GOUT, PODAGRA - The Painful Killer of Chameleons Caused by Wrong Care
Gout has never been reported from any wild chameleon. But it is a common disease among captive chameleons, developing slowly from prolonged improper care and often remaining unnoticed for extended periods. This condition is primarily caused by inadequate husbandry practices, making it irreversible, untreatable, and potentially fatal. Preventing gout is relatively straightforward: provide appropriate care parameters without compromise, focusing especially on thermal and hydration regimes, as well as a balanced feeding and supplementation routine.
Symptoms and Diagnosis
Gout can only be diagnosed in its early stages through bloodwork, which reveals abnormal renal parameters, particularly elevated uric acid levels. In its acute phase, gout can be identified by the presence of crystals around the heel joint, as seen through X-ray or ultrasound. However, since blood tests, X-rays, and ultrasounds are not typically standard practices in chameleon healthcare, gout usually becomes evident only in its acute phase. Symptoms include:
Immobility
Lethargy and weakness
Changes in coloration—commonly lighter or yellowish
Swelling along the spine, especially along the transverse vertebral processes
Discoloration, often appearing black, in the pelvic region above the kidneys
Significant unilateral or bilateral swelling of the heel joint, and occasionally the wrist, elbow and/or knee
Avoidance of using the swollen extremity(-ies)
Signs of sensitivity and pain in the affected extremity(-ies)
While immobility may sometimes be replaced by hyperactivity due to pain, the first five symptoms can be rather nonspecific. Additionally, pain and swelling, along with the non-use of extremities, can stem from other issues such as trauma, fractures, inflammation, abscesses, or metabolic bone disease (MBD). Nonetheless, symptoms five and six are notably characteristic of gout and frequently observed.
Physiopathological Cause
Gout primarily arises from elevated levels of uric acid in the blood. When the kidneys are unable to effectively filter and excrete uric acid and its salts, these substances crystallize and deposit in various internal organs, most commonly in the joints. In chameleons, crystals typically accumulate around the heel joint, where they irritate surrounding tissues, causing inflammation and pain. Although uric acid is the main contributor, it is the crystallized form, specifically monosodium urate, that triggers the symptoms associated with gout.
Traditional causative factors include:
A diet high in protein and or purine (which is not natural for chameleons)
Insufficient hydration
However, the true underlying causes of gout in chameleons under human care can be attributed to four primary issues:
Supplementation Issues: Renal damage may occur due to a diet excessively rich in phosphorus (such as adult crickets and locusts, particularly those raised in captivity), which is not sufficiently balanced with calcium.
Alimentational Issues: An excessively high uric acid content in food (particularly with adult roaches raised on high-protein diets) can lead to unnaturally elevated levels of uric acid and its salts in the blood. This poses a significant challenge for both healthy and damaged kidneys, which struggle to eliminate these substances from the body.
Overfeeding: Excessive food intake, especially of nutrient-rich foods, can result in obesity. This not only puts stress on the body but can also lead to a general failure of various organ systems, including the urinary system.
Overheating: As ectothermic reptiles, chameleons depend on external temperatures to regulate their metabolism. Excessively high temperatures—particularly from overbasking and unreasonably elevated nighttime temperatures—can increase metabolic rates and hinder the digestion process. This disruption damages homeostasis, ultimately leading to organ failure.
In practice, a combination of the aforementioned issues is often at play, potentially compounded by other factors such as diseases, parasite infestations, or genetic predispositions.
Origin of Gout
To determine the root causes of gout in chameleons, careful evaluation of the following areas is necessary:
Feeding Routine: Assess the types of feeders used and their source, as well as the quantity and frequency of feeding.
Hydration Routine: Evaluate the methods of hydration (e.g., drippers, foggers, misters) and ensure appropriate humidity levels during both daytime and nighttime.
Supplementation Routine: Examine the specific minerals, vitamins, and bee pollen provided, including brands and products, as well as the dosage, application methods (dusting, gut loading), and frequency.
Thermal Regime: Monitor the temperatures during the day and night, including basking temperatures, duration, and frequency of basking sessions.
Treatment
Unfortunately, gout is incurable and leads to significant pain and discomfort, primarily due to renal malfunction, which ultimately results in a grim prognosis. Regrettably, the disease is often diagnosed too late for effective intervention. However, there are measures to slow down the progression of gout, outlined below:
Long-term Prophylactic Actions:
Conduct a thorough analysis of the captive environment to identify potential causes.
Adjust care parameters to optimal levels across all identified areas with special attention to low purine diet and low uric acid diet.
Immediate Acute Actions:
Increase Water Intake: Slightly overhydrate (around 1.5 times the normal dosage, if known) to help prevent the formation of uric acid crystals and facilitate their expulsion from the body.
Reduce Basking: Decrease basking time to slow down metabolism.
Limit Food Intake: Reduce or stop food intake for 1-2 weeks.
Boost Immunity with Bee Pollen: Incorporate a higher dose of bee pollen into the diet (approximately one granule per 10 grams of the chameleon's weight) for one to two weeks to enhance immunity and provide a quick energy source.
Consult a Qualified Reptile/Chameleon Veterinary Specialist
Veterinary Intervention for Gout in Chameleons
When gout is suspected in chameleons, a veterinarian will likely undertake a series of diagnostic and treatment procedures to confirm the diagnosis and alleviate the condition. Below are the typical steps involved:
1. Blood Sampling and Analysis: A blood sample is collected to analyze bloodwork for renal function and uric acid levels. While this step is valuable for diagnosing gout, it can be stressful for the chameleon, as it involves painful blood extraction, loss of a significant volume of blood, and potential complications such as bleeding. There is also a risk of damaging the tail during the procedure, which may involve tiny blood vessels, muscles, and nerves. Though useful, this test is not strictly necessary for diagnosing gout. Additionally, joint fluid analysis can also be done.
2. Imaging Studies: A fine X-ray or ultrasound scan may be performed to assess the overall health of the chameleon. Gout often arises from improper care parameters, which can lead to additional complications like low bone density, metabolic bone disease (MBD), inflammation, digestive issues, and organ failure. These imaging techniques can reveal swelling around the joints and, in some cases, visualize uric acid crystals accumulating in the affected areas.
3. Pain Management: Pain relief is crucial in managing the discomfort caused by uric acid crystals infiltrating tissues. Veterinarians may administer pain medications to alleviate this distress.
4. Nutritional Support: Supporting substances such as calcium, glucose, vitamins, and other essential nutrients may be provided to aid the chameleon's recovery and overall health.
5. Fluid therapy: Intravenous fluids, oral rehydration solutions can be administered.
6. Colchicine Administration: Colchicine is often given for acute treatment. It serves multiple purposes:
- Reducing Inflammation: It lessens inflammation caused by uric acid crystals in the joints.
- Inhibiting White Blood Cell Activity: Colchicine prevents white blood cells from migrating to the inflamed area, thereby reducing pain and swelling during gout attacks.
- Decreasing Pain: By alleviating inflammation and blocking pain signals, colchicine helps improve symptoms during acute gout flare-ups. It is most effective when administered early in the onset of a gout attack.
7. Allopurinol for Long-Term Management: Allopurinol (known by various trade names such as Isopurinol, Puranol, Zyloprim, Lopurin, and Allopurinolum) is used for long-term management of gout. Its primary roles include:
- Inhibiting Uric Acid Production: Allopurinol works by inhibiting the enzyme xanthine oxidase, which plays a key role in producing uric acid from purines. This reduces uric acid production in the body.
- Preventing Gout Attacks: By lowering uric acid levels, allopurinol helps prevent the formation of uric acid crystals, reducing the frequency and severity of gout attacks.
- Managing Chronic Gout: It is often prescribed for long-term management in cases of chronic gout or conditions that lead to elevated uric acid levels, such as certain types of kidney diseases. However, allopurinol is not suitable for treating acute gout attacks; its use is primarily for ongoing management.
8. Provide guidance on optimizing husbandry practices to prevent future occurrences of gout.
9. Develop a follow-up care plan to monitor the chameleon's health and adjust treatment as necessary.
Long-Term Prevention of Gout
Feeding Routine: No Roaches, no High-Phosphorus feederss such as adult locusts. No overfeeding, no obesity.
Hydration Routine: Proper water intake, usage of natural hydration methods such as nighttime fogging.
Supplementation Routine: Complex supplementation with vitamins, minerals and Bee-Pollen, with special focus of enough Calcioum to compensate the general high level Phosphorus feeders in captivity to ratio Ca:P at level 2:1 (minimum 1:1).
Thermal Regime: Nighttime drops as in the wild, no overheating and control of the basking temperatures (es required species by species) and duration (never full day basking exposure, ideally 2 times a day several minutes only).
Additional Terminology
GOUT
Gout may be referred to by other names, including:
Podagra: Specifically refers to gout affecting the big toe in humans.
Gouty Arthritis: Refers to the inflammatory form of arthritis caused by gout.
Gouty Rheumatism: Another term encompassing the rheumatic symptoms associated with gout.
PURINE
A purine is a type of nitrogenous base that is a fundamental component of nucleotides, which are the building blocks of nucleic acids like DNA and RNA. Purines play crucial roles in various biological processes, including energy transfer (as seen in ATP) and cellular signaling.
Key Characteristics of Purines:
1. Structure: Purines have a double-ring structure composed of carbon and nitrogen atoms. The two most common purines are adenine (A) and guanine (G).
2. Function in Nucleic Acids:
- DNA: In DNA, adenine pairs with thymine (A-T), while guanine pairs with cytosine (G-C).
- RNA: In RNA, adenine pairs with uracil (A-U) instead of thymine.
3. Energy Molecules: Purines are integral to the structure of adenosine triphosphate (ATP), which is a primary energy carrier in cells. ATP transfers energy within cells for metabolism and other cellular processes.
4. Metabolism: Purines are metabolized in the body to produce uric acid. Excessive purine consumption can lead to elevated uric acid levels, which may contribute to conditions such as gout.
5. Sources: Purines are found in many foods, particularly those high in protein, such as meat, fish, beans, and certain vegetables.
Understanding purines is essential not only for molecular biology but also in medical contexts, especially concerning conditions like hyperuricemia and gout, as their breakdown products can significantly impact health.
Final words
By following these veterinary recommendations and establishing proper care routines, chameleon owners can better manage gout, thereby enhancing their pets' quality of life and overall health.