Gout- Herp vet did not offer treatment

My chameleon started showing swelling in his rear Rt foot/ankle about a week ago (photo attached). I suspect gout given he has no symptoms of MBD and the swelling seems to reduce with increased hydration/soaking. I immediately took him to the only exotic vet in the area who will take chameleons; he didn’t do any bloodwork or x-rays and told me my only option was euthanasia. Obviously I am not willing to euthanize my otherwise healthy cham if there are other options that can help reduce his gout and give him a good quality of life! I have done a lot of research and have reduced his protein intake, increased his hydration, and have been soaking him in warm water when he is willing to come out of his enclosure. It seems to have reduced some of the swelling but he is still not using that leg. I have read about the use of cherry extract for gout treatment in bearded dragons, does anyone have experience with this in chameleons and could advise? I am open to all suggestions.

Included below is an updated husbandry questionnaire since I have made some changes since last posting. Thank you all for your advice!

Chameleon Info:
  • Your Chameleon - Veiled chameleon, male, around 2.5 y/o, 165g. He has been in my care since April, 2020.
  • Handling - Handling only when necessary or when initiated by him. No more than once a month. Has been extra aggressive since symptoms developed.
  • Feeding - He is currently on an adjusted diet to combat his gout; normally he is fed 2-3 dubia roaches every other day. Hornworms, wax worms, and superworms are fed on occasion as a treat. All are gut loaded with greens. Always dusted with calcium w/o D3, dusted with calcium w/ D3 2x/month, multivitamin dusting 1x/mo. Currently only eating silkworms and greens to reduce his protein intake.
  • Supplements - What brand and type of calcium and vitamin products are you dusting your feeders with and what is the schedule? Calcium w/o D3 daily, Calcium w D3 2x/month, multivitamin 1x/month. Zoo Med brand I believe.
  • Watering - Mist system runs for 10 minutes every hour, humidifier throughout the night. Humidity sits around 50% during the day and 70% at night.
  • Fecal Description - Firm in appearance with white or light yellow urates. Has been tested for parasites but not within the last year.
  • History - We were moving from Jan-Feb of this year and he was temporarily in a smaller, store bought enclosure that did not keep the humidity as well as his usual enclosure. I am wondering if this may have caused chronic dehydration during these months.

Cage Info:
  • Cage Type - Custom 18x24x60 enclosure, naturalistic background with screen door and top.
  • Lighting - Reptisun T5 HO 10.0 UVB/UVA, Exo Terra Basking Spot lamp 75-Watt, 8:30AM-8:30PM.
  • Temperature - 72 at lowest point, 80-85 basking spot. 65 at night. Using two thermometer/humidity gauges at top and bottom of his cage. My apartment has been hotter than usual and I would like to ideally lower these temperatures slightly.
  • Humidity - Humidity fluctuates around 50% during the day and 70% at night.
  • Plants - I have used live plants in the past and he stayed mostly on faux vines/plants and I had trouble keeping them alive. I have since switched to all faux plants.
  • Placement - Enclosure is in my reptile room, he cannot see any of the other reptiles but can see out the window (looks out on another building). Enclosure sits about 6” off the floor and is 5’ tall.
  • Location - Where are you geographically located? Ohio.

Please note in the photo that he is shedding, however this issue occurred prior to the start of his shed. Any and all advice is appreciated, thank you!
 

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Hey there can you post some more pics of the cham's entire body as well. Can you also post a pic of your exact supplements?

They can not confirm gout without blood work. And then there is pseudogout which can go away and come back but then there is regular gout which is horrible and painful and linked to kidney failure essentially. The kidneys can not flush the uric acid. In this case avoiding feeders that can be higher in uric acid (like roaches) can be helpful. But also hydration plays a major role in this. However your almost over misting with your schedule. But was kept in a different enclosure so yes dehydration can be linked and play a role.
 
Hey there can you post some more pics of the cham's entire body as well. Can you also post a pic of your exact supplements?

They can not confirm gout without blood work. And then there is pseudogout which can go away and come back but then there is regular gout which is horrible and painful and linked to kidney failure essentially. The kidneys can not flush the uric acid. In this case avoiding feeders that can be higher in uric acid (like roaches) can be helpful. But also hydration plays a major role in this. However your almost over misting with your schedule. But was kept in a different enclosure so yes dehydration can be linked and play a role.
My cham has tucked himself away in his enclosure but I will get a full body photo as soon as he comes back into view. I’ve attached a picture of the supplements I use as well.

I did ask the exotic vet that I went to to do bloodwork, he tried for about 30 minutes but was unable to draw blood and gave up once he got frustrated. I stopped feeding roaches as soon as I noticed the swelling (more info in the feeding section of husbandry review) to reduce his protein intake but it has only been about a week on the new diet. I had a suspicion I was over misting so it’s good to have that flagged. In his temporary enclosure we used while moving I was using the same misting schedule but the humidity never really went above 30% (hence my worries about chronic dehydration). Thanks for the reply and please let me know if you have any comments regarding his supplementation!
 

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He couldn't have damaged the leg somehow, could he?
That was my first thought, I checked all of his toe nails to see if he had any damage to them and everything looks normal, just the swelling. The exotic vet said it wasn’t a break or anything of that nature, but he also was clearly not good at his job so I wouldn’t rule it out….
 
One thing I see is you are giving to much D3. There’s D3 in the calcium and the reptivite. They can overdose on D3 and to much D3 can cause gout. If he does have gout, there’s some pretty good meds to treat gout these days. Where do you live? I might be able to recommend a good chameleon vet.
 
My cham has tucked himself away in his enclosure but I will get a full body photo as soon as he comes back into view. I’ve attached a picture of the supplements I use as well.

I did ask the exotic vet that I went to to do bloodwork, he tried for about 30 minutes but was unable to draw blood and gave up once he got frustrated. I stopped feeding roaches as soon as I noticed the swelling (more info in the feeding section of husbandry review) to reduce his protein intake but it has only been about a week on the new diet. I had a suspicion I was over misting so it’s good to have that flagged. In his temporary enclosure we used while moving I was using the same misting schedule but the humidity never really went above 30% (hence my worries about chronic dehydration). Thanks for the reply and please let me know if you have any comments regarding his supplementation!
Ok with these supplements... You will use the calcium without D3 version at almost all feedings except two times a month say the 1st and the 15th you will use the reptivite with D3. You can drop using the calcium with D3 because your reptivite has it.

Keep him on the silkworms to see if they help. Might get some loose stools with them so don't be surprised.

What is your total distance from the bottom of the t5 fixture to the closest branch below it?
 
One thing I see is you are giving to much D3. There’s D3 in the calcium and the reptivite. They can overdose on D3 and to much D3 can cause gout. If he does have gout, there’s some pretty good meds to treat gout these days. Where do you live? I might be able to recommend a good chameleon vet.
Thank you! I will cut down on the D3 supplementation. I live in southwest Ohio, I called 4 or 5 exotic vets in Cincinnati and only two said they were comfortable working with reptiles (I appreciated their honesty). I already brought him to one of the two (All Creatures Animal Hospital in Anderson) and am on the cancellation list for the other (I am unable to recall the name, but will get back to you) since they didn’t have any immediate appointments. I’d be open to going to northern Kentucky as well if you know of anyone worth seeing there. Thanks in advance for any suggestions!
 
Ok with these supplements... You will use the calcium without D3 version at almost all feedings except two times a month say the 1st and the 15th you will use the reptivite with D3. You can drop using the calcium with D3 because your reptivite has it.

Keep him on the silkworms to see if they help. Might get some loose stools with them so don't be surprised.

What is your total distance from the bottom of the t5 fixture to the closest branch below it?
Thank you so much for this advice, I am absolutely going to make these adjustments. His t5 is ~8 inches from the closest branch, but I just lowered it from ~6 inches because with the warmer weather the lights were starting to burn his casque a bit (which has since been treated by the vet). Do you think it needs to be moved back up?

I also attached a full body photo I just grabbed of him now that he is asleep. He is actually using all four feet, but you are still able to see the swelling in the rear Rt foot/ankle. Again, don’t be alarmed by the burn on his casque as it has been looked at by the vet and his basking spot has been moved!
 

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I'm reasonably sure soaking the foot in warm water isn't going to help and may even be too hot for it.

If the chameleon is acting fine other than favouring that foot I wouldn't euthanize it either.
 
I'm reasonably sure soaking the foot in warm water isn't going to help and may even be too hot for it.

If the chameleon is acting fine other than favouring that foot I wouldn't euthanize it either.
Thank you, I wouldn’t have known that soaking him may actually cause more harm than good so I appreciate this comment.
 
You said..."I did ask the exotic vet that I went to to do bloodwork, he tried for about 30 minute"...
Is this where he tried to take the blood?
 
You said..."I did ask the exotic vet that I went to to do bloodwork, he tried for about 30 minute"...
Is this where he tried to take the blood?

Yes, he tried several spots along the underside of his tail. He also tried several different needle sizes. Now my cham’s tail is all discolored, which makes me concerned but I read in another thread is normal after bloodwork? Photo attached for reference.
 

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Thank you so much for this advice, I am absolutely going to make these adjustments. His t5 is ~8 inches from the closest branch, but I just lowered it from ~6 inches because with the warmer weather the lights were starting to burn his casque a bit (which has since been treated by the vet). Do you think it needs to be moved back up?

I also attached a full body photo I just grabbed of him now that he is asleep. He is actually using all four feet, but you are still able to see the swelling in the rear Rt foot/ankle. Again, don’t be alarmed by the burn on his casque as it has been looked at by the vet and his basking spot has been moved!
No keep it where it is now. You want the highest branches below the T5HO fixture to be 8-9 inches down from the screen if your T5 has a 5.0 or 6% uvb bulb and is sitting on the screen. So he was actually getting too much UVB having it at 6 inches.


Can you post a pic of your entire enclosure for me? I would like to double check it as well in case something stands out.
 
No keep it where it is now. You want the highest branches below the T5HO fixture to be 8-9 inches down from the screen if your T5 has a 5.0 or 6% uvb bulb and is sitting on the screen. So he was actually getting too much UVB having it at 6 inches.


Can you post a pic of your entire enclosure for me? I would like to double check it as well in case something stands out.
Hmm okay, I have always heard 6-7” so I’m glad to hear that he will do fine with his 8” placement and I can even go lower if needed.

I also attached a photo of my enclosure; there used to be a yucca plant filling out the bottom of the enclosure but it died while we were moving recently and I haven’t decided what to replace it with. Accepting suggestions for tall, chameleon-safe plants that are easy to keep alive.

I know I’m going to cause an upset with my fake plants, but I promise he doesn’t eat them and he seems much happier than when I had live plants in the enclosure and was constantly in his enclosure switching them out (I can’t keep a plant alive to save my life)😂. Open to any suggestions for improvement!
 

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^Edit to my last post, you may notice his basking bulb is off right now (it’s very hot inside my apartment even with the AC running) but I wanted to point out that it is placed on the right hand side in front of the T5 strip. Thanks for reviewing!
 
Hmm okay, I have always heard 6-7” so I’m glad to hear that he will do fine with his 8” placement and I can even go lower if needed.

I also attached a photo of my enclosure; there used to be a yucca plant filling out the bottom of the enclosure but it died while we were moving recently and I haven’t decided what to replace it with. Accepting suggestions for tall, chameleon-safe plants that are easy to keep alive.

I know I’m going to cause an upset with my fake plants, but I promise he doesn’t eat them and he seems much happier than when I had live plants in the enclosure and was constantly in his enclosure switching them out (I can’t keep a plant alive to save my life)😂. Open to any suggestions for improvement!
So yes keep it 8-9 inch distance this will put him in the correct UVI level.

So the one thing I want to be sure of is that ALL wood you used you sealed. If it is left natural it can emit VOC. This would be hazardous for him to sit and breathe in.

I won't pick on you for the fake plants just know they are a high risk thing with Veileds. Real plants can thrive but they do need plant lighting for this. Of course real plants have other benefits such as balancing humidity and keeping the air cleaner.
 
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