Health Section F -Gout and False Gout

GOUT & GULAR EDEMA

WARNING: This health chapter is written in hope to educate new chameleon owners to recognize early symptoms of sickness. Many of the pictures shown in health chapter are an advanced case of the disease. If your chameleon exhibit symptoms like these, it is HIGHLY advised for you to bring your chameleon to an exotic veterinarian as soon as possible. This article should NOT be used as a substitute for a vet visit. Please be a responsible pet owner. The author cannot be held responsible for any abuse or form of misused of the post. The identity of the sick chameleon's owner(s) is kept hidden to respect their privacy.

A. Gout


FACTS:

Gout is a common serious condition for chameleons in captivity. It is caused by excessive level of uric acid in the blood (hyperuricemia). Gout is a very complex disease that has many forms. To understand better about it, let us study of what happened to protein inside of chameleon’s body by reading at this simplified diagram:

(Area 1: Protein → amino acids) → (Area 2: Broken by liver into Purin and pyrimidine → Purin is degraded into uric acid) → (Area 3: Cleared by kidney from the blood).

Gout is divided into 2 types:

1. Happened in the area of number 1 is Primary Gout = this type derived from excessive intake of protein and/or failure in amino acid metabolism.
2. Happened in the area of number 3 is Secondary Gout =this type derived from renal failure. The crystal urate, then, turned into crystallized deposits (tophi) that find their way into your chameleon organs (visceral gout), around the joints (peri articular gout), and joints (articular gout).

Prevention:

1. Avoid feeding your chameleon with high protein diet. Your chameleon is a low protein (insects) eater. Therefore, feeding him with high protein (mammals and other vertebrates, i.e.: pinky mice and anoles) feeder EXCESSIVELY can raise the risk of him getting gout.
2. Avoid feeding your feeder (such as roaches) with high protein gut load (cat food, dog food, and fish flakes). These gut load are fine for your roaches but NOT for your chameleon. If you need your roaches to establish a colony, you may feed them dog food. But avoid feeding the roaches to your chameleon while they are in the dog food regiment. I recommend taking out the roaches that are about to become your chameleon's food and put them on the vegetable gutload diet for at least 24 hours, to ensure there is no more traces of dog food in the roaches' guts.
   
3. Monitor the hydration status of your chameleon closely. Dehydration is also a common cause of renal disease that leads to gout.

Symptoms to watch out for:

1. Swelling joints and reduced mobility (articular gout).
2. Your chameleon looked painful when climbing or walking (due to this, gout is often misdiagnosed as arthritis).
3. Over aggressiveness from your chameleon when his joints are touched.
4. Anorexic and excessive drinking behavior.

Treatment:

1. Go to the vet ASAP.
2. Depending on the severity of the case, your chameleon might have to undergo a surgery to remove the excessive tophi.
3. Prescription medications to dissolve crystals.
4. Increased misting and water supplies for your sick chameleon.

Please be aware that this disease is very complex. And this chapter has covered nothing but the surface. Gout is an extremely serious condition that needed attention fast. So, consult to your qualified vet.

Sources:
Kenneth Lopez, D.V.M article
Ivan Alfonso, D.V.M article

B. Gular Edema


Dave Weldon's chameleon Case Study:

"The panther appeared to have gular edema. The vet verified through blood tests that it wasn't kidney failure but a poor Ca:Ph ratio of 1:2 instead of 2:1 likely brought on by diet (not enough calcium or too much phosphorus). He prescribed 0.1cc a day of Mylanta for a couple of weeks. The Mylanta binds-up excess phosphorus and lets it be excreted. Another blood test was done and the ratio was back to 2:1 where it should be."

(Please realize that this case study is presented to educate people the importance of consulting to the vet BEFORE registering a treatment. Without consultations, trying to cure gular edema is the same as walking on top of a thin bridge blindfolded. There are too many complex elements in dealing with this disease. Each chameleon is unique and there is NO such thing as one standard treatment for all Gular Edema cases).

BE AWARE that the solution presented in this case study might NOT be the solution for your chameleon. Therefore, I STRESSED it again to CONSULT your VET.

FACTS:

This is the area where everything is a bit murky and undefined. I will try my best to explain what I know from my research about this. If any of you out there can help me in providing more information about this, please send me a message.

According to Adcham.com glossary, Gular Edema is basically a buildup of fluid in throat and neck. As far as I know, Gular Edema is a clinical sign of body unbalance and the symptom of organ failure in correcting the imbalance.

Due to my difficulty in finding thorough facts about this, I decided to ask Dr. Matthew Wheelock about Gular Edema. This is his reply:

Edema usually occurs when there are less proteins flowing in the blood stream. The proteins do other things, but in this case it causes an osmotic level that usually keep fluids within the blood vessels. When the blood is carrying less protein than the "stuff" in the tissues around it, it will cause the interstitial space (in the tissues) to fill with fluid causing edema.

Since edema is usually gravity dependent, this is why feet and hands/ or legs tend to get edematous first. (This is where it gets iffy...) In the chameleon, I imagine that cervical or gular edema is also due to gravity. I imagine that a chameleon that normally hangs on a branch in the down position would cause edema to be in the front end. Since they don't have a diaphragm, I imagine that the neck might be more prone than the front legs. (Just a hypothesis.)

So, why edema in the first place? Usually there are three reasons for low albumin/total proteins:

1. Loss
2. Destruction
3. Not creating them

In this case it is usually 3. Hypervitaminosis usually causes mineralization in the major organs. The one specific to this conversation is the liver. The liver not only filters excess items (some vitamins and minerals), it is where most of the total proteins in the blood is made.
So destruction of the liver = edema. In chameleons, this usually manifests in gular edema.

With the above being true, any liver problem, or destruction, or loss of total blood proteins would cause this problem, not necessarily just hypervitaminosis A.

Prevention:

1. Provide adequate supplements (not too much and not too less)
2. Monitor the hydration status of your chameleon closely.

Symptoms to watch out for:

1. Swelling joints
2. Swelling Throat and neck region

Treatment:
Go to the vet ASAP. So, he/she can diagnose the exact cause of this disease.