Ricki does not want any medicine today!
- Thread starter Jo00
- Start date
Jo00
Avid Member
Not eating on his own. Looking very lethargic. Not at all himself. Legs seem rubbery and difficulty with mobility. Diagnosed with early kidney disease. So, syringe feeding, getting injections of antibiotics every 3 days, oral liquid calcium and lactose to help ease the way for feces. Seems to be getting a little better but he still can’t eat on his own Going back to the vet this week to check his tongue/mouth more thoroughly and asked for X-rays to see if kidneys are enlarged. If I use my finger nail to gently very slightly open his mouth and put a worm in when he opens it a bit more, he takes it but has trouble getting it past his tongue to swallow it. But that’s progress
. It’s been a very rough road over the last few weeks.
MissSkittles
Chameleon Enthusiast
So sorry that your big handsome guy isn’t doing so well. Sending healing vibes and prayers. 
Jo00
Avid Member
Not eating on his own. Looking very lethargic. Not at all himself. Legs seem rubbery and difficulty with mobility. Diagnosed with early kidney disease. So, syringe feeding, getting injections of antibiotics every 3 days, oral liquid calcium and lactose to help ease the way for feces. Seems to be getting a little better but he still can’t eat on his own Going back to the vet this week to checking
So sorry that your big handsome guy isn’t doing so well. Sending healing vibes and prayers.
his tongue/mouth more thoroughly and asked for X-rays to see if kidneys are enlarged. If I use my finger nail to gently very slightly open his mouth and put a worm in when he opens it a bit more, he takes it but has trouble getting it past his tongue to swallow it. But that’s progress
Jo00
Avid Member
Thank you. Hard to believe
. The vet said his husbandry is “exemplary “ (thanks to the guidance of people like you who give their time to help others) so that’s not the cause. Does there happen to be anyone on the forum who can take a look at his test results to see how things look to them or if anything stands out?
. The vet said his husbandry is “exemplary “ (thanks to the guidance of people like you who give their time to help others) so that’s not the cause. Does there happen to be anyone on the forum who can take a look at his test results to see how things look to them or if anything stands out?
MissSkittles
Chameleon Enthusiast
You can post the labs and some of us may be able to tell you what the different values are, but to interpret them all together as a whole requires higher skill such as that of a veterinarian. You may want to call to go over all of the abnormal values with your vet and have him/her explain them and how they all fit together into the diagnosis given.
Jo00
Avid Member
Thanks. I have another appointment on Thursday so I’ll see how that goes.
Jo00
Avid Member
Thank you. The vet did prescribe lactose to facilitate easier bowel movement. She said that enlarged kidneys interfere with feces getting through resulting in constipation. Thing is, she didn’t do an X-ray so I think she’s assuming they are enlarged. I’m going back thursday and have asked her to do an X-ray and more thoroughly check his tongue and mouth. He has has problems with constipation in the past.
You said…”Not eating on his own. Looking very lethargic. Not at all himself.”…how long has he not been eating on his own?
You said…” Legs seem rubbery and difficulty with mobility”…this sounds like a nutrient issue..like calcium imbalance.
You said…”Diagnosed with early kidney disease.“…diagnosed on what basis?
You said…”So, syringe feeding, getting injections of antibiotics every 3 days, oral liquid calcium and lactose to help ease the way for feces”…
syringe fed what? What antibiotic? What UVB light specifically are you using? Long linear? Brand? What supplements and how often for each…particularly interested in the phis, calcium, D3 and form of vitamin A. Does he drink well?
You said…” Seems to be getting a little better but he still can’t eat on his own Going back to the vet this week to check his tongue/mouth more thoroughly and asked for X-rays to see if kidneys are enlarged. If I use my finger nail to gently very slightly open his mouth and put a worm in when he opens it a bit more, he takes it but has trouble getting it past his tongue to swallow it. But that’s progress. It’s been a very rough road over the last few weeks.”…do you think/know something is going on with the tongue or mouth? Is his tongue swollen?
You said…” Legs seem rubbery and difficulty with mobility”…this sounds like a nutrient issue..like calcium imbalance.
You said…”Diagnosed with early kidney disease.“…diagnosed on what basis?
You said…”So, syringe feeding, getting injections of antibiotics every 3 days, oral liquid calcium and lactose to help ease the way for feces”…
syringe fed what? What antibiotic? What UVB light specifically are you using? Long linear? Brand? What supplements and how often for each…particularly interested in the phis, calcium, D3 and form of vitamin A. Does he drink well?
You said…” Seems to be getting a little better but he still can’t eat on his own Going back to the vet this week to check his tongue/mouth more thoroughly and asked for X-rays to see if kidneys are enlarged. If I use my finger nail to gently very slightly open his mouth and put a worm in when he opens it a bit more, he takes it but has trouble getting it past his tongue to swallow it. But that’s progress
. It’s been a very rough road over the last few weeks.”…do you think/know something is going on with the tongue or mouth? Is his tongue swollen?
Jo00
Avid Member
You said…” Legs seem rubbery and difficulty with mobility”…this sounds like a nutrient issue..like calcium imbalance. YES. IN FACT I WONDERED IF THE WHOLE RANGE OF SYMPTOMS WAS A NUTRIENT ISSUE BUT AS MENTIONED ABOVE MY ORIGINAL VET WAS NOT AGREEABLE TO BLOOD WORK. WHEN MADE THE APPOINTMENT WITH NEW VET, I TOLD THEM THE HISTORY AND SAID I THINK HE NEEDS BLOOD WORK.
You said…”Diagnosed with early kidney disease.“…diagnosed on what basis? BASED ON LAB RESULTS AND SYMPTOMS
You said…”So, syringe feeding, getting injections of antibiotics every 3 days, oral liquid calcium and lactose to help ease the way for feces”…
syringe fed what? EMERAID FOR EXOTIC ANIMAL CRITICAL CARE. What antibiotic? CEFTADIZIME. What UVB light specifically are you using? Long linear? Brand? ARCADIA 12% ON RISERS TO ACHIEVE RANGE OF 3.2-4 UVI Long linear? 42” Brand? ARCADIA
What supplements and how often for each…particularly interested in the phis, calcium, D3 and form of vitamin A. FLUKERS CALCIUM WITHOUT D3 AT EVERY FEEDING EXCEPT ON 1st AND 15th OF MONTH WHEN FEEDERS ARE DUSTED WITH REPASHY CALCIUM PLUS. Does he drink well? NO HE NEVER HAS. LEAVES ARE MISTED BEFORE LIGHTS ON AND AFTER LIGHTS OUT; FOGGER RUNS STEADY 10pm TO 6am FOR AVERAGE 90% HUMIDITY; DRIPPER IS RUN TWICE A DAY AND HE SHOWS NO INTEREST IN IT.
You said…” Seems to be getting a little better but he still can’t eat on his own Going back to the vet this week to check his tongue/mouth more thoroughly and asked for X-rays to see if kidneys are enlarged. If I use my finger nail to gently very slightly open his mouth and put a worm in when he opens it a bit more, he takes it but has trouble getting it past his tongue to swallow it. But that’s progress
I WELCOME ANY AND ALL INPUT AND ADVICE. I DO HAVE THE LAB REPORTS THAT I‘D BE HAPPY TO SHARE
You said…”JANUARY: HAD TROUBLE HITTING TARGET WITH TONGUE.
FEBRUARY: I HAD TO HAND FEED HIM. HE COULD TAKE FOOD WITH LIPS BUT WASN’T SHOOTING TONGUE. TOOK TO VET AND HE SAID HE SEES NOTHING OUT OF ORDINARY.”…the tongue not working properly is definitely out of the ordinary and it should have been investigated to see why IMHO.
You said…”MARCH: LOST APPETITE AND ONLY ATE FROM HAND FEEDING PERIODICALLY AND WAS GETTING WEAK AND DEHYDRATED. WENT BACK TO VET AND ASKED FOR BLOOD WORK BECAUSE HE WAS STILL NOT ESTING AND WAS GETTING WORSE. HE SAID HE FELT BLOOD WORK WAS TOO INVASIVE AT THIS TIME!!!”…tongue issues are not just something caused by the season…and IMHO should have been investigated further.
You said…”SUGGESTED GIVING IT A COUPLE OF MORE WEEKS TO SEE IF HE IS JUST REACTING TO THE SEASON AND PERKS UP AT THE END OF THE MONTH!!! I WAS FLABBERGASTED SO WENT HOME AND STARTED LOOKING FOR A NEW VET. FOUND ONE BUT COULDN’T GET AN APPOINTMENT UNTIL APRIL 25.”…good idea to look for a good exotics chameleon vet.
FEBRUARY: I HAD TO HAND FEED HIM. HE COULD TAKE FOOD WITH LIPS BUT WASN’T SHOOTING TONGUE. TOOK TO VET AND HE SAID HE SEES NOTHING OUT OF ORDINARY.”…the tongue not working properly is definitely out of the ordinary and it should have been investigated to see why IMHO.
You said…”MARCH: LOST APPETITE AND ONLY ATE FROM HAND FEEDING PERIODICALLY AND WAS GETTING WEAK AND DEHYDRATED. WENT BACK TO VET AND ASKED FOR BLOOD WORK BECAUSE HE WAS STILL NOT ESTING AND WAS GETTING WORSE. HE SAID HE FELT BLOOD WORK WAS TOO INVASIVE AT THIS TIME!!!”…tongue issues are not just something caused by the season…and IMHO should have been investigated further.
You said…”SUGGESTED GIVING IT A COUPLE OF MORE WEEKS TO SEE IF HE IS JUST REACTING TO THE SEASON AND PERKS UP AT THE END OF THE MONTH!!! I WAS FLABBERGASTED SO WENT HOME AND STARTED LOOKING FOR A NEW VET. FOUND ONE BUT COULDN’T GET AN APPOINTMENT UNTIL APRIL 25.”…good idea to look for a good exotics chameleon vet.
You said…”YES. IN FACT I WONDERED IF THE WHOLE RANGE OF SYMPTOMS WAS A NUTRIENT ISSUE BUT AS MENTIONED ABOVE MY ORIGINAL VET WAS NOT AGREEABLE TO BLOOD WORK. WHEN MADE THE APPOINTMENT WITH NEW VET, I TOLD THEM THE HISTORY AND SAID I THINK HE NEEDS BLOOD WORK.”…I assume they did it since you have lab reports.
You said…”BASED ON LAB RESULTS AND SYMPTOMS”…what did they say the symptoms were?
You said…”EMERAID FOR EXOTIC ANIMAL CRITICAL CARE”…this is ok for a few days.
You said…” CEFTADIZIME“…why an antibiotic? They are almost all hard on the kidneys….and unnecessary unless the chameleon had an infection. Does it?
You said…,”FLUKERS CALCIUM WITHOUT D3 AT EVERY FEEDING EXCEPT ON 1st AND 15th OF MONTH WHEN FEEDERS ARE DUSTED WITH REPASHY CALCIUM PLUS“…I don’t know the form of vitamin A in the repashy. Anyone? @Beman ? @MissSkittles ?
You said…regarding drinking…”NO HE NEVER HAS. LEAVES ARE MISTED BEFORE LIGHTS ON AND AFTER LIGHTS OUT; FOGGER RUNS STEADY 10pm TO 6am FOR AVERAGE 90% HUMIDITY; DRIPPER IS RUN TWICE A DAY AND HE SHOWS NO INTEREST IN IT”…what colour are his urates?
You said…”I DO THINK SOMETHING IS GOING ON WITH HIS TONGUE BUT IT IS NOT, FROM WHAT I CAN SEE, SWOLLEN. VET SAYS TONGUE ISSUES ARE ANOTHER SYMPTOM OF KIDNEY ISSUES. NONETHELESS, I’VE ASKED THAT THEY MORE THOROUGHLY EXAMINE IT ON THURSDAY AND THAT THEY X-RAY TO SEE IF KIDNEYS ARE ENLARGED AND INTERFERING WITH BOWEL MOVEMENTS”…I'm not a vet…but the only thing I can think of that could affect the tongue that would have to do with kidneys is that the vitamin D3 could be off because damaged kidneys wouldn't be able to store D3…so calcium levels could be off. As for bowel movements…is he not pooping?
You said…”BASED ON LAB RESULTS AND SYMPTOMS”…what did they say the symptoms were?
You said…”EMERAID FOR EXOTIC ANIMAL CRITICAL CARE”…this is ok for a few days.
You said…” CEFTADIZIME“…why an antibiotic? They are almost all hard on the kidneys….and unnecessary unless the chameleon had an infection. Does it?
You said…,”FLUKERS CALCIUM WITHOUT D3 AT EVERY FEEDING EXCEPT ON 1st AND 15th OF MONTH WHEN FEEDERS ARE DUSTED WITH REPASHY CALCIUM PLUS“…I don’t know the form of vitamin A in the repashy. Anyone? @Beman ? @MissSkittles ?
You said…regarding drinking…”NO HE NEVER HAS. LEAVES ARE MISTED BEFORE LIGHTS ON AND AFTER LIGHTS OUT; FOGGER RUNS STEADY 10pm TO 6am FOR AVERAGE 90% HUMIDITY; DRIPPER IS RUN TWICE A DAY AND HE SHOWS NO INTEREST IN IT”…what colour are his urates?
You said…”I DO THINK SOMETHING IS GOING ON WITH HIS TONGUE BUT IT IS NOT, FROM WHAT I CAN SEE, SWOLLEN. VET SAYS TONGUE ISSUES ARE ANOTHER SYMPTOM OF KIDNEY ISSUES. NONETHELESS, I’VE ASKED THAT THEY MORE THOROUGHLY EXAMINE IT ON THURSDAY AND THAT THEY X-RAY TO SEE IF KIDNEYS ARE ENLARGED AND INTERFERING WITH BOWEL MOVEMENTS”…I'm not a vet…but the only thing I can think of that could affect the tongue that would have to do with kidneys is that the vitamin D3 could be off because damaged kidneys wouldn't be able to store D3…so calcium levels could be off. As for bowel movements…is he not pooping?
MissSkittles
Chameleon Enthusiast
Repashy calcium plus has preformed vitamin A. It’s ok to use, but the Repashy calcium plus LoD is more appropriate for chams.
Jo00
Avid Member
Jo00
Avid Member
I absolutely agree with all of your opinions. It’s been very frustrating trying to find another vet. Chameleons are rarely kept by people in my geographic area so the exotics vets have very little opportunity to work with them. I’ve been told that people who do get them have no idea what they need and don’t take them to a vet when they are ill! Very sad. I’m really hoping things go well with this vet but if not I would have to bus to another city for vet care. I decided to try this new vet based on the recommendation of a local reptile rescue I support. The owner is a RVT and worked with this vet for a number of years. She takes all of her reptile rescues to her.
Repashy Plus also has Vit D so I guess the LoD has less Vit D? I will switch to LoD if it’s more suitable.
Jo00
Avid Member
JOANNE’S NOTES TO FORUM MEMBERS…THIS IS PART 1
I’LL HAVE TO BREAK THIS UP INTO MORE THAN 1 POST SINCE IT’S OVER THE ALLOWABLE NUMBER OF CHARACTERS
1). IDENTIFYING VET INFORMATION REMOVED SINCE THIS IS A PUBLIC FORUM
2). Error in weight loss amount. not 25 gr; more like 10 gr.
3). Not sure what she means by “perching upside down”
VET REPORT AND LAB RESULTS
SOAP Text Jun 8 2023 2:36PM –
PATIENT HISTORY
Presenting for weak tongue, not eating as much, imbalance on perches, losing wt April not eating much
o mashesup silkworms and he'll eat, now he's eating he's getting stronger but still struggling no bm recently
lost 25 g in 2 mos shed
NI eating yesterday
hx of intermittent constipation in past
EXAM FINDINGS
Respiratory Rate (BPM) - eupnic
Fear Free: not as social as Willy but allows handling General:Bright, alert and responsive - quiet
Hydration:Well hydrated - tacky mmb/ropy oral mucous
Eyes: No discharge, corneas clear OU -
Nares: No discharge -
Gular: No discomfort, nor swelling -
Oral - General: No mucosal changes -
Teeth: Normal occlusion, no missing nor discoloured teeth, normal gingiva -
Cardiovascular: Doppler; no murmur/arrhythmia on heart or jugular groove - incr hr but handlign/stress species
Pulmonary: Normal respiratory effort -
Coelomic cavity: No distension or palpable masses - CFAST no ff, liver nsf fat pad nsf, gi material noted, prominent kidneys with mild spiculated hyperechoic lines with casting (rarebut present)
Vent: Clean, no swelling, good tone; digital exam not performed - Integument:No retained shed, nails intact - light retained shed along veil Musculoskeletal: Ambulatory x 4 - strong grip no overt joint swelling
Nervous system:No overt neurological deficits - listing on perch, intermittently perching upside down
BW:
WBC, Total 3137 (61 + 62 JGL) ddx summative low vs wnl (range 1.1-36, but mean 9.6, median 6.8) Heterophils 68 : Lymphocytes 9 (~10% reactive) : Monocytes 22
Left Shift Heterophils 0 Thrombocytes <2/oil (M1 clumping) WBC Morphology wnl
RBC Morphology M1 polychromasia, M2 aniscocytosis/poikilocytosis, M2 cells folded
DVM Assessment - CBC 0 - 6/8/23 wbc wnl high azuro/mps, morphology wnl, elevated pcv mild withmild incr pr - dehydration, chr inflammation, no overt sepsis
2023-06-08 2:44:44 PMOrdered Lab Test: Maxi Blood Panel - Avian/Reptile (Abaxis)
PCV 33 (JGL) >27 (mean 28, median 27.5)
K+ 5.9 wnl
GLOB 33 ALB 39 TP 72 mild elevated
PHOS 2 wnl
CA 3.8 wnl
Ca
1.9 wnl
GLU 16 >15.6 slight elevated, wnl; ddx stress UA728 high normal
CK 4485 AST 423 stress, handling (ast not liver spc in chameleons)
BA 35 no clear reference for chameleons - random or post prandial can be elevated to this range (VIN)
Can J Vet Res. 2018 Apr; 82(2): 106–114. Venous blood gases, plasma biochemistry, and hematology of wild-caught common chameleons (Chamaeleo chamaeleon)
reviewed results; discussed limits of references but some work has been done on captive and wild type chameleons and including veiled chameleons - with the info and behaviour ddx is renal lesion; recc as he's feeling stronger with supplemental feeding to do this, improve hydration (oral rehydration via carnivore care), lactulose (stool softner and liver support), ceftazidime as saw several VIN posts aboutsupportive (ddx renal infection, low wbcs), sqft today and increase misting at home, sq ca today then boost at home; recc d/c d3 supplement and make sure UV output is good (meters or new bulbs)
as his values are not as derranged as see in advanced dz worth trying to see if with supplementalsupport we can help him
the renomegaly can explain constipation issues
reviewed renal dz in reptiles and how varies from mammals, common in older chameleons, given the elytes are normal and mild dehydration, worth seeing if can support him back to balance; risk with protein loading may worsen - if sees this then recc reck UA and consider allopurinol - reviewed ELDU and extrapolated dosing for this; as we do not know if this would work or cause harm (reviewed works well in birds) hold for now as his UA values are elevated but rest of values are not as severe to prompt gout risk worries just yet; reviewed visceral vs articular gout; concerns wrt US findings; weekly updates; if doinggreat continue course, if not improving recc XR to assess bone density (given husbandry if see signs of MBD concern for neoplasia vs renal pathology) and reck UA to assess if should try extrapolating allopurinol dosing
Treatments/Outpatient:
Prescribed - Ceftazidime 300 mg/ml Injectable (0.140)
Instructions - KEEP FROZEN and THAW SINGLE DOSE BEFORE USE. Inject entire content of syringe (0.02 ml) under the skin (subcutaneously) every 72 hours for 7 doses or otherwise directed into the FRONT LEGS/front part of body. Alternate sites with each dose. - Expires: 2024-06-07 0 Refills
Instructions - Give 100 mg/kg (0.24 ml) diluted into 3 ml LRS sq (multiple sites) - Expires: 2024-06-07 0Refills 2023-06-08 3:06:29 PM
Prescribed - Lactulose Solution 667mg/ml (Acilac) (10.000)
Instructions - Give 0.1 ml by mouth every 12 hours (can mix into carnivore care) for a week then oncedaily; if stool gets too lose reduce dose to once daily sooner. - Expires: 2024-06-07 0 Refills
Instructions - Give 0.25 ml by mouth once daily (can mix into carnivore care) until consistently eating well on his own. - Expires: 2024-06-07 0 Refills
Instructions - Mix 1 part powder with 1 part warm water and gently trickle feed 3 ml (more if he wants it) daily, you can divide into meals (up to 7 ml a day). ideally give after a warm soak or misting. Increasemisting frequency - Expires: 2024-06-07 0 Refills
Follow Up:
1. pending progress see comms
I’LL HAVE TO BREAK THIS UP INTO MORE THAN 1 POST SINCE IT’S OVER THE ALLOWABLE NUMBER OF CHARACTERS
1). IDENTIFYING VET INFORMATION REMOVED SINCE THIS IS A PUBLIC FORUM
2). Error in weight loss amount. not 25 gr; more like 10 gr.
3). Not sure what she means by “perching upside down”
VET REPORT AND LAB RESULTS
SOAP Text Jun 8 2023 2:36PM –
PATIENT HISTORY
Presenting for weak tongue, not eating as much, imbalance on perches, losing wt April not eating much
o mashesup silkworms and he'll eat, now he's eating he's getting stronger but still struggling no bm recently
lost 25 g in 2 mos shed
NI eating yesterday
hx of intermittent constipation in past
EXAM FINDINGS
Vitals
Weight - xgm - 238 Heart Rate(BPM) - 60Respiratory Rate (BPM) - eupnic
Fear Free: not as social as Willy but allows handling General:
Hydration:
Eyes: No discharge, corneas clear OU -
Nares: No discharge -
Gular: No discomfort, nor swelling -
Oral - General: No mucosal changes -
Teeth: Normal occlusion, no missing nor discoloured teeth, normal gingiva -
Cardiovascular: Doppler; no murmur/arrhythmia on heart or jugular groove - incr hr but handlign/stress species
Pulmonary: Normal respiratory effort -
Coelomic cavity: No distension or palpable masses - CFAST no ff, liver nsf fat pad nsf, gi material noted, prominent kidneys with mild spiculated hyperechoic lines with casting (rarebut present)
Vent: Clean, no swelling, good tone; digital exam not performed - Integument:
Nervous system:
BW:
LabOrders
2023-06-08 2:44:42 PMOrdered Lab Test: Avian or Reptile CBC (LAH)WBC, Total 3137 (61 + 62 JGL) ddx summative low vs wnl (range 1.1-36, but mean 9.6, median 6.8) Heterophils 68 : Lymphocytes 9 (~10% reactive) : Monocytes 22
Left Shift Heterophils 0 Thrombocytes <2/oil (M1 clumping) WBC Morphology wnl
RBC Morphology M1 polychromasia, M2 aniscocytosis/poikilocytosis, M2 cells folded
DVM Assessment - CBC 0 - 6/8/23 wbc wnl high azuro/mps, morphology wnl, elevated pcv mild withmild incr pr - dehydration, chr inflammation, no overt sepsis
2023-06-08 2:44:44 PMOrdered Lab Test: Maxi Blood Panel - Avian/Reptile (Abaxis)
PCV 33 (JGL) >27 (mean 28, median 27.5)
TS 6.6 (JGL) >5.6
mild dehydration NA+ 145wnlK+ 5.9 wnl
GLOB 33 ALB 39 TP 72 mild elevated
PHOS 2 wnl
CA 3.8 wnl
Ca
1.9 wnlGLU 16 >15.6 slight elevated, wnl; ddx stress UA728 high normal
CK 4485 AST 423 stress, handling (ast not liver spc in chameleons)
BA 35 no clear reference for chameleons - random or post prandial can be elevated to this range (VIN)
Can J Vet Res. 2018 Apr; 82(2): 106–114. Venous blood gases, plasma biochemistry, and hematology of wild-caught common chameleons (Chamaeleo chamaeleon)
ASSESSMENTS
ddx RI vs renal disease; pos liver dz (fatty liver, other) mbd,NHPT less likely husbandry related, ddx neoplasiaPLANS
Discussion/Recommendations:reviewed results; discussed limits of references but some work has been done on captive and wild type chameleons and including veiled chameleons - with the info and behaviour ddx is renal lesion; recc as he's feeling stronger with supplemental feeding to do this, improve hydration (oral rehydration via carnivore care), lactulose (stool softner and liver support), ceftazidime as saw several VIN posts aboutsupportive (ddx renal infection, low wbcs), sqft today and increase misting at home, sq ca today then boost at home; recc d/c d3 supplement and make sure UV output is good (meters or new bulbs)
as his values are not as derranged as see in advanced dz worth trying to see if with supplementalsupport we can help him
the renomegaly can explain constipation issues
reviewed renal dz in reptiles and how varies from mammals, common in older chameleons, given the elytes are normal and mild dehydration, worth seeing if can support him back to balance; risk with protein loading may worsen - if sees this then recc reck UA and consider allopurinol - reviewed ELDU and extrapolated dosing for this; as we do not know if this would work or cause harm (reviewed works well in birds) hold for now as his UA values are elevated but rest of values are not as severe to prompt gout risk worries just yet; reviewed visceral vs articular gout; concerns wrt US findings; weekly updates; if doinggreat continue course, if not improving recc XR to assess bone density (given husbandry if see signs of MBD concern for neoplasia vs renal pathology) and reck UA to assess if should try extrapolating allopurinol dosing
Treatments/Outpatient:
Prescriptions
2023-06-08 3:06:27 PM
Prescribed - Ceftazidime 300 mg/ml Injectable (0.140)
Instructions - KEEP FROZEN and THAW SINGLE DOSE BEFORE USE. Inject entire content of syringe (0.02 ml) under the skin (subcutaneously) every 72 hours for 7 doses or otherwise directed into the FRONT LEGS/front part of body. Alternate sites with each dose. - Expires: 2024-06-07 0 Refills
2023-06-08 3:06:28 PM
Prescribed - Calcium Gluconate 10% inj. (10ml) (0.240)Instructions - Give 100 mg/kg (0.24 ml) diluted into 3 ml LRS sq (multiple sites) - Expires: 2024-06-07 0Refills 2023-06-08 3:06:29 PM
Prescribed - Lactulose Solution 667mg/ml (Acilac) (10.000)
Instructions - Give 0.1 ml by mouth every 12 hours (can mix into carnivore care) for a week then oncedaily; if stool gets too lose reduce dose to once daily sooner. - Expires: 2024-06-07 0 Refills
2023-06-08 3:06:31 PM
Prescribed - Calcium Gluconate Oral 22mg/mL (20.000)Instructions - Give 0.25 ml by mouth once daily (can mix into carnivore care) until consistently eating well on his own. - Expires: 2024-06-07 0 Refills
2023-06-08 3:06:32 PM
Prescribed - Lafeber Emeraid Carnivore (100g) (1.000)Instructions - Mix 1 part powder with 1 part warm water and gently trickle feed 3 ml (more if he wants it) daily, you can divide into meals (up to 7 ml a day). ideally give after a warm soak or misting. Increasemisting frequency - Expires: 2024-06-07 0 Refills
Follow Up:
1. pending progress see comms
