pygmy with swollen feet/joints??

[fishinmyhead]

ok.. so my jackson is doing better, but now, i look in my pygmys cage today and BOTH of his back feet are swollen! he is still active.
what is it? i have never seen this. there are no puncture marks or anything. it looks a lot like joint disease or something..
any ideas?
(im going to take him to work/the vet tomorrow but any input from you guys would be fantastic.)
thanks!

 

[gpmo]

It looks like gout to me, but I'm not an expert. What do you feed your pygs and your feeders?

gpmo (her)

 

[FFSTRescue]

I have the same problem in my pygmys, I figured it could be edema from over-supplementation, but I really don't supplement that often with them. I am trying different therapies and treatments, I will keep you posted on what I find.

 

[fishinmyhead]

i feed them crickets and flightless fruit flies. the crickets i feed apples, potatoes, pears, baby foods like sweet potatoes and peas, sometimes dog food (rarely). and i give them "zoo med's reptivite" with d3. they have a uv light all day too.
does it go away? how do you treat it? should i do some subcutaneous fluid therapy to try to flush it out if its because of too much vits?

 

[fishinmyhead]

if it is gout...

i found this article:
Clinical picture of a veiled chameleon
This is a case someone send me by e-mail and I believe is important to expose to the people this kind of pathology, I had the same problem on my Johnston's chameleon; this case is a Chameleon calyptratus that presented the same symptoms my Johnston developed

Question
Dr. I have a 2 year old male veiled that has developed some lumps around both carpal regions. The lumps are fairly large, the one on the left forelimb is solitary & consolidated, the one on the right appears larger and more like generalized swelling (it is older than the lump on the left, however). I took a radiograph of both limbs several months ago when the problem began, but could not see bony involvement (only soft tissue swelling). I did 3 weeks worth of oral Baytril but there was no observable change. I feel that the lumps are getting worse and am considering repeating x-rays and possibly surgical correction if indicated. My main rule-outs at this point are gout and abscess. Any suggestions as to further diagnostics or therapeutics? Thanks!

Answer
When you did X rays what you descried to me as soft tissue swelling sounded more like crystals deposits around the joint (periarticular gout) I could be wrong but I think we got to review the case together. There are two classifications of gout: primary (hyperuricemia) and secondary (chronic disease or a drug that interferes with normal balance between the production and excretion of uric acid) I'm afraid that you got a case of tophaceous gout which is the inability to excrete uric acid resulting in urate crystal deposits in cartilage, sinovial membranes, tendons, and soft tissue. The treatment could be orientated to lower the serum uric acid levels with antihyperuricemic drugs like allupurinol, or promote uric acid excretion with probenecid.
Allopurinol 20mg/kg, PO every 24hours
Probenecid 250mg/kg PO (increase as needed)

Diagnosis
The early ocular changes of the disease are confirmed to mild eye edema we also can confirm the disease by checking the clinical sings of eye problems and diet history. Histophatologic diagnosis at biopsy should rarely be required.

In reptiles, uric acid is cleared from the blood through the kidneys tubules, dehydratation does not impair tubule excretion, but lower ambient temperatures does decrease renal tubule function. So provide the chameleon with temperatures ranges of 80-84ºF

Unless a bacteria has developed resistance to enrofoxacin the 3-week treatment period of Baytril would've kill any microorganism. Please keep me informed bye. Dr.J

 

[FFSTRescue]

I hate to be Debbie downer here, but in many cases with gout in insectivorous reptiles, it is because of impaired renal function, and goes from bad to worse. The kidneys are supposed to remove the uric acid and if they are not functioning correctly, they aren't able to do so, and gout develops. Often I have seen gout at my clinic in herbivorous reptiles that are fed insects, and their bodies didn't evolve to handle such large amounts of protein, but carnivores/insectivores did evolve, or adapt, to be able to consume high amounts of protein, and should consume protein, as long as they are able to consume enough water. But in so many cases, no matter how much water we give them orally, it does not make a difference because the uric acid remains high in the blood, therefore collecting in the joints and other areas of the body, which is very painful. Reptiles that had renal insufficiency or failure, in my cases, only improved with subcutaneous fluid, however it is not humane to keep using an animal as a pin cushion and poking it daily. There are also NSAIDS such as Metacam (meloxicam) that can be used to reduce inflammation and pain, but those can also contribute to kidney damage as well. It is a hard one to decide what to do. My pygmy is in obvious pain, and despite all my efforts, she has not improved so the most humane thing to do is euthanize. That is my plan, I am not saying that is what you should do. I would consult with your veterinarian about SQ fluids (remember chameleons bruise easily from SQ fluid administration, and I have seen some bleed out internally from it and die), as well as pain relievers. But for now, I would definitely increase the hydration and make sure she is ingesting the water. Keep me updated on your chameleon, and thank you for posting that information, I really enjoyed reading it!

 

[fishinmyhead]

*sigh* yea.. i talk to 3 different vets today and they all said pritty much the same thing.
we can do rads and bloodwork but how much stress can i put him through with sq fluids and oral meds before that kills him?
and yes the metacam thing came up too but like you said. kidneys. its not going to be good.
one of the vets suggested doing prednisone. im going to have to formulate the crap out of it to make it small enough for a pygmy but i might try that. hes VERY active. actually, more than he was before the gout. last night it looked liek he was trying to get out of the cage. im not sure if hes just very uncomfortable or what. hmmm...
it really sucks because iv only had him for about 2 months. i got him and he was full grown so im not sure how old he really is or what he was eating before..
anyway. i will keep you posted. and thanks for your help!!!

 

[BocaJan]

Does everyone use a low level UVB tube with their brevs? I have an old 5 that I use but I hear you can also use a 2. Even on a forest floor they do get UVB and I bet they can get MVB also. I'm not saying this isn't gout because I am sure the vets are correct, but I'm just throwing out the MVB question to find out what people are doing.