Mouth infection after one moth treatment persists - help!

[Crofty]

Chameleon Info:

• Your Chameleon - Panther /Male/ 2 years old - in my care for 1 year (first time cham owner)
• Handling - taking him out of the cage at-least twice a day - very social
• Feeding - Mix of crickets / meal worms / super worms /wax worms and horn warms (3 every 1.5 weeks) he is a picky eater as he always leaves food in his cup. He eats when he feels like it - He does not refuse a horn worm - eating normal during the treatment
• Supplements - Repashy Superfoods : Calcium NoD (Mo/Wed/Fri/Sun) - Calcium Plus (Tue/Thu/Sat) sprinkle on his feeders (can Calicum expire?)
• Watering - Misting 5 times a day (45 secs) Mist King with two nozzles + shot glass full of water that i thought him how to use
• Fecal Description - regular / normal with a big dark brown section and the separate white chalky segment
• History - I got him a year ago and I built him a new cage right after I got him

Cage Info:

• Cage Type - Huge - DIY built - the walls are wire stainless steel mesh. Pic: https://i.imgur.com/qEgala9.jpg
• Lighting - Light from 7:00 AM to 8 PM - 1 Tube - Reptisun 5.0 UVB / Main basking spot Exoterra Day Baskin Spot 100w . Second basking spot + uvb light is a old dome light with 60w Reptisun UVB and blue heat bulb 60w - pic: https://i.imgur.com/RnOJ3RD.jpg
• Temperature - Highest temp main basking spot 93 - cage is tall and he has foliage therefore temp goes down the lower he goes in the cage: pic https://i.imgur.com/cZfgVwE.jpg
• Humidity - Humidity meter in the cage fluctuates between 60% and 90 % depending when last mist took place
• Plants - Only live plants - 1x big photos / 2x dieffenbachia and 1 croton petra
• Placement - neutral area / kitchen living room
• Location - Toronto, Canada

Story: I took Abu to the vet because i noticed the right side (note: only the right side was inflamed at the lip level) lip being inflamed and some pink-ish meat hanging out of his mouth - exactly 1 moth ago since this post.

Doctor diagnostics - start of stomatitis and the pinkish inflammation is mechanical and the cham keeps biting on it when he eats making it hard to heal

Treatment - Metacam 0.02 MLS (for pain) - by mouth every 24
Baytril (antibiotic) 0.10 MLS on the lesion (pink infected area) every 24 hours

I was applying both with a syringe straight on the lesion area. Little guy is very cooperative he opens his moth and after i put in the fluids he hates me for 20 secs

After two weeks the right lip recovered perfectly - but inside his mouth the pinkish inflammation did not ( it only shrunk just a little bit)
Went back to the followup exam after two weeks .Doctor suggested that she can remove it with surgery as she thinks that is a mechanical infection (ie insect bite or cricket leg got stuck in there)
I was reluctant and ask if we can do something else as surgery seems intrusive at this point.
Doctor suggested two more weeks of the same treatment + an extra OraZn - pet oral care (neutralized Zinc) that I apply only on his lips with a Qtip (after each administration of Metacam in the morning and Baytril around 7 PM every day)

Bad news: an extra pink-ish inflammation appeared now on his left side inside his mouth!
My next appointment is next week and I'm sure the Doc will suggest surgery - correct me if I'm wrong but because the left side got a new infection it leads to believe that his infection is not mechanical (due to insect bite or stuck cricket leg) it looks to me like a bug of some sorts.

Pics taken today - after 1 month of treatment

Right side - The size of the inflammation is almost the same (but much cleaner with no mucus around it as it was in the beginning)

Left side infection was first noticed about two weeks ago and growing slowly (this was not there 1 month ago) Much smaller than the original right side infection

His lip today - looks good. 1 moth ago it was looking badly dark grey with the start of mouth rot: looks fully healed to me:

Here's a full pic of him - he actually gain a bit of weight between his two checkups (so he still eats good) his colors are off because I pissed him off with the previous open mouth pictures

What to do next? Vet will probably suggest a surgery after two expensive checkups and two set of meds.
Any suggestions? I'm kinda lost and don't know what to believe

 

[kinyonga]

I'm not a vet but that doesn't look like an infection to me. Hopefully someone else will tell you.

 

[Action Jackson]

That looks nasty. I've never seen something like this.That doesn't look like "mouth rot" or stomatitis to me. It looks more like an infected injury or something of that nature. Baytril isn't a topical antibiotic but since you are putting it in his mouth it ending up where it needs to go. I'm not a vet but I'm also not sure if Baytril is the drug you should be using for this. I would think treating it daily(probably at least twice a day) with a diluted chlorhexidine solution or a betadine solution may be the way to go. I've treated stomatitis along the teeth line and outer gum /lip area with Baytril and diluted chlorhexidine with good success but nothing like what's going on there. When you apply the chlorhexidine using a q tip and wipe the sore and surrounding mouth area including the gums and teeth after the chameleon closes its mouth the chlorhexidine remains in place and does its job. I'm not sure what surgery would accomplish here unless there was something stuck in there that is causing this. I would be very interested it the cause of this. Can you post pictures of the cage including the plants please?

 

[Mawtyplant]

when you talk about 1 Tube - Reptisun 5.0 UVB are you talking about this one (at the left?) http://www.neherpetoculture.com/img/zoomedreptisuncfl.jpg

and 60w Reptisun UVB i can found this anywhere, you have a picture of the box from the store ? of a picture from internet (the box not the bulb)

and how ols are your two bulb?

 

[Crofty]

That looks nasty. I've never seen something like this.That doesn't look like "mouth rot" or stomatitis to me. It looks more like an infected injury or something of that nature. Baytril isn't a topical antibiotic but since you are putting it in his mouth it ending up where it needs to go. I'm not a vet but I'm also not sure if Baytril is the drug you should be using for this. I would think treating it daily(probably at least twice a day) with a diluted chlorhexidine solution or a betadine solution may be the way to go. I've treated stomatitis along the teeth line and outer gum /lip area with Baytril and diluted chlorhexidine with good success but nothing like what's going on there. When you apply the chlorhexidine using a q tip and wipe the sore and surrounding mouth area including the gums and teeth after the chameleon closes its mouth the chlorhexidine remains in place and does its job. I'm not sure what surgery would accomplish here unless there was something stuck in there that is causing this. I would be very interested it the cause of this. Can you post pictures of the cage including the plants please?

I'm inclined to think the same. Especially since after 3 weeks of applying Baytril did not improved the situation by much - I'm very against surgery and I'm willing to try to apply Betadine daily (do I have to mix it with water 50/50?)

Here's some pictures of the plants (look on my Cage info on the original post for more details)
Recent picture:

Older picture before the plants grew:

More pictures of the cage can be found here :https://imgur.com/a/MlqZY

Let me know if you need more info

 

[ChamNewbie6540]

I can't really address the mouth infection but I will say that it would be a good idea to really cut down on the mealworms - they're honestly nothing but fat and aren't good for your cham

 

[ponders]

Dieffenbachia can cause mouth irritation if bitten. Those green and white plants are those. You might want to remove them.

 

[Mawtyplant]

I'm inclined to think the same. Especially since after 3 weeks of applying Baytril did not improved the situation by much - I'm very against surgery and I'm willing to try to apply Betadine daily (do I have to mix it with water 50/50?)

Here's some pictures of the plants (look on my Cage info on the original post for more details)
Recent picture:

Older picture before the plants grew:

More pictures of the cage can be found here :https://imgur.com/a/MlqZY

Let me know if you need more info

when you talk about 1 Tube - Reptisun 5.0 UVB are you talking about this one (at the left?) http://www.neherpetoculture.com/img/zoomedreptisuncfl.jpg

and 60w Reptisun UVB i can found this anywhere, you have a picture of the box from the store ? of a picture from internet (the box not the bulb)

and how ols are your two bulb?

 

[Crofty]

when you talk about 1 Tube - Reptisun 5.0 UVB are you talking about this one (at the left?) http://www.neherpetoculture.com/img/zoomedreptisuncfl.jpg

and 60w Reptisun UVB i can found this anywhere, you have a picture of the box from the store ? of a picture from internet (the box not the bulb)

and how ols are your two bulb?

Sorry I was not clear enough - here's a picture of the 4 bulbs placement along with description below

1- Reptisun T5 HO - 5.0 UVB - 24W - 24" - installed 7 months ago (this model: https://www.amazon.ca/Zoo-Med-Reptisun-Fluorescent-Lamp-24/dp/B00AQU8GF0 )

2- Exoterra 100 W Daylight Basking Light - installed 1 month ago as before I had a regular 60 W incandescent bulb in the same clamp lamp and I wanted to up the temperature in the basking spot in case he needs it - description of the bulb (scroll down to 100W) http://www.exo-terra.com/en/products/daylight_basking_spot.php


In the double dome (it was my old setup so I put it on top of the new cage as a secondary basking spot and source as extra light) he spents almost no time under this double dome anymore

3- Zoomed - Blue Daylight Blue Heating Bulb 60W - over a year old (but it think this one does not matter) link: https://zoomed.com/daylight-blue-reptile-bulb/

4- ReptiSun 5.0 Compact UVB bulb - here's a picture of it https://i.imgur.com/v1GXMr4.jpg this one is over 1.5 year old but it does not matter as I have the big 24" covering the whole cage

 

[Mawtyplant]

Sorry I was not clear enough - here's a picture of the 4 bulbs placement along with description below

1- Reptisun T5 HO - 5.0 UVB - 24W - 24" - installed 7 months ago (this model: https://www.amazon.ca/Zoo-Med-Reptisun-Fluorescent-Lamp-24/dp/B00AQU8GF0 )

2- Exoterra 100 W Daylight Basking Light - installed 1 month ago as before I had a regular 60 W incandescent bulb in the same clamp lamp and I wanted to up the temperature in the basking spot in case he needs it - description of the bulb (scroll down to 100W) http://www.exo-terra.com/en/products/daylight_basking_spot.php


In the double dome (it was my old setup so I put it on top of the new cage as a secondary basking spot and source as extra light) he spents almost no time under this double dome anymore

3- Zoomed - Blue Daylight Blue Heating Bulb 60W - over a year old (but it think this one does not matter) link: https://zoomed.com/daylight-blue-reptile-bulb/

4- ReptiSun 5.0 Compact UVB bulb - here's a picture of it https://i.imgur.com/v1GXMr4.jpg this one is over 1.5 year old but it does not matter as I have the big 24" covering the whole cage

Good this is better (cristal clear!) thx

4-this bulb useless (after 3-4 month it have no uvb at all, you can replace this by a exoterra uvb 100-150) (trust me i have buy allllll those uvb bulb and i have test it with 3 differents uvb meters)

3-you right does not matter, i dont really know about this one but it provide heat and light

2-still nothing wrong here if you have a temperature gun it could be a good idea to double check the spots

1-If you have a way too test your t5ho it could be a good idea but still not think this is the problem

Your caging look perfect too me.. so, my guess now is your supplement schedule (vitamin every day its a bit too much vitamin for him and can lead to imbalance)

how far go the tongue when he catch a prey?

PS: sorry for my english this is not my first language!

 

[Mawtyplant]

Sorry I was not clear enough - here's a picture of the 4 bulbs placement along with description below

1- Reptisun T5 HO - 5.0 UVB - 24W - 24" - installed 7 months ago (this model: https://www.amazon.ca/Zoo-Med-Reptisun-Fluorescent-Lamp-24/dp/B00AQU8GF0 )

2- Exoterra 100 W Daylight Basking Light - installed 1 month ago as before I had a regular 60 W incandescent bulb in the same clamp lamp and I wanted to up the temperature in the basking spot in case he needs it - description of the bulb (scroll down to 100W) http://www.exo-terra.com/en/products/daylight_basking_spot.php


In the double dome (it was my old setup so I put it on top of the new cage as a secondary basking spot and source as extra light) he spents almost no time under this double dome anymore

3- Zoomed - Blue Daylight Blue Heating Bulb 60W - over a year old (but it think this one does not matter) link: https://zoomed.com/daylight-blue-reptile-bulb/

4- ReptiSun 5.0 Compact UVB bulb - here's a picture of it https://i.imgur.com/v1GXMr4.jpg this one is over 1.5 year old but it does not matter as I have the big 24" covering the whole cage

So, all your caging, watering, uvb, look perfect (more than perfect) the only thing wrong is your vitamin schedule.. its way too much and it can be a real problem (calcium-phosphorus imbalance, VitA overdosage, too much of vitamin hard on the kidney.. worst with the medication) all this can lead to disease like mouth root, eodema and death.

So, i really think your panther is overdosed and might have a bad phosphorus/calcium ratio and imbalance with D3/A/E vitamins.. those 3 are toxic if come too high)

Here is a new vitamins schedule for him.

1) phosphorous free calcium with out D3; dust feeders daily (Rep-Cal Calcium - Phosphorus and Vitamin D3 Free)
2) multivitamin; dust feeders 1 a week (i suggest you repashy loD because youruvb lightening is good)

With the baytril and the disease i might need more heat, so i suggest you to replace the uvb 5.0 reptisun by a heat lamp

Continue too clean the mouth infection, i also suggest you too feed him with lot of slikwork (contain serrapeptases.. really good with inflamatory response) you can also check for serrapeptase (natural product helping for inflamation response.. can help him a lot!)

If you want too chec if he is overdosed.. you can go too the vet and have a blood punction.. but its a bit expensive i think and may be stressfull but im 91% sure this is your problem.

Also the diffenbachia is really toxic and the sap can lead to severe damage () you also can have a little wikipedia pothos are great, toxic also but not TOXIC (diffenbachia are TOXIC++ )

So.. good luck with him, continue the treatment, reduce the vitamin (you can stop it for the baytril time), double your misting session (baytril really really hard on the kidney so he gonna need more water), increase the temperature (during the treatment), stop the mealworm and the super worm (bad calcium ratio, hard to digest.. its like mcdo for cameleon..he need good foor for now soo silk, horn and crickets)

it make sens?

 

[Crofty]

Dieffenbachia can cause mouth irritation if bitten. Those green and white plants are those. You might want to remove them.

You are right ! He seem to not care about the plants I never saw him even once attempting to bite on any leafs.
I have removed the Deffenbachia and replaced it with another Pothos that I already had outside - just to be on the safe side.

Thanks!

 

[Crofty]

Good this is better (cristal clear!) thx

4-this bulb useless (after 3-4 month it have no uvb at all, you can replace this by a exoterra uvb 100-150) (trust me i have buy allllll those uvb bulb and i have test it with 3 differents uvb meters)

3-you right does not matter, i dont really know about this one but it provide heat and light

2-still nothing wrong here if you have a temperature gun it could be a good idea to double check the spots

1-If you have a way too test your t5ho it could be a good idea but still not think this is the problem

Your caging look perfect too me.. so, my guess now is your supplement schedule (vitamin every day its a bit too much vitamin for him and can lead to imbalance)

how far go the tongue when he catch a prey?

PS: sorry for my english this is not my first language!

We are on the same page with the light setup. I'm looking to change bulb 4. as you suggested.

Tongues shoots no problem he did half the cage to catch a loose cricket 2 days ago.

No need to appoligize (English is my second language as well )

Thanks for taking the time

 

[Crofty]

Here is a new vitamins schedule for him.

1) phosphorous free calcium with out D3; dust feeders daily (Rep-Cal Calcium - Phosphorus and Vitamin D3 Free)
2) multivitamin; dust feeders 1 a week (i suggest you repashy loD because youruvb lightening is good)

So, all your caging, watering, uvb, look perfect (more than perfect) the only thing wrong is your vitamin schedule.. its way too much and it can be a real problem (calcium-phosphorus imbalance, VitA overdosage, too much of vitamin hard on the kidney.. worst with the medication) all this can lead to disease like mouth root, eodema and death.

So, i really think your panther is overdosed and might have a bad phosphorus/calcium ratio and imbalance with D3/A/E vitamins.. those 3 are toxic if come too high)

Here is a new vitamins schedule for him.

1) phosphorous free calcium with out D3; dust feeders daily (Rep-Cal Calcium - Phosphorus and Vitamin D3 Free)
2) multivitamin; dust feeders 1 a week (i suggest you repashy loD because youruvb lightening is good)

With the baytril and the disease i might need more heat, so i suggest you to replace the uvb 5.0 reptisun by a heat lamp

Continue too clean the mouth infection, i also suggest you too feed him with lot of slikwork (contain serrapeptases.. really good with inflamatory response) you can also check for serrapeptase (natural product helping for inflamation response.. can help him a lot!)

If you want too chec if he is overdosed.. you can go too the vet and have a blood punction.. but its a bit expensive i think and may be stressfull but im 91% sure this is your problem.

Also the diffenbachia is really toxic and the sap can lead to severe damage () you also can have a little wikipedia pothos are great, toxic also but not TOXIC (diffenbachia are TOXIC++ )

So.. good luck with him, continue the treatment, reduce the vitamin (you can stop it for the baytril time), double your misting session (baytril really really hard on the kidney so he gonna need more water), increase the temperature (during the treatment), stop the mealworm and the super worm (bad calcium ratio, hard to digest.. its like mcdo for cameleon..he need good foor for now soo silk, horn and crickets)

it make sens?

I will go with your suggestion and get the supplements scheduled changed (My Calcium NoD just expired anyhow). I have fallowed supplements schedule without to much research - the previous owner of my cham simply told me to)

What heat lamp do you recommenced?

I'm not doing a blood check right now as the cham looks healthy to me - he eats and he is active in a very good environment

I'm continuing the treatment and cleaning.

Mealworms (I get it I will cut him from them) - I thought that's my go to food as he always like them. He is picky but I always had success with mealworms (he is used to eat them in the morning) I will get some silkworms - I use to give them for him before (but my current place does not carry it - I will go to another place that has them)

I have removed the diffenbachia today and substitute with another pothos.

I will increase the misting as well.

Thank you for taking the time to look into this. I will update you guys as things change.

 

[Crofty]

Has anyone seen this type of infection before ?


Update:
Doctor called today back - suggesting a very expensive surgery in order to remove the infection or a puncture test to see the exact nature of the inflammation (less expensive but it will still put me into a newer expensive treatment or just back to surgery) - I care very much for my cham but can't afford the price for a surgery nor see it reasonable.

I'm positive that there are alternative ways to treat this.

 

[Extensionofgreen]

I would suggest a culture and sensitivity and immediate change of antibiotics, preferably to injectible Fortaz, until the results are back. You are over supplementing.
Plain Ca 3-4 times per week and the Repashy Plus only once every other week or very lightly once per week. You need to get him to take feeders with some shell. Feed him something he likes and slip in a few crickets, one after the other, right before he's done swallowing the previous. Same idea if you'd like to get some roaches in him. I agree that if he's eating the plants, they should come out. This isn't usually a major issue with panthers, so if he isn't ingesting them, I'd leave them there.
You mentioned some blue bulbs and such.
Other than a halogen or incandescent basker, between 5000 and 6500 k, and some UVB source, all of your lighting should be daylight spectrum of 5000-6500 k. Those are just suggestions and likely not the cause of his infection. Fortaz is great stuff and I've never had it fail, if implemented in time and it is a true bacterial infection. It's also very well tolerated by the chameleon.

 

[Crofty]

I would suggest a culture and sensitivity and immediate change of antibiotics, preferably to injectible Fortaz, until the results are back. You are over supplementing.
Plain Ca 3-4 times per week and the Repashy Plus only once every other week or very lightly once per week. You need to get him to take feeders with some shell. Feed him something he likes and slip in a few crickets, one after the other, right before he's done swallowing the previous. Same idea if you'd like to get some roaches in him. I agree that if he's eating the plants, they should come out. This isn't usually a major issue with panthers, so if he isn't ingesting them, I'd leave them there.
You mentioned some blue bulbs and such.
Other than a halogen or incandescent basker, between 5000 and 6500 k, and some UVB source, all of your lighting should be daylight spectrum of 5000-6500 k. Those are just suggestions and likely not the cause of his infection. Fortaz is great stuff and I've never had it fail, if implemented in time and it is a true bacterial infection. It's also very well tolerated by the chameleon.

I will buy new Ca today does it mater if it's phosphorus free? | Got it, no more Repashy Plus - just light once per week.

I can't get Dubia roaches in Canada (it is illegal) I will add more crickets and I will get silk worms today (no more meal worms or super-worms for him for a while) and the occasional horn worm (I don't want him to hooked on them - he will dismiss crickets if he gets to many horn worms, that happen earlier this year)

I agree the light is not a problem or cause (will keep in mid the input) and the plant problem has been addressed.

I have a fallow up vet visit later this week and I would ask about the injectible Fortaz and the cost of a culture.

Thank you very much for your reply.

 

[Mawtyplant]

I will buy new Ca today does it mater if it's phosphorus free? | Got it, no more Repashy Plus - just light once per week.

I can't get Dubia roaches in Canada (it is illegal) I will add more crickets and I will get silk worms today (no more meal worms or super-worms for him for a while) and the occasional horn worm (I don't want him to hooked on them - he will dismiss crickets if he gets to many horn worms, that happen earlier this year)

I agree the light is not a problem or cause (will keep in mid the input) and the plant problem has been addressed.

I have a fallow up vet visit later this week and I would ask about the injectible Fortaz and the cost of a culture.

humm you speak french? i think you said previously english is not your first language no?

Thank you very much for your reply.

Where are you in Canada? oh toronto sorry

Go with the Calcium Rep-cal n D3 no phosphorus, your problem may come (95%sure) from a over phosphorus feeding. so you really need to cut this phosphorus income

And Repashy Lod 1 time a week max! (and for now, go with 1 time 2 week because vitamin + antibiotic get heavy on the kidney and it can cause more damage (vitamin not always a good thing)

Water + water.. + water (did i say water?) you can order some food from elevage lisard (from canada, she provide good healthy and gutloaded food

 

[Extensionofgreen]

Don't use a D3 product except as directed for using the Repashy plus. Your plain calcium supplement should be phosphorus free and you should rely more on dark, leafy greens as a gutload, than on fruits. Fruit is higher in Phosphorus, with a few exceptions.

 

[Crofty]

I went to the store and bought Rep-Cal - Calcium NO Phosphorous - NO Vitamin D3 (for daily use)
I have stop Baytril administration and on my next Visit I will ask the vent if they can give me injectible Fortaz as treatment. I will say No to surgery as I want to see how the new diet + supplements will work
He will get only silk worms a crickets for few days - and will supplement with horn worms at the end of the week.
Misting times increased (setting it up right now) and added a 50W daylight bulb to replace (4) because it was doing nothing (for the second basking spot - that he never uses anyhow)

Noted: leafy greens > fruits for gutload