Swollen Limb - Update Dec 21/11 - Uh-oh...

[baby_geek]

She still seems to be doing well. She took her Baytril like a champ again - those 30g needles seem to do the trick. Insulin syringes usually have a 27g or smaller (larger number) with them. I have started massaging the injection site when she is in her bath later on in the day and it seems to help. I can only tell where I gave the injection for about 10 hours post injection. Then I need to remember what side and how far up I gave it so I don't poke her in the same spot every time. I think I could feed her anything in a bug - she doesn't even look to see if they are moving. She snatches them up as soon as I put the container in the tank. She is on the antibiotics for 10 days unless I'm told otherwise by the vet - if the cultures come back negative I'm sure we will be stopping the antibiotics. She is on the metacam right now indefinitely (basically until we can get the swelling down). I didn't realize how much the swollen joints/limbs would affect her until she had her metacam. She seemed so much brighter and following me with her eyes when I was walking around the house. Something she did not pay attention to for the last week or so. She is swimming and splashing in her bath now instead of sitting in the same position I put her down in.

She is also starting the shed now. She has finished peeling the thin skin on the sides of her face and eyelids. The larger scales on her nose are getting ready to go. Unfortunately the thick ares (belly, back legs/feet, sides all have the really think tough skin so it may be a while before they start to shed.

Here are a couple of picture updates.

Her front leg - her foot is looking a bit better but her forearm is still swollen:

Her sutures - the skin seems to be healing nicely and there isn't any sign of infection:

Hasn't lost her appetite - eats like a horse!:

A happy girl basking - it is so nice to see her bright colours again:

I can't stop pointing the IR heat gun at everything - the dog, cat, wall, furnace vent, husband, window... everything and anything I can find!

I figure if I haven't heard anything from the hospital by tomorrow I will give them a call and find out what is what. I am away Saturday night so I am unable to go in that day and I would rather not wait until next week to get her in.

 

[Drache613]

Hello,

She looks beautiful!
So she seems to be moving around a little bit better then? The Metacam is pretty helpful in reducing the localized pain around the joints so that is probably helping quite a bit.
How is her appetite today?
I couldn't remember the exact size of insulin needles, but knew they were at least 27. I have some but they are packed right now since we recently moved. Are you rotating the injection sites then, from one side to the other side, etc?
That is good she seems to be enjoying her baths then, splashing around & playing.
Hopefully she will shed everything soon, it takes awhile for some of the areas to fully shed because the skin is thicker in some areas than in others.
Maybe you will hear back from the vet regarding the swab test soon.

Keep us posted on her.
Tracie

 

[baby_geek]

She is doing so much better than I expected. I have always been a fan of metacam for my critters if they have had a minor injury I just worry about long term as it is hard on the stomach, kidneys and liver.

I left her with some veggies before I left (her light was still off) and I expect them to be gone when I get home. I don't give her much in the am as I want her to be good and hungry when I get home for her bugs and more veggies with the acidophilis. Then she has unlimited until about 2 hours before bed.

I have been alternating sites for her injections. I alternate between sides of her back and I am working my way up her back. In about 3 days I will start over (starting on her lower back and working my way back up). She wasn't overly impressed with the injection this morning. Had a bit of a tantrum with the poke. She seems to have gotten used to the feeling of her skin stretching so the injecting doesn't phase her.

I called the vet this morning and they haven't received the results yet (which means something grew...) so I have made an appointment for next Wednesday as that will be the longest I will wait to get her in. If they get the results this week I am going to try and get her in earlier. Unfortunately I am going away this weekend so I can't take her in on Saturday again.

She had her first BM since Saturday but with the diarrhea I assumed it would take a bit of time for anything to make it down tot he end of her GI tract again. It wasn't diarrhea but it is still a bit soft. Her urates were a bit firm as well so I am going to push more fluids. She dislikes drinking but her body is telling me she needs more so I will get smaller amounts into her more frequently. It is hard when I am at work all day - I try to get her to drink as much as I can when I am home and awake but that is a fairly short amount of time.

 

[baby_geek]

Well I was hoping to weigh Squishy twice a week but unfortunately that fell by the wayside, life gets so busy sometimes. I weighed her the day I took her to the vet (she was 382 gm) and then I weighed her again tonight. She has been feeling so good with the metacam that her appetite went up and she is a whopping 396 gms now. I can't believe she has put on 14 gms in just over a week. I didn't realize how skinny she had gotten.

She finished her Metronidazole on Friday and her Baytril yesterday. She is only on metacam now until Wednesday when she goes back in for a check up. The vet's office gave me the option of coming in on Saturday to her her checked out but unfortunately I was going away with family and was unable to take it. So it is Wednesday at 1:50pm that she has another appointment now. Hoping things will get sorted out soon as the swelling has not gone down and I would prefer to not have her on metacam long term.

I will be posting videos of her within the next couple of days (unfortunately I dropped my camera in the bath tub when I was filming her so I have to wait for it to finish drying out...). I've stopped the flamazine cream as well as her incision is healing very well and is not open at all any more. One of her sutures came out on it's own on Thursday but her incision was well sealed so I'm not too concerned. The other suture is still there and I figure it won't hurt to leave it there until Wednesday when I head back in.

 

[Drache613]

Hello,

Sorry I missed your last post.
How is Squishy doing today?
Great that she finished her Baytril & Metronidazole already. The metacam should only be given short term, of course. If she is doing pretty well on it, then she could go for another week or so, if needed.
That is excellent she has gained some weight then, the meds must not be affecting her too negatively then, overall. The swelling hasn't gone down though, not yet?
That is super her incision is healing up with no signs of infection at all for her. The other suture will be fine, it may even fall out on its own also before wednesday.
I wonder what grew in the culture then, that is going to be interesting. You will find that out on wednesday then?
The rotation of the injection sites sounds fine then. I am sure she is no fan of the injections though, but, at least she is tolerating them right now.
So she is eating pretty well then, her veggies & bugs? I am sure the acidophiliz is helping her out quite a bit since she has been on meds. I would continue that for a couple of more weeks for her.
I imagine it is very difficult to give fluids frequently when you are at work. Do the best you can with the fluids. It sounds like she is staying pretty well hydrated though right now.
I hope you have someone watching her on saturday when you are gone.
Keep us posted on her!

Tracie

 

[baby_geek]

So we are back from the vet's (well we've been back for a while now). Squishy's left rear foot is slightly less swollen but her forearms and her left elbow joint are still very swollen.

Her culture came back as a non-fermenting species (although the lab did not identify it) and it is intermediately susceptible to the Baytril. It is considered contamination and not a pathogen however they want to take it on the cautious side so she is to remain on the Baytril for now.

We collected blood from her today for a reptile panel. She was so well behaved - I didn't even know the vet had hit the artery because Squishy did not even move! We collected just over a ml for the panel. I am hoping to hear what the results are tomorrow however I probably won't be able to get a copy of the results until the next time she goes in.

It has been decided we are going to keep her on the 2 antibiotics (until we figure out the problem) but reduced to every second day instead of everyday. If she takes any turn downwards we are going to reassess, however, she has been in the best spirits with the biggest appetite. We are also keeping her on the metacam (slightly lower dose) for now because this amount of swelling is painful for her to move.

We went and sat outside in the sun today (first really nice day of the year) however I would like to get her a harness for when we are out there for safety sakes. Do you know of anywhere that I can purchase a beardie harness? She has become the talk at the vet's and everyone stops by the exam room while we are there

 

[Drache613]

Hello,

How is Squishy doing?
The swelling is still present? I am a little worried about keeping her on antibiotics with the swelling being what it is still.
If she has any kidney issues, the antibiotics are going to make it worse. Great you are giving it only every other day then, along with the metacam then.
When do you get the blood tests back?
At least she seems to be in good spirits anyway. An artery was hit during the blood draw? Poor girl, that is surprising that she didn't flinch though.
I am sure that the swelling does cause some discomfort for her though. I hope she starts to feel better soon.
I can't remember who sells the harnesses on here. I would inquire in the General Discussion area, to find a harness!

Let us know how she is doing.

Tracie

 

[baby_geek]

Squishy is still doing very well. Taking her meds like a champ. The swelling is still there, there hasn't been much change, although her left elbow seems to be more swollen.

I called the vet's to find out if the results were in and they said yes and that the vet would be starting her callbacks in about 20 minutes. (That was yesterday at 3:20pm... and I haven't heard back yet) I am thinking they will probably call me today however I hate waiting when they could have the answer to her problems sitting in their hands...

Yes, the underside of the tail is an artery. The veins run down the sides of the tail (at least that is the way it is in all other animals so I am assuming it is the same. They would have a really hard time collecting 1.5mls from a vein in a lizard and having it not clot before they could get it into the tubes.

Yay, I found the harnesses and I've ordered one. Hoping it will be here late next week or early the week after I can't wait to take her outside and relax as the weather gets warmer.

 

[Drache613]

Hello,

Oh yes, I have been present for a blood draw in the caudal vein, ventrally, in the tail. It runs vertical & should usually give enough blood for a blood draw in most instances in larger lizards. In smaller lizards, they might have some trouble.
Did you ever hear back from the vets yet?
That is great you found a harness for her! It should warm up soon hopefully.
I hope that the swelling goes down some for her, that is not comfortable. That is what worries me about her being on the antibiotics.

Let us know how she is doing.

Tracie

 

[baby_geek]

So the vet's just called me and there is NO kidney or liver dysfunction! The only part of her bloodwork that was abnormal was her blood calcium which, go figure, is too high. So we are decreasing her calcium intake to once a week instead of twice a week. The pathologist thinks it is probably due to a vitamin D3 overload. Should I purchase calcium without D3 to reduce the amount of D3 she is getting?

We still aren't 100% sure that is what is causing the swelling so the vet would like to keep her on the antibiotics until I run out (a couple more weeks) to be sure there isn't any underlying infection brewing. So we are continuing with Metacam, Metronidazole and Baytril every second day for a couple more weeks. I alternate so she gets the metronidazole one day and the other 2 on the opposite day (because the metronidazole is such a large volume...)

So glad her kidneys are fine She goes in for her next checkup with I run out of the first antibiotic.

 

[Drache613]

Hello,

That is great news! So, the uric acid levels were alright?
Which UVB light do you use?
It may be a D3 overload. How often did you give calcium with D3 previously? Also, if she is having trouble absorbing her calcium that will cause an imbalance of the calcium to phosphorus ratio.
I would give just straight calcium with no D3 for awhile right now. What was your supplementation schedule previously?

Tracie

 

[baby_geek]

Hi Tracy,

Yes, uric acid levels were good as were all liver enzymes and kidney function - I'm going to get a copy next time I am in the clinic for my own personal file and to see the actual numbers. She has had ReptiSuns for about the last 10 months. She is currently on her second light bulb so I know it is only about 4 months old. She has ben getting the ReptiCal (pink label) twice a week and the vitamins (blue label) every week to week and a half. I need to find somewhere that has calcium without D3 now (any suggestions?)

She has been doing well otherwise - loves her 5 (shhhh injected) bugs a day, and 1/2-1 cup veggies a day (she is quite the little porker now! I am hoping to weigh her again in a day or 2 to see how much more weight she's put on (maybe AFTER her next poop)

She was very well behaved for a little photoshoot today - a bit picture heavy but it shows what her little body is doing.

Chubby bunny!

Right front foot - only lateral digit is swollen, and her forearm

Right hind limb - ankle is still a bit swollen but actually is better compared to the very beginning

Incision is healing well

Upper leg is still okay

Left hind limb is still all normal

Left forelimb still has a normal foot

But her forearm and elbow are very swollen

Then some 'fun' pictures:

Yikes, spikes!

Eye've been watching you!

Oh and the moderators are free to move this thread to the health forum as she is no longer an 'emergency' I will keep you updated. I am almost out of the metronidazole so I may be in for a checkup sooner than previously anticipated...

 

[baby_geek]

Oh and just to add she is up to 420 grams That is an increase of 38 grams in about 2.5 weeks

 

[Drache613]

Hello!

Great to hear Squishy has gained some weight now. It sounds like she is slowly improving then! The pictures were superb of her.
That is good to know her uric acid levels & liver enzymes were fine then.
Is she still enjoying her bugs & veggies? At least she is eating well right now, that is excellent.
You can get Repcal calcium without D3, so I would definitely choose that.

I hope she keeps doing better each day for you.


Tracie

 

[baby_geek]

Okay, it's been a while but here is an update on my Squishy...

We went to the vet's again tonight for a checkup (she is done her antibiotics now) and we are still lost... We took another radiograph as her LF elbow is more swollen than last time and her RH long toes is swelling now as well. We are at our wits end (PLEASE HELP! - if you have any suggestions).

Squishy is staying on 0.03ml Metacam orally once a day until we can figure this out as she is much more comfortable now. The vet has been consulting VIN (Veterinary Information Network) for help with this confusing case. One of the veterinarians from down the road is convinced it is MBD but with her calcium levels of 10.91 mmol/L and bone density that looks pretty good on radiographs we are confident that is not it. My vet is going to consult with this other vet (and share all the bloodwork, radiographs and history with him) and call me when she has some additional information.

She has been doing some research on fungus as well and (although she has never done it) amputation of an affected toe/limb is the most accurate way of diagnosing it. She is very reluctant to go that path unless Squishy's toe swells up to the point of needing to be removed - then we will send it away for analysis.

We are to hang out until she gets some additional information. Thankfully Squishy is maintaining her weight, eating her salads like a champ, pooping regularly and taking her metacam well. We shall see how it all goes...

Here is a radiograph taken on April 21/11 - no eggs but a very angry elbow.