Possible gout?

[KLowery88]

My problem child of a rescue continues to gather more issues. For the past week, week and a half, he's been fairly sedentary and has been dangling feet off branches more than he used to. A few days ago he started shedding and I noticed his front left foot has a rather swollen ankle.



I'm not sure if it is gout, since he really hasn't been eating anything for me for about a month now besides the bug juice I've been giving him. Two weeks ago I took him to the vet to get a vit A shot to hopefully fix whatever is causing his recurring impacted sperm plugs, which my vet and I thought could be causing him to go off food.

He has his follow up vet visit scheduled for this Friday, so I'll definitely be bringing it up to see what kind of tests we can run to see what's up.

I've been reading the chapter on gout in Mader's Reptile Medicine and Surgery, and what it says about gout and renal disease worries me. I have no idea how much misting Monty's previous owners were doing, but the hand mister that was given to me with him was very small, so I'm willing to bet that in the year he was with them, he wasn't getting the water he needed. They fed him on mealworms and crickets, so nothing too hydrating.

Thoughts? Does it sound like gout or could it be some other problem going on?

 

[KLowery88]

He's been very lethargic the past few days. Leaning against branches, and while he's normally feisty, this morning he wouldn't gape or puff up at me when I offered his bug juice. I really hope we find out what is going on tomorrow, but this is the fourth vet visit over the past two and a half months and so far nothing has really helped.

 

[maryanne27]

That does sound similar to what happened with my graceful... his joints look the same from that picture, and the behavior sounds pretty similar. Rorschach still ate and drank, but he was lethargic, leaned, and dangled limbs a lot toward the end.
Is he able to bend his joints or do they seem fairly locked? At first, my vet thought it was just an infection and was able to remove some of it surgically, but after multiple joints began to lock and antibiotics did nothing, that is when we figured it was gout and it had progressed too far (not sure what caused it, as he had a varied diet and seemed to drink fairly often). Maybe if you are catching it early enough, something could be done!
Good luck and keep us posted - I am really curious how this turns out.

 

[KLowery88]

That does sound similar to what happened with my graceful... his joints look the same from that picture, and the behavior sounds pretty similar. Rorschach still ate and drank, but he was lethargic, leaned, and dangled limbs a lot toward the end.
Is he able to bend his joints or do they seem fairly locked? At first, my vet thought it was just an infection and was able to remove some of it surgically, but after multiple joints began to lock and antibiotics did nothing, that is when we figured it was gout and it had progressed too far (not sure what caused it, as he had a varied diet and seemed to drink fairly often). Maybe if you are catching it early enough, something could be done!
Good luck and keep us posted - I am really curious how this turns out.

He's able to bend them and move around, he's just very reluctant to do so. I'm pretty sure this also hasn't been brought on diet, though I could be wrong. I'm more worried about it being tied to kidney issues. When his previous owner dropped him off, I didn't think to ask how long they had been misting him for, or how many times a day. I'm assuming not very much, since the spray bottle dropped off with his things was very small. Did your vet put your chameleon on any pain meds? What I've read on gout mentions that it's very painful.

 

[gotwqqd]

If it's anything like gout in humans, I can attest it's excruciatingly painful.... Even when not moving.

Antibiotics will do nothing.... You need anti inflammatory/pain meds and something to help body eliminate the uric acid.

Lots of water... So I'd increase mistings to get drinking stimulated.
Lower protein and high Purine foods... So I wouldn't give bug juice.... I'd lean toward low pouring vegetable matters until the inflammation goes down.

This is speculative and based on human response. But as it seems there is no concise proven answers for a lizard I'd give it a shot as it would probably be best solution/chance.

 

[KLowery88]

If it's anything like gout in humans, I can attest it's excruciatingly painful.... Even when not moving.

Antibiotics will do nothing.... You need anti inflammatory/pain meds and something to help body eliminate the uric acid.

Lots of water... So I'd increase mistings to get drinking stimulated.
Lower protein and high Purine foods... So I wouldn't give bug juice.... I'd lean toward low pouring vegetable matters until the inflammation goes down.

This is speculative and based on human response. But as it seems there is no concise proven answers for a lizard I'd give it a shot as it would probably be best solution/chance.

Thank you very much for the tips. I increased his misting times last week (Five minutes in the morning, two minutes at noon, and four minutes at four) and the bug juice has a lot of water and unflavored Pedialyte for hydration. I haven't been forcing it down his throat, just what he'll accept, which isn't much. I'll start adding vegetables and greens to the mix though. I've also been offering water from a syringe, sometimes he'll drink from it, sometimes not. His poops are very small, but more regular than they were before he got the vitamin A shot. Urates are very small, but white.

I'll be discussing everything with the vet. From what I've read, allopurinol is the drug of choice to try and lower the uric acid in the blood.I worry about his prognosis if it is gout linked to renal disease, but we'll just have to wait and see what the vet says.

 

[lainezor]

Pain medications can cause extra kidney issues especially if the cause of his swelling does in fact come from gout.

My 3 year old veiled was diagnosed with gout about a month ago and I have been giving him allopurinol (a human medication that they had componded for vet use) every day for the last 2 weeks. As far as I know this is the only safe chameleon treatment.

Keep in mind that my chameleon had a biopsy, x rays and a blood test done before we had come up with gout. The only true way to tell if your chameleon has gout is to have bloodwork done and to check the uric acid levels in the blood. Also a died high in animal proteins (such as pinky mice), inadequate hydration, excess or not enough supplmentation, feeding insect feed on dog or cat food, and kidney failure can cause gout.

 

[KLowery88]

Pain medications can cause extra kidney issues especially if the cause of his swelling does in fact come from gout.

My 3 year old veiled was diagnosed with gout about a month ago and I have been giving him allopurinol (a human medication that they had componded for vet use) every day for the last 2 weeks. As far as I know this is the only safe chameleon treatment.

Keep in mind that my chameleon had a biopsy, x rays and a blood test done before we had come up with gout. The only true way to tell if your chameleon has gout is to have bloodwork done and to check the uric acid levels in the blood. Also a died high in animal proteins (such as pinky mice), inadequate hydration, excess or not enough supplmentation, feeding insect feed on dog or cat food, and kidney failure can cause gout.

This goes along with everything I've read so far in Mader's book, so that is good. I was pretty sure an x-ray and possibly blood work would be done.

As far as what caused it, I doubt it was a diet high in animal proteins (His previous owners fed mealworms and crickets from the store, and he hasn't eaten much for me), but I do believe he suffered from inadequate hydration.

 

[gotwqqd]

You can also try mixing in olive oil to your concoction

 

[KLowery88]

You can also try mixing in olive oil to your concoction

I do have olive oil. How does this help? Just additional liquids?

 

[maryanne27]

He's able to bend them and move around, he's just very reluctant to do so. I'm pretty sure this also hasn't been brought on diet, though I could be wrong. I'm more worried about it being tied to kidney issues. When his previous owner dropped him off, I didn't think to ask how long they had been misting him for, or how many times a day. I'm assuming not very much, since the spray bottle dropped off with his things was very small. Did your vet put your chameleon on any pain meds? What I've read on gout mentions that it's very painful.

From what I have read, there are two types of gout. It can be cause by renal problems or by excess proteins and sometimes minerals in their diet. I feel that if your previous owners only fed crickets and mealworms plus slacked with hydration, it could be the perfect storm for gout.
By the time we came to the conclusion, it was too late. It was difficult to get labs on him, so the vet used his best judgment with surgery and antibiotics; he did do some cultures and found some infection. Just a few months ago, though, it seemed to spread to more joints and nothing was helping. I just had to put him down in January, he was almost three. My vet said he could refer me to another vet much farther away, but there was most likely nothing they could do besides make him comfortable for a little longer.

I do agree, though, with whoever up above mentioned the meds causing more renal problems. It is sort of a double-edged sword once it progresses too far.

**and please be aware I am no expert in this. I'm just sharing my experience which could be different from yours! We never were able to get the proper labs to make a solid diagnosis of gout... it was just based on clinical diagnosis. Hopefully your little guy is better off than my Rorschach

 

[KLowery88]

From what I have read, there are two types of gout. It can be cause by renal problems or by excess proteins and sometimes minerals in their diet. I feel that if your previous owners only fed crickets and mealworms plus slacked with hydration, it could be the perfect storm for gout.
By the time we came to the conclusion, it was too late. It was difficult to get labs on him, so the vet used his best judgment with surgery and antibiotics; he did do some cultures and found some infection. Just a few months ago, though, it seemed to spread to more joints and nothing was helping. I just had to put him down in January, he was almost three. My vet said he could refer me to another vet much farther away, but there was most likely nothing they could do besides make him comfortable for a little longer.

I do agree, though, with whoever up above mentioned the meds causing more renal problems. It is sort of a double-edged sword once it progresses too far.

**and please be aware I am no expert in this. I'm just sharing my experience which could be different from yours! We never were able to get the proper labs to make a solid diagnosis of gout... it was just based on clinical diagnosis. Hopefully your little guy is better off than my Rorschach

Yes I'm definitely keeping the advice about the meds in mind for when I talk to the vet.

The past few days has gotten me very worried. He's normally a very grumpy cham and the fight has gone out of him. The past two nights he's turned this dark color an hour or so before lights out when he's on his sleeping branch that I've never seen before, even with his other ongoing issues.

 

[maryanne27]

Aw poor guy I hope he gets better soon

 

[KLowery88]

Unfortunately I don't have a good update for you guys. He did have gout, and my vet said that while we could attempt treatment, the results he'd had were hit and miss. With already sick chameleons suffering from other issues, like Monty, it usually just prolonged their suffering. The meds to treat the gout and pain would be hard on his kidneys and liver, and with him having not eaten for a month, it would just be too much. He gave me all the options on the table, but when I asked his personal opinion, he said it would be best to let him go.

https://www.chameleonforums.com/threads/im-so-sorry-monty.148076/