What dose is he starting him on?
The alfalfa meal is good, it has no purine to be hard on the kidneys. A few crickets a day would not cause gout though. Roaches are very high in protein & could contribute but not always. A lot of times it is genetics that cause a large number of cases, along with husbandry issues.
You can continue the tart cherry extract daily, that will help out for him. Avoid the higher oxalate greens such as mustard & collard greens, kale & spinach but go to dandelion greens, arugula, or the spring mixes minus the spinach to help cut down on stress to the kidneys.

Let us know how he is doing.

Tracie

 

[mygirlz]

Hello Jenny,

Yes, wait on the Sulfa based drug right now, I just don't think he needs it.
Go ahead & start him on the allopurinol & colchicine. What dose is he starting him on?
The alfalfa meal is good, it has no purine to be hard on the kidneys. A few crickets a day would not cause gout though. Roaches are very high in protein & could contribute but not always. A lot of times it is genetics that cause a large number of cases, along with husbandry issues.
You can continue the tart cherry extract daily, that will help out for him. Avoid the higher oxalate greens such as mustard & collard greens, kale & spinach but go to dandelion greens, arugula, or the spring mixes minus the spinach to help cut down on stress to the kidneys.

Let us know how he is doing.

Tracie

I really appreciate all your help Tracie!!! They have him on .24ml/day, but I don't have the compound in front of me. I gave him 2 baths today, trying to keep him hydrated. The first day he loved the tart cherry, but since then it's been a struggle. Meds were not easy either. In any case, I guess that's a good sign. Ornery little bugger! I'll hold off on the sulfa drug. I'm actually allergic to sulfa drugs...lol. He did eat 20 crickets last night. But only a couple/day (7-10) the last few days. He usually heats 45-50. Anyway, I'm offering lots of delicious fruits and veggies... I'll lay off the oxolate greens for now. Sweet potato is his favorite! Hope that's still ok... He's a sweet baby, but definitely not moving around too much. I have been taking him outside as much as possible for natural sunlight. He stays pretty alert so I worry about stressing him out. I have to leave for the weekend, will return Monday. I left him and Animal, my other dragon, with a very trusted friend. So grateful to have someone I feel comfortable leaving them with. I hated to go. But duty calls.... Again, I truly appreciate everything Tracie. Truly!

Jenny

 

[Drache613]

Hello Jenny,

You are welcome, I am glad that I could help out. I am happy that he is on the Allopurinol now. That dose seems conservative & likely correct. I am sure he probably started him on the higher dose of 20mg/kg to begin with so it would get in his system more quickly. Remember too, that it may take a bit of time for the swelling to go down because they respond more slowly to treatment than mammals or humans. You could see progress as soon as a week, or it could take several weeks to notice anything.
Be sure to take certain pictures now, then take the same ones weekly or bi-weekly to see any differences. He should start feeling better pretty soon though!
Too many baths will definitely stress him. So you can give just a few weekly & concentrate on oral fluids to help, he will be fine!
The sweet potato will be ok for him, with other foods. It sounds like he has a great menu! LOL
I am sure he loves going outside, too. Once his joints start feeling better he should start moving around more.
Terrific you had someone to leave him with for a few days so he can get his meds on time! That's good you are holding off for awhile on the Sulfa meds, we will see how he does with just the allopurinol & colchicine. I am allergic to Sulfa drugs, too, they are pretty harsh.

Let us know how he is doing when you get back.

Tracie

 

[mygirlz]

Update:

Elliot seems to be doing better as he has been on the compound meds for over a week now. The swelling has not subsided much, but he is moving around a bit better. He is hunting his crickets, which I find as a good sign. I posted this pic to show he is bearing weight on his limbs again. He's a stubborn turd tho. I have to fight everyday to give him his meds and cherry juice. He stayed in his water dish for hours yesterday, is this ok? I eventually took him out on my own and put him on his tree. Worried me that we was too cold to make it out on his own. Anyway, hope he continues to improve. Thanks for all your help!!!

Jenny

 

[Drache613]

Hello Jenny,

That is great! Elliot is looking better & I am happy to see him putting weight on his limbs & going after his food, too. Wow, I am surprised that you have already seen some of the swelling go down, even if it's slight.
Oh geez, he fights you with getting his meds & cherry juice? That definitely can be very stubborn when it comes to that. LOL
I am so glad to hear he is improving for you. I hope he continues down the road to full recovery!

Tracie

 

[mygirlz]

Yes. I had to Google and watch videos on how to get his meds in. I guess it would be easier with a smaller syringe. Mine is 1ml to start. Anyway, you don't think the staying in the water for hours is a problem do you? I took him outside for some real sunlight today, he's pretty stressed by it as we live in the country and there's many birds flying over. I just cover his head so he can't see them...lol. I'm so glad he's showing signs of improvement. I still have the antibiotics, but it doesn't look like he'll need it... Fingers Crossed! I do appreciate all your continued support! Let me know what you think about the water issue. Thanks again!!!

Jenny & Elliot

Here are some updated pics...