Re: Bearded dragon - stomatitis +/- RF?

Marie Kubiak — Sat, 14 Jun 2014 21:48:23 GMT

Hi,

'icteric' serum is a common finding in normal reptiles and is not an indication of liver disease on its own, the calcium value as Catherine has said is not markedly high especially if it has been sexed wrong (check the underside of the hind legs for waxy secretions from large femoral pores to confirm male). You need to get uric acid and phosphate values to assess renal function, urea is mainly used a marker of hydration status and not useful in renal assessment. Low normal urea supports normal hydration, 'dehydrated' appearance may actually be weight loss which could explain the creatinine. Yellow membranes can be normal, or anaemia - I agree, check PCV.

The problems I would be concerned about are:

ALP elevation - can be liver, kidney, bone or GIT origin so needs further investigation of renal function with reptile-specific biochem, and poss GI parasitism/infection with faecal flotation and smear. You may find no obvious cause as all soft tissues can contribute

the mass - reptiles don't have lymph nodes so this is not a physiological response and can only be bad! Beardies do get tumours relatively frequently, palpate coelom very carefully for any further masses and consider FNA and in house cytology for prognostic reasons. Abscesses and granulomas are also possible as fibrin content in both forms very solid lumps.

Stomatitis - acrodont dentition can be associated with tartar, gingival regression and osteomyelitis so check for underlying dental disease and start on antibiotics with gram negative spectrum if there is significant infection/necrosis. If purely cheilitis then consider Devriesea agamarum or fungal causes, try and remove loose crusts, keep dry and give systemic antimicrobials based on likelihood of bacterial (deep, dry crusts with no discolouration) or fungal (brown/yellow discolouration, more likely to be moist and ulcerative) as supreficial cytology is unreliable and biopsy at this stage is not the ideal first step.

?anaemia

?neuro problem causing wobbling (adenovirus, toxicity, trauma) or just generalised weakness (worth checking glucose as a basic assessment)

I would stop IP fluids and switch to maintenance SC fluids as no marked evidence of dehydration and IP fluids risk coelomitis.

With no firm diagnosis it is hard to advise on treatment so worth doing the additional bloods, faecal analysis and cytology of the mass and then you'll be in a better position to decide if prognosis is reasonable and justifies ongoing supportive measures and further diagnostics (scan, biopsy of mass etc etc) or PTS.

Marie

Re: Bearded dragon - stomatitis +/- RF?

CatherineThomas — Sat, 14 Jun 2014 07:16:36 GMT

you could also use pevidine topically on the lesions around the mouth.

Re: Bearded dragon - stomatitis +/- RF?

CatherineThomas — Sat, 14 Jun 2014 07:04:15 GMT

I don't think creatinine and urea are very good indicators of anything in reptiles. They are not included in the profiles for bloods I send away so i don't know what normal values are for them. Uric acid is of most value in assessing the kidneys, can you run that on your in-house machines?

2.71 is not high for calcium levels in a beardie, I've got some beardie results here and the quoted normal range is 1.98-3.0. If female there could also be reproductive disease, i.e follicular stasis but the calcium is usually much higher than that.

I would think the icteric blood could be due to fat, there is probably some degree of fatty liver disease. But ALP isn't very sepcific for liver in reptiles, AST is a better indicator..

Have you checked PCV? yellow membranes are often due to anaemia which is quite common in chronic conditions.

Do you have critical care formula or emeraid to syringe feed with? If not you could use some baby food over the weekend until you can get some. Try to get ones which are meat and veg without potatoes or grains.