Interpretation of bloodwork?

[liestesnevada]

I received a jacksons chameleon less than 1 year ago, I do not know his age, background or where he is from. He lives in a XL zoo med repti breeze (48"H) with two sides covered to keep in humidity. His basking spot is 80-85 while his ambient temp is 70-75 during the day in the summer (basking light often turned off on hot days not allowing it to go above 80) and 80 basking spot during winter and ambient temp of 70-75 and remains in the low 70's at night. Misted at least twice a day and has a slow dripper keeping huimdity around 60-80%.
He is fed every other day with gutloaded crickets (gutload pre-made mix alfalfa based protein and veggies), hornworms, mealworms, and mealworm beetles and get sticky tongued miner-all indoor vits/ calcium with D3 3 or 4 times a month. He has two 5.0 UVB lights (one is a older than 6 months but mainly for his live plants). Enclosure: paper towel substrate, tons of vines and branches, tons of room for him to retire from the heat, live Dracaena plant (sorry for the mispell) and a live tropical palm plant.

Last week i noticed he started slowing down on eating normally he eats everything in sight, but still eating. I thought maybe he was getting sick of his crickets. On sunday i noticed a small amount of what looked like fluid accumulation around his neck behind his head that extended slightly down toward his throat. It looked like the beginning of edema. Vet was closed for the long weekend and I was only able to get him in on Tuesday. Vet agreed and says it looks like edema, we are trying to figure out WHY though. Here are the bloodwork results.
Any thoughts?
I haven't heard back from my vet yet, but have been increasing his water intake by leaving his dripper on and syringing him water.


EDEMA (AREA OF SWELLING BEHIND / JUST AROUND NECK, SOFT, SUSPECT FLUID FILLED. NO OTHER ABNORMAL FINDINGS UPON PE. URIC ACID, CA AND P ARE PRIORITY THEN PROTEINS / HEPATIC ENZYMES.
Tests Ordered: Avian Chemistry Profile, ALT (SPGT), Bile Acids, Phosphorus, PCV (Packed Cell Volume) Hematology PCV (Packed Cell Volume) HCT 0.54 L\L
Chemistry Avian Chemistry Profile Glucose, Serum 11.1 mmol/L
Calcium 1.97 mmol/L
Total Protein 21 g/L
Albumin 4.8 g/L
Globulin 16 g/L
Albumin/Globulin Ratio 0.3
AST 196 U/L
CPK 49 U/L
Uric Acid 100.0 umol/L
ALT 9 U/L
Bile Acids 79.5 umol/l
COMMENTS: Chemistries run on dilutions up to x5 due to small sample volume. Phosphorus 0.67 mmol/L Comments: No reference for chameleons is available. ISIS values are published on Wikivet and were used for reference. Hematocrit is perhaps slightly high for the species which could reflect dehydration. Proteins are low- third space loss related to the swelling might be a consideration; any evidence of GI disease/ eating well? AST, ALT look ok. Ca and P appear low end to slightly decreased, however note that hypoalbuminemia can lead to low Ca through decreased protein binding. An ionized Ca level would be a more accurate assessment of calcium status if there is ongoing concern. Any anorexia, low VitD concerns? Uric acid is ok. No reference is available for bile acids but subjectively this does seem high for a reptile and could indicate hepatic disease; monitoring is waranted.

 

[Lathis]

My Jax passed away from liver failure, and I posted his blood results somewhere here. His bloodwork was all over the place with AST levels sky-high at 2000, if I remember right. Yours seem to be closer to normal ranges for reptiles (known values anyway). Slight edema was a symptom but it's not always a sign of liver failure. Jax are sensitive to long term chronic dehydration and over supplementation. Unfortunately, since you don't know how he was cared for before you had him, it could be an issue that predates you.

One thing I would try first is to cut the all-in-one supplement and just use plain calcium for a few weeks. If it is over supplementation, the edema should go down. You might also take a hard look at your gut load and reduce proteins. I believe too much protein can also contribute to edema.

Those would be two easy things to try first. And make sure he is really well hydrated. Do you know if he prefers misting or dripper? My Jax was such a slow drinker, I had to run a 20 minute session in the morning to be sure he had enough time to drink.

Keep a really close eye on his weight and hydration. I fought against secondary infections and steady weight loss with my Jax for months before he finally passed away. It wasn't until after his bloodwork and then necropsy that the vet could find info to better suggest that it was liver failure.

Edit: Bloodwork for my Jax as the very end of his illness showing what the vet suspected was liver failure. https://www.chameleonforums.com/threads/ferdinand-update.142511/#post-1212910

 

[liestesnevada]

T

My Jax passed away from liver failure, and I posted his blood results somewhere here. His bloodwork was all over the place with AST levels sky-high at 2000, if I remember right. Yours seem to be closer to normal ranges for reptiles (known values anyway). Slight edema was a symptom but it's not always a sign of liver failure. Jax are sensitive to long term chronic dehydration and over supplementation. Unfortunately, since you don't know how he was cared for before you had him, it could be an issue that predates you.

One thing I would try first is to cut the all-in-one supplement and just use plain calcium for a few weeks. If it is over supplementation, the edema should go down. You might also take a hard look at your gut load and reduce proteins. I believe too much protein can also contribute to edema.

Those would be two easy things to try first. And make sure he is really well hydrated. Do you know if he prefers misting or dripper? My Jax was such a slow drinker, I had to run a 20 minute session in the morning to be sure he had enough time to drink.

Keep a really close eye on his weight and hydration. I fought against secondary infections and steady weight loss with my Jax for months before he finally passed away. It wasn't until after his bloodwork and then necropsy that the vet could find info to better suggest that it was liver failure.

Edit: Bloodwork for my Jax as the very end of his illness showing what the vet suspected was liver failure. https://www.chameleonforums.com/threads/ferdinand-update.142511/#post-1212910

Thank you so much for your input. I will just use a straight calcium supplement for the next while. It bothers me that I do not know his previous care. He doesn't have a huge preference as to how he gets his fluids but I have been leaving his dripper on for at least 8 hours a day lately and usually leave it on 3-4 days out if a week for several hours at a time. He is attracted to moving water so I let it drip into a 'pool' the leaves create.
I will take a look at your thread, thank you so much for taking the time to share this and I am so sorry for your loss. They are quite the characters and though I haven't had him for long I have bonded with him very quickly.
*Update* vet believes it to be an infection or liver disease. We are going to treat him with enrofloxacin and metronidazole

 

[Lathis]

https://en.wikivet.net/Lizard_Blood_Values
These are the reference blood values the lab noted in your report. Based on what my vet told me, this is about the most reliable references available except for those places lucky enough to have internal test result data banks.

Unfortunately, there really is just not that much information out there about reptiles at all, much less about chameleons specifically. We do have a few vets who are members here, but I don't know how much they get to visit and reply.

Good luck with your jax. They are such amazing little guys with the best personalities. I hope he is able to come through this.