Sodium & Chloride sky high

[Little Man Simba]

I've posted off and on about Simba's ongoing health problems, some of which are not related to each other, some obviously are...

We went to our new chameleon vet for a recheck last week for blood work, because he is still not improving as much as we'd like. She prescribed baytril to clear up an infection from a little cyst near his nostril. I was a little hesitant to do the baytril because i know it can be really hard on their little bodies and with everything he's been through i didnt know if he could handle it, but she said the previous bloodwork showed good values and she wanted to try something stronger because of the amount of bacteria she saw...Took him home (Fri) and all was fine, but when I checked on him the next morning (Sat) he was SO dark and lethargic I thought I would lose him that day. Needless to say I discontinued the antibiotics right away and we went back in for a recheck on Tuesday when he was much more stable. We did recheck blood work which revealed that his levels look great, except for Sodium and Chloride which are literally off the chart!!! For now, I am supplementing 4ml sub cutaneous fluids (lactate ringers) daily with benebac plus (.5g every 3 days) and tramadol for pain. When he provides a fecal, I will submit it for testing.

Two vets and over $2000 later and we are still desperately trying to find out what the underlying cause of this mystery illness is! I'm worried that we'll lose him before we find out.

I have always used Filtered water with him, but switched over to distilled (bottled) last night.

The good news is that the infection has resolved, but he is still incredibly dehydrated and weak.

Has anyone seen this before? Does anybody have any suggestions? I have tested our tap water (pre-filter) and sodium & chlorine levels are very low. Kidneys and liver are functioning well...


What on earth is going on?!? Help please

 

[kinyonga]

Can you post a couple of photos of him now please?

 

[Beman]

@ferretinmyshoes

 

[snitz427]

What supplements are you using, and what bugs do they usually eat? (Curiosity)

 

[kinyonga]

Has your chameleon had any electrolyte drinks in the last little while…before the last bloodwork?

What color are the urates? Is he drinking well?
Did the vet say anything about his kidney function?

 

[Little Man Simba]

Can you post a couple of photos of him now please?

I have posted the progression, the first is the oldest ( oct 2021), the 2nd is Aug of last year, pics 3/4 are from nov last year (respiratoryinfection after tail amputation and hemipens prolapse), pic 5 is after baytril a week and a half ago, when I didn't think he would make it. And the last is from this morning, move in to new house, which we adapted to help so he doesn't fall. I know this is a horrible angle but I didn't want to disturb him even more for a pic.

 

[Little Man Simba]

A much better one from a minute ago

 

[kinyonga]

This might help…
http://www.chameleonnews.com/02NovDonoghue.html

 

[Little Man Simba]

What supplements are you using, and what bugs do they usually eat? (Curiosity)

Supplements:

-Zoomed reptical without d3 @ every feeding
-Reptivite with d3 every other week
-Bene-bac plus 0.5g every 3rd day

Feeders:
-Dubias (fed spinach/carrots & various other scraps of good veggies/potato)
-Superworms when he refuses dubias
-Occasional hornworms/wax worms when I can find them

Has your chameleon had any electrolyte drinks in the last little while…before the last bloodwork?

What color are the urates? Is he drinking well?
Did the vet say anything about his kidney function?

Kidneys are the first thing i suspected too. But it doesnt look like it.

No electrolytes. I was thinking about it, then decided to wait for bloodwork and I am so relieved I did. With his high levels electrolytes probably would have killed him...

Also strange, everything else looks good diagnostically. All other bw values are perfect (except those due to stress; alb etc).

Urates are white. Stools before baytril were small, but normal, occasionally only partially digested, and only occasional constipation.

After baytril, colonic prolapse occurred. The vet was able to reinsert (non surgically & no anesthesia). She said that inside he had a major sperm plug and "a ton of shit" which she removed. He has not produced anything since then. That was Wednesday. He is eating with encouragement. (I push it gently daily but he's been eating about every other day or so.) I am anxiously awaiting the first stool since the prolapse. He's holding it, which is not making me feel better. Tomorrow he's due for probiotics which should (hopefully) make it easier to pass.

This might help…
http://www.chameleonnews.com/02NovDonoghue.html

Kinyonga,

Thank you!!! This was a great article, very informative. Based on this, possibly fluorosis... while I have been filtering the tap water, fluoride isn't removed. That combined with high stress from broken tail, hemipenis prolapse, ongoing treatments and vet visits, is probably magnifying it. He was showing edema a few months ago, the vet suspected gout was possible at that time. It has reduced, however that doesn't mean the issue is resolved. I am also noticing swelling under his chin/chest area after water intake.

I am only using fluoride free distilled bottled water at this time. What are you using? Is there a better option (R/O?)

 

[kinyonga]

I’ve always used tap water….but some areas have too many chemicals in and it might be better to use something else.

With any kind of prolapse, the chameleon can develop a fungal infection sometimes. It might be worth mentioning it to the vet.

BTW…I’m not a vet…I just speak from experience and what I’ve learned in 30+ years of keeping chameleons and a lot of other reptiles, etc.

Are you doing anything to keep the stool soft to make it easier to pass so the prolapse area can heal?

 

[Little Man Simba]

I’ve always used tap water….but some areas have too many chemicals in and it might be better to use something else.

With any kind of prolapse, the chameleon can develop a fungal infection sometimes. It might be worth mentioning it to the vet.

BTW…I’m not a vet…I just speak from experience and what I’ve learned in 30+ years of keeping chameleons and a lot of other reptiles, etc.

Are you doing anything to keep the stool soft to make it easier to pass so the prolapse area can heal?

 

[Little Man Simba]

I had always used tap water before all of these issues arose. Everyone said I should use distilled/filetered/ro(vet included) so I started filtering it and then after a month or so, the problemsstarted popping up one by one. However, maybe he is missing some vital nutrients that are in the tap water.

The benebac (probiotic) does soften the stool quite a bit...

He has never been a good water drinker. He has always preferred to drink by hand, although he has a Mister and drip cup available. This has always been a concern of mine.

He is coming off of a course of antifungal meds. After his surgical hemipenis prolapse last fall, despite tazicef antibiotics, he didn't recover fully. After pushing this to the vet, she prescribed a course, and he did improve a bit. He started drinking and eating much more regularly, passing stool/urate regularly and thermoregulating better.

Now he is so stressed out, I wish I could leave him alone, but he needs these treatments (and forcing water/pain meds). I just hope I'm not stressing him to the point of distruction.

 

[kinyonga]

What Antifungal meds did he take?

I would think changing the water to one with no minerals could have an affect on him….after all, you’ve changed the nutrient content he’s been receiving.

 

[Little Man Simba]

What Antifungal meds did he take?

I would think changing the water to one with no minerals could have an affect on him….after all, you’ve changed the nutrient content he’s been receiving.

Itrafungol x 14 days

Just reviewed the water analysis and it is shocking. 90th percentile nationally for lead and copper, sodium @ 16.2 mg/liter, fluoride @ .72

Definitely seems like the water is the issue. I think he was receiving some good nutrients pre filter, and that is possibly why he was able to filter out the sodium and fluoride, but when I started filtering it, it removed the good nutrients and left him unable to process the sodium and fluoride. The filtering I know removed a lot of the lead and copper at least.

I'm looking up natural spring water. I feel that he'll get good nutrients, minus excess heavy metals.

I hope this helps and that it isn't too late

 

[kinyonga]

Apparently Itrafungol contains Itraconazole and I know Itraconazole can cause liver issues and anaemia. is the timing of the Antifungal in line with the raise in sodium and chloride?

 

[Little Man Simba]

Apparently Itrafungol contains Itraconazole and I know Itraconazole can cause liver issues and anaemia. is the timing of the Antifungal in line with the raise in sodium and chloride?

The timing is right, but none of the other values match up...bw was submitted two days following the end of the course. Two days later an initial dose of baytril was administered (which was the one I was really concerned about), and that really knocked him down. (There is a pic above)

 

[Little Man Simba]

Update:

I have been having to "force" water down Simba off and on for months, especially in the last two. Today I gave him his water via syringe/dropper as I have been doing in the morning followed by a long mist (to encourage his drinking/eye washing). FINALLY, he's drinking on his own! He has his good eye open (the bad one is trying to open) & he is moving around!!!

 

[kinyonga]

Fingers crossed!