My Merauke's Infection, Vet Treatment, and Death [Full Report]

[Janella]

I am so sorry for the loss of your BTS. May his loving memories live on in your heart forever. Definitely let us know what the vet finds.

[kingofnobbys]

So sorry your old BTS boy has passed away .

I'd lay the blame entirely at the incompetent vet's feet , since no bloods or swabs were ever even taken, he was incompetent and needed to assess the exact desease that was making him ill and should have done sensitivity tests to identify the most effective antibiotic - this was not done.

https://www.drugs.com/pro/ceftazidime.html , essentially the vet wasted time by taking a shot in the dark.

If you have not already done so only a necropsy done by another vet in an entirely different practice will tell you (maybe) what killed him other than vet incompetence. I wlouldn't trust the vet who was treating him to be honest if with the this process - he'll be too busy butt covering for himself.

[trex]

Unfortunately, it may be too late to have a second opinion on the cause of death.

I agreed to receiving the ashes of my Merauke at the vet's office before I read your post, king. I'm not sure what other options are available to me at this point.

It's a little tough right now, because this is the second long term herp I've lost. It's difficult to stare at the empty cage. I keep feeling like I could have done more. But I don't know.

[alichamp]

I'm really very sorry that your bluey died. Thank you for letting us know, and we are sad for you.

kingofnobbys I don't think it's reasonable to lay such blame on the vet and we do not have all the facts. Please refrain from such accusations especially when it is not going to be helpful to the original poster.

Reptiles are very good at masking illnesses if you don't know what to look for and often by the time the illness becomes obvious it is far progressed. This is why it is good to seek advice and treatment early if there are any concerns and continue to monitor your reptile pet's condition and behaviour.

[kingofnobbys]

Unfortunately, it may be too late to have a second opinion on the cause of death.

I agreed to receiving the ashes of my Merauke at the vet's office before I read your post, king. I'm not sure what other options are available to me at this point.

It's a little tough right now, because this is the second long term herp I've lost. It's difficult to stare at the empty cage. I keep feeling like I could have done more. But I don't know.

I know how you feel. I've had dealings with an incompetent reptile vet and lost a much loved pet as a result. (Misdiagnosed, expensive surgery based on bad diagnosis, left me out of pocket for near $1000, and no pet came home afterwards, left me with a very nasty taste in my mouth).

[R176]

Aww.. I'm so sorry to hear about this
You did everything you could and cared about him as best you could. Sometimes these things just happen.
I don't know what else to say. Hopefully you get some firm information back, so we can all at least learn something from this unfortunate situation.
I hope you the best, and to not be too sad!

[trex]

UPDATE: 7/3/2017

I went to pick up my beloved BTS's ashes today and received the full necropsy report orally. In addition, I also received my BTS's full medical chart.

I have posted the image of reports below and will do my best to transcribe the picture into text format on this post so that it may be easily read by those who do not have access to view per the forum's rules so that everyone reading this in the future may benefit.
Medical Report:
http://imgur.com/a/zZiDI
Page 1: http://imgur.com/4iX1xzL
Page 2: http://imgur.com/7jerH8z

The most surprising finding was that my "male" BTS was in fact a female. I thought he was my baby boy, but she was my baby girl this whole time. I originally thought I had seen sperm plugs when she was younger, but they were likely just urates in her stools.

Necropsy Summary:
The immediate cause of death was ruled to be due to a hemorrhagic pneumonia. The vet found that my girl's lungs were bloody due to ruptured blood vessels. This was likely because she was already weakened due to her state. She was a victim of septicemia (blood poisoning) which had weakened her immensely. Secondary to the cause of death, she was also suffering from fatty liver disease. The vet noticed an unusually large amount of stored fat deposits in her liver area, yielding hepatitis. This attributed to the lack of appetite. Apparently my BTS was living off her fat reserves the whole time. This would explain why she wasn't losing weight. On initial checkup, she weighed in at 1198 grams, which seems to be quite far from skinny/thin.

My BTS's Medical Chart

6/16/17
Background Information

Diet - Kroger Brand wet dog food (canned)
Cage - Melamine 48" x 20" x 18"
Heat - Exoterra sunglo 75 watt
UVB - None
Bedding - Aspen shaving
Basking - 89-94 degrees
Cool - 75-77 degrees

First Visit Exam

MM: Excessive oral mucous
Skin: Multifocal scabby dermatitis
Eyes: ok
Ears: ok
Teeth: ok
Genitals: suspect female
H.W. prevention: N/A
Wgt.: 1198 grams
Abdomen: fair

Treatment and Remarks

- Decreased appetite, sores on left side and hind legs
- Eating every other day
- Multifocal sores w/ scabs
1) legs
2) ventrolateral thorax

Tx: Fortaz (ceftazidime) 36 mg IM (intramuscularly)
3.0 ml
Rx: Fortaz 100mg/1ml
sig: Inject 0.36 ml into muscle every 3 days x 6

Rx: Powersun 100 watt

Rx: Silvadene (Silver Sulfadiazene) cream
sig: apply topically SID (daily) till resolved

Plan Soak in warm water for 1 hr prior to inj., silvadene SID

6/19/17
Phone
- bottoms of feet now have wounds
Plan: topical silvadene then telfa then trans spore tape
- Change bandages every 3 days

RVR (return visit requested) - last day of antibiotics

6/20/17
Phone
- trouble getting feed bandaged
Plan: stop bandage, topical silvadene only w/ Fortaz inj.

6/22/17
Phone
- wounds slowly improving, a little more energy
-discussed fungal enteritis

Itraconazole 5mg/kg SID
Vorivonazole 10mg/kg SID

Fecal..[illegible].. Fungal hyphae (This was when I brought in the fecal sample for the exam)

Rx: Voriconazole 25mg/ml suspension apple 8 ml
sig: 0.5 ml P.O. (by mouth) SID x 14 days

6/30/17
Necropsy - septicemia, hemorrhagic pneumonia
Cremate save
[x]Card made []Card sent

My vet also had a conversation with me about the entire ordeal. I believe he did have my BTS's and my best interests at heart. He knew I was a young guy and on initial checkup, he stated that he didn't want to gouge me on prices of exams and tests because he knew that I was just trying to get established as a young adult. He refused to charge me for a few consults and the necropsy.

My takeaways as an ex-owner:
I realize I was not the perfect parent to my skink. I know I have likely made some mistakes that may have unfairly and prematurely ended the life of my pet.

Among the mistakes I have noticed:
1) I probably did not provide high enough basking temperatures for my girl. I was told that their immune systems are extremely dependent on heat, and low 90s for the basking temperature might not have been high enough. When I purchased the Powersun bulb from the vet, basking temps rose to 105-107 degrees.
2) I did not monitor humidity. Living in South Texas, near the gulf, humidity is naturally high here (50-70%+). As a result, I never misted the cage, and only used aspen until the end when I transitioned the setup into a hospital cage. I may have become complacent and this complacency might have yielded a respiratory infection. I believe Meraukes need higher humidity to thrive.
3) MOST IMPORTANTLY: I acted too late. In the beginning, when my skink went off food, I worried a lot because that was unusual behavior. I went from hand feeding her EVERY single meal for 3 years to her refusing food even during the warmer spring and summer months. Looking at my post history, one can see that this all started piling up during the summer of 2016 (1 year ago).

By December 2016 (7 months ago), sores started appearing on her feet. I thought those were just from abrasions because I had recently trialed removing substrate. I was told by the vet that when reptiles start showing sores and open wounds, they become septic and become much harder to heal. This was the warning sign I overlooked. Fast forward to the current time of this post, and it has already been too late. My girl is now gone.

For those reading this story, I highly suggest taking your BTS to see the vet as soon as you notice something is off. It's preferable to spend a small amount (I paid ~$60 USD) for the vet examination fee to get a peace of mind than to deal with the pain of losing your animal like I did. By the time my BTS was showing the open wounds to the degree they were, I imagine the damage was getting hard to reverse. If I would have gone earlier, when the spots were little, back in December, I might still have my little girl with me.

Final Words
All in all, I hope that I didn't cause my BTS too much suffering in her final moments with me. I would change quite a few things if I could go back in time, but I can't. Instead I have made her debilitating story as detailed as possible here in order to assist those may need information in the future. I'd rather some good come out of her life being cut short.

I'd like to think that my little girl enjoyed the majority of the short amount of time I had her. I will especially remember how gentle she was and how she was during her nightly spoon feedings.

I have her ashes placed in an urn in her cage. I still miss her when I walk by her cage. Rest in peace, Pinto.
http://imgur.com/a/6SLLN

*I will attempt to streamline this entire story by linking all of my related historical posts together and editing the first post so anyone reading this will have an easy time following along.

[kingofnobbys]

Wow he really had an ordeal.

[Janella]

Trex,

I want to let you know how proud of you I am. I know that may sound absolutely silly to some, but you took this heartbreaking ordeal, learned from it and most importantly turned it around to teach others. Good for you. You are 100% correct in every thing you posted here. Again, you have my deepest condolences. Maybe some day down the road you will find another BTS to steal your heart.

Janella

[alichamp]

Thank you so much trex for posting this. I imagine it may have been very difficult for you at this time, and I thank you for posting your information and reflections so we may learn from your experience. All the best.