Drug Interaction Question - backstory and details inside.

[JSkelt]

Hello All,

Thank you in advance for taking the time to read and assist. Heads up - this is a sad story, and I'm hoping it doesnt get any sadder.

Looking for some medical advice before I can get to my exotic vet Monday. I have tried calling various vets, and even the ASPCA's 24/hr Animal Poison Control Center to no avail. Bad timing to have this problem at 3pm on a saturday in a semi-rural area.

The story:
This morning, I fed my panthers, went to brunch, came home to find my sub-adult ( 8.5mo ) ambilobe male hanging lifeless. Very sudden, extremely sad and an absolute shock. I was immediately heartbroken. I have had him about a month. His husbandry is on point, I take very good care of all my dudes.

Based on how quickly this appeared to happen, I thought he had to have choked or had a sudden episode, like a stroke. There were no signs of anything wrong this morning, he looked healthy, was very active, his stool and urates looked normal, he ate like a champ...

I put on nitrile gloves to examine. Upon taking him out of his branch, I found his mouth and throat full of roundworms. With forceps, I pulled out at least 2.5-3 dozen ranging from 3/4" to 2+" in length. He was CB locally in my area from very reputable breeder, clean fecals at the time I acquired him. Everything way above board - full known bloodline and just absolutely striking colors.

Unsure if he came into my care with undetected parasites, or if they were contracted through a feeder insect - which I hear isn't uncommon with roundworm in particular.

I'm extremely saddened by the loss - as I lost my cat to a long battle of renal failure, and got this new guy very soon after - to cheer me up ( which he did ). I have spoken with the breeder prior to posting this, who provided some initial insight - as I was at first freaking out that my entire home may be contaminated ( also have an adult dog, a 7mo old puppy, an adult cat, a 7week old kitten and a very patient wife ). He said while rare, this can happen, and it is always unfortunate. Sometimes a fecal test doesnt catch everything. Sometimes it can come from feeders. With gut / intestinal parasites like roundworms, the more they eat, the more the worms eat, the better the husbandry - the better environment is for the parasites to thrive. So without routine parasitic checks it can be easy to miss.

Housed next to the recently deceased in a separate yet identical 2x2x4ft screen enclosure is a mature ambilobe male. 3.25 years old, I have had him for 2+ years, from the same breeder. He's pretty big, and slipped off while climbing the screen roughly 2.5 weeks ago, and cracked his jaw in the fall - the very front part between two front bottomm teeth, just split apart - its a very fragile bone, I was quite shocked how fragile when the vet showed me.

My exotic vet prescribed him with baytril 0.15ml sub-q injections for 7 days, ( i administered the injections, baytril treatment ended 7 days ago ) and he is still currently finishing a round of SulfaTrim 0.2ml / day for another three days. Infection is nearly gone and he is healing.

However, now I'm very concerned about him in regards to parasites, since the other ambilobe showed no signs of having a gut full of roundworms, I'm very nervous for this guy who has been a part of the family for a long time now. They get fed from the same source of feeders ( primarily crickets I buy by the 1000 that come from a cricket farm, and then some mega worms for treats). Their enclosures are sealed, but right next to each other.

I cannot get to my vet until Monday at the earliest, or whenever their next appointment is. They closed at 1 today, closed tomorrow ( sunday ) and are generally pretty busy.

I can aquire panacur 100mg/g tomorrow morning from a local tack shop and I understand the consensus for dosage is 0.1ml / 100g. I know from the last visit 2 weeks ago for his jaw that he is is 230g.

My question:
Is there any known drug interaction between Sulfa Trim and Panacur?

Should I proactively administer a dose of panacur tomorrow or until I can see a vet?

I checked the mature adults fecals and I didnt see anything abnormal, but I just have my eyes, no equipment to look closer. They were about 24hrs old.

I have since bleached the bottom of his enclosure and am in the process of completely torching everything in the other affected cage.

Im mostly concerned if I should proactively administer pancur just in case, and if I did would it interfere in a negative way with the antibacterial sulfa trim.

Thank you SO MUCH for reading and for your time, and expert advice.

 

[JSkelt]

For help, based on guidelines:

Chameleon Info:

• Your Chameleon - 3.25yr old male ambilobe
• Handling - very rarely, only to administer medicine or move to free range area
• Feeding - 10-12 crickets / day. Megawords, hornworms for treats on occasion.
• Supplements - Fluckers calcium w/o d3 every other feeding. Fluckers calcium w/ d3 once a week, Herptivite multivitamin 2-3x /mo
• Watering - Each enclosure has two mist king nozzles, 2min sprays 5 times a day for 12 hours.
• Fecal Description - Appears normal. Firm stool and white-ish urates. Last tested for parasites when acquired.
• History - None other than recent which is listed above

Cage Info:

• Cage Type - 24x24x48” screen
• Lighting - 2x24” arcadia t5
• Temperature - Gradient: 85º-75º Basking 85-88º
• Humidity - 50-70% depending on time measured
• Plants - Fake plants, swapped out every few months. Washed every few weeks in soapy water with a touch of bleach. Rinsed throughly. Bamboo branches and exo terra jungle vines. weaved throughout.
• Placement - In corner of home office. I’m the only one ever in here. 3.5ft off ground, top of enclosures much higher than eye level ( I’m 6ft )
• Location - Greater New York City area

Current Problem - Chameleon currently being treated with SulfaTrim for broken jaw. Parasite emergency from another adjacent enclosure. Advice needed before a vet visit can be arranged ( as soon as possible, it is the weekend ).

 

[Nursemaia]

There are no known drug or food interactions with panacur

 

[JSkelt]

There are no known drug or food interactions with panacur

Thank you!

 

[Nursemaia]

Here's the caveat, if an animal has a heavy parasite load and you kill too many of the parasites too fast that can make them ill as well.

 

[Andee]

Likr the above post said, you should use the panacur in smaller amounts, to kill the round worms off slower and allow hisr body to reduce the toxins in his body before the next dose from the rotting worms.

 

[JSkelt]

I should receive proper vet attention in hopefully 72 hours, I have left a voicemail already, they know us well and I'm certain we will get first available appointment.

Hopefully, I'm being over precautious. My nightmare would be he does have roundworms, and by the time fecals come back its too late, when I could have been proactive.

So a lower dose is advised, thank you. Something preventative until test results come back.

Given he is 230g, maybe, 0.1ml or 0.05ml?

To disclose - I am seeking advice, and will treat all information provided as so, acting on my own behalf.

Thank you all for your input. If there is anything else or any other recommendations, please, I'm all ears.

Very grateful to have such an awesome community to reach out to at troubling times like this.

 

[Andee]

I sadly do not know the dosage you should give him... I have yet to need to worm my chameleons myself. Thankfully I have an amazing exotic vet who can get me in 6 days a week. However there are several users on here who might be able to tell you, maybe @jannb , @jajeanpierre , or @ferretinmyshoes . One of them may be able to tell you, all of them have multiple chameleons and have experience with worming. Jannb does rescues, jajeanpierre works with wildcaughts and breeding so she definitely knows about taking it slow with parasites, and ferretinmyshoes is a vet who knows an extreme amount about chameleons.

 

[JSkelt]

Thank you for the references and shoutouts, @Andee !

I wish there were a way I could check my dude, as the wait for the vet appointment is going to be riddled with anxiety. I'm about to give him his SulfaTrim, will try to get him to gape and take a look to see if there is anything abnormal.

Tomorrow morning I will acquire the panacur and administer a small, precautionary / preventative dose of 0.05ml unless recommended otherwise. I have the proper instrument to accurately deliver this amount.

Just laid my young little homeboy Leonard "Lenny" Flare to rest out back, underneath an aloe plant I picked out for him a few hours ago. So sad. Randy, my older panther, is the man, and I'm worried sick about him - as if the broken jaw wasn't enough... And just last night I was checking out Lenny thinking how good he looked.

At the very least, I've learned my lesson to get your chams checked for parasites regularly, even if fecals come back clean. I know all too well how fragile they are, which is part of the craft and intrigue of the species and their husbandry, and how quickly things can go from being apparently fine to tragic.

Thank you to everyone, once again. Your time and insight is extremely appreciated.

 

[Andee]

I am truly sorry about your unexpected loss. He will be watching over you guys from the big rainforest in the sky. Rip Lenny

 

[jajeanpierre]

I am very sorry for your loss.

Wait until you talk to the vet. Did you keep some of the worms? Perhaps they were lung worms, not intestinal roundworms. Lungworms will end up in the trachea and be coughed up. Did you keep the body in the fridge? I would suggest a necropsy since you are so worried about your other guy. Just because an animal has a heavy parasite load and dies does not meant the parasites actually killed them. It is rare that parasites actually kill the animal.

As far as the dosage for Panacur, it is 50mg per kilogram. I don't know where you got that number of 100mg/g. That is 2000 times the dosage for a chameleon which is a massive dose compared to the recommended dosage. The Panacur I have is 50mg/ml. A horse wormer paste is compounded for a 1000 pound animal.

Wait and speak to your vet.

 

[JSkelt]

I am very sorry for your loss.

Wait until you talk to the vet. Did you keep some of the worms? Perhaps they were lung worms, not intestinal roundworms. Lungworms will end up in the trachea and be coughed up. Did you keep the body in the fridge? I would suggest a necropsy since you are so worried about your other guy. Just because an animal has a heavy parasite load and dies does not meant the parasites actually killed them. It is rare that parasites actually kill the animal.

As far as the dosage for Panacur, it is 50mg per kilogram. I don't know where you got that number of 100mg/g. That is 2000 times the dosage for a chameleon which is a massive dose compared to the recommended dosage. The Panacur I have is 50mg/ml. A horse wormer paste is compounded for a 1000 pound animal.

Wait and speak to your vet.

I will heed your advice and wait.

Thank you @jajeanpierre for taking the time to respond.

The panacur I can acquire is indeed sold as a horse paste, Panacur 100 ( 100mg/g and it comes in a 25g tube ). I may have been ill advised from the internet and other posts that 0.1ml of this per 100g of animal weight was a 'normal' dose. Basically equivalent to the size of a raindrop in total.

I don't even know if the older cham has the worms, I am just paranoid as he is already on meds, and if it came from bad feeders may already be exposed. Also, I understand that my emotions and personal judgement should never get in the way of proper treatment. Which is why I am cautious and seeking advice here until I can get treatment. I will monitor him closely and await proper medical attention.

I buried "Lenny" but I did keep the parasites I collected. They are in ziplock bags, 3 deep ( bag inside bag inside bag ). Currently at room temperature but can freeze in the basement freezer if that will help them keep for identification.

Here is a *GRAPHIC* video my wife took post mortem once I realized parasites were involved. Please click with caution, not a fun link, and NSFL:
https://vid.me/2q8z

The video is short, but I ended up pulling out about 5-7 times what is seen on the video, all within a 10-15min period. And that was just in the mouth, from what I could see without probing or damaging any tissue. There was no question that this was still just a fraction of the total. I assumed these to be roundworms based on my paltry knowledge of common parasites, but I am no vet. This video was taken no more than 3hrs after passing.

 

[JSkelt]

To lighten the mood after that last post, here is some chameleon eye bleach



Randy, the chameleon I'm concerned about, is the panther in that video. You can also get a visual of the setup.

 

[ferretinmyshoes]

So sorry for your loss. That video you posted is kind of unreal! Those are a lot of very large worms! Gross.

0.05ml would be appropriate. The fenbendazole you have is 100mg/ml (g = ml so the concentration is 100mg/ml) so at 20mg/kg, which is my standard starting dose, for a 230g cham would be 0.046ml, or 0.05ml when rounded up. Fecals are definitely a very useful diagnostic but sadly may not catch everything if the worms are not actively shedding eggs or if they're lungworms and may not be passing in feces in high enough numbers. Even captive bred good bloodline chameleons can still get parasites although it is uncommon.

 

[Andee]

Once again the braniacs come to the rescue. Thanks you two. Hopefully all goes well for your baby at the vet visit. Good luck and keep us updated.

 

[rminnis]

Very sorry for all you have been thru!

 

[jajeanpierre]

So sorry for your loss. That video you posted is kind of unreal! Those are a lot of very large worms! Gross.

0.05ml would be appropriate. The fenbendazole you have is 100mg/ml (g = ml so the concentration is 100mg/ml) so at 20mg/kg, which is my standard starting dose, for a 230g cham would be 0.046ml, or 0.05ml when rounded up. Fecals are definitely a very useful diagnostic but sadly may not catch everything if the worms are not actively shedding eggs or if they're lungworms and may not be passing in feces in high enough numbers. Even captive bred good bloodline chameleons can still get parasites although it is uncommon.

Thanks for setting the record straight. I was mixing up the dosage and concentration of the horse wormer.

 

[jajeanpierre]

@JSkelt Don't freeze the worms if you want the vet to look at them. Just put them in the fridge.

 

[JSkelt]

Been a while, wanted to provide an update:

Randy was prescribed panacur by our vet, a 3-day course. Fecals were tested, he's all good to go. The worms Lenny had were classified by the vet as lungworms.

Randy had his Surgery monday to repair his broken jaw ( had to wait for the panacur cycle to complete before they would administer anesthesia ) and all went well.

He's eating like a champ, and has two little stitches on his lip, our vet did a great job. He'll be all healed up good as new in no time.

Thanks again to everyone for your time and insight.

 

[JGspecial]

very crazy situation(s). glad the other one is doing well. so sad to lose a chameleon, the guy in my avatar died suddenly as well. RIP little guys.