Xrays & lab results in comments!

[Claudiusx]

Ok, I was mainly concerned with his activity levels, so thanks for coming back and touching base on that.

It's really great news that he has been so active! While they are good at hiding things when they are sick or feel ill, it's still a very good sign that he's not feeling too bad if he is staying active and lively.

No more flipping over since stopping the antibiotics right?

I really think that this might just be a case of him being off of his groove because of being out of your care, and that there really isn't anything that is actually wrong besides that (besides his other neurological issues of the past).
It sounds like things are at least improving back to the point of where he was before he left your care, so that's good

-Brandon

 

[MissCutiePatootie]

Yes, of course! His activity levels are good minus today. Today has been sucky for him since he had to go to the vets.

I am hopeful that in time it can turn around. He does have some liver abnormalities. He had a ultrasound done today and they found some inconsistencies. The next step for this would be a liver sample. But I'm not going to do that right now. I'm going to at least wait until I'm confident he could withstand going under anesthesia and to not put unnecessary stress on him while recovering. Unless for some reason it turns into a bigger priority than time.

His blood glucose was still high today despite fasting.

His xrays looked good according to the vet. I have to wait until tomorrow for them to be emailed to me. I'm eager to see his new xrays to see if those spots are still there or if it was the xray machine causing them.

His fecal I believe I will get the results of tomorrow too.... possibly Monday.

Right now it looks like there are two things potentially going on. One being gastric endocrine adenocarcinoma and the other being nutritional secondary hyperparathyroidism. What I'm treating and correcting now is the NSHP by correcting his husbandry and giving extra calcium.

I ordered an emulsifier so I can blend up fresh bugs and leafy greens into his daily meals. Nothing better than fresh food! I'm also gonna try my best to stay away from most sugar like sugar from carrots and stuff to see if his glucose numbers will go down. I'm going to give it a few weeks or so for his levels to balance out and then have another full blood panel done on him. If his numbers don't show a significant improvement then I will continue diagnostic testing.

Any suggestions for liver support?

 

[MissCutiePatootie]

Also, I explained to my mom what his lab results meant and she confessed to only feeding him 2x a week maybe more. I can not even express my feelings right now. It's horrible.

And yes, he hasn't flipped over again since Tuesday I think it was. So I definitely think it was the antibiotics!

 

[Claudiusx]

Any suggestions for liver support?

Cut the protein down a bit is all I would say, he's old enough he really doesn't even need protein every day, IMO. Tracie I'm sure has some supplements she can recommend you that are supposed to help.

Also, I explained to my mom what his lab results meant and she confessed to only feeding him 2x a week maybe more. I can not even express my feelings right now. It's horrible.

And yes, he hasn't flipped over again since Tuesday I think it was. So I definitely think it was the antibiotics!

That's not surprising, unfortunately. Most people end up just forgetting about them or not seeing them as a priority, so they end up not feeding them. It happened to my last "crew". I left them in the care of my family for probably nearly a year and a half, they all passed. I found out they just weren't feeding them at all. It's horrible, but all that matters is he's back in your care now. I wish I had that same opportunity with past dragons (and a uromastyx) of mine.

Sorry, not trying to rain on your parade haha. :silent:
I really am glad that he hasn't flipped since the antibiotics stopped.

Sorry if you mentioned it earlier, I don't recall, what was he prescribed and what dose? Curious if there is any literature that might relate to it affecting his neurology.

-Brandon

 

[MissCutiePatootie]

You think the protein he's getting is too much? I feel like it's not enough actually. And with his recent muscle loss I feel like his body could use the protein.

I don't understand how people can just not think about a creature that depends on them and not feel responsible to make sure they get what they need. Whether that means taking care of them properly or just giving them away to someone else who wants to... It's inexcusable and inhumane to let them die so horribly because of their selfish lack of concern. I'm sorry to hear that your family did that to your poor scale babies. I'm glad I made it back before that result.

He was on Ceftazidime 100mg/ml and given 0.1ml intramuscularly every 48 hours. I think I gave him roughly 8-9 doses before he started flipping on his back. He was prescribed 14 doses. If you find any literature that relates to his case, please do share it! It will be informative for anyone else that may come across this post for a similar situation and be really important. Plus I'd be interested in reading it too.

 

[Claudiusx]

Well just a quick google search shows it shouldn't be given to patients with histories of seizures, or to patients with renal issues. But I will dig in deeper and see if there is anything concrete or any papers on it. I have time to kill tonight ha. Would be interesting to read why it shouldn't be given to seizure patients.

Whatever neuropathways it disturbs, and how it disturbs them, obviously had an impact on him.

He was getting about an average dose of it, but it's usually given every 3 days, not 2 days from what I've seen.

Will keep diggin'

-Brandon

 

[Claudiusx]

Not much on the why, but if you google ceftazidime neurotoxicity
There are actually a decent amount of links discussing it.

Here is one, with this key bit of info: https://www.hindawi.com/journals/crim/2019/8936478/

Cephalosporin and specifically ceftazidime-induced neurotoxicity although an infrequent adverse effect is likely underrecognized especially in extremes of age, critical illness, renal dysfunction, and prior neurological disease.

So while I don't know why, and it probably doesn't matter in this case as to why, I think it's safe to figure that Ceftazidime is not an acceptable antibiotic for him. So that's good to know for future reference in his care. Baytril will probably be the best bet for him if he needs an antibiotic. But, due to how he reacted to this one, it's probably best to not use them at all unless they are actually needed (Eg bacteria actually being found in lungs/wound etc.)

To get back on track, maybe just ignore what I said about cutting down on the protein. It's usually best to just make 1 change at a time. That allows you to figure things out easier lol. And, really, the amount of protein he is eating is most likely not affecting his liver much at all.
However, did your vet actually think his liver values were high? They really aren't that high, despite being out of range.

However, the high glucose can cause liver value enzymes to rise too, especially in diabetic patients. In fact... diabetes could also explain the neurological symptoms... I would STRONGLY suggest looking into a diabetes diagnosis.

-Brandon

 

[MissCutiePatootie]

That was a good read! I might even send that to my vet and see what they say. Thanks for that. And yeah I don't think it's safe for him either. I wish I looked into it more before starting it now. From what I could tell though was that it was really unlikely to cause any adverse symptoms, I figured the chances were low enough to chance it. But I don't think that now! That's for sure. I was just so worried seeing him so ill when I got back. He's never been super ill before like that and I took what I could get for him thinking it was the best thing I could do right then as a start for him.

My vet doesn't think it's super high no, but they think it's elevated and definitely worth investigating what's going on there. They found inconsistencies on his liver via ultrasound. The glucose is what is concerning to my vet more so. They think it could be caused by tumors from GNT but that's only a possibility not confirmed. They did say that this could have all started when I first noticed his tremors and has just kinda sprung out more being out of my care. There's lots of possibilities right now it's impossible to say anything for sure without more diagnostic tests. It's going to take time though before we can really do any more than we have.

If you're able to figure out why it shouldn't be given to seizure patients, that might end up giving me more insight on Malachi's tremors in particular and could be really helpful for his diagnosis even possibly! Who knows haha would be awesome though.

 

[MissCutiePatootie]

I would like to know what's causing him to lose his muscle mass everywhere. I can see his shoulder blades more, his knees look tinier too... On his forearms I see a line indent like his forearms deflated.. his thighs are squishy as heck and not full feeling, almost saggy even from it. And his eye sockets much more pronounced around his eye. The base of his tail is indented on the sides and on top of it I can see his spine sticking out more. He's not emaciated looking like some dragons can be and I know a lot of people would say he looks good even but I can see a big difference from what's normal for him. And all that just happened overnight one day. He didn't progressively just get worse it was like it happened suddenly. It really concerns me a lot.

 

[MissCutiePatootie]

My vet emailed me Malachi's recent xrays. They are not sure if they are seeing abnormalities on his liver or if it is an overlapping of the GI tract. They are limited by their xray machines ability to pick up detail.

They are going to reach out to their ultrasound specialist and get me a quote on how much a guided fine needle aspirate would be to lay out my options.

Still waiting on my fecal results to come in. Here are the xrays.

 

[MissCutiePatootie]

I just realized today that I have been feeding Malachi 10-20mL of food everyday. Not 20-40mL. Gosh that must have sounded like so much if anyone caught on to that! That would make him so bloated and uncomfortable... So I'm gonna go back and correct that in this post in case anyone gets confused... Sorry about that guys! I feed about 5mL then give him a break and do it again until he's done.

 

[MissCutiePatootie]

Just wanted to post an update on Malachi...
I have some AMAZING news...

Well first of all his fecal came back negative...
Secondly he is doing better overall I just want him to put some weight on now.

THIRDLY.... HE IS EATING AGAIN!! After a very long 2yr stretch of not eating at all... He has eaten for himself! I am over the moon thrilled! I actually cried I was so happy lol! He ate mealworms and crickets today on his own... No assistance from me... I didn't even have to entice him! That's freaking AMAZING for him! I'm so proud! Never give up!

He still really struggles a lot with his intention tremors when he goes for them but I am so impressed he doesn't just give up after the first couple tries and missing! He even ran across his enclosure for the crickets which I am just completely blown away by! He's so flipping awesome! I'm going to work with this and try to get him to eat his salads this week hopefully. Would be amazing if he made a complete turn around after all these years!

================================================================

I made a few changes over the last week and on top of the extra care he's received for a while now I believe they have helped him get to this point. I don't think that the extra care is the only thing contributing to him eating again because this is a normal thing he receives and has been an ongoing issue for 2yrs now and I have tried everything I could think of. So these extra things may be the last thing he needed to get him to eat again. I hope that others have luck with it if they find themselves in a similar situation.

1. I bought fresh Hawaiian blue spirulina and have been giving it to him since Tuesday. Spirulina helps oxygenate the blood which is partially why I wanted to use it aside from it being a superfood.
2. I bought moringa leaf powder which is another super food and helps the liver. I've also been giving this to him since Tuesday.
3. I bought a fine mister for him to mist him inside his enclosure instead of doing baths because recently he has not enjoyed them and I like to have options. He really enjoys his mistings and I think he may be going into shed soon too. It doesn't cause his humidity to go too high and even at the higher end, it doesn't hurt. It goes back down fairly quickly. (for those who are afraid of going above 40% humidity)
3. He's been trying to dig and dig for hours everyday in his enclosure for weeks now and since his fecal came back negative I decided to purchase some aussie beardie sand called "Jurassic Natural Australian Desert Dragon Habitat". I know some people have heard of it and say they are unimpressed with it and find it far too expensive but I like it quite well and got it with 25% off coupon by ordering online and doing in store pickup. I think it's aesthetically pleasing. Over the years I have given him substrate off and on for enrichment. He never really dug into it though from what I had seen... he just liked sleeping on it lol. If I had paper down then he would shred it up. But with this stuff he really seems to like kicking it around! I don't know what the difference is for him but I'm happy he's enjoying it since it is expensive! lol
He's never eaten any type of substrate I've used so I trust him well on it however if I'm away or if he's acting unwell, I do remove his substrate and keep his enclosure sterile until things are back to normal and he starts digging around again. So for anyone who is worried, just know I am aware of the risks of loose substrate and I take caution to them. However, I do believe it is a natural behavior for them and they should be able to do it freely unless there's a medical reason that they CAN NOT be on it for. I also know what to look for before anything serious does happen which is why I remove it if I am away for up to weeks or months.

 

[Drache613]

Hello Tina,

That is really great news Malachi is eating again, bless him! So you are thinking he is getting
ready to shed now? It sure has been a long haul for you both.
Those supplements should help him a lot & give more nutrition, too. I hope he continues to do
better for you.
The x-rays don't look too bad. Hopefully the liver is healthy & his kidney function is optimal. I'm
not sure exactly what would cause the mottled appearance onthe x-rays. Did you get the blood
work in also?
I am hoping that he continues to improve & starts gaining weight. That amount of food for him
is fine, he will hopefully regain his natural appetite soon!

Tracie

 

[MissCutiePatootie]

Hello Tina,

That is really great news Malachi is eating again, bless him! So you are thinking he is getting
ready to shed now? It sure has been a long haul for you both.
Those supplements should help him a lot & give more nutrition, too. I hope he continues to do
better for you.
The x-rays don't look too bad. Hopefully the liver is healthy & his kidney function is optimal. I'm
not sure exactly what would cause the mottled appearance onthe x-rays. Did you get the blood
work in also?
I am hoping that he continues to improve & starts gaining weight. That amount of food for him
is fine, he will hopefully regain his natural appetite soon!

Tracie

Hey Tracie!

His scales on his tail kinda looked like they were gonna go into shed but now they don't so I'm not too sure.
Thank you I really appreciate all the help you've been and I hope he keeps getting better too.
The vet said that they think their xray machine caused the mottled appearance. He didn't have the same look on his second xrays so I suppose that's good lol. No, we haven't had labs done since he's eating again. We are trying to keep the stress levels low for him right now.

 

[MissCutiePatootie]

Round 2 CBD Treatment!

I think I've decided to start his second round of CBD treatment that I started a couple years ago. I've resurrected the post today to get others involved. Here's the link.
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