Iguana Kidney Failure: Personal Perspective
Final update: December 14, 1997
Wally has had a few bouts of resistant abscesses from iguana bites, necessitating surgery to clean them out and systemic antibiotics, either amikacin sulfate (Amiglyde-V) or enrofloxacin (Baytril). In 1996, he had two very resistant abscesses which were being treated Baytril. When they failed to resolve in a reasonable period of time, cultures were done which confirmed Baytril was the right drug; the dose was doubled as per recommendations for resistant infections.
In the fall of 1996, Wally suddenly went blind. No cause was ever found, and he did regain his sight (and confidence) after several weeks. Residually, he has problems using is hind feet - just the feet, not the legs - but again nothing has been found. He ambulates well, still climbs up things (down is a little harder and, in some situations, impossible), displays and chases off subordinate males, and most recently has been using them to grip in an attempt to avoid injections.
He was having trouble eating as his tongue didn't seem to work right - it seemed to be more than just the thickened saliva due to the dehydration, so feeding had to be assisted. At times he would sit with his mouth slightly agape, the tongue sticking out. There was no sign of respiratory infection (of which gaping is a common sign). I was, along with fluid injections, giving him fluids orally, with a long, soft plastic, 3 cc eye dropper, mixing liquid calcium and vitamins in with the Pedialyte or water that I was using.
On the off chance that it might be a kidney infection due to a systemic infection, I also started to give him Baytril, but became concerned that all the Baytril he's been on in the past year may have precipitating the kidney problem, so stopped. Instead, I started giving him colloidal silver. This is a sort of old-fashioned antibiotic in liquid form, in wide use before penicillin was discovered. I have no idea if it really works or not; all I knew was that it would not hurt him.
Past experiences I've had with kidney failure have been acute and abrupt. Behavioral changes begin to occur up to two weeks before the acute onset of the rapid dehydration and weight loss, with the latter happening within 24 hours, with continued dehydration and weight loss despite fluid and nutritional support (with no interest whatsoever in food), lethargy lapsing into unconsciousness, seizures, with death following within 24-48 hours. (Other signs I've seen or heard of include severe swelling of the eye orbs and drooping of the lids, and extensive and sudden swelling of the neck and dewlap (not the swelling of the subtympanic scale area, associated with normal male maturation)). When iguanas have remained non-responsive, or progressed to the seizure state without any improvement, rather than let them linger till death, I have euthanized them.
Wally, on the other hand, while being lethargic, still spent some time alert to his surroundings, and seemed interested in food although he would give up when he couldn't get it down unless I assisted him (altered food preparation and squirted fluids in his mouth when he was trying to work it down his tongue, pushing the food a bit with the eyedropper). Instead of getting worse, he seemed to rally, enough so that Glenn was finding his arms tattooed with the raised, keeled edges of Wally's scales after holding him for injections. On Wednesday, September 3, I took Wally to my vet for a blood work-up. Despite being bathed and pooped before we left home, Wally kindly gave the vet a fecal sample to be tested while he was there (found positive for protozoans, so he is being treated metronidazole now, as well). He told me when I picked him up later than he believed he felt the kidneys when palpating the ventral area. Healthy normal kidneys cannot be felt, nor seen on x-rays, as they are hidden inside the pelvic girdle. When swollen and hardened, they can be felt and sometimes visualized on radiographs. We decided to not x-ray at this time, nor do a biopsy.
In the course of the physical exam, my vet found that the inside back of Wally's mouth was all swollen. This was something neither of us had ever seen before. Dr. Harkewicz. says that it is usually due to elevated levels of uric acid, and can be reduced using methyl-prednisolone injections (1 mg/kg IM).
While success is not necessarily assured, it is something to try...so try I will. Wally is starting to glare at my hand, inspecting it closely for needles and syringes whenever I simply pet him now. While I would not blame him in the least if he tried to take a chunk out of me or Glenn, he has not made any suggestion of biting. It is so sad to see him suck his tummy in, trying to get away from the needle. He also gives great exhalations of breath, sounding anthropomorphically like deep sighs, when he finally submits to the numerous SQ sticks as I shove 10cc at a time into each area, doing 30-60 cc at a each session.
He's been on the Amphojel daily now for 6 days, and still gets a rather surprised look on his face from the minty flavor.
I was starting to get blood every time I tried to do an IC injection so I gave his belly a rest for a few days and went strictly with SQ...even using a topical anesthetic (Bactine, which contains lidocaine), he has grown so tender and strong enough to make the dozens of sticks a day an ordeal. Yesterday, I thought I would try to get him to drink more, and to administer fluids orally.
He is, physically, looking better: his skin doesn't look or feel so dried out, shed is coming off easier, and he has filled out, losing those lateral horizontal and vertical folds associated with serious dehydration.
One new concern is his tail. When being held vertically for the belly sticks, Glenn, to give me wide enough access to the belly to fit my hand and the 60 cc syringe in at the shallow angle I needed, was holding Wally with one hand across the shoulders, both supporting his forearms and using a finger or two to rub his chin and dewlap, which does seem to help distract his focus from the injection when done vigorously enough. Glenn's other hand was placed below the pelvic girdle, and several inches down the tail. As Wally struggled when feeling the sticks, Glenn would hold with both hands to try to gently restrain him, both of us fearing the needle breaking off in the belly or it being forced too deeply and puncturing something. Well, Wally's tail has been twitching and vibrating when touched or petted in that area now, looking uncomfortably like the movement of an autotomizing tail (preparatory to part of the tail being released from the main tail), making me fear that he will drop it. It's almost as if one of the trigger points that starts a tail-release has been activated (injured? severed?), and drop signals are being fired, but incompletely, so the drop has not occurred. Since the sensitive point is barely a few inches below the bottom of his hemipenes, it's made me quite nervous.
He is still rather quiet. The saliva in his mouth is still thick, so I continue to do squirts, including to help get food down. He's been sleeping on my bed at night - something he's never been interested or willing to do since I've had him. He will only stay there if I put him there later in the evening, usually after an hour or so of an extended cuddle session. Between the towels and heating pad over him, he is warm enough, and seems to be making himself comfy enough propped up like a raja on the comforter and pillows. His sleeping there is more for me than for him - I can reach out and touch him at night, monitor his respiration, and will know if, heaven forbid, he starts seizing.
And so starts another day...
I talked briefly by email yesterday with a fellow I know whose huge, handsome 10-year old iguana, Hood, died suddenly earlier this year of kidney failure. Later in the day, I got a call from a friend of mine who just lost one of her six-year old iguanas, also to kidney failure. One of the vets she saw in the week that Stimpy was ailing said that he is seeing and hearing from others of a rash of big, otherwise healthy older males who are succumbing to kidney disease.
Between these mounting deaths despite what we know to be proper care, and too damn many phone calls and email from people trying to find homes for their "beloved" 6-7 year old iguanas because they are too big/take up too much room/won't let their owners pick them up despite the owners' claims that they are "very "tame. I continue to question whether these lizards should even be kept in captivity since, despite decades of captive care, we still can't seem to keep most of them alive anywhere near their wild lifespan...
He continues to require daily fluid and nutritional support, only rarely showing any interest in food. I have been able to get him to eat a little solid food, but have to rely on forcing slurries into him. I've been trying to give him some needle-free days now and then, just to give him and his poor skin a break from getting stuck several times a day. Not that he's particularly thrilled with having all that fluid administered by mouth, but we are dealing.
One other ongoing problem, besides the daily routine of forcing fluids and food, is the fact that he is always bloated. He is still somewhat incontinent, never able to get it all out at once. The bathing and massaging isn't doing the trick, nor is anything else I'm giving him working to relieve the situation.
A couple of times over the past week or so, he has climbed down from his basking area in the den and made his way into the Iguana Room, his old hang-out. Even though he hasn't been there in a while, and even though he isn't moving with his old speed and his ability to climb is impaired, his presence is enough to cause Rugwort to turn dark and Frankie to immediately lose his bright orange-and-white coloring as he goes scurrying out of the room, crabwalking to get by Wally. Guanie remains as out-of-sight as he can get from Wally, creeping by the doorways of the rooms Wally is in. It is interesting that, despite Wally's drastically altered behavior and even appearance (he should be looking like a pumpkin at this time of year, in full breeding season color, but is instead has even less orange than his usual out-of-season dominant male coloring), he is still considered to be the alpha male by the other males here and treated/avoided accordingly. Which is just as well....the stress of being challenenged could well destroy the fine balancing act currently being maintained by his overly taxed immune system.
Yesterday, Wally tried to climb up onto the top of the basking area in front of the window...but couldn't get all the way up. I heard his attempts and so went in to assist. I provided traction for his hindlegs and he made it to the top...whereupon his swung his head around and nipped at me as I pet his head and neck. It was as if he was upset at having had to be helped up and so took it out on the nearest target. He seemed happy enough after spending several hours there to return to the den after another bath. Having been a caretaker to seriously ill and terminal humans, and knowing many chronically ill people who have daily caretakers and personal aides, I see some definite similarities between some of Wally's behavior and reactions to me. I am now his caretaker/aide in a way far surpassing that of the usual healthy iguana/owned human relationship. His occasional snappishness, especially when frustrated at not being able to do things he used to be able to do with ease, occasional querulousness during feeding and fluid time, the sometimes resigned, sometimes grumpy air with which he tolerates my working with him getting him cleaned up or in and out of the bath...
And that's the way it is, here in Week 11... Wally and I both send our thanks for the kind thoughts and letters from those of you who have written to enquire about his health...
This morning, after a couple of days of increasing edema, he went downhill very fast. Breathing problems, obvious discomfort, unresisting when I put the needle in for morning fluids...I decided to give it an hour or so to see if it continued or got worse, in which case I was going to have him put to sleep. Perhaps not wanting yet another needle stuck into him, Wally died shortly thereafter.
While he was not my first iguana, he was the only one I ever intentionally acquired. He has been my constant companion for all but a few days during the past almost 7 years. He has seen me through the death of my husband, my own health ups and downs, traveled with me, moved across state with me, gone to school with me, and has been an effective educator and ambassador himself, communicating eloquently both on the importance of preserving the remaining rainforests as well as the plight of reptiles in the pet trade, especially that of green iguanas. His commanding presence and patient soul and will be greatly missed...
Thank you all who have been so supportive to the two of us through the past several months...your kindnesses and thoughtfulness has been greatly appreciated...
I'd be interested in knowing the survival rates and causes of death in Puerto Rican iguanas. They are not indigenous to that island, having colonized there from people who brought them or as stow-aways. They have figured out what plants to eat - and are seen to eat animal protein. The colonies in the Florida Keys would also be an interesting study group, as they too are not native to that area and are living on non-traditional foods.
Are the iguanas in captivity who are developing kidney failure at relatively young ages (2-5 years) doing so because genetically they are weak in some area, and have survived as long as they have because they were in captivity and not in the wild? While, on the one hand, the pet trade and effects of captivity are devastating to exotic species, responsible for killing animals who would have survived to reproduce for a normal life span in the wild, we are also keeping alive animals who might never have survived their first year in the wild... The former is reprehensible, of course...is the latter any better? Ethically, environmentally, socially, and politically, this opens up a whole new arena of discussion, debate, and soul-searching...
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