Strange face issue, vet confused!

[Katy52]

Hello!

My little kiwi is showing signs of illness that the vet can’t work out…

Problem:
About 6 weeks ago he started rubbing the right side of his face. This includes the eye but it really is the whole side of his face he rubs. Sometimes he then does that weird eye bulge cleaning thing. Some days he will close his right eye for periods while he is static, while keeping the other eye open. I also noticed a small growth on that side of his under jaw.

The Vet did a CT scan, there is a lump visible in that tissue that also affects the jaw bone but they were unable to tell if it is a tumour or an infection - the vet examined the inside of his mouth, all fine. Kiwi was given a 10 day course of injected antibiotics. 1 week has passed since he finished the antibiotics and he is still rubbing that side of his face and closing that right eye periodically. He has worn down the scales on the front of his face from this

The vet has hypothisised that the irritation that is causing the rubbing is connected to the growth and he should be put to sleep. It is an exotic vet but it is an extreme decision so if anyone else has any alternative ideas the vet could investigate I would really appreciate your expertise!

Aside from the rubbing he is still eating lots, very active, interacting and being cheeky. The only other change I have noticed is a lack of drinking during this period. Normally I would see him drink most days, in the past 6 weeks I haven’t seen him drink once even when he shows the swallowing drink response thing.

His aim has been gradually getting worse over the past year (I previously posted about it and did a husbandry check) but it doesn’t stop his appetite he just gets closer.

Thank you in advance,
Katy & little kiwi


Husbandry Form

Your Chameleon - Male, panther chameleon, nearly 4 years old. Had him since he was a baby.

Handling - He is very friendly, most days he will voluntarily come out of his enclosure and climb onto me. He then explores my hanging house plants. I limit the time out of enclosure to ensure he gets enough time under enclosure lights.

Feeding -: Staple: dubias, silkworms ) Secondary:BSFL, waxworms, morioworms

Feeding 3 x per week in a cup either held by me or attached inside his enclosure

Gut loading - Silkworms: mulberry leaf paste. Dubia: carrots & sweet potatoes, courgette, broccoli.

Supplements - Daily: Repashy SuperCal no d3, 1st & 3rd Sundays of month: Repashy Calcium plus LoD

Watering - Mistking system, 2 mistking nozzles, each one placed in top front corner

8:20am = 2min
1pm = 1min (to keep daytime humidity above 50%)
8:15pm = 3min
1am = 2min
5am = 2min

Fecal Description - during this period of illness his rates have been small an orange -

Cage Type - customised reptibreeze XL, 61x61x126, acrylic panels on back & sides & top door, mesh lower door & mesh ceiling for chimney effect. No substrate, water drains through holes drilled into the base.

Plants - 3 x pathos, 2 bromeliads, a few air plant. pots have been covered with reptile bark to disguise the plant pot.
All branches are natural ones from outdoors that i scrub with hot water & soap & rinse. I am carefully to never use ones that are peeling or have lichen etc.

Lighting -

• UVB: Arcadia ProT5 22" with Arcadia Forest 6% bulb.

I don't have a UVB meter so I replace the bulb every 12 months religiously. UVB is raised on top of enclose to create 8.5 inches between UVB and the basking branch itself (so Cham's feet).

• Basking: 100 watt ExoTerra basking bulb

Controlled with Habitstat thermostat, probe fixed to basking branch with zip ties. Also have an Exoterra digital thermometer attached to thermostat probe to supervise accuracy.

• Plant grow light - generic one

Light Schedule - UVB & basking operate 8am - 8pm, plant light 9am-5pm

Temperatures -
30C / 86F basking temp controlled via thermostat
20-22C/ 68-72F ambient measured at lower end of cage

Humidity -
Measured with a Govee digital hydrometer & phone app, attached to enclosure back wall

Daytime: average 69% (Lowest 55% Highest 82%)
Nightime: average 76% (Lowest 68% Highest 87%)

Placement - low traffic room 1.2 metre off the floor

Photos - the affect side (right side) and the underside where the growth is

 

[Carlton]

Was the lump ever aspirated to determine what's inside it? Diagnostic imaging might not distinguish between solid tumor or the "caseous" material reptile abscesses form. It isn't as liquid as mammalian abscesses tend to be. It doesn't drain well either. Reptile abscesses also tend to be difficult to treat with systemic antibiotic therapy alone. The abscess itself usually needs to be opened up and thoroughly cleaned out, then followed by a course of oral/injected antibiotics.

Before you put down an animal that still seems to have an interest in living, consider this. Maybe a second opinion too.

FWIW, I had an imported F. verrucosus that developed a slow growing lump between his nares on the top of his snout. There was no obvious wound in the skin. When it finally became obvious the lump was getting larger, took him to a reptile vet. He opened the lump and found it packed with yellowish white cheesey material. The more the vet probed and cleared out, the deeper he found the abscess went. It extended all the way through the roof of the cham's mouth. He could push a swab from the top of his snout all the way down to his tongue. It really was a shock. The vet flushed out the hole and packed it with antibiotic ointment (might have been Silvadene...don't recall now), put him on oral antibiotics and we waited for it to heal. Amazingly, it did and never recurred.

 

[ehdee6]

Just tagging @kinyonga, Do you have any knowledge in this?

 

[MissSkittles]

^^^^ 100%!
First, I would definitely try to find a vet with more experience with reptiles, specifically chameleons. A needle aspirate or tissue biopsy needs to be done before you accept euthanasia as a solution. Reptile pus is a thick cheesy material that does not go away unless it is physically removed. Abscesses can be mistakenly identified as tumors or other growths on visual imaging diagnostics (x rays and the like). His targeting may be off if the abscess is pressing on something related to his eye.
Let me tell you about one of mine - Lucky. One of his eyes puffed way out. Took him to an exotics only vet who I know has seen many chameleons. They gave the antibiotics, anti inflammatory and x rays showed what they believed to be a growth way behind his eye. They suggested just keeping him comfortable. I accepted this. The eye puff resolved, but then his eye flattened a bit, was itchy at times and I realized he had lost vision in that eye. Just for the heck of it, and many months after the initial problem settled down, I went to a much better exotics vet just to make sure my guy was comfortable. He explained that he likely had an abscess (that could have been accessed in the roof of his mouth) that probably ‘popped’ and drained out the cheese on its own. It would have been in a way behind the eye and what the first vet thought was an inaccessible growth. My guy is mostly blind in that one eye and I have to help him eat most of the time. He does have a quality life and is not in pain or suffering. No idea how old he is (he’s a veiled that was wild in Florida and found by kids) but he’s at least 4 if not much older.
The moral of story - second opinions always! Not all vets who see exotics are experienced with reptiles and chameleons. Exotics is a very broad term that encompasses birds, ferrets, rabbits, snakes, and pretty much everything else that isn’t a farm animal or a cat or dog.

 

[MissSkittles]

I just saw this NERD video this morning and it shows the consistency of reptile pus perfectly. Advance to 8:58 if you aren’t too squeamish. While the snake in the video actually somehow expelled that from its respiratory tract, it shows how thick and solid it is and Kevin explains it a little bit.

 

[kinyonga]

@Carlton has given you a good bunch of information.

I wouldn’t be putting your chameleon down at this point. I’ve had the exact same experience as @Carlton has had with the infection being extensive. It’s amazing how they cope with such “trails”of infection.

I was told that they can “wall” of the infection in many cases, so it won’t affect them until/unless it breaks free again.

Giving them antibiotics without debriding the infected area will do no good because the antibiotics will not penetrate the thick cheesy pus and kill it off. Packing the infected area with antibiotics is useful as long as it’s the right antibiotic to kill the involved bacteria. A culture and sensitivity test will help to determine the best antibiotic to use. Also, often there is more than one bacteria involved.

Hope you can get the issue solved. Keep us posted.

I would set up a dropper to see if he would drink from it as well since the urates are orange. Or try using a needless syringe to ease a few drops of water into his mouth while he’s chewing.