Red tegu full of fluid

[Legion6789]

I took my red tegu to the vet on Monday. I was taking her in for a check up. I didn't think anything was wrong with her except for being fat. My hope was to get some advice from the vet on bringing her weight down. Instead, what they found was that she isn't fat at all, she's full of fluid. So much fluid it was compressing her lungs and intestines, approximately 500ml. We brought her back yesterday and they drained about 300ml of the fluid. Her behavior in no way indicated anything was wrong.

In addition to the fluid, the ultrasound revealed numerous cysts on the abdominal wall. They ran cytology on the fluid in the abdominal cavity and fluid drawn directly from the cysts.

The vet said he's pretty sure it's egg yolk coelomitis. Basically the ovaries release follicles into the body cavity which then implant in the abdominal wall causing inflammation and in this case, fluid production. They know the fluid does not contain urine and the cytology report did not indicate anything cancerous.

He offered two options. One option is to use drugs to treat the condition. In this case a hormone producing implant is placed under the skin which would prevent ovulation. Kind of a lizard equivalent of an IUD. It's a bit of a wild card though. The implant is called Desnorelin and is usually used in mammals. However, a researcher in California used it on iguanas. The results of the study have not been published yet and the vet has emailed the researcher to ask about the results. Even if the results are positive, an iguana is not a tegu so there's still no guarantee. It's also difficult to verify if it's working. It took two years for my lizard to build up that much fluid. So it'd probably take months to notice if fluid production was still occurring. I also asked if the follicles presented any kind of danger besides fluid production. If not, could we just drain the fluid once a year? It's not ideal, but it's minimally invasive and her demeanor has changed dramatically since the 300ml drain from yesterday. Improved appetite and feisty instead of lethargic. However he couldn't provide a definitive risk assessment for leaving the follicles in place and not using the implant. Cost for the implant procedure is ~$200.

The second option is surgery. They'd open the abdomen, remove the fluid and the follicle cysts and remove the ovaries. He indicated that he thought this was the best option for eliminating the issue. However it's still not a guarantee. If part of the ovary is missed it could continue to produce new follicles. If a cyst isn't completely removed it could break off and implant elsewhere or continue producing fluid. The surgery worries me since so much can go wrong. She could die on the table or later due to infection. These are the most qualified lizard vets I've met, but it gives me pause that even for them it's a lot of guess work. "It worked in an iguana. Should work in a tegu." I keep thinking if I went to the doctor's office and he said "It worked on a chimp, but you'll be my first human." I may not be inclined to proceed. Cost for the surgery is ~$1200, plus any post-operative care we may need to administer when she gets home.

I haven't made a decision yet. Any advice is appreciated.

Below are the ultrasound images.

https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 1.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 2.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 3.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 4.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 5.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 6.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 7.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 8.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 9.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 10.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 11.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 12.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 13.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 14.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 15.jpg
https://dl.dropboxusercontent.com/u/91808950/GizmoUltrasound/Gizmo 16.jpg

 

[Legion6789]

Images 6, 7, 8, 9, 10, 15 and 16 show the cysts.

 

[marydd]

Though decision. I have no input to give but I hope you keep us updated. Sounds like you are a great tegu keeper.

 

[Legion6789]

I spoke to the vet again. I wanted to get a clearer idea of what threat the cysts represent. He said in this case they produce fluid, cause inflammation of the abdominal wall and can lead to bacterial infection. After weighing the options I decided to go with the medical treatment (drain remaining fluid plus implant) while leaving the surgical option available for the following reasons.

She passed feces for the first time in 5 weeks yesterday, so the fluid draining has been incredibly effective at improving her health. We thought she was overweight, so we likely have underfed her in a misguided attempt to bring her weight down. This gives us time to feed her properly and make sure she's healthy. The fluid in her abdomen at the least made her extremely uncomfortable. The rest of the fluid will be drained in the next appointment. Again, this will give her time to be comfortable and recover. The vet indicated that the implant has no foreseeable negative consequences. The worst case is it does nothing. So we can bring her in for regular check ups to see if the cysts are being reabsorbed into the body and the fluid levels are staying low. If the medical option doesn't work and surgery is still necessary, at least she will go into the surgery as healthy as possible.

 

[Aardbark]

I always hate hearing peoples gus haveing troubles. I hope everything turns out well for her.

 

[Legion6789]

We took her to the vet to get the implant on Friday (June 6). They drained the remaining fluid and put in the implant. He also gave us an anti-inflammatory which we're supposed to give her daily for two weeks with food. She's responded well to the fluid draining. She's passing feces every few days and she's more active. It's too soon to tell if the implant is having any effect. I'm not a fan of the anti-inflammatory. Feeding her everyday makes her balloon up again. We're trying to keep the meals small, a few blueberries or a couple mango chunks or a fuzzy, but even still her belly is getting big. I know it could just be the food, but I thought she was just fat before and it turned out to be fluid. The circumstances are frustrating since I always end up second guessing myself.

 

[marydd]

Keep us updated! Your tegu is one lucky baby to have you!

 

[Legion6789]

I built an enclosure for her on my balcony so she can get some real sun instead of just the MVB. I took a few pictures of her sunbathing.

 

[SamBobCat]

Those jowls are looking like you have got a boy

 

[Legion6789]

We weren't sure of her gender for a while. But the vet confirmed it when he saw her ovaries on the ultrasound.

 

[SamBobCat]

Oh yeah (duh) sorry I feel oblivious now lol