Padre (my Parsonii) Needs Your Thoughts and Prayers

[Chamgirl]

Since losing my last chameleon I don't go on this forum much anymore except to vote on the monthly photo contest.
I had to read this thread though after hearing on Facebook that Padre had died. This is awful news, he was so very beautiful, it's a tragic loss and I am so sorry Jann XX

 

[jannb]

Thank you everyone for all the kind words and for keeping me and my family in your thoughts and prayers. It really means allot to us.


I'm attacking Padre's surgery photos below.

 

[jannb]

More surgery photos

 

[Dr O]

i guess i'll step in here in try and walk y'all through the photos as best as i can make them out. after i'll discuss some aspects of why this was a terminal situation.

photos 1-6 show the devastating necrotizing ulcer that formed way in the back and bottom of the mouth, just before the true esophagus begins. this region is known as the oropharynx. we are looking at the floor of the mouth well behind the glottis and tongue. there is a full-thickness ulcer through the membrane of the oropharynx that happens to lead right into the trachea (windpipe) itself. those are the whitish cartilage rings that can be seen through the fissure. the yellowish exudate around the edge of the lesion is pus/crud/bacteria all mixed together.

photos 7-15 move back towards the front of the mouth a bit (rostrally) where the tongue and finally the glottis itself can be seen. to verify that the hole in the back is indeed in the trachea, they have taken a polypropylene tomcat catheter and inserted it into the glottis where it naturally would continue into the trachea. and that's where you can see the tip of the catheter in the ulcer and even able to come back out of the trachea and into the oropharynx again.

Thank you everyone for all the kind words and for keeping me and my family in your thoughts and prayers. It really means allot to us.


I'm attacking Padre's surgery photos below.

 

[Dr O]

these photos may be a bit harder to understand and i'm not going off of any surgical notes, but this is my understanding from what i'm seeing.

these photos appear to be taken from the side of the neck where an incision was made, as they were unable to reach back far enough into the oropharynx to attempt a repair of the lesion into the trachea. so by making an incision in the side of the neck and lightly dissecting down to where all of these "tubes" (trachea, esophagus) enter the chest, it was hoped that they would be able to patch the lesion from that area and have much more room to work.

unfortunately, it appears that when they went in, there was another large tear in the esophagus. the orange tube is a red-rubber feeding tube that was inserted from the mouth, larger in diameter than the tomcat catheter. that way when dissecting through the side of the neck (and things can get a bit bloody or slightly disorientating), one can feel the red rubber tube within the esophagus and get a better landmark, and also have something to "grab" to be able to move the structures around during the repair. photos 3 & 4 best show that as they dissected down to the area, there was yet another gaping hole allowing the tube to be visible, when it should have been inside the esophagus. this is devastating. air goes to the lungs via the trachea, and food and water go to the stomach through the esophagus. and here they found that not only were food and water entering the lungs though the oropharyngeal ulcer into the trachea, but also that food and water going down the esophagus properly were falling out of yet another hole into what is best described as the mediastinal space; a complicated web of tissues that surround the trachea, esophagus, lungs, heart, and major blood vessels. and that is nowhere that non-sterile food needs to go.

More surgery photos

 

[rendos]

Jann, I am very sorry for your loss. It has been a rough year. I am glad Lisa and I got to visit last year and see Padre, and all your chameleons, in person. My heart goes out to you as I know how much you care for all your animals.

 

[Dr O]

so what caused this?

it is possible, but less probable that this was something that Padre was born with as many of these structures tend to have a common embryonic ancestor, and as they divide, split and mature, something may have gone wrong in the process. and it could have begun as something minute that grew over time or when aggravated by something else. however, that is probably unlikely as he was such a healthy boy with no history (that i know of) of chronic coughing or illnesses that would have been the hallmark of this kind of genetic flaw.

what is more likely, and it grieves me to say it, but it was probably from an insect bite or trauma from something he ate, which can include a spiky leg, a pointy twig or thorn that came in with a meal, or even some kind of burr (the type that catches on your clothes/pet hair and has the built-in Velcro fuzzies).

a Parsons is generally going to eat larger meals, so the bite or thigh spur of a feeder going down would also be correspondingly large. a few weeks ago someone posted on the Forums about some sort of feeder (a superworm/hornworm,?) that was actually seen alive in the back of the throat grasping the tongue. certainly if some of these critters bit down, they could have caused enough damage to the mucosa of the oropharynx to eventually erode through the wall, if not perhaps immediately. having the trachea exposed just underneath is basically just terrible luck. a few cm's one way or the other and the trachea would not have been directly underneath the lesion. it would still not have been good, as food and water would still be falling into the mediastinal space and causing the same problem as the second tear.

since we're playing medical forensics, the odds of a small scrape leading to an ulcer exactly over the trachea seem a bit small to me. i would rather guess that when the insect bit down it was strong enough that he was able to feel the firm, cartilaginous trachea through the soft and thin mucosa of the oropharynx, and that bite went through-and-through. what started small became worse with bacteria and repeated swallowing; it looks like the initial tear up top is 1-2 cm in length. if it was not a bite, a very similar argument could be made for a sharp leg point or plant thorn/etc.

as for the deeper tear it could have been more of the above, related bacteria, possibly the tear coming from the outside-->in rather than inside--->out. but i would have had to be there in surgery or see surgical notes to fully understand what was going on there.

all in all, it was a terrible set of situations/timing/coincidences that led to this. and it was accidental. no one will ever question jann's husbandry or devotion to her pets. in terms of euthanizing on the table under anesthesia; imo it was the best choice in a terrible situation. Padre would have gotten VERY sick very quickly soon after, abscesses in his throat and around his heart and lungs, septic from all of this getting into his bloodstream. i for one say that if he had to go, i am glad that he went with his pride and dignity intact, and was gently let go while already unconscious. the other scenario would have been terrible to even consider, and not fair to him. no one wanted to see him wasting away, mortally wounded, and die in pain. thank you jann for making the best choice all along for his care from the moment you got him to the moment that he had to leave us. you were the best mom he could have ever had, and there was nothing that you could have done to prevent this.

 

[Chamgirl]

Thank you for explaining so thoroughly your theory as to what happened to Padre. I agree, Padre was very lucky to have Jann as his keeper and we all have to accept that he couldn't be saved
Jann you should take comfort in the fact that you acted quickly and did everything you could for your precious Parsons chameleon X

 

[Chris Anderson]

i guess i'll step in here in try and walk y'all through the photos as best as i can make them out. after i'll discuss some aspects of why this was a terminal situation.

photos 1-6 show the devastating necrotizing ulcer that formed way in the back and bottom of the mouth, just before the true esophagus begins. this region is known as the oropharynx. we are looking at the floor of the mouth well behind the glottis and tongue. there is a full-thickness ulcer through the membrane of the oropharynx that happens to lead right into the trachea (windpipe) itself. those are the whitish cartilage rings that can be seen through the fissure. the yellowish exudate around the edge of the lesion is pus/crud/bacteria all mixed together.

photos 7-15 move back towards the front of the mouth a bit (rostrally) where the tongue and finally the glottis itself can be seen. to verify that the hole in the back is indeed in the trachea, they have taken a polypropylene tomcat catheter and inserted it into the glottis where it naturally would continue into the trachea. and that's where you can see the tip of the catheter in the ulcer and even able to come back out of the trachea and into the oropharynx again.

these photos may be a bit harder to understand and i'm not going off of any surgical notes, but this is my understanding from what i'm seeing.

these photos appear to be taken from the side of the neck where an incision was made, as they were unable to reach back far enough into the oropharynx to attempt a repair of the lesion into the trachea. so by making an incision in the side of the neck and lightly dissecting down to where all of these "tubes" (trachea, esophagus) enter the chest, it was hoped that they would be able to patch the lesion from that area and have much more room to work.

unfortunately, it appears that when they went in, there was another large tear in the esophagus. the orange tube is a red-rubber feeding tube that was inserted from the mouth, larger in diameter than the tomcat catheter. that way when dissecting through the side of the neck (and things can get a bit bloody or slightly disorientating), one can feel the red rubber tube within the esophagus and get a better landmark, and also have something to "grab" to be able to move the structures around during the repair. photos 3 & 4 best show that as they dissected down to the area, there was yet another gaping hole allowing the tube to be visible, when it should have been inside the esophagus. this is devastating. air goes to the lungs via the trachea, and food and water go to the stomach through the esophagus. and here they found that not only were food and water entering the lungs though the oropharyngeal ulcer into the trachea, but also that food and water going down the esophagus properly were falling out of yet another hole into what is best described as the mediastinal space; a complicated web of tissues that surround the trachea, esophagus, lungs, heart, and major blood vessels. and that is nowhere that non-sterile food needs to go.

so what caused this?

it is possible, but less probable that this was something that Padre was born with as many of these structures tend to have a common embryonic ancestor, and as they divide, split and mature, something may have gone wrong in the process. and it could have begun as something minute that grew over time or when aggravated by something else. however, that is probably unlikely as he was such a healthy boy with no history (that i know of) of chronic coughing or illnesses that would have been the hallmark of this kind of genetic flaw.

what is more likely, and it grieves me to say it, but it was probably from an insect bite or trauma from something he ate, which can include a spiky leg, a pointy twig or thorn that came in with a meal, or even some kind of burr (the type that catches on your clothes/pet hair and has the built-in Velcro fuzzies).

a Parsons is generally going to eat larger meals, so the bite or thigh spur of a feeder going down would also be correspondingly large. a few weeks ago someone posted on the Forums about some sort of feeder (a superworm/hornworm,?) that was actually seen alive in the back of the throat grasping the tongue. certainly if some of these critters bit down, they could have caused enough damage to the mucosa of the oropharynx to eventually erode through the wall, if not perhaps immediately. having the trachea exposed just underneath is basically just terrible luck. a few cm's one way or the other and the trachea would not have been directly underneath the lesion. it would still not have been good, as food and water would still be falling into the mediastinal space and causing the same problem as the second tear.

since we're playing medical forensics, the odds of a small scrape leading to an ulcer exactly over the trachea seem a bit small to me. i would rather guess that when the insect bit down it was strong enough that he was able to feel the firm, cartilaginous trachea through the soft and thin mucosa of the oropharynx, and that bite went through-and-through. what started small became worse with bacteria and repeated swallowing; it looks like the initial tear up top is 1-2 cm in length. if it was not a bite, a very similar argument could be made for a sharp leg point or plant thorn/etc.

as for the deeper tear it could have been more of the above, related bacteria, possibly the tear coming from the outside-->in rather than inside--->out. but i would have had to be there in surgery or see surgical notes to fully understand what was going on there.

all in all, it was a terrible set of situations/timing/coincidences that led to this. and it was accidental. no one will ever question jann's husbandry or devotion to her pets. in terms of euthanizing on the table under anesthesia; imo it was the best choice in a terrible situation. Padre would have gotten VERY sick very quickly soon after, abscesses in his throat and around his heart and lungs, septic from all of this getting into his bloodstream. i for one say that if he had to go, i am glad that he went with his pride and dignity intact, and was gently let go while already unconscious. the other scenario would have been terrible to even consider, and not fair to him. no one wanted to see him wasting away, mortally wounded, and die in pain. thank you jann for making the best choice all along for his care from the moment you got him to the moment that he had to leave us. you were the best mom he could have ever had, and there was nothing that you could have done to prevent this.

A very thorough and articulate explanation of the photos and what likely led to it occurring in the first place. I was struggling to follow what some of the photos were showing (particularly at the end) but your explanations really help them make sense. I also agree with the assessment of this being the result of a series of unfortunate and ultimately unlikely events that just happened to coincide with each other to create a perfect storm, if you will. Definitely not a husbandry issue in any way, in my opinion, and I also agree that under the circumstances, putting him down while under anesthesia was the right thing to do. Very sad.

Chris

 

[K9Luvn]

Thank you both for helping us to understand the photos with your opinions and observations. You are both such an wonderful asset to this forum.

 

[lisagr07]

Thanks sooo much for the explanation of what we are looking at. It's plain to see that this was an "injury" that wasn't going to heal itself and was too extensive for even an expert to repair..... We're all beyond sad that it happened, it was just a freakish turn of event...

 

[cricketkilla]

so what caused this?

it is possible, but less probable that this was something that Padre was born with as many of these structures tend to have a common embryonic ancestor, and as they divide, split and mature, something may have gone wrong in the process. and it could have begun as something minute that grew over time or when aggravated by something else. however, that is probably unlikely as he was such a healthy boy with no history (that i know of) of chronic coughing or illnesses that would have been the hallmark of this kind of genetic flaw.

what is more likely, and it grieves me to say it, but it was probably from an insect bite or trauma from something he ate, which can include a spiky leg, a pointy twig or thorn that came in with a meal, or even some kind of burr (the type that catches on your clothes/pet hair and has the built-in Velcro fuzzies).

a Parsons is generally going to eat larger meals, so the bite or thigh spur of a feeder going down would also be correspondingly large. a few weeks ago someone posted on the Forums about some sort of feeder (a superworm/hornworm,?) that was actually seen alive in the back of the throat grasping the tongue. certainly if some of these critters bit down, they could have caused enough damage to the mucosa of the oropharynx to eventually erode through the wall, if not perhaps immediately. having the trachea exposed just underneath is basically just terrible luck. a few cm's one way or the other and the trachea would not have been directly underneath the lesion. it would still not have been good, as food and water would still be falling into the mediastinal space and causing the same problem as the second tear.

since we're playing medical forensics, the odds of a small scrape leading to an ulcer exactly over the trachea seem a bit small to me. i would rather guess that when the insect bit down it was strong enough that he was able to feel the firm, cartilaginous trachea through the soft and thin mucosa of the oropharynx, and that bite went through-and-through. what started small became worse with bacteria and repeated swallowing; it looks like the initial tear up top is 1-2 cm in length. if it was not a bite, a very similar argument could be made for a sharp leg point or plant thorn/etc.

as for the deeper tear it could have been more of the above, related bacteria, possibly the tear coming from the outside-->in rather than inside--->out. but i would have had to be there in surgery or see surgical notes to fully understand what was going on there.

all in all, it was a terrible set of situations/timing/coincidences that led to this. and it was accidental. no one will ever question jann's husbandry or devotion to her pets. in terms of euthanizing on the table under anesthesia; imo it was the best choice in a terrible situation. Padre would have gotten VERY sick very quickly soon after, abscesses in his throat and around his heart and lungs, septic from all of this getting into his bloodstream. i for one say that if he had to go, i am glad that he went with his pride and dignity intact, and was gently let go while already unconscious. the other scenario would have been terrible to even consider, and not fair to him. no one wanted to see him wasting away, mortally wounded, and die in pain. thank you jann for making the best choice all along for his care from the moment you got him to the moment that he had to leave us. you were the best mom he could have ever had, and there was nothing that you could have done to prevent this.

Just wanted to thank you Dr. O for interpreting the images from the surgery. I think this tragedy will have a lasting effect on everyone who watched Padre live and flourish. I hope this will make everyone take a hard look at their feeding methods, and place a greater emphasis on making sure prey items are of appropriate size and prepared in a manner that places the chameleons health and safety as the number one priority. Once again Jann, my wife and I hate that something like this happened to you. We loved watching Padre's progress as he grew into the majestic animal that he was. Even though his physical self has passed on, the effect he had on everyone that knew of him and grew to love him, will live on forever. You were a great Cham mommy and thank you for sharing him with all of us, you and padre are what inspired me to get back into this hobby in the first place. Thoughts and prayers for your family are on their way from OKC.

Trey

 

[jastate09]

This is just so sad. I am so sorry that you lost Padre. He was such a magnificent animal. What happen to the pictures? I would have liked to have seen them all.

 

[carol5208]

trying to figure that out! I let Jann know and on her computer she sees all the pics still!!! Very weird!!!

 

[Dr O]

I'm guessing that since they are hosted on photobucket, they must have some rules regarding surgery/bloody photos and took them down.

they can be reposted here on the Forums and still be safe.

 

[Lamour]

I just saw this thread and I'm so sorry for your loss Jann. Padre was such a handsome boy and will be greatly missed. My thoughts go out to your family and your other chams, I hope things start looking up for you. I give my chameleon medicine everyday and I will definitely start inspecting his mouth as well.

 

[jannb]

All of your comments, cards, PM's, emails, phone calls and text mean so much to me. It all happen so quick, I am still having a hard time believing he is gone.

I will try to load the pictures by up or if you pm me your email address I will email them to you.

 

[Montium]

I am at a total loss. Like many others I logged in to see how his recovery was going. I can only begin to imagine the pain you and Mike are going through. If there is anything I can do please let me know.

 

[moviemanmania]

Oh my darling Jann, how I feel for you so. What an unexpected loss of such an amazing creature. You did everything you could for our dear Padre. I am so sorry to hear of his passing. Keep your head up high my dear.

 

[nimmitz]

aw sorry to hear jann