Blood test results

[Chameleon Creator]

These results are from over a year ago, and resulted in putting my first Cham to sleep.
I was uneducated on proper chameleon care, as Petsmart helped me in chameleon care (fed incorrect information).
I recently requested the blood work results from my deceased chameleon and wanted clarification on exactly what went wrong. I'm sure it was improper care and it still upsets me.
Just because I was uneducated does not mean I was neglectful, I loved that chameleon and did my best at keeping her happy.
I have done much research since then and I am very educated on chameleons now, I'm glad this forum is here I have learned a lot.
Here is a picture of the bloodwork, I would appreciate it if someone educated in the portion of the blood tests that say what is what (different level tests, for example, the atl levels, what does that mean, etc etc..).
I'm pretty sure atl is liver function or kidneys, not sure about any others..

 

[Chameleon Creator]

And quite clearly some levels are extremely elevated.. But what are they and why? This will really help me on several levels. Just need clarification

 

[Chameleon Creator]

I can post a picture of her before I put her down if someone would like, brings back bad memories. And I do regret many things with her but I can't change any of the past choices. Sorry to anyone this offends.

 

[Chameleon Creator]

Bump up to the top

 

[Chameleon Creator]

Any vets on here that can answer?

 

[TreyLcham]

Dont cha just hate when u get no messages on ur thread lol. Wish i could help but i have no clue what thet meab,u may want to try and google what some of the terms mean

 

[Chameleon Creator]

Dont cha just hate when u get no messages on ur thread lol. Wish i could help but i have no clue what thet meab,u may want to try and google what some of the terms mean

Yes I do. Lol. I feel like no one will see this thread after a couple hours. Yeah maybe it will best to just google it all. I was just hoping someone could shed some light on what causes such extremely elevated levels

 

[laurie]

Send a private message to ferretinmyshoes she is a vet and a moderator here on the forum.

 

[Chameleon Creator]

Looks like to me after a little digging that it was internal organ failure, I'm guessing liver and kidneys went out, possible heart attack or stroke, and possibly diabetic. Not sure if this was due to supplementation or if this was caused by genetics.

 

[Chameleon Creator]

Send a private message to ferretinmyshoes she is a vet and a moderator here on the forum.

Okay thank you

 

[shmeenakoz]

Hi not a vet but a med lab tech so the reasons for elevations differ most likely from ours but i don't know how much. Ok so the AST, TP, ALB and GLOB were all abnormal indicating liver failure. Why..? I can't really say since for this part you will need a vet. I can say this tho, if you have a low albumin, globulin and total protein correlates with things like proper delivery of vital nutrients, hormones, fluid balance etc. Albumin is synthesized/made by your liver so…this poor guy had some liver issue.This makes sense since his aminotransferase was sky-high. Sorry I can't help more but hopefully a vet gives you a better answer.

 

[ferretinmyshoes]

Unfortunately reptile bloodwork can be difficult to interpret because even though many of the same values between reptiles and mammals are measured with reptiles it can often mean significantly different things. You have to look at the whole picture, not just the individual numbers. And depending on where the bloodwork was done the reference ranges may be for that specific species or for a more generic reptile profile. There are not established reference ranges for veiled chameleons for example, so often panther ranges are used since they're most likely similar, but there can be minor differences. Or it may just be "lizard" reference ranges, which takes averages of the most studied species.

Shmeenakoz would be correct if this was a mammal, but reptiles don't play by the rules.

While AST often correlates to liver in mammals, in reptiles it has little reliable correlation to liver function - it's considered too non-specific to use to diagnose problems in reptiles because it can also be indicative of muscle damage, which can happen for a variety of microscopic reasons (MBD, gout, kidney disease, anorexia, etc). Bile acids are the preferred method of diagnosing liver function, but it often isn't part of the standard blood tests. It looks like it was part of this one (BA) but read too low to read, which is not clinically useful. Liver failure causes elevated bile acids.

Albumin is also poorly correlated in reptiles to the true albumin level. Total protein is more accurate. In this case it's low, but not tremendously low, so doesn't really point to anything in particular.

High glucose often causes concern for diabetes in mammalian species, but not so in reptiles. There is an intestinal adenocarcinoma in bearded dragons that can cause extremely elevated blood glucose levels (like in the 600+ range). But otherwise sometimes stress can cause it to elevate at the time of the blood draw and we don't really worry about it much.

The sodium (Na) levels are significantly low, which may be lab error but since the other electrolytes are normal I'm more inclined to think it's real.

CK is creatine kinase, which often an indicator of damage to tissues like muscle, which again can happen for many reasons.

The way to look at calcium and phosphorus is in ratio with each other: calcium should be at least twice as high as the phosphorus levels. If this ratio is inverted then it is suggestive of MBD or kidney failure. If the uric acid(UA) levels are also high this is extremely suggestive of advanced kidney failure. However it is not always so straightforward - my 6 year old male that just passed had a 1:1 ratio of calcium to phosphorus, which isn't good but isn't terrible, and his uric acid levels as normal. But on necropsy his kidneys were in advanced stages of failure microscopically. Females with egg activity will often have significantly elevated calcium levels. Maybe here the calcium was elevated due to reproductive activity but under normal circumstances would have matched the phosphorus and thus making me worry about kidney disease/failure. This can be a result of improper care (low hydration levels, incorrect supplementation and diet, etc). Not a judgement on your care - you just mentioned that you got a lot of misinformation so this may have been a major contributing factor. It sounds like you've learned a lot since then.

A CBC was not done, which looks at the red blood cell and white blood cell counts to look for infection or anemia.

The first page of this document (for one of the blood machines for reptiles) has a good basic explanation of many of the values: http://www.abaxis.com/pdf/Avian-Reptilian Profile Plus.pdf

You have to correlate the bloodwork with the clinical symptoms, and there are many problems that either do not appear on bloodwork or are only minor changes and not indicative of one specific problem. Unfortunately the only way to know for sure what happened is to do a necropsy with histopathology of the major organs, which does cost a bit. Without that it is often just speculation.

 

[Chameleon Creator]

Unfortunately reptile bloodwork can be difficult to interpret because even though many of the same values between reptiles and mammals are measured with reptiles it can often mean significantly different things. You have to look at the whole picture, not just the individual numbers. And depending on where the bloodwork was done the reference ranges may be for that specific species or for a more generic reptile profile. There are not established reference ranges for veiled chameleons for example, so often panther ranges are used since they're most likely similar, but there can be minor differences. Or it may just be "lizard" reference ranges, which takes averages of the most studied species.

Shmeenakoz would be correct if this was a mammal, but reptiles don't play by the rules.

While AST often correlates to liver in mammals, in reptiles it has little reliable correlation to liver function - it's considered too non-specific to use to diagnose problems in reptiles because it can also be indicative of muscle damage, which can happen for a variety of microscopic reasons (MBD, gout, kidney disease, anorexia, etc). Bile acids are the preferred method of diagnosing liver function, but it often isn't part of the standard blood tests. It looks like it was part of this one (BA) but read too low to read, which is not clinically useful. Liver failure causes elevated bile acids.

Albumin is also poorly correlated in reptiles to the true albumin level. Total protein is more accurate. In this case it's low, but not tremendously low, so doesn't really point to anything in particular.

High glucose often causes concern for diabetes in mammalian species, but not so in reptiles. There is an intestinal adenocarcinoma in bearded dragons that can cause extremely elevated blood glucose levels (like in the 600+ range). But otherwise sometimes stress can cause it to elevate at the time of the blood draw and we don't really worry about it much.

The sodium (Na) levels are significantly low, which may be lab error but since the other electrolytes are normal I'm more inclined to think it's real.

CK is creatine kinase, which often an indicator of damage to tissues like muscle, which again can happen for many reasons.

The way to look at calcium and phosphorus is in ratio with each other: calcium should be at least twice as high as the phosphorus levels. If this ratio is inverted then it is suggestive of MBD or kidney failure. If the uric acid(UA) levels are also high this is extremely suggestive of advanced kidney failure. However it is not always so straightforward - my 6 year old male that just passed had a 1:1 ratio of calcium to phosphorus, which isn't good but isn't terrible, and his uric acid levels as normal. But on necropsy his kidneys were in advanced stages of failure microscopically. Females with egg activity will often have significantly elevated calcium levels. Maybe here the calcium was elevated due to reproductive activity but under normal circumstances would have matched the phosphorus and thus making me worry about kidney disease/failure. This can be a result of improper care (low hydration levels, incorrect supplementation and diet, etc). Not a judgement on your care - you just mentioned that you got a lot of misinformation so this may have been a major contributing factor. It sounds like you've learned a lot since then.

A CBC was not done, which looks at the red blood cell and white blood cell counts to look for infection or anemia.

The first page of this document (for one of the blood machines for reptiles) has a good basic explanation of many of the values: http://www.abaxis.com/pdf/Avian-Reptilian Profile Plus.pdf

You have to correlate the bloodwork with the clinical symptoms, and there are many problems that either do not appear on bloodwork or are only minor changes and not indicative of one specific problem. Unfortunately the only way to know for sure what happened is to do a necropsy with histopathology of the major organs, which does cost a bit. Without that it is often just speculation.

Wow well thank you for the very detailed response, exactly what I was hoping to hear, well besides the matter of topic. Unfortunately it's far too late to get a necropsy and I can only assume it was improper care. I have a picture of her in her last days alive; if you think this will help determine why the bloodwork is as shown then I'll post it, just know it is not a pleasant sight. I do take full responsibility for what happened and I have learned the hard way, as I always do.
I greatly appreciate you taking the time for this

 

[Chameleon Creator]

Hi not a vet but a med lab tech so the reasons for elevations differ most likely from ours but i don't know how much. Ok so the AST, TP, ALB and GLOB were all abnormal indicating liver failure. Why..? I can't really say since for this part you will need a vet. I can say this tho, if you have a low albumin, globulin and total protein correlates with things like proper delivery of vital nutrients, hormones, fluid balance etc. Albumin is synthesized/made by your liver so…this poor guy had some liver issue.This makes sense since his aminotransferase was sky-high. Sorry I can't help more but hopefully a vet gives you a better answer.

Well you are far more knowledgable than I am in this field so I will take your word on this. I also believed it to be liver failure but I suppose I will never know. Thanks for the response

 

[Psychobunny]

Who ever did the blood testing for you should be able to explain what it all
means.
I would call the lab, or vet involved and ask them.

Oops, nevermind, I see ferret already answered your question in detail

 

[Chameleon Creator]

Who ever did the blood testing for you should be able to explain what it all

means.

I would call the lab, or vet involved and ask them.



Oops, nevermind, I see ferret already answered your question in detail

Yes, very helpful. Thankfully there are vets on this forum willing to help

 

[shmeenakoz]

Well you are far more knowledgable than I am in this field so I will take your word on this. I also believed it to be liver failure but I suppose I will never know. Thanks for the response

No problem and very much thought and agree with Ferretinmyshoes on the big difference between mammals and reptiles. Very interesting physiology of these little creatures. So sorry about your loss though

 

[laurie]

Thanks Dayna, I learn so much from your posts. Some day you may sent me a bill for vet fees. I really do learn that much.

 

[Lathelia]

Thanks Dayna, I learn so much from your posts. Some day you may sent me a bill for vet fees. I really do learn that much.

Same here