Vet suggesting a blood test... is the stress to my cham worth it?

[blue_cham]

Hey all, I'm dealing with an ongoing problem with my panther cham. My last post with his husbandry here: https://www.chameleonforums.com/threads/chronic-eye-problem-should-i-take-to-vet-a-3rd-time.163796/

Husbandry Changes: Basking temp raised to 90. Humidity raised 60-70. Beta carotene drops on feeder 2x week per vet.

So I did take Blue to the vet for 3rd time. Finished the antibiotic/steroid eye drops and no improvement. He is staying dark colors more often (dark greens, not showing his pretty turquoise or reds much) and is using his hiding spots more. His appetite is kind of okay. Wont eat crickets and only the occasional dubia. So it's really only been silk worms, hornworms and superworms, occasional wax worm. He is not eating his normal amount. About 4 large feeders every other day. When I hand fed him two days ago, he missed with his tongue, he didn't shoot far enough, but I wasn't holding the feeder that too far away. Because he has issues with right eye, I'm hoping it's just a depth perception problem. But I'm really concerned its a Vit A deficiency. The vet didn't seem convinced about a vit A deficiency at last visit though, and suggested the beta carotene only as a precautionary.

The next step she suggested if drops don't work for eye, is a blood test. This makes me nervous, I don't mind paying for one but she admitted she doesn't know what they are looking for. Last time I took him to vet she had to hold him to palpate his abdomen and he was SO stressed. Black color and thrashing around. It was pretty horrible to watch even though I knew she was doing it as carefully as possible.

So what can the blood test tell me? Is it worth the cost and the stress it will cause my boy?? There are no other good exotics vets around for reptiles (only other one has a really bad reputation), so I can't get second opinion. I hate to question my vet but I really am concerned about some sort of vitamin deficiency

 

[blue_cham]

Just got off phone with vet, she returned my voicemail. Told her about the tongue issue. I'm sending video to her, so she can forward to specialists. Now talking about x-rays to rule out early onset MBD :/ Thoughts?

 

[blue_cham]

He doesn't like the camera at all. Am I missing MBD signs? Do his legs look okay?

 

[jannb]

My vets do blood work on my guys. He likes to get a baseline so if and when they get a problem, he’s know what normal is for them. When someone does have a problem normally, the first thing he does is x-rays. If he doesn’t find out what he wants with X-rays then he normally does bloodwork and sometimes an ultrasound.

 

[Remkon]

I see nothing wrong with the limbs so if it is, I overlooked it aswell...

Just reading your first post and skimming over the previous I'd say go with your gut feel and add a dosage of vit A to his supplements, look for the eyehealth topic it has valuable info on it.

A bloodtest may give some answers, I'd do it if you can spare the money... Stress is always a factor to consider so if you just been, maybe wait a week or so before you go for it.

Missing the shots on the food can be due to the eye. My jax had eye issues and started missing his shots, they need both eyes to hunt effectively...
I chose to put my jax to sleep when the vet told me he'd lose his eye in order to remove the tumor behind it... It's where I draw the line, I feel it's no quality life for such an animal if he can't hunt for himself (my opinion).

Good luck.

 

[Graves923]

Just out of curiousity what types and brands of supplements are you using? I know my multivitamin has beta-carotene in it. I use Rep-Cal Herpavite

 

[blue_cham]

Just out of curiousity what types and brands of supplements are you using? I know my multivitamin has beta-carotene in it. I use Rep-Cal Herpavite

Hi there @Graves923 ! I use ReptiCalcium every feeding. Reptivite (vitamin a acetate, 99,910 IU per lb) every two weeks, alternated with Repashy Supercal HyD every two weeks as well. The uvb is a zoomed T5 HO 5.0, 5 month old bulb. Have replacement ready for later this month.

 

[JacksJill]

The only thing I can add to the decision to do any diagnostic test is whether or not the outcome will change the course of treatment. A good discussion to have with your vet if you haven't already. Then you have to weigh the risks associated with the test. Radiographs and ultrasound are low risk but mildly stressful. Radiographs can show how well calcified the bones are and can reveal MBD.
The tongue issue could easily be related to the eyes. Try playing catch with one eye closed.

 

[blue_cham]

The only thing I can add to the decision to do any diagnostic test is whether or not the outcome will change the course of treatment. A good discussion to have with your vet if you haven't already. Then you have to weigh the risks associated with the test. Radiographs and ultrasound are low risk but mildly stressful. Radiographs can show how well calcified the bones are and can reveal MBD.
The tongue issue could easily be related to the eyes. Try playing catch with one eye closed.

That is a good way to look at it. Thanks. I think I've decided on xrays first. I've read a few places that Chams may get MBD even with "everything done right." It hasn't been proven but who knows. I think the radiograph will be more revealing. I'll ask my vet more specifically about what a blood test may tell us.

 

[makkatfloof]

Some may disagree, but I 100% condone any and all tests your vet (as long as they are a good vet and are, indeed, knowledgeable in chameleons) thinks they may need.
My boy just got over a major eye infection his previous owner gave him. The eye infection spread to his own body and he ended up throwing up everything until he was throwing up mucus. He got so underweight and is still struggling to recover. We just got his eyes back open and healing, and are doing all we can to get his weight back up.
If I didn’t condone the tests he needed, he would’ve never gotten the help he needed and no one would’ve known what to properly do.
Chameleons are sensitive to so many illnesses, even if you are perfect in every single bit of care with them.

 

[Mawtyplant]

Hi there @Graves923 ! I use ReptiCalcium every feeding. Reptivite (vitamin a acetate, 99,910 IU per lb) every two weeks, alternated with Repashy Supercal HyD every two weeks as well. The uvb is a zoomed T5 HO 5.0, 5 month old bulb. Have replacement ready for later this month.

For how long you got this vitamin schedule

Cut all the vit d3 supplement.. i think your problem is here.. there is a competition with the balance of fatty vitamins.. D3, A, E and K if you provide t5ho uvb (a good source of uvb) + reptical every feeding (a strong source of synthetic D3) + a Hyd super cal (A HYPERACTIVESUPERBOOSTERTOOMUCHgoodforbeardeddragon D3 synthetic source) you overdose him of D3 and you create a imbalance between D3, A, E and K.. cut it.. just to give you an example, with my panther i use calcium plus low D (V. A = 80,000 iu/lb, vitamin E = 800 iu and vitamin D = 8,000 iu) and i give this every two week max.. (so ratio A/D = 10/1


So me in 2 week :

Repashy Low d : 8,000 iu/lb
total.. 8,000

(+i gut load my feeders sometime with yolk, a natural D3, A, E, K source)

Compare to you :
reptical (if its the D3 version : Vitamin D3 (min) 10,390 x 10 (i figure you dont feed him every day) IU
reptivite : D3 = 10,390
Reptical hyd = Vitamin D-3 50,000 IU/lb

you Total : about 110,000 iu/lb

so based on your post you give more than 12 time more D3 than i do, but not much more Vit A and E (or K but.. dont really know if its usefull with chameleon) so you got a imbalance

Your uvb is good! let the nature convert the D3 he need

So cut all the synthetic D3 and let the UVB on this is the only way he will regularize the situation but be patient.. can take month to year so be patient.

beta caroten is useless in your case you need preformed source but you need too reduce the vitamin D3 before you can have a blood test if you want, this is stressfull but i never seen a chameleon died from this) here a user friendly reading on vit A https://www.petcoach.co/article/chameleons-signs-treatment-and-prevention-of-vitamin-a-defi/

Make sens?

 

[blue_cham]

Thanks for the info @Mawtyplant ! Honestly, my vet didn't ask specifically which d3 supp I used, just that I used d3 every other week. Both my Reptical and Reptivite are the No D3 versions. But I will look into the HyD. I've been using the HyD since I got them. Started feeding them every other day (as opposed to everyday) about a month ago. It was sold to me by a vendor at the expo where I bought him at. The vendor actually sold it to me as an every feeding supp, which was easy to debunk when I got home and looked up care sheets. I feel like I'm failing at cham ownership right now, ugh I will bring this up with my vet, and stop using it asap. Actually, because of his reduced appetite, he hasn't had d3 supp much and I think he is slightly better. He has good days and bad days.

 

[Mawtyplant]

Thanks for the info @Mawtyplant ! Honestly, my vet didn't ask specifically which d3 supp I used, just that I used d3 every other week. Both my Reptical and Reptivite are the No D3 versions. But I will look into the HyD. I've been using the HyD since I got them. Started feeding them every other day (as opposed to everyday) about a month ago. It was sold to me by a vendor at the expo where I bought him at. The vendor actually sold it to me as an every feeding supp, which was easy to debunk when I got home and looked up care sheets. I feel like I'm failing at cham ownership right now, ugh I will bring this up with my vet, and stop using it asap. Actually, because of his reduced appetite, he hasn't had d3 supp much and I think he is slightly better. He has good days and bad days.

Dont be to hard on yourself, learning all theses details about chameleons are really hard i think probably 80% of the chameleon owner have kill or injured his fist chameleon with basics mistakes (i included myself here) and.. % of competent vet with chameleon are ridiculously low! have you try to give low dosage of vitamin A oils pills? continue with the calcium but you can cut all other synthetic vitamins for the moment. I suggest you to gutload your feeders with good vegetables, yolk and feed him every 3 days. let the uvb on and provide lot of water till the situation reversed (you can dro paway the Hyd except if you want a bearded dragon in the futur

 

[blue_cham]

HUGE UPDATE:

Blue also is starting to have tongue problem. His accuracy is okay, but is tongue doesn't shoot far enough to hit his target. I have to hold food at least 5inchs up to him. Had xrays done, tried blood test but Blue was too stressed and vet postponed that. She consulted with three other reptile vets. No MDB but they see two things. Some constipation (even though he is not hugely constipated and still passes some stool, he has been having some issues). And the scary thing... Density in the tissues of his renal area She gave me some possible issues but honestly it was over the phone, I can't remember the big vet words. She basically concluded that there is no good way to know anything until the blood draw, which is this coming Monday morning. I am now spending my morning in renal problems research, but any input is appreciated. I do believe I've read that D3 over supplementation can cause renal issues? This is also something @Mawtyplant brought up.

Some husbandry changes suggested by the vets (Most of these suggestions are coming from multiple consults that my own vet is getting, which means there are 4 reptile vets all suggesting slightly similar but different changes) after knowing the medcical issues and seeing the xrays:

1) Hydrate hydrate hydrate. I have no problem with this one. I don't think hes dehydrated. But I'm going to diy a dripper to run into one of his plants as an added source of drinking water.
2) Lactulose for constipation. Asking more about this Monday at vet.
3) Use Repashy Calcium Plus, instead of current one. One vet is guessing imbalance and that Repashy Calcium Plus provides more Vit A. I ordered it, will be here by Monday. This will give me to discuss D3 overdose issue, since Repashy Plus has Vit D in it too...
4) Change UVB from HO 5.0 T5, to 10.0. I'm conflicted on this one. My set up is heavy enough on foliage and light is passing through screen, that I don't think it will be too strong (36 in tall cage). And if the cham doesn't need vit D, his body will not use the UVB to convert right? I will post pics of set up with light placement from front and side.

So yeah... I feel like I'm falling down a rabbit hole here. Any advice on other things I can ask my vet or areas to research renal issues would be greatly appreciated. Thanks for all your support you guys. If I did not have somewhere to talk this out, I'd be going crazy

 

[blue_cham]

Dont be to hard on yourself, learning all theses details about chameleons are really hard i think probably 80% of the chameleon owner have kill or injured his fist chameleon with basics mistakes (i included myself here) and.. % of competent vet with chameleon are ridiculously low! have you try to give low dosage of vitamin A oils pills? continue with the calcium but you can cut all other synthetic vitamins for the moment. I suggest you to gutload your feeders with good vegetables, yolk and feed him every 3 days. let the uvb on and provide lot of water till the situation reversed (you can dro paway the Hyd except if you want a bearded dragon in the futur

Thanks again, it means a lot. I'll see about giving the Repashy to my friend, she is actually looking at bearded dragons. She lost her beardie first to cancer I bought the vitamin A pills and have been on the fence about giving some. Keepers on here have no problems with a small drop once a month. But when I mentioned to my vet, she was very apprehensive and suggested that I don't because of OD possibilities, so I have yet to do it... I also ordered Cricket Crack last week, and man do those bugs like it. It will make sure to put good veggies in too. Thank you again. I posted an update from vet too, you can see the craziness, ha!

 

[blue_cham]

Almost forgot pictures... In case anyone wants to weigh in on upticking lighting from 5.0 to 10.0

Side view (technically my nosey be's because Blue's cage is blocked on both sides. Lights spaced same tho)


Front. Blue basking at the top

Blue's is on left

 

[Mawtyplant]

HUGE UPDATE:

Blue also is starting to have tongue problem. His accuracy is okay, but is tongue doesn't shoot far enough to hit his target. I have to hold food at least 5inchs up to him. Had xrays done, tried blood test but Blue was too stressed and vet postponed that. She consulted with three other reptile vets. No MDB but they see two things. Some constipation (even though he is not hugely constipated and still passes some stool, he has been having some issues). And the scary thing... Density in the tissues of his renal area She gave me some possible issues but honestly it was over the phone, I can't remember the big vet words. She basically concluded that there is no good way to know anything until the blood draw, which is this coming Monday morning. I am now spending my morning in renal problems research, but any input is appreciated. I do believe I've read that D3 over supplementation can cause renal issues? This is also something @Mawtyplant brought up.

Some husbandry changes suggested by the vets (Most of these suggestions are coming from multiple consults that my own vet is getting, which means there are 4 reptile vets all suggesting slightly similar but different changes) after knowing the medcical issues and seeing the xrays:

1) Hydrate hydrate hydrate. I have no problem with this one. I don't think hes dehydrated. But I'm going to diy a dripper to run into one of his plants as an added source of drinking water.
2) Lactulose for constipation. Asking more about this Monday at vet.
3) Use Repashy Calcium Plus, instead of current one. One vet is guessing imbalance and that Repashy Calcium Plus provides more Vit A. I ordered it, will be here by Monday. This will give me to discuss D3 overdose issue, since Repashy Plus has Vit D in it too...
4) Change UVB from HO 5.0 T5, to 10.0. I'm conflicted on this one. My set up is heavy enough on foliage and light is passing through screen, that I don't think it will be too strong (36 in tall cage). And if the cham doesn't need vit D, his body will not use the UVB to convert right? I will post pics of set up with light placement from front and side.

So yeah... I feel like I'm falling down a rabbit hole here. Any advice on other things I can ask my vet or areas to research renal issues would be greatly appreciated. Thanks for all your support you guys. If I did not have somewhere to talk this out, I'd be going crazy

For 3)

I agree with you, go with the repashy calcium + LOd (this is the version with less D3 or, Repashy calcium plus NoD (version with No D3) For the vitamin A i stronlgy recommend the vitamin A pills from the pharmacy dip your feeder in the oil (small dosage, pm me if you want more details about this!

4)i agree with them, 10.0 can help to reverse the situation because the uvb have 2 function with D3 : conversion of D to D3 and degradation of D3 in blood plasma so this can help to maintain the balance, for now it can help with the over D3 degradation can use the 10.0 till the oedema slow down

i suggest you to switch your feeder and feed him with silkworm (silkworm are good and contain natural serrapeptase, antiinflamatory substance) this can help!

 

[Mawtyplant]

Thanks again, it means a lot. I'll see about giving the Repashy to my friend, she is actually looking at bearded dragons. She lost her beardie first to cancer I bought the vitamin A pills and have been on the fence about giving some. Keepers on here have no problems with a small drop once a month. But when I mentioned to my vet, she was very apprehensive and suggested that I don't because of OD possibilities, so I have yet to do it... I also ordered Cricket Crack last week, and man do those bugs like it. It will make sure to put good veggies in too. Thank you again. I posted an update from vet too, you can see the craziness, ha!

i will shot you a video of how to do it if you change your mind

 

[blue_cham]

Thanks @Mawtyplant . I will keep the vitamin A in mind and PM you if I end up doing it. Silkworms are easy, I have local place to get them and they are Blue's favorite. Actually they have been a main part of his diet since his appetite decreased.

10.0 can help to reverse the situation because the uvb have 2 function with D3 : conversion of D to D3 and degradation of D3 in blood plasma so this can help to maintain the balance, for now it can help with the over D3 degradation can use the 10.0 till the oedema slow down

This is very interesting, not something I've come across before. You wouldn't happen to know a good source to read up more on this??

Thanks again!

 

[Mawtyplant]

Thanks @Mawtyplant . I will keep the vitamin A in mind and PM you if I end up doing it. Silkworms are easy, I have local place to get them and they are Blue's favorite. Actually they have been a main part of his diet since his appetite decreased.



This is very interesting, not something I've come across before. You wouldn't happen to know a good source to read up more on this??

Thanks again!

take a look on photodegradation of D3 vitamin

https://www.ncbi.nlm.nih.gov/pubmed/2541158