Mouth infection after one moth treatment persists - help!

[Mawtyplant]

Way better you can also give a try to serrapeptase and repaid..

Go buy some betadine and clean the infected parts with this (http://www.anapsid.org/stomatitis.html). You can use a q-tip for the cleaning job. Personally, I do my cleaning and medical stuff before the bed (sometime at the beginning of the bedding time.. because he go to sleep straight and they are more easy to manipulate at this period of the day

Good luck with your boy!

 

[Crofty]

This morning update! (after just one day of no Baytril) It got worst

The pic is not perfect (because I was home alone and I had to take it myself) but the white spots on the infection area bigger now - looks like something white spots on tonsils on humans - the white spots where definitely not as prominent before - almost yellow-ish

After I saw it I administered Baytril and Metacan on the problematic area and clean his gums with OraZn - pet oral care (neutralized Zinc) - Thursday I will go to the Vet but I think it is best to keep him under Baytril to not allow the white spots grow.

I will get Betadine as you suggested @Mawtyplant and will apply it tonight

 

[Mawtyplant]

This morning update! (after just one day of no Baytril) It got worst

The pic is not perfect (because I was home alone and I had to take it myself) but the white spots on the infection area bigger now - looks like something white spots on tonsils on humans - the white spots where definitely not as prominent before - almost yellow-ish

After I saw it I administered Baytril and Metacan on the problematic area and clean his gums with OraZn - pet oral care (neutralized Zinc) - Thursday I will go to the Vet but I think it is best to keep him under Baytril to not allow the white spots grow.

I will get Betadine as you suggested @Mawtyplant and will apply it tonight

Yeah really important too clean this out (white part look like pus). Metacan is a anti-inflamatory med, he need this so follow the vet instruction about this one (be carefull you donc want him to swallow betadine (so be caution with the q-tip).

 

[kinyonga]

Did you talk to the vet about using the betadine? Did you talk to the vet about stopping the baytril?
If it's an infection, the pus may be too thick for the antibiotics to penetrate and it may need to be cleaned out (surgery). This is normal when you deal with chameleons. What vet clinic are you going to?

 

[Extensionofgreen]

Stopping and starting antibiotics without veterinarian supervision/advice is a recipe for resistant infections and bad outcomes. Baytril is not the easiest on a chamelon’s system and if there’s been no improvement in a months time, the infection is in danger of infecting the bone and may not be sensitive to Baytril. A more experience vet may be needed and certainly a new approach to treatment is advised, due to the lack of response to Baytril. As I advised, I’d request Fortaz and a culture and sensitivity test to be sure what your are treating and that the right medication is used. Fortaz is very good at treating bacterial infections, but I’ve seen fungal infections in the bones of chameleons and you need a culture and sensitivity to know what is what it at least a gram stain. Time is of the essence. I would give Fortaz a week or 2, before opting for surgery, unless there was a compelling emergency situation.

 

[Crofty]

Stopping and starting antibiotics without veterinarian supervision/advice is a recipe for resistant infections and bad outcomes. Baytril is not the easiest on a chamelon’s system and if there’s been no improvement in a months time, the infection is in danger of infecting the bone and may not be sensitive to Baytril. A more experience vet may be needed and certainly a new approach to treatment is advised, due to the lack of response to Baytril. As I advised, I’d request Fortaz and a culture and sensitivity test to be sure what your are treating and that the right medication is used. Fortaz is very good at treating bacterial infections, but I’ve seen fungal infections in the bones of chameleons and you need a culture and sensitivity to know what is what it at least a gram stain. Time is of the essence. I would give Fortaz a week or 2, before opting for surgery, unless there was a compelling emergency situation.

I agree - skipping Baytril for one day was bad - after this morning Baytril and Metacan it already looks better without that puss.
Thursday I will see another Doc (within the same vet place) a second opinion and I will ask for Fortaz and probably a culture test.
I don't think we are at the emergency point- he acts normal and does his usually thing but did not eat for the past two day (because I finished the horn worms ) and he does not like silkys that much. He did it before - after few day with horn worms, he does a hunger strike (expecting another horn worm)

 

[kinyonga]

At least if you do a culture and sensitivity test it should tell you what bacteria is involved and what medication will fight it.

 

[Crofty]

Update (after vet visit)

I got a second Doc's opinion and it went very well - the new Doc summed up pretty much what all of you figured out here. So I can say I got equivalent diagnosis from this forum as from a caring professional

New treatment :
Fortaz injection for 2 weeks - once a day - if no change are registered then do the culture and sensitivity lab work
Metacan - once a day 0.01 (down from 0.02)
Cleaning his gums with the same OraZn - pet oral care (neutralized Zinc) daily

He did not lost weight (actuality gain a bit) I saw him eating alone today after 2 days hunger strike and 2 days of force feeding him silkys. Got him phoenix worms he ate them this morning.

Now waiting to see if the injection do a better job!

 

[kinyonga]

Good that you got to see another vet. Did he/she say it was an infection?

 

[Extensionofgreen]

If the infection bacterial and he is eating, that Fortaz will do wonders! Suggestion: wait until lights out and he’s been slumbering for an hour or so and give him the injections quickly and get out. That’s the least stressful way and they hardly seem to notice, though they tolerate the needle very well, generally and in my experience; doesn’t seem to hurt them much.

 

[Crofty]

Update: After one week of Fortaz -0.01 injectible

Colors are much better (actually I could say he has brighter colors that he ever had) and he is very active.
He eats well - he is back on crickets and noticed if I released them in the cage he hunts them down almost instantly (he does not like crickets in the cup anymore)
He takes the injection well at night -he is not to fussy about them

Infection is still there dough! a bit smaller but still there - In your experience does it take longer than a week to see significant diminishing in such types of infection?
I still clean his mouth every day with OraZn - and give him Metacan anti-inflammatory.

Temp and humidity is up - I think I'm on a good path I just don't see that thing going down fast enought
He had a whole week of silk worms force fed because he does not like them (no more mealworms) and everything dusted with Calcium NoD no Phosphor - No more multi vitamins for one more week.

But keeping my fingers crossed!

 

[Extensionofgreen]

A lot depends on the type of infection and how much tissue it has infected, including the bone. 2-3 weeks is a normal routine for Fortaz to be used in these cases and even longer in persistent infections. Unless the vet has advised you to clean the wound, I would not, as this can be irritating to the newly forming tissue and actually prolong healing. Perhaps soft prey, until the wound is healed or crickets without the back legs is a good idea to avoid abrading the area with sharp cricket parts.
I’m glad things are going in the right direction.

 

[Crofty]

Update: After 2 weeks and 4 days of Fortaz injectible - things are not looking better. Doc stopped the antibiotics (since it has been 1 moth of antibiotics administering; first Baytril then Fortaz)

Today I went back to the vet for the fallow up check. I know I have said that in the first week there was a slight improvement it looks that the inflammation came back with vengeance and it is a bit bigger - therefore antibiotics are not really helping (stopped administering antibiotics)

I ran out of Metacam 4 days ago and I noticed things got worst after I have stopped administering it.

New plan - he is on Rheumocan (meloxicam) 0.02ml for two weeks - it is a Metacam replacement (same medicine)

Meanwhile the doc will post on there vet board to see if somebody else can identify this or if somebody else dealt wit it. Has anyone here seen this before? because Is getting frustrating.

If nothing will be found the next step will be to do a culture test (send it to the lab)

Vet + treatment is not cheap at all - I don't want to even know how much a lab work will cost.

On the good side - he is eating well and being active(gained 7 grams since last visit) and his colors are great (new calcium no Phosphorus works wonders)... With that in mind he is in no critical state so the doc is somewhat at ease that I take very good care of him.
He's right side lip started to become a bit less flexible and look like his moth does not close perfectly (just like at the beginning when the infection was discovered) but I guess the Metacam replacement will fix it quickly in the next few days (as it did before)

Any input is greatly appreciated

 

[Crofty]

Good that you got to see another vet. Did he/she say it was an infection?

That's the thing - they don't have a diagnostic - so they can't say what it is for sure. Two more weeks until I will probably be forced to do the culture test as nothing else worked so far

 

[kinyonga]

This still doesn't look like any infection I've ever seen. It looks more like a growth of some kind..but I'm not a vet...and a vet (your vet) should know. Without a culture and sensitivity test you don't know what bacteria it is or if the meds your chameleon was on will kill it. Also...as I already said...If it's an infection, the pus is likely too thick for the antibiotics to penetrate and it would need to be cleaned out (surgery). This is normal when you deal with chameleons for an infection to need to be cleaned out.

 

[Extensionofgreen]

I agree that it may be a growth of some kind, than an infection. It could also be a fungal infection, viral infection, or even a forgein body. It may be best to have the chameleon put under anesthesia and have the area cleaned out/removed/examined closely, or cultures run as needed. It doesn’t appear to have inflammation around it, the way infections do, leading me to suspect a growth.

 

[OldChamKeeper]

This thread is an absolutely perfect example of why you spend the money on a culture the second or third time you go into the vet for rechecks.

Just my .02 cents but you might have made the infection resistant to some antibiotics in doing some of what you described. That doesn't look like a mechanical injury so much as he bit into something that resulted in it getting on both sides.

Ever seen a chameleon bite on a finger? A good bite? You'll have nearly equal pressure on each side of the wound. To me, looking at that it looks like he bit down on something exposing both sides nearly equally while other areas in the mouth are not affected. Odd for sure but what is not in question is you have a nasty infection that could be more than one type of bacteria. I once had a Cham with a mouth infection consisting of two bacterias.... and each was resistant to what the other other was sensitive to. I need two antibiotics at once to save the animal.

 

[Crofty]

@kinyonga you where probably right all along - you called it the first time. I was just taking the cheapest route out and gave him antibiotics and the vet rolled with it

@Extensionofgreen and @OldChamKeeper I think you summed it all perfectly, what you say makes cents.

I'm just waiting for the vet to do their research and they will probably come back to me with the same options (put him under/clean - run a sensitivity test)

He is doing well since Tuesday he stopped taking antibiotics and there is no buildup around the infected area (just checked this morning) so I think he can leave with it for a while until we figure it out. He eats like crazy and is active.

Thanks you guys for reading thru the whole thread - your input is truly appreciated.

 

[Crofty]

side question: I have birch branches in his cage (they where all dried up nicely when purchased from a garden farm) Are birch branches ok for them? I just noticed after allot of misting cycles some white buildup getting deposited on the ropes around the birch twigs (or it is maybe just chlorine/calcium from the water when it dries after a mist session)

 

[kinyonga]

Has he ever chewed on the birch branches? Are they white birch? Would the insects chew on them?
I should have thought of asking you this before being that it's a panther and the marks are even in its mouth.