Zulu's infection - photos

MomofZulu

New Member
I posted two photos of Zulu's mouth on another thread started by someone else called "jaw problem." For some reason, I can't attach them again, but if you can take a peek, I'd appreciate it. You can see the hard goldish-brown ring around his teeth. He has puss of the same color coming out of one of his two bumps on his head. Some of you are probably familiar with his illness as I have posted a lot about it. But this is the first time I've posted photos. He is not responsive to the drug that is supposed to battle this infection. I have made several changes in husbandry since my original post. Any feedback is greatly appreciated.
 

ponders

Chameleon Enthusiast
Has your vet cultured the pus? That will tell you which antibiotic will kill the bacteria. If the pockets keep filling with pus then the antibiotic he is on isn't the right one and might be time to switch to another. The infected areas should be drained and cleaned too. Good luck, he's a handsome cham.
 

kinyonga

Chameleon Enthusiast
I replied on the other thread.
Here it is...
Momofzulu...Re: the two bumps on his "nose" between the bony crests....infection needs to be cleaned out of areas like this persistantly and the area flushed until it stops filling up again. Just giving the chameleon medication won't clear it up. Things like this can go inside...can fill the sinus area...can even have occurred due to a sinus infection. As well they may have been causing him problems inside his mouth. Also...the swelling on the lower part of the turret is indicative of something going on.

Does the exudate from the bumps look green and smell something like rotten grapes? Has it ever been tested to see what antibiotic works best against the germs involved?
 

MomofZulu

New Member
Thanks for the info, Kinyonga. Only gunk comes out of one bump, and generally it comes out by gently pushing on the area around his eyes. It used to be darker -- a gold-brown color, much like the area thatbis hard around his gum line. Now it's slightly lighter. I'm vigilant about this.

Here's some info from my vet:
He has been on ceftazadime 25 mg/kg IM q 3 days, amikacin 5 mg/kg IM q 3 days plus SQ fluids 6 ml with each antibiotic treatment. *The amikacin is the one I discontinued. *I did not culture his mouth (was afraid of getting "normal flora" contaminants), but did culture the abscesses on face immediately after they were opened. *It grew Pseudomonas aeruginosa, which was susceptible to both antibiotics.

I don't know what most of that means, but I hope it makesvsense to you.

BRW, I'm not sure what part the turret is.
 

kinyonga

Chameleon Enthusiast
You said..."Only gunk comes out of one bump, and generally it comes out by gently pushing on the area around his eyes."...squeezing the pus out is not enough...it has to be scraped out clean and flushed...by a vet because the chameleon should be put under while its done. If its a particularly stubborn infection it can continue to be flushed/cleaned out several times.

3 days is not long enough IMHO for the antibiotics to work. In many cases that I've known about/had experience with, the chameleon might be on it for 2 or 3 weeks at least.

Pseudomonas aeruginosa is the most common bacteria found in these abcesses...and not one of the easiest to get rid of. Its a gram negative opportunistic bacteria and that's another reason for persistence in repeating the cleaning out/flushing.
 

RenVet

New Member
This sounds like a case of severe stomatitis to me. The concerning part here is that he also has the lesions (abscesses) on his nose, just above the stomatitis. Where things can get dangerous is if the infection in his mouth (stomatitis) penetrates the maxilla (upper jaw bone) causing an osteomyelitis (bacterial infection of the bone, which basically 'eats the bone away'). I'd be suspicious that this has already begun to occur and surgical debridement of the bone (shaving away the infected bone) may be warranted.

The only real way to diagnose if this is occurring is by radiographs of the maxilla. This will show whether there are any areas of 'bony lysis' (radiographic finding indicating bacteria are eating away at the bone). If this has indeed occurred, there is little chance that antibiotic therapy on its own, will have any chance at beating this infection. He would need to surgical debridement of the maxilla. This is all speculative, but its a gut feeling from reading your post and seeing the pictures. And especially since there are unresolving abscesses on the nose as well. My guess is the bacteria from the stomatitis (from the mouth) has infiltrated as least some of the maxilla, and is associated with these abscesses as well. You might be in for quite a veterinary visit with radiographs and surgery. I'm afraid if this course of antibiotics he is on now fails, this will be the only option remaining.

Dr Ren (Vet)
www.mypetmobilevet.com
 

MomofZulu

New Member
This is from my vet:
"I looked at the xray I took yesterday.* The mandibular bone (lower jaw) appears to have normal bone density.* However, on the upper jaw, just in front of (and possibly including the front part of) the eye socket, the bone density appears decreased.* This is typically what you see with osteomyelitis.* This area is sitting right under the 2 swellings on the face.* Unfortunately, I think the vet on the forum is right- the prognosis is not great because it is very difficult to get infection out of bone.* There are some antibiotics that penetrate into bone better than others.* I need to look at the ceftazadime that he has been on and see what levels it gets in the bone.* Ideally it is helpful to remove infected bone, but in this area, that could be difficult and risky, I am afraid."
 

RenVet

New Member
Sorry to hear about Zulu :( A drug that is not commonly used in reptiles but is excellent at penetrating bone and very effective at targeting anaerobic bacteria is Clindamycin. Its a bit hard on the kidneys, but at this point, it would be worth a shot. 2.2mg/ lb would be the dose. Comes in oral suspension.

Hope this information can be of use. Best of luck.
 

jojackson

New Member
Mom of Zulu,
Sorry to hear of your lizards infection.
Reptiles are notorious for not appearing ill or showing any signs, often until an
infection becomes system wide and even life threatening. Your lizards
condition is in no way something you could have forseen and as far as Im
concerned you have been most responsible and caring and are doing all within
your means to alleviate it's discomfort and treat it. Your efforts deserve respect, Bravo.
Im hoping the new drug proves effective, though understand the infection is
quite severe, treatment will be slow to take effect and the outcome is unsure.
Be positive but prepare, and try to keep in mind what I said above.
Meanwhile, the experience overall is proving a valuable learning curve. Id like to suggest you write yourself extensive notes about Zulu's case and tuck them away for future reference. Particularly the type of infection, drugs involved and so on.
Hang in there, Thinking of you and Zulu, best wishes :)
 

MomofZulu

New Member
Thank you, JoJackson. Zulu has been struggling with this infection now for months. We have tried a lot of different treatments, starting with the Baytril which didn't help, and then he's been getting shots at least twice a week since December.

I think my biggest mistake has been not providing a humid enough climate for him. I just didn't get that he needed it not just for his own hydration. I am trying to rectify this. I got a temp gun, and the temps in his cage are fine, and he's getting roaches that have been dusted and gutloaded. He hates the roaches, but I'm making him eat them anyway.

Poor guy. He's so tolerant. I can read him so well -- and he puts up with me. He hasn't given up, so I'm not either. He's obviously sick, but he's been stable for a while now, so I'm just going to keep at it, do my best to improve his environment and give him whatever medical treatment I can.

I know this is a slow process. I love this guy. I pray the new drug will help. It's really my only hope.

I still haven't figured out what the hard, brown substance is around his bottom jaw. He's had it the whole time he's been sick. It's hard as a rock and the same color as the goo that comes out of those bumps. I don't know if it's the same, but I'm guessing it is. Does anyone know about this? I haven't seen any posts that relate to this.

Thanks so much for your support. It means a lot.

Mom
 

jojackson

New Member
I still haven't figured out what the hard, brown substance is around his bottom jaw. He's had it the whole time he's been sick. It's hard as a rock and the same color as the goo that comes out of those bumps. I don't know if it's the same, but I'm guessing it is
Yes its quite possible it's hardened infectious debris, it often begins as a 'cheesy' type gunk. Your vet may be able to clean the area for you, this would be wise if it is infectious debris since it will harbour bacteria.
 
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