VERY Conflicting Vet Information - Please Help!

[ILoveMyMonsters]

So in the last few days, I have received a diagnosis from Gauge's primary veternarian, and I have also gotten a second opinion from a recommended herp vet by the name of Dr. Wentz.

Primary Vet: After a week and a half and 4 specialists later, says Gauge has an acute calcium deficency as a result of not enough calcium or vitamin D3 in her diet. MBD is the result. Recommended a partial dietary overall - a switch to Merrick Before Grain or something similar and proceed with the rest of her diet as normal. Is not considering a genetic or congential problem. Also was interested in having a two-part series of hormonal injections (the name of it eludes me right now) done to speed up recovery time and to restore calcium in her bones. However, she has to have sufficent calcium intake for a week, otherwise it will cause hypocalciogenic (can't spell it ) shock and potentially kill her...on top of that, there is no way to measure if she is getting the proper amount - no bloodwork or anything. Oh and I have to buy the bottle for $188 because they get such few reptilian clients and it would go to waste.

It didn't sound right to me somehow, so I got a second opinion:

Dr. Wentz (aka "Second Vet"): I saw him as a recommended BTS vet on this website, and his clinic is only 15 minutes from me, so I schedule an appointment and went today. He is keeping an MBD with dietary deficency in mind, but it's not 100%. He is also recommending a dietary overall - wants me to cut out all dog food (Gauge's protein base) because he says that the balance of phospherous can interfere with calcium uptake and it is very difficult to measure the precise ratio. Dog food is bad, cat food is worse. He wants her to switch over to Top Cal Adult Bearded Dragon Food, as apparently beardies and BTS's have similar nutritional requirements (is this true? ). I would cut out all meat and veggies, as this food is made with them already, and fruit and live food would be an occasional treat. She would also no longer need a calcium supplement, but her condition would be monitored as she grows to ensure this doesn't worsen. Congential and kidney defects are being considered, and he has offered bloodwork in the future to check renal function. Hormone injections NOT recommended.

BONUS: Dr. Wentz also informed me that the fecal exam performed by her first vet showed pinworms (gross). He wants me to have them send over a more detailed report for closer examination. Here's the kicker: they never told me. So now she has to be treated for pinworms as well. When I called the first vet to ask as to why they never informed me, I was told that an occasional pinworm larve or egg is normal for reptiles, hence why they didn't say anything. that doesn't make sense either. Is that true? This is the first I have heard that tidbit, and it sounds fishy.

I'm really confused now. Can anyone give me some more insight into either of their opinions?

[Katrina]

That is confusing, but it definitely happens with exotic vets. I don't think either is necessarily wrong - it is like asking people for advice on forums sometimes.

I can help a bit...

The part about the pinworms is true, if my vet finds only a few they give you an option of deworming but don't force it as it is normal. Of course if the animal was underweight or the parasite load seemed high they would strongly recommend deworming.

I think you meant to say that Dr. Wentz talked about phosphorus interfering wth calcium uptake. I was curious about the Ca:P ratios in cat and dog food and so I emailed Merrick and Wellness a while ago and got the full nutritional info of many of their canned foods a while ago. I posted about it, it received an overwhelming response.
http://bluetongueskinks.net/forum/viewt ... ht=calcium

I can send you what they sent me if you would like (Merrick or Wellness), or if you feed a different brand food I am sure you can email and ask. It isn't hard to get detailed nutritional info from them. From what I got, it seemed like the Ca:P ratio wasn't as high as the recommended 2:1 but there was more calcium - so a pretty good ratio. Maybe you can show this info to Dr. Wentz?

I haven't fed the beardie food, I don't know enough to say if it is good or bad. Beardies and blueys do have similar dietary needs though.

Because so many breeders have fed a diet primarily of dog food for so long with no ill effects, I'd be inclined to think that dog food as the primary protein source isn't the problem.

I'm sorry I can't help more. They seem to have similar conclusions but slightly different ideas on diet. I like that Dr. Wentz is offering to look a bit further, it might be a good idea to get blood work done.

[Nae]

Wow, what a difficult situation your in However, I know nothing and thus will say nothing, except that I wish you the best of luck!

[Susann]

I have been using Mazuri Insectivore Diet dry pellets as a fortified protein source that I add to the veggie/dog food mix.

Here's the link to the detailed list of ingredients:
http://www.mazuri.com/PDF/5MK8-5MM3.pdf

Maybe show this to your veterinarian, see if this could be an alternative source of fortified protein if you choose to cut out the dog or cat food.

I know it contains ash and fish oil and probably other things that are not the perfect solution, but maybe a choice to consider.

I have plenty, and would love to overnight ship a bag of it to you if you and your vet think it might be something to try.

Mazuri is a company that produce and supply food for zoos. Rather than try to put together ideal mixes for, sometimes, hundreds of different animals daily, and keeping track of --for example-- how much folic acid is in a medium carrot, they have done the research and put together different feeds for each type of animal.

Let me know if I can ship some to you. Or do anything else....
Good luck!

[Katrina]

Great point Mel - I was thinking I should split this and then I just posted and moved on.

Sorry to hijack this! Please continue the original discussion, diet and dog food one is now a separate thread.

[Susann]

I am sorry it has taken this long to reply on this. Frankly, I meant to answer after questions arose from my comment, but instead, I forgot. Besides dealing with the loss of Joey, there has been many other issues, and the saying: “when it rains, it pours” has felt especially fitting lately.
But, alas, I am back to explain my comment.
However, the thread that I am bringing up comments/quotes from is Nekton Rep and Calcium (by Copper), which is from more than 3 months ago.
http://bluetongueskinks.net/forum/viewtopic.php?t=18481
Since I'm really writing this with Gauge in mind, I hope you excuse me bringing quotes from an old thread.....

First off, my hasty comment was very poorly worded.

When it comes to calcium you have to not only look at the amount of calcium, but the amount of calcium in relation to phosphorus.
MBD results from an improper calcium to phosphorus ratio in the body. Normally this ratio should be around 2:1 calcium:phosphorus (in the range of 1:1 to 2:1).
So you can add all the calcium you want, but it will do no good unless you add phosphorus in the relative right amount.

Thus, the misunderstanding:

I've never heard of anyone using a phosphorus supplement? Generally, most foods already have very high phosphorus compared to calcium, thus the need for the calcium supplement.
Susan, did you mean D3? The body can't metabolize calcium without D3, thus you could add infinite calcium and if the skink had no way of getting D3 (supplement or natural) it would do no good. I think calcium:phosphorus cancel each other out, so you would only need to add phosphorus if the skink was getting too much calcium in the diet?

Calcium, phosphorus, and vitamin D3 are all three nutrients that work together to develop healthy bones; develop AND maintain healthy bones. Even though phosphorus binds calcium, phosphorus (along with D3) is still necessary for metabolizing calcium and many other things. To metabolize calcium, the amount of phosphorus is not necessarily as important as the ratios to each other. I erroneously stated that adding calcium would do no good, unless you ADD phosphorus in the right amount. What I should have said was RAISE phosphorus LEVELS. You can double Gauge’s calcium intake, but unless his phosphorus levels are raised by the right ratio, Gauge will continue to loose bone-mass as his body will be unable to metabolize the calcium, and therefore starts taking calcium from the bones.
However. As has been stated, nearly every food contains phosphorus, so the need to supplement phosphorus is probably unlikely Gauge’s need.
Too little phosphorus CAN lead to bone loss, but the more common reason for bones to lose calcium if phosphorus is the cause, is TOO MUCH phosphorus in the blood. And that may have nothing to do with intake.

What your description of seemingly very rapid bone loss has made me wonder, is whether his kidneys are functioning properly? Because phosphorus plays a big part in waste filtration, and if the kidneys are not functioning properly, elevated phosphorus levels circulating in the blood are likely a result. When there is too much phosphorus in the blood (hyperphosphatemia), the body can not metabolize calcium, no matter how much you add to his diet. The body, in order to keep other life supporting functions going, then starts to leech calcium from the bones, resulting in different types of bone disease.

PLEASE understand that I am NOT an expert in ANY way! I am merely citing MY understanding of calcium and phosphorus functions in the body. I may very well have misunderstood some, or even all of this. PLEASE do not read this and think this is fact! I have simply stated how I have understood things from reading up on the issue when deciding whether to supplement calcium/D3 and/or use UVB. ALWAYS talk to your veterinarian, especially before doing ANYTHING when you have a sick animal.

I would think checking kidney functions and phosphorus levels would be a matter of simple blood work, but your veterinarian should be able to tell you whether any of this is a valid concern.

We haven’t heard about Gauge in a while, I hope he is well, and I’m really hoping me writing all this was completely unnecessary because the vets have already figured out what is wrong and are well underway to curing Gauge!
Please let us know. And I’m more than happy to take a hike with my kidney function theories, faulty or not!