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!
