Visceral gout-how long is treatment?

[Psychobunny]

I have a 10 month old panther with visceral gout and he is on the 14th day
of treatment with a liquid med I give him by mouth every day.

The vet told me treatment is likely long term, and I have enough med till
March.

Has anyone had experience with this?
How long did it take your treatment so the blood test would show normal
uric acid levels?

I just want some idea what to expect.

 

[jannb]

When my daughter's chameleon had gout she stayed on treatment until she had to have her put to sleep.
Here's some info from Dr. Alfonso: http://www.kirkmanareavet.com/Gout.html

 

[Psychobunny]

Did she have articular gout, or visceral gout?

Squee has not lost appitite, just a little slow.
He has no signs of swelling anywhere, so the uric acid buildup is in his gut

 

[jannb]

Did she have articular gout, or visceral gout?

Squee has not lost appitite, just a little slow.
He has no signs of swelling anywhere, so the uric acid buildup is in his gut

Lula had articular gout, in all of her joints. It was very sad. There's a thread on here about her. I'll see if I can find it.
https://www.chameleonforums.com/problem-gout-36830/

 

[ferretinmyshoes]

That tends to be how it goes with treatment continued until quality of life suffers and euthanasia is needed. Unfortunately gout in reptiles of either type is very bad. My panther Oscar has been on pain meds for his articular gout for quite a few months now and it's progressing slowly. My young montium died of visceral gout when he was just a year old. He showed practically zero symptoms and I just found him dead on the bottom of his cage. The only way I knew was through histopathology of his organs on necropsy which showed urate crystals everywhere in all his organs and massive kidney failure. I suspect that when it happens this young that there is a congenital defect causing their kidneys to fail at such an earlier age than they should. Allopurinol is the medication to decrease uric acid levels, however it can't get rid of crystals that have already formed in tissues, and it doesn't work as reliably in reptiles as it does in mammals. So it's one of the worst case scenarios most of the time...

 

[Psychobunny]

This doesnt sound good at all!!
The vet told me it's a rather complex thing, and I just cant imagine how he
got it.
He has never been given anything with animal proteins, but his basking temps
were too high for a while and he got a small burn on his spine, which has
healed.
Could this be a "birth defect" of some kind?

I got him from Komeleons, and they told me none of the others from the
same sire and dame have ever developed gout.

Yes, that is what I am giving him, Alloprinal once a day.

If caught and treated in the early stage, is there any better chances of recovery?

He is eating, and moving around him cage and free range okay, he just moves slow. He doesnt show any pain when I massaged his legs.

What else should I be doing for him?
I have increased the misting, and giving him a warm shower every day.

 

[ferretinmyshoes]

(Btw, I meant to say my montium died of visceral gout, not articular)
Yes, I suspect a congenital birth defect in these young guys because mine didn't make any sense either. He had never gotten high protein or vitamin D to predispose his kidneys to problems. His siblings were not affected either. Based on your care I think it was just an unfortunate luck of the draw. The other key is fluids! Lots of hydration to help flush everything out. Some cases do not have any noticeable improvement even with lots of fluids and allopurinol. But sometimes they respond well and after 4-6 months the uric acid level starts to improve. Time will tell which group Squeeze falls into. But remember that reptiles' metabolism is about 8 times slower than ours. So they get sick slowly and they heal very slowly.

 

[jannb]

I'm not sure if you read my daughter's thread linked above about Lula but Dr. Alfonso recommend she feed her only soft body feeders such as silk and hornworms. Shortly after that post Lula was also put on pain meds.

 

[Psychobunny]

Yes, I have been feeding him mostly silkies and hornworms, some cricks, but
no roaches, as they seem to be higher in protein.
My problem is getting him to drink enough, so I give him some water after
his med. Just to make sure.

 

[Lathelia]

I just cant imagine how he
got it.
He has never been given anything with animal proteins

I've been wondering the same thing about my panther female - Marocco. She has articular gout, but she has always been well hydrated and never got animal proteins neither. What's more concerning I've taken my panther male for the blood work as well and his uric acid is also too high (both have approximately twice the norm)!
I was asking my vet how is that possible and she told me there is a parasite from monocercomonas genus (I have the exact name but cannot read it, the second word starts with "P") that usually don't show on the fecal test, but can make the kidneys work less effecive (I forgot if it damages them or works in some other way). Have anyone heard of it? She said she only read it in one book, but also noticed if with her reptile patients.
Are there any more possible causes?

Has anyone had experience with this?
How long did it take your treatment so the blood test would show normal
uric acid levels?

I just want some idea what to expect.

I was prescribed alloprinal to use for 3 weeks and then we have to do blood work again, but I don't know what will be next...

 

[Psychobunny]

This must be very prevalent in panthers, can you please get me the exact name of that parasite so I can do some research?

My vet just said (he knows my husbandry) it was likely genetic and born with
a problem. Not something I did.

I am very concerned, since you cant tell they have it until it's too late, and
med treatment and prognosis is not too good.

If lucky, could clear up in a few months, but best to prepare for the worst

I will keep him on the Allopurinol through February, then get another blood
test done.
I cant believe this is happening to me! such a perfectionist at what I do to
care for my boyz

Is there any sort of test that can be done when they a still babies to tell if
they are likely to get this??!!

 

[deadhd5]

Sorry to hear about Squee's health problems PsychoBunny.

I am just curious, how do you diagnose visceral gout? I know articular gout is diagnosed by swollen joints, but not sure on the visceral.

TIA

 

[ferretinmyshoes]

Gout is diagnosed a few ways. On bloodwork through high uric acid levels and can be supported by high creatinine kinase levels. If it's in the joints you can take a small needle sample of the joint fluid and look at it under the microscope to see uric acid crystals. If the bloodwork is supportive and there are no swellings then visceral becomes the concern. Occasionally for visceral gout you can see mineralization of the organs on X-rays. It's not the uric acid crystals you're actually seeing because those don't show up on X-rays, but when the crystals are in the organs it causes damage and then other minerals start accumulating there. To make things more complicated if the calcium and phosphorus ratio is inverted due to kidney failure then that can also cause the uric acid levels to be high.

 

[Lathelia]

This must be very prevalent in panthers, can you please get me the exact name of that parasite so I can do some research?

Sure

What do you guys think about using lemons any cherries? My father always drink lemon juice when his gout is getting worse and it works well for him. I was thinking about using them for gutload or maybe even add some lemon juice to their meds?

 

[ferretinmyshoes]

This must be very prevalent in panthers, can you please get me the exact name of that parasite so I can do some research?

Fortunately it is not very prevalent, and is seen in multiple species with about the same representation. Also in other species of lizards, turtles, etc. It is much more common for reptiles with poor care. I have never heard of this parasite either so I would like to know as well so I can see what I can find.

Is there any sort of test that can be done when they a still babies to tell if they are likely to get this??!!

Unfortunately not.

 

[Lathelia]

To make things more complicated if the calcium and phosphorus ratio is inverted due to kidney failure then that can also cause the uric acid levels to be high.

Interesing. My male has edema on and off, I'm 99% sure it's only after he eats crickets, so due to high phosphorus. When we did blood work, his edema went down and results showed correct Ca ratio. Do you think it is possible his higher uric acid could be a result of previous high levels of phosphorus?

 

[Psychobunny]

With visceral gout, you cant tell they have it because there are no 'tell-tale'
signs. Only the blood test can tell you.
I took Squee in as soon as I noticed that he was acting different; lethargic,
difficulty grasping things, weak grasp.

In my case, he had a small burn on his spine and was being treated with
Baytril due to infection. We suspected something else was wrong too, that's when we did the blood test.

I am making sure he is hydrated! I feed him water twice a day with a pipette.

His poops don't look too bad, a little soft, but the urates need to look better!!

I was noticing that he was going through the motions of drinking water, but not actually getting much in his mouth.
That's when I started feeding it to him with pipette.

 

[Psychobunny]

Fortunately it is not very prevalent, and is seen in multiple species with about the same representation. Also in other species of lizards, turtles, etc. It is much more common for reptiles with poor care. I have never heard of this parasite either so I would like to know as well so I can see what I can find.



Unfortunately not.

Then would you recommend a routine blood test for uric acid and kidney function at an early age?

 

[Lathelia]

I found the note and I think it just says: "Monocercomonas protozoa"

 

[Lathelia]

Then would you recommend a routine blood test for uric acid and kidney function at an early age?

That's what I did with my male. He recently turned two and the thought of him getting old was so scary that I thought the blood test won't hurt. Thank God I did!