Advice for Kidney Disease?

[SilverWolf]

After analyzing my chameleon's blood we found he has high phosphorus. And likely kidney disease. The veterinarian suggested that I give him 0.05 of antiacids with aluminum hydroxide twice a day. He mentioned Mylanta but all I could find was Gaviscon. I only gave him about one drop yesterday.

What worries me most is that for about a week now I've been force feeding him with repta+boost because he stopped eating quite a while ago. I didn't give him any repta+boost yesterday because I wanted to focus on just giving him water (he won't drink either) and the medicine. yesterday when I gave him the water he just started squeaking like a dolphin and held his head over my hand like he was going to barf and some of the water started dripping out. He has not defecated in over a week. Some say this is normal since he hasn't eaten any solid foods but I thought I would at least see some urates. I have some lactulose, would that be a good idea to give him some of that? I just don't want to give him too much of anything and I'm kind of stuck.

 

[kinyonga]

Did you give him the water a couple of drops at a time or fill up his mouth with it?
Was the tongue sticking out very far/strained looking when he was doing this squeaking?
Was his nose pointed up or down?

 

[SilverWolf]

Did you give him the water a couple of drops at a time or fill up his mouth with it?
Was the tongue sticking out very far/strained looking when he was doing this squeaking?
Was his nose pointed up or down?

Thank you so much for responding.

When he would open his mouth I would drop as much water as I could before he would shut it, which would b quite quick.

When he was squeaking his tongue was sticking out just a tad bit, I do not really know how it would look if it was "strained." HE looked a bit strained, wiggling around like he was really uncomfortable, but no stress colours.

When I put the water in and his mouth was open his nose was pointed up. When he was squeaking it was pointed straight ahead and he slowly moved his head down while squeaking, wiggling and gaping very wide as water was dripping out.

EDIT: also worth mentioning, he often gets irritated when I mist his enclosure now, and will twitch, gape and wiggle around when I do, even when I am spraying no where near him.

 

[SilverWolf]

Just bumping

 

[ataraxia]

Thank you so much for responding.

When he would open his mouth I would drop as much water as I could before he would shut it, which would b quite quick.This is not recommended. With a ill or weak chameleon (or any animal in this instance) extra small quantity/patience is the name of the game. Literally a drop at a time and depending on the dosage may take a considerable amount of time.

When he was squeaking his tongue was sticking out just a tad bit, I do not really know how it would look if it was "strained." HE looked a bit strained, wiggling around like he was really uncomfortable, but no stress colours.

When I put the water in and his mouth was open his nose was pointed up. When he was squeaking it was pointed straight ahead and he slowly moved his head down while squeaking, wiggling and gaping very wide as water was dripping out.

EDIT: also worth mentioning, he often gets irritated when I mist his enclosure now, and will twitch, gape and wiggle around when I do, even when I am spraying no where near him.

I hope the squeaking along with the other symptoms are not indicating aspiration.

 

[ataraxia]

Also, i would look into other hydration avenues. There are tricks/techniques to get most to drink. Weather is also starting to break. I would get your chameleon out in some fresh sunlight as much as possible. This will help with the calcium absorption. ***Plain calcium at every feeding.

Another thing. You may want to change your indoor UVB bulb.

 

[SilverWolf]

Also, i would look into other hydration avenues. There are tricks/techniques to get most to drink. Weather is also starting to break. I would get your chameleon out in some fresh sunlight as much as possible. This will help with the calcium absorption. ***Plain calcium at every feeding.

Another thing. You may want to change your indoor UVB bulb.

Thank you

1) Just recenty changed the UVB.
2) I just took him out earlier. He honestly doesn't seem to be fond of sunlight anymore. Until just yesterday he'd puff up, turn dark and just sit and bask in the sunlight. BUt now he'll wake up (open his eyes at least) turn around and climb my arm to shade.

As for the squeaking, he has been gaping a bit more often especially when I take him out (only to give him medicine, water, etc.).

Thank you very much for the advice though, I will be sure to give him very little bits here and there. But he is refusing to drink or eat on his own. What else could I do other than opening his mouth by pulling under his chin? I've tried putting very gentle pressure on the sides of his head too but that does not cause him to gape, rather, he will try to swerve his head out of my grip.

 

[SilverWolf]

I also really want to say that he seems incredibly uncomfortable. He seems to be sleeping, then will wake up and either scratch his head or wiggle around and gape. I will try to link a video to show this.

 

[Bush baby]

Could anyone way in on the high phosphorus diagnosis/kidney disease; in general is this cause by not using calcium at EVERY FEEDING to correct the bad calciumhosphorus ratio seen in most feeder insects…?

These symptoms mirror the same ones a Jackson i had many years ago had. I beg you; stop trying to force feed him; i know you want him to eat, but you're making it worst by stressing him.

Just because he's turning dark when you take him outside, doesn't mean he's not benefitting from the outdoor exposure to the sun. He's just in an environment that's not familar to him, so he's uneasy. You should leave him out there, temperature permitted.

Like someone else mentioned, try to get him to drink without squirting water down his throat. I did the exact same thing, and days later i found my cham dead, with his mouth wide open, lying at the bottom of his cage. Him turning his head up, squeaking, etc is a sign that some of that fluid is going down into his lungs.Try the shower method, or leave him outside when it's raining…

Lastly, Since he's gaping, try placing a freshly killed/gut loaded and dusted cricket in his mouth and see if he chews and swallows food that way..

 

[SilverWolf]

Could anyone way in on the high phosphorus diagnosis/kidney disease; in general is this cause by not using calcium at EVERY FEEDING to correct the bad calciumhosphorus ratio seen in most feeder insects…?

These symptoms mirror the same ones a Jackson i had many years ago had. I beg you; stop trying to force feed him; i know you want him to eat, but you're making it worst by stressing him.

Just because he's turning dark when you take him outside, doesn't mean he's not benefitting from the outdoor exposure to the sun. He's just in an environment that's not familar to him, so he's uneasy. You should leave him out there, temperature permitted.

Like someone else mentioned, try to get him to drink without squirting water down his throat. I did the exact same thing, and days later i found my cham dead, with his mouth wide open, lying at the bottom of his cage. Him turning his head up, squeaking, etc is a sign that some of that fluid is going down into his lungs.Try the shower method, or leave him outside when it's raining…

Lastly, Since he's gaping, try placing a freshly killed/gut loaded and dusted cricket in his mouth and see if he chews and swallows food that way..

It has been over two weeks since he last ate anything. The only nutrients he's gotten is the medicine and repta+Boost I've given him.

Also, turning dark outside isn't the problem, if anything that's positive. I would often take him outside until two days ago and he would turn dark to absorb heat and ultra violet rays, that's fine. But I mean now when I take him outside as soon as he feels the sun he turns around and bolts for the shade.

What is the shower method? A plant in the shower?

Also to what you suggested with a cricket, do you think I could open his mouth similarly to how I did with putting water and food down his throat? But rather just set it in there to see if he starts chewing it? I'm just worried that's actually getting too much stuff now. he hasn't defecated even with this stuff I'm putting in his stomach (all fluids) and yet, no urates, feces or excretion of any kind.

I attatched a picture I took. The lights are on in this picture but that's only because I turned them back on, they were off as it is night time now. he was hanging upside down with his mouth open. I encouraged him up higher where his belly is parallel to the ground, but he still gaped and moved around a bit (with eyes closed) with an occasional "hiss."

EDIT: Now I went back to check on him and I've found him hanging upside down from a branch only by his tail. He is not gaping though.

Second edit: Now a bit lower and hanging by the screen. I did move him to a vertical branch, this time still facing down but on the branch hopefully he will be more secure, since it is easier to grip.

Should I mention in relation to the fact that he hasn't defecated in over a week even with stuff going down his throat, even teh veterinarian who examined him on Tuesday said that he did feel a little bit full in the back but that it would come out when it's time. Although, it has been a week starting today since he's last defecated, any feces, urates, or excreted any sort of fluids at all.

 

[SilverWolf]

Here is a video of him earlier before night. The loud bit of air you will hear is not from, Tricky. I think it is from me actually.

https://drive.google.com/file/d/0B12ZzMMMtMynMWFQOW1Ec3lrRE0/view?usp=sharing

 

[SilverWolf]

I just saw him on the floor squirming a bit, I have him in my hand now. Iis there anything i can do?

 

[ataraxia]

Did the vet not see raised level for infection in the blood work?> He looks like he has a RI.

I would put him on a towel on the floor of the cage and leave him be.

 

[SilverWolf]

Did the vet not see raised level for infection in the blood work?> He looks like he has a RI.

I would put him on a towel on the floor of the cage and leave him be.

okay i will do that.

I put a towel ina small box wit holes and a stick under the towel. I did this because every now and then he will squirm around and I do not want him getting somewhere in the back corners of the enclosure where I couldn't get to hmi easily, or in time.

As for teh RI, that was my thinking as well. But all the vet said was that the phosphorus levels was the only thing that really seemed off, and that he likely has kidney disease.

Do you suppose the RI could be caused from the water, or even some of the gaviscon (antiacids with aluminum hyrdroxide) got down his trachea and into his lungs? If so, what can be done about RI?

 

[ferretinmyshoes]

Poor Tricky.
When the phosphorus is elevated, especially in a male, it is often the only thing you'll see wrong on the bloodwork to indicate kidney disease or even failure. Reptile bloodwork is not quite as sensitive as mammal bloodwork where we get a pretty clear picture of what's going on and how advanced it is. The aluminum hydroxide is to bind up the phosphorus to reduce its level. Kidney problems are common in captive reptiles and can be attributed to several factors: incorrect supplementation or poor nutrition, dehydration even at low levels chronically, MBD, gout, kidney tumors, etc.

Once kidney issues start it is like a boulder rolling down a hill - you can try to slow the progression but you can't stop it. Fluids are the mainstay of therapy. Fluids will help flush out the toxins that build up that would normally be filtered out by the kidneys. Even minerals like phosphorus become toxic at high levels and it tends to make them feel crummy. This is what is meant by shower session: https://www.chameleonforums.com/blogs/ferretinmyshoes/732-shower-sessions-hydration.html

While nutrition seems paramount, I don't worry about force feeding until they haven't eaten for several weeks, and even then feed sparingly. Repti-boost is mostly electrolytes and not really calories or food replacement. Carnivore/omnivore care or something similar is much better for assist feeding.

Some signs do sound suspicious for a respiratory infection as others have mentioned. Unless the infection is overwhelming the body's ability to cope with it then you won't see evidence of it on bloodwork in most cases. URI are usually treated with antibiotics, which are tough on the kidneys even when they're healthy. Unhealthy kidneys do pose more of a risk there.

Unfortunately, hanging from the branch with mouth open is not a good sign. Aside from offering water I would not handle him at all tomorrow. He sounds extremely stressed. Skip his meds and definitely his feedings and just give him some time to rest and relax.

 

[SilverWolf]

Poor Tricky.
When the phosphorus is elevated, especially in a male, it is often the only thing you'll see wrong on the bloodwork to indicate kidney disease or even failure. Reptile bloodwork is not quite as sensitive as mammal bloodwork where we get a pretty clear picture of what's going on and how advanced it is. The aluminum hydroxide is to bind up the phosphorus to reduce its level. Kidney problems are common in captive reptiles and can be attributed to several factors: incorrect supplementation or poor nutrition, dehydration even at low levels chronically, MBD, gout, kidney tumors, etc.

Once kidney issues start it is like a boulder rolling down a hill - you can try to slow the progression but you can't stop it. Fluids are the mainstay of therapy. Fluids will help flush out the toxins that build up that would normally be filtered out by the kidneys. Even minerals like phosphorus become toxic at high levels and it tends to make them feel crummy. This is what is meant by shower session: https://www.chameleonforums.com/blogs/ferretinmyshoes/732-shower-sessions-hydration.html

While nutrition seems paramount, I don't worry about force feeding until they haven't eaten for several weeks, and even then feed sparingly. Repti-boost is mostly electrolytes and not really calories or food replacement. Carnivore/omnivore care or something similar is much better for assist feeding.

Some signs do sound suspicious for a respiratory infection as others have mentioned. Unless the infection is overwhelming the body's ability to cope with it then you won't see evidence of it on bloodwork in most cases. URI are usually treated with antibiotics, which are tough on the kidneys even when they're healthy. Unhealthy kidneys do pose more of a risk there.

Unfortunately, hanging from the branch with mouth open is not a good sign. Aside from offering water I would not handle him at all tomorrow. He sounds extremely stressed. Skip his meds and definitely his feedings and just give him some time to rest and relax.

So you would not recommend giving him a "shower session" even? of course my main concern is him drinking, even above eating. I will stop with the repta+boost and won't give him the gaviscon tomorrow either. But he does feel a bit full and has not excreted anything, feces, urates, fluids. Could this not mean that he doesn't have a second impaction? it has been a week since his last excretion.

 

[Bush baby]

I feel really bad for Tricky. Since we got our chams from the same breeder, it's likely that out chams are related in some way.

Again, i emplore you to take him outside, and leave him there (weather/temps permitted.

Stop handling him. I know you want to adjust things, etc but you're making things worst.

The RI/aspiration is probably from the force feedings/drinking sessions. Stop. Him haging upside down is probably his way of getting some relief from how bad he feels, so you adjusting where he sleeps is making him feel worst.

In reference to the phosphorus levels; this is why i dust with calcium at EVERY feeding….even for Jacksons. The Ca ration is so off for crickets that this long term is likely the cause of the high phosphorus blood work you received.

Keep us posted…..

 

[SilverWolf]

I feel really bad for Tricky. Since we got our chams from the same breeder, it's likely that out chams are related in some way.

Again, i emplore you to take him outside, and leave him there (weather/temps permitted.

Stop handling him. I know you want to adjust things, etc but you're making things worst.

The RI/aspiration is probably from the force feedings/drinking sessions. Stop. Him haging upside down is probably his way of getting some relief from how bad he feels, so you adjusting where he sleeps is making him feel worst.

In reference to the phosphorus levels; this is why i dust with calcium at EVERY feeding….even for Jacksons. The Ca ration is so off for crickets that this long term is likely the cause of the high phosphorus blood work you received.

Keep us posted…..

I've taken your advice and others' advice - it is difficult to do everything that everyone suggests, and impossible to do all of it simultaneously. Everyone's advice here is unfortunately so conflicting that at the moment I am stuck. Three people tell me I will have to force feed him, one of them being a veterinarian. Two others say to stop it and leave him be. Most jackson keepers say to dust every two weeks with calcium those who have kept jacksons alive for their entire life span. You tell me to dust every single day which several here refuse to agree with. I will be doing more research on calcium intake and will try to apply that to his diet but right now he isn't eating ANYTHING.

I am just saying this site, since this problem occurred has only been bringing me conflicting answers. Chameleons just seem to be so new to human care, so we don't know everything, or even as much compared to caring for other lizards. It's unfortunate, but I already knew, I cannot go here expecting for one solid answer on everything. I have to take everything that everyone says into account, and it just so happens you've been somewhat of a minority recently in terms of what you're saying compared to everyone else. Please do not stop with the advice though, obviously you're chameleon is alive and well.

Tricky is still alive, but he is obviously rather weak. He's not gaping but that's likely just due to his lethargy. I tried to do the shower method but he didn't react to that at all. I took him outside for a moment but he didn't open his eyes, just moved them a bit. I brought him back to his enclosure to see if he would want to sit and rest near the basking spot but he wouldn't move, at least not walk back onto it. So I set him back in the box with the towel. I am trying to limit my handling of him as much as possible. I suppose the best thing to do when would be to leave him outside now, but in a safe spot and in this box where nothing can get him and he cannot escape. He will still get the air and the sun.

 

[Bush baby]

I've taken your advice and others' advice - it is difficult to do everything that everyone suggests, and impossible to do all of it simultaneously. Everyone's advice here is unfortunately so conflicting that at the moment I am stuck. Three people tell me I will have to force feed him, one of them being a veterinarian. Two others say to stop it and leave him be. Most jackson keepers say to dust every two weeks with calcium those who have kept jacksons alive for their entire life span. You tell me to dust every single day which several here refuse to agree with. I will be doing more research on calcium intake and will try to apply that to his diet but right now he isn't eating ANYTHING.

Every feeding NOT every day. I feed my cham 3-4 times a week.

Sorry for the confusing.

It is less about supplementing them with calcium but more about correcting the poor phosphorus:calcium ratio, that may be at the heart of Tricky's issue.

 

[SilverWolf]

Thank you for clearing that up. Tricky would eat every day or ocasionally every other day. There were a few times where he would go two or even three days without eating anything but never any longer than that. I only started to get worried when ten days passed without any food. I was concerned before that but realized there was seriously a problem by then.