Please, help me! Veiled with MBD and constipation

[Dr O]

everything that the vet has, exam notes, labwork and X-rays are yours to have copies of. I think ferret and i would both be very interested in seeing bloodwork results if you can post the numbers. additionally, if they are digital rads you can upload them here, or frankly just a focused photo of a traditional X-ray on a viewbox and a little photo manipulation on my end if you upload it would allow us to take a look as well. it sounds like they are doing a good job so far from what you have described, but unfortunately there is just no way to reproduce ICU care at home, lizard or person. hopefully if they can get him back from the edge, then there are certainly continuing meds that will make his life better. but if he is pulled from ICU too soon, well.......not so good

 

[Dr O]

Yo did you ask the vet to do a sonogram on him to see if he has swallowed something he can not pass ? I just had to take a friends cham to the vet for him because he and I thought he had swallowed plastic leaves off of a vine that was suppose to be unbreakable but that crazy little B****** found a way to yank them off so we found some on the floor of the cage and thought he may have swallowed some. He also was not eating as much as he used to but it is the change of the season and it may slow a cham down a little. Thankfully he did not swallow any some people will say x ray but a sonogram is way more accurate and yes it is possible to do a sonogram on a cham they have small receptors made for small animals like birds and what not.

I love doing ultrasounds and could be happy doing them all day. however, it's not a very reliable tool for the stomach and GI tract due to the always present gasses that completely reflect the sound waves, not to mention a foreign body itself reflecting the waves. I have to say that typically an X-ray along with palpation of the abdomen is better, and even if I needed more info after that I would still use an X-ray with contrast medium. other organs, completely different story.

 

[mcbdz]

Chameleon Info:
Your Chameleon - Male Veiled, hes about 8 months and was only around 2 weeks when I got him.
Handling - I take him out when I clean his cage, or re-arrange his plants which is around once a week.
Feeding - I feed him small crickets because he refused to eat the larger ones. I offer them to him around 2-3 times a day usually around 10 am and 2pm
Supplements - on the 5th and 20th of every month I dust his crickets with d3, on the 10th and 30th I used the multivitamin.
D3 -reptocal
Multivitamin- reptocal
plain calcium- blue iguana (cal-stron)
Watering - We have 3 drip systems going constantly, and turned off through the night. We mist him 3-4 times a day and make sure we see him drink before we stop misting.
Fecal Description - White or black, very liquidy.

Cage Info:
Cage Type - Our cage is completely screen all around with aquarium film on the bottom. 2 x 2 x 4
Lighting - Zoomed, he has one normal house bulb 60 watt, & his uvb 5.0
Temperature - his basking spot is around 80 degrees and the bottom is around 70-75. We have two thermometers in his cage.
Humidity - Our humidity levels around between 60-80% throughout the day, we have almost completely live plants to help.
Plants - We are using live plants, a pothos and two umbrella plants.
Placement - Infront of a glass sliding door, away from any airconditioning vents or fans.
Location - Central Florida.

I am in no way experienced but, did notice that your basking temp is listed at only 80 degrees. Is this correct?
Some other question also, would be when the last time you changed out your UVB bulb was since, you have had him 7 1/2 months?
What is the distance from the UVB bulb to your Chams basking spot?
Do you gut load your feeders and, if so, what with. Just trying to clear this up to see any possible reason for the MBD.

 

[Pascalperfect]

If there is a calcium deficiency there are multiple body systems affected. We all know bones suffer greatly with calcium deficiency, which is why there are so many limb deformities with MBD, but other systems are affected as well. And the degree to which different systems are affected can vary in individual cases. One of the systems that suffers when there is a lack of calcium is the musculature. Smooth muscle is what is responsible for gut motility, and if there is insufficient calcium for smooth muscle to function you can get ileus, or lack of gut movement. This can lead to constipation because there isn't enough calcium available for the smooth muscles in the intestinal wall to be strong enough to move the digested food down the tract and out. This is the same concept for females who are eggbound due to calcium deficiency - not enough calcium so the muscles aren't strong enough to actually push the eggs out.

The picture you posted does look good, however it isn't a good angle for evaluating how straight his legs are. There are cases of MBD that are mild enough to cause symptoms of calcium deficiency without the bone deformities yet, which may be what is happening here. Your husbandry sounds good but each animal is different and sometimes illness pops up despite good care.

You mentioned acidosis, so what did the rest of his bloodwork show? Did he have abnormalities associated with kidney dysfunction, like elevated uric acid? Did his calcium to phosphorus ratio indicate MBD? Did they say he had poor bone density on the x-rays?

As long as he is able to support himself enough to eat, drink and be able to bask I would not give up on him just yet. It may take a lot of nursing care, maybe force feedings, a hospital cage setup so he can't fall and hurt himself and liquid calcium supplementation, but sometimes they can make miraculous recoveries. But it's going to take a lot of TLC at home to et him back on the right track. If you're up for the challenge we will offer advice to try to help you as best we can!

On the xrays it showed one of his back legs had a folded-bone fracture, we will be receiving a copy of the x-ray soon. We have him back in the cage he was in when he was small,
2 x 2 x 2
and we are trying to keep his overall temperature high because he cant really climb up and bask.
He got home this morning, we have a humidifier going on him and its really helping his breathing, because he is usually gasping.

 

[Pascalperfect]

everything that the vet has, exam notes, labwork and X-rays are yours to have copies of. I think ferret and i would both be very interested in seeing bloodwork results if you can post the numbers. additionally, if they are digital rads you can upload them here, or frankly just a focused photo of a traditional X-ray on a viewbox and a little photo manipulation on my end if you upload it would allow us to take a look as well. it sounds like they are doing a good job so far from what you have described, but unfortunately there is just no way to reproduce ICU care at home, lizard or person. hopefully if they can get him back from the edge, then there are certainly continuing meds that will make his life better. but if he is pulled from ICU too soon, well.......not so good

We dont have copies of any blood work but we have papers on what all they did to him there, we asked for copies of his x-ray and they are being sent to us. I will post pictures a.s.a.p.
I know its very hard to take care of them as the professionals did but ICU gave up on him, they said they couldnt do more for him and were telling us to put him down. There was no choice in us leaving him there, we had to bring him home. We have what they have been feeding him, which is like a powder you mix with warm water, and all his medications including and injection he is supposed to get once every 3 days. He has been with 5 different vets at ICU and the most recent one said he wasnt seeing improvement, but we have. Before we took him there he was weak, gave up on walking and would litterally lay on his side on the bottom of the cage, dark brown colored with his eyes closed. miserable looking. Since he has been home, today we had to give him his medication orally and force feed him, and his grip is so strong, and he has been walking around. grabbing the branches we have lower to the ground, not climbing yet but so much better than before. When trying to feed him he grabbed the syringe and literally pushed it back and away from his mouth, he is so strong now, unbelievably strong from how weak he was. We are so proud, he is really improving and we have so much hope in him now. We are keeping a close watch, he hasnt given up and we havent given up on him.

Thankyou for all your replies, we are so grateful for all the help we are getting.

 

[ChameleonMom]

I am so glad to hear your little one is doing better. I'll keep my fingers crossed for his complete recovery!

 

[Pascalperfect]

Also on a side note, around his neck is swollen, but we are thinking its just where he had been injected with fluids, its just a build up because it takes time for it to be absorbed.
Our cat went through a strange unknown illness where they had to inject him with fluids and it looks just like this after, any comments on this?

 

[Kate]

I am so glad you haven't given up on Pascal when others have. He seems to be a fighter and deserves the chance you are giving him. However he is a sick boy and only you will know if he has had enough. You and Pascal are in my thoughts. Hang on in there.

 

[ferretinmyshoes]

What you are seeing with the swelling is called gular edema. You are right that in cats and dogs fluids can be given under the skin, which will produce a lump as they are absorbed slowly. If they gave fluids like that in your cham it would have been in the back half of his body near his hindlimbs. They would never give them around the neck region.

Gular edema refers to the buildup of fluid under the skin in the area between under the arms of chameleons. It is not known specifically why this buildup occurs but it is speculated to be a symptom of a mineral imbalance (it is not clear which ones), or potentially an indication of liver or kidney disease. The best treatment in the experience of some is as much natural sunlight as possible, significantly increased hydration and ensuring adequate calcium supplementation with very limited phosphorus content in food and minimal supplementation of other vitamins to promote good kidney health. There is no medication to use or one treatment that has proven effective in every case. The amount of edema may fluctuate and seems to decrease most consistently when water intake increases. Sometimes the edema goes away with time, and sometimes it is permanent. For some reason edema is seen commonly with gravid females and it usually resolves once the eggs are laid.

The leg fracture would be consistent with MBD. Poor guy has been through the ringer lately. I'm glad you are seeing some improvement so far. Sounds like he has a long road to recovery ahead of him. It's good he has dedicated owners.

 

[Pascalperfect]

What you are seeing with the swelling is called gular edema. You are right that in cats and dogs fluids can be given under the skin, which will produce a lump as they are absorbed slowly. If they gave fluids like that in your cham it would have been in the back half of his body near his hindlimbs. They would never give them around the neck region.

Gular edema refers to the buildup of fluid under the skin in the area between under the arms of chameleons. It is not known specifically why this buildup occurs but it is speculated to be a symptom of a mineral imbalance (it is not clear which ones), or potentially an indication of liver or kidney disease. The best treatment in the experience of some is as much natural sunlight as possible, significantly increased hydration and ensuring adequate calcium supplementation with very limited phosphorus content in food and minimal supplementation of other vitamins to promote good kidney health. There is no medication to use or one treatment that has proven effective in every case. The amount of edema may fluctuate and seems to decrease most consistently when water intake increases. Sometimes the edema goes away with time, and sometimes it is permanent. For some reason edema is seen commonly with gravid females and it usually resolves once the eggs are laid.

The leg fracture would be consistent with MBD. Poor guy has been through the ringer lately. I'm glad you are seeing some improvement so far. Sounds like he has a long road to recovery ahead of him. It's good he has dedicated owners.

The strange swelling is down to half the size it was yesterday, so its slowly but surely going away. All this support is really helping to motivate us even more, Pascal is family, he is my baby and Im thinking he is really going to pull through. How he is acting right now is such a miracle, its a gloomy day outside and very cloudy which is disappointing since we wanted to take him out for some nice Florida sunshine. We took him out yesterday and he really enjoyed it, he curled his tail up and was a beautiful lime green!

 

[ferretinmyshoes]

Was he on IV fluids while he was there? It could just be from a lot of intensive care fluids that he wasn't able to eliminate appropriately if his kidneys weren't up to the challenge I suppose. We'll just have to wait and see what he does. Is he on liquid calcium supplementation?

 

[Pascalperfect]

Was he on IV fluids while he was there? It could just be from a lot of intensive care fluids that he wasn't able to eliminate appropriately if his kidneys weren't up to the challenge I suppose. We'll just have to wait and see what he does. Is he on liquid calcium supplementation?

Yes, he is taking liquid calcium. We just took him outside, and held him next to his old hibiscus plant that used to be in his cage before it started dying.
He right away reached out for it and grabbed it, he is too weak to hold himself so we just held his butt up while he held the branches, it was really sweet.

 

[ChameleonMom]

Poor little guy! He doesn`t look toooo bad but his veil is a sunken which indicates a lack of water. Sorry, I can`t remember if he`s drinking or if you`ve seen him drink? Either way, you may need to hand water him, which I do using a syringe - drop some drips on his nose and after a while they usually start opening their mouth and licking any excess water around their mouth.

 

[Pascalperfect]

Poor little guy! He doesn`t look toooo bad but his veil is a sunken which indicates a lack of water. Sorry, I can`t remember if he`s drinking or if you`ve seen him drink? Either way, you may need to hand water him, which I do using a syringe - drop some drips on his nose and after a while they usually start opening their mouth and licking any excess water around their mouth.

We JUST gave him water, we hold his dripper over his mouth and he starts opening. He doesnt drink by himself, but anytime we hold that dripper up to his lips he drinks everytime.

 

[ferretinmyshoes]

How's he doing?