Reptile & Amphibian Forums

A bit of background, first:
This water dragon came to my teaching clinic in 2004 in wretched condition. He had a MBD that lead to fractures of both his forelimbs (and since the kid didn't bring him to the vet right away, they healed in a very crooked position), dysecdysis, missing a claw, dehydrated... The works.

(March 31, 2004)

A year later, I adopted him, as he was doing much better, but the college's clinic was having a hard time giving him a proper environment... Most of the rooms he was kept in were too cold, and the humidity was grossly insufficient. He'd also developed an infection in his mouth, which I believe is a periodontal disease. About a week after I brought him home and had him in his new enclosure, the gunk in his mouth cleared up, but some discolouration discolouration remained.

(November 5, 2005)

And a shot of his gingiva:

So about two weeks ago, Puff ("the Magic Dragon," since his recovery was pretty phenomenal for a CWD) lost some of his appetite, and seemed reluctant to go after prey items (which are handfed because of his slightly limited mobility). I became worried that his mouth may have been bothering him, that it was either uncomfortable or painful. He dropped from 145g to 136g in these two weeks, so I brought him into the clinic and discussed meloxicam for pain management with the vet to see if pain was actually the problem, and took a deep culture of his gingival discolourations to see what's growing there.

Just for fun, we took an x-ray:

Lo and behold, Puff is female! I see at least 8 eggs on the radiograph (sorry it's a photo of the x-ray, the contrast is better on the actual film). They look half-decently calcified to me, and her bone density is pretty good, too (but doesn't show too well on this photo). The eggs are easily palpable, as well, so I'm quite sure that they've ovulated and aren't just follicles. I've given her a laying box of moist sandy soil, about 2.5" deep.

We're going to hold off on the antibiotics until she's laid, and I'm giving her another week and a half to two weeks to see if she'll lay the eggs naturally, unless her condition suddenly declines. The vet wants to try oxytocin after that- surgery is the absolute last resort.

Any input on what else should be done? I've also posted this on the WD and Basilisk forum.

Christina

PS: We also took an x-ray of my MBD rescue iguana, Draco. Eight years old and about 3 feet STL, he's got very bad kyphoscoliosis since about 6-8 weeks of age (it's also possible it was a congenital defect due to poor incubation temps). Let me tell you, my heart melted when I saw how beautiful his bone density was...

Good husbandry and a little TLC really pays off

Thank you for sharing that Christina. Very interesting! I enjoy reading your posts.

Dawn

It is a good idea to have asked the water dragon forum about nesting and such, unfortunately I"ve found that to be a rather slow and unhelpfull forum. Perhaps it's changed, but I'd suggest looking elsewhere as well.

Just last week I thought I had a dystocia problem in my corn snake... it turned out it's probably a tumour of some sort, but in my search, it sounds like oxytocin can be tried, but how likely it is to work is questionable. One thing to remember though, is after you've given the oxytocin (look up the dose, but you can give it twice, several hours apart), the need for surgery if unsuccessfull becomes more immediate. With this in mind, have the surgery suite warm and ready (I know that can take a while). Sometimes several days of fluid therapy is necessary, and hydration is super important in reptiles. In my opinion, moreso than in mammals because of the slow metabolism. Have you placed a femoral IOs cathetor before? I"ve found a spinal needle works well, if you don't stock the IOs cathetors. This can be placed under a quick, and temporary iso induction. For the surgery, propofol can be given IOs as well, which really helps if you can't keep'm down on just Iso. Do you have endo tubes that'll fit? I guess I"m getting ahead of myself... do you have a DVM willing to do the surgery if necessary?

Back tracking a bit, post-pone treatment to allow for the natural progression of things until it becomes apparent that the dragon might soon not be a good surgical candidate. Considering this isn't a breeder animal, doing a spay prior to a health decline might be an option as well. Something to think about anyways.

Good luck with this, I'm sure you and you're dragon will get through this I'll be sure to check this forum moreso in the next day or so if you have any questions.

Ian

A lot has happened in the past 24 hours. I got home last night to find that Puff had a small cloacal prolapse, but laid all her eggs. I kept it moist with bacitracin-polymixin ointment (no KY Jelly handy) and phoned the vet. She instructed me to keep it moist, but that I could attempt to reduce the edema with some saturated sugar water and attempt to replace it, which was unsuccessful.

(Unfortunately, the photos I took last night of it didn't come out.)

I brought her in this morning, and the vet tried to replace the prolapse herself. She used some lidocaine gel to numb the tissue, and tried replacing it gently... but it was too swollen to easily place back. She wasn't inclined to place sutures as they'd likely get in the way of her defecating. So... she gave me the lidocaine gel and to watch if the swelling goes down (so far it's reduced quite a bit), and try to gently replace it myself. If it hasn't fully retracted by Monday morning, I'm to bring her in again and have a suture placed to keep the proctodeal tissue in place.

We gave her a dose of meloxicam at 0.2mg/kg, as I can't really imagine this being painless.

I took this photo about 10 minutes ago, last night it was twice this size (not the amount of tissue persay, but how swollen it was).

We also took an x-ray to confirm that all her eggs have passed... Indeed they did

As for the culture of the gum discolourations, there were three different types of colonies: Gm- bacilli, Gm pos. cocci, and Gm pos. cocci and streptococci (from the same colony).

I think the Gm- bacilli are of particular concern, but I'm considering doing C&S for each bacteria just in case (thoughts on this?). I'm going to start the C&S Monday so that I can check it Tuesday, so far the vet wants to test enrofloxacin and amikacin for certain, any other suggestions?

Thanks,
Christina

nt

That's awesome Christina!, from the pic's the prolapse is minimal and should replace itself as the swelling goes down. For the future, discuss with your vet about putting a steriod opthalmic ointment on it to reduce the inflammation. It worked the few times I've used it.

Remember that this is the mouth that you're culturing. Thus I wouldn't read to much into the results. How did you get your sample? Was there an obvious imbalance in the swab? Concentrate on that strain perhaps.

I'm happy she's doing better

Ian

The prolapse has almost completely retracted I think the sugar solution was supposed to be an "at home" solution, but I agree that something like BNPH would've been better.

I figured that I would have some normal mouth bacteria contamination in the sample. I took a slightly dulled needle and gently scratched at one of the discolourations, then took the sample, but the technique isn't perfect, of course. The Gram negative bacilli were about 60% of the cultures on the plate, but it crossed my mind that perhaps they just grow better than the rest on TSA. I had a thought that the Gram negative were perhaps more likely to be pathogenic, but it's just a thought.

Christina