Help: Bearded Dragon Ponazuril and Dr. Geoff Stein?

[Jennifer0148]

Hello,
I am a new member and I was hoping to get some advice and info on Dr. Stein. I have been doing a lot of research and he keeps popping up. I don't have a chameleon (anymore) but I just got a bearded dragon. From what I understand, Dr. Stein is a herp vet generally, so he would be able to help, I think.

Long story short, my dragon apparently has parasites. I say apparently because I don't trust the vet I took him to first, which coincidentally is also one that is often recommended here: Tom Greek. Despite being far from me, I took him to Dr. Greek because I figured he'd be one of the best herp vets I could get to (I hadn't heard of Dr. Stein then). He wasn't very friendly or open with me during my dragon's exam, however.

He wouldn't tell me what parasites he had exactly until I asked a million times and frustrated him enough to get an answer. Even then, though, he only mentioned one by name: coccidia. I had to call back the next day to ask the girl at the desk to tell me what else Dr. Greek had put on the chart and it said: coccidia, strongyls, and protozoa. That last one confuses me because giardia are protozoa, coccidia are protozoa, etc. There were also no counts even though I repeatedly asked him for them as he typed in the info into the computer after doing the fecal during the exam.

I don't doubt my dragon has parasites, as it's common for them to. I also don't question Dr. Greek's experience. My issue is with the meds he prescribed my dragon. He gave him Panacur and Albon. Panacur is mild enough and I have no problem giving that to my dragon, especially because there is a 2 week break in between. But the Albon for the coccidia? No way.

Albon is too harsh and can damage kidneys. It's also not even coccidiocidic. I've seen and heard horror stories of both chameleons and dragons losing weight and appetite, needing to be hand and even force fed, and taking weeks to months to recover afterward, if they make it, only to find they still have coccidia. When I asked Dr. Greek about this, he was extremely condescending and rude. He didn't like my asking questions because he had 20 years experience and said he had never had any issues with Albon. Ever. Not in 20 years of experience. I didn't buy that.

I wanted Ponazuril because it is much more gentle, coccidiocidic, and effective in fewer doses. However, Dr. Greek wouldn't even hear me out. I expected more of someone with his credentials. Giving Albon for coccidia to me is like treating depression with electroshock therapy. They're both things of the past.

There's no way I'm administering Albon to my little guy. There's zero reason to with Ponazuril around. I read on here in particular that Dr. Stein is more up to date with the latest treatments and does indeed work with Ponazuril. I also know Diamondback Drugs in AZ compounds the Ponazuril for small reptiles. I would like to see him (he's now in Pasadena) and I wanted to know if he really is patient, willing to listen, experienced, and not condescending. I was also wondering what the average dose and strength of Ponazuril is for a reptile 113 grams in weight.

Sorry for the long post. I hope I chose the best forum for it. Thank you.

 

[JoeVet]

I believe Ponazuril is standard treatment for reptiles needing a cocidia medication. I believe you have a right to question your animals treatment.

 

[Jennifer0148]

Thank you! I believe so too, on both counts. That's why I just paid for the office visit and promptly left. I won't work with a vet who is condescending and won't communicate with me about my own pet's health. I don't understand why some vets are like this. If it were me, I'd be impressed by a client who knew about treatments, parasites, etc., not angered by it. I'm surprised more vets don't know about Ponazuril by now. It's been around long enough.

 

[JoeVet]

When I was practicing, I really like those clients who knew their animals. Really hated the ones who didn't but thought they did. Remember that coccidia can be normal inhabitants of the GI and not cause disease. In bearded dragons they are common and generally not treated. If they are causing disease then ponzuril is the accepted treatment.

 

[Jennifer0148]

Thank you. I went to another vet today and he prescribed Ponazuril. However, because he didn't have the drug available, he wrote me a prescription that I'll have to have compounded elsewhere. On it all he wrote was "Ponazuril .3mg two doses 48hrs apart." Is .3mg correct? My dragon is apparently somewhere between 113-117g (he weighed 113 at the first vet and 117 today).

 

[ferretinmyshoes]

Remember that coccidia can be normal inhabitants of the GI and not cause disease. In bearded dragons they are common and generally not treated. If they are causing disease then ponzuril is the accepted treatment.

Yep, that's the norm. Even with treatment you rarely truly get rid of coccidia in bearded dragons especially. I only treat if in very high numbers or causing clinical symptoms. The strongyles I'd treat. Other protozoa can include flagellates, ciliates, etc. that aren't easy to differentiate so often reported by a category (like "protozoa") rather than the species themselves. And in most cases they are normal inhabitants of the GI tract and aren't treated.

Ponazuril is considered a better option by most, but some vets still use it regularly and see good results with it. So it's all with what your vet is comfortable and experienced with.

 

[Jennifer0148]

Thank you. I do know coccidia is common in dragons and present in most. Those weren't as numerous as the other parasites, however, which I'm glad about.

The vet I just took him to found coccidia and trichs. He showed me on the microscope. He told me to give the Panacur and then prescribed Flagyl and Ponazuril. Now, where I really don't know much of anything is compounding or interpreting prescriptions.

On the prescription he wrote, "Flagyl 5mg every seven days for 3 doses" and "Ponazuril .3mg 48 hours apart for two doses." Are those correct for an animal 113-117g? And how does that translate into cc or ml? I have zero idea. A prescription of .3 for Ponazuril seemed rather small.

 

[ferretinmyshoes]

It depends on the concentration of the medication as to how much to give or to verify doses. Are you sure it says mg not ml? That'd be an unusual way to send home meds with a client. It might have been a typo. Those do happen. I'd call the clinic to verify dosage you should be administering.

 

[Jennifer0148]

Well, I don't have the medications. Just the prescription, but it's confusing. It says, ".3mg". I knew something wasn't right. I emailed the compounding pharmacy I'll be working with and asked for help so that when I go back to my vet, I have more info myself.