Update on my WC Quad

[jajeanpierre]

My vet squeezed me in yesterday and we took a couple of pictures of his hip joint from a ventral and a dorsal view. He gave me the CD, but my computer is in disrepair as I wait (and wait) for my son to rebuild it. At the moment, I have no CD drive.

It seems nothing is broken or dislocated. Whew! There is a mass that the vet doesn't know what it is. He gave a bunch of possibilities, everything from fibrous osteodystrophy, to an abscess that has encapsulated or even the body walling off a parasite migration. Or, an old soft tissue injury around the pelvic joint that has calcified. Fibrous osteodystrophy is not normally at the end of a long bone, usually in the middle of the long bones so we are thinking that doesn't really fit. I suspect it is an old soft-tissue injury. How old, don't know.

As soon as I can get a download of the pictures, I'll send them to a very good avian vet friend of mine who early in his career was a research fellow at the Zoological Society of London where he worked on projects with reptiles. He's currently the chairman of the Education and Residency Committee for the European College of Zoological Medicine. He's also authored several text books, including one on Exotic Animal Medicine. I don't think the x-ray is very good quality, but at least I'll have another opinion. If I can't get a download, I'll send the CD to him in Abu Dhabi.

Treatment is wait and see, so good news I guess.

 

[jajeanpierre]

X-rays

Here's the x-rays, one ventral, one dorsal view.

The lesion in question is up near the hip joint, and posterior to the femur on the right leg.

I've emailed the pictures to an avian vet friend who has done research work in reptiles.

I'm curious is he thinks there is an old fracture to the shaft of the left femur--it looks like it on one view but I'm not experienced in looking at x-rays.

Thoughts?

 

[jajeanpierre]

I sent the x-rays to an avian-vet friend in Abu Dhabi. He's written several veterinary text books, including one on exotic animal medicine.

Here are some of his comments:

"There is some soft tissue swelling around the coxofemoral or hip joint. The radiograph does not provide a clear view of the joint. I would like to suggest you wait and see. Most fractures at the joint level (e.g. fractures of the head or neck of the femur) without displacement heal well and allow animals in general to live normal lives."

In a subsequent email he wrote this:

"The joint actually looks slightly displaced and certainly more radiodense. The radiograph is in fact not well positioned since the spine is somehow superimposed. This is more evident on the ventrodorsal view. I also suspect poor bone mineralization. The radiographs are not really good enough for an adequate evaluation. "

So, for all you who have a good understanding of the species Trioceros q. quadricornis and especially wild-caught quads, where do I go from here? How do I supplement this guy just in case he really does have some demineralization.

 

[kinyonga]

I can't tell from the xrays if there is bone demineralization or not....my playbook won't let me see clearly enough...but if there is you need to provide some extra calcium in liquid form such as calcium sandoz or gluconate until the bones are strong again and the blood calcium levels high enough. Liquid calcium absorbs more readily than the powders. While doing this you need to maintain appropriate temperatures to aid in proper digestion and thus indirectly in the nutrient absorption, appropriate UVB to allow the chameleon to produce the D3 needed to use the calcium in its system, proper feeding/gutloading of the insects and proper supplementing/dusting of the insects.

 

[ferretinmyshoes]

The radiographs are not really good enough for an adequate evaluation.

Unfortunately that's really the truth right there...


I managed to bring some of the detail back with exposure and contrast adjustment. But they are not positioned very well and the detail is just too poor around the area of concern. In the second image it looks like there are defects in the vertebrae of the tail that would make me worried about osteomyelitis, but I don't see that in the first image, so I suspect this is just due to the poor quality images.

There is some soft tissue swelling around the coxofemoral or hip joint. The radiograph does not provide a clear view of the joint.

I agree with this as I can definitely see the soft tissue swelling, but the underlying cause is not evident on these views alone. I don't really appreciate any displacement per se, but it is not a straight view so that can make things looks abnormal when they aren't, or hide things that are abnormal. I also can't really comment on the bone density quality because the rads are blown out, so they're not accurate for assessing bone quality. Liquid calcium never hurt anyone and if there is a fracture or MBD that will certainly help. I think bloodwork would be an excellent next step to see if there are signs of active infection/inflammation as well as the calcium to phosphorus ratio to better assess possibility of MBD.

 

[jajeanpierre]

Unfortunately that's really the truth right there...

View attachment 105485
I managed to bring some of the detail back with exposure and contrast adjustment. But they are not positioned very well and the detail is just too poor around the area of concern. In the second image it looks like there are defects in the vertebrae of the tail that would make me worried about osteomyelitis, but I don't see that in the first image, so I suspect this is just due to the poor quality images.


I agree with this as I can definitely see the soft tissue swelling, but the underlying cause is not evident on these views alone. I don't really appreciate any displacement per se, but it is not a straight view so that can make things looks abnormal when they aren't, or hide things that are abnormal. I also can't really comment on the bone density quality because the rads are blown out, so they're not accurate for assessing bone quality. Liquid calcium never hurt anyone and if there is a fracture or MBD that will certainly help. I think bloodwork would be an excellent next step to see if there are signs of active infection/inflammation as well as the calcium to phosphorus ratio to better assess possibility of MBD.

Thanks so much.

This is a wild caught, imported mid December. Do you think it is possible to develop MBD so soon? He has not been supplemented very much since he is a newly imported wild caught. The species is sensitive to supplements, often developing edemas.

 

[ferretinmyshoes]

Not really, no. Adults rarely are able to get MBD, especially the males, and especially after being in optimal environment for most of his life. I'd be more likely to think an injury or infection or something along those lines. You're right that montanes are more prone to supplementation problems. But calcium alone should not be a cause for concern given how it's metabolized and it will help healing if there is a bone related injury.

 

[jajeanpierre]

Not really, no. Adults rarely are able to get MBD, especially the males, and especially after being in optimal environment for most of his life. I'd be more likely to think an injury or infection or something along those lines. You're right that montanes are more prone to supplementation problems. But calcium alone should not be a cause for concern given how it's metabolized and it will help healing if there is a bone related injury.

Thanks so much! You are really kind to look over my x-rays.

I feel so much more confident that the joint isn't dislocated after looking at the x-rays after you cleaned them up.

What specific tests would you recommend? What dosage of liquid calcium? He weighs about 50g and has been steadily gaining weight.

I'm putting Neosporin (original formula) on his exposed spines. My avian vet friend suggested I continue until they are healed, but I'm not sure if his description of healed is completely covered over or just nice pink granulation starting. The treatment is quite stressful for a wild caught--a big scary monster touching his back must throw him into a complete panic and he must be in mortal terror whenever I do that. I worry that treating him will stress him so much, he gets sick from something else.