I am sorry to hear he is lethargic, that is concerning. I would be concerned that it might be from the infection or from dehydration.
I am asking because I wanted to double check the dosage of sulfadimethoxine he is receiving. There are couple of ways to dose this medication to treat coccidia, every day for 3-5 days then every 24 hours or a daily dose for a week with the first dose being a higher loading dose. It is very important when giving this medication that adequate body hydration be maintained so if he's not eating well, then twice daily warm water bathes are a good idea.
Thank you for that information. So he is receiving 0.3ml of 250 mg/ml suspension which is 75 mg and his weight is 0.304kg (304 gm), so that works out to a dosage of 25 mg/kg.
That is an unusually low dosage, typical dosage is either 50 mg/kg once daily for 3-5 days then decreasing frequency to every other day as needed or the more typical 90 mg/kg on day one followed by 45 mg/kg once daily for 5-7 days.
Since I did not do the exam on your animal I do not know why your veterinarian prescribed this dose, but there is a possiblity that it might not be a sufficient dose to treat the coccidia infection. While you can get some transient lethargy or loss of appetite when starting therapy as the animal doesn't feel so good as the parasites are dying off, I am a bit concerned about seeing bloody poops a number of days after therapy was started.
If your vet's office has office hours today (Saturday) I strongly encourage you to call them and ask about the dosage and the fact that he is having bloody poops, lethargy and loss of appetite.
However in the meantime, I can give you suggestions on home care of Kermit to perhaps help him feel a little better, though I do think he might need an adjustment of his medication (and that is something only your veterinarian can do since I am not the prescribing veterinarian).
With any sick bearded dragon, it is always a good idea to start by checking that their environment and husbandry are proper for their species. Taking a physical measurement of the temperature gradient within the enclosure and measuring humidity with a hygrometer are a good idea. Making sure the UVB bulb is appropriate for the size of the space and has been changed regularly. Even if they are still producing visible light, UVB bulbs have a limited lifespan and need to be changed every 6-12 months, depending upon bulb type. Making sure diet is varied and the insects have been gut loaded with a nutritious gut-loading diet as well as dusted regularly with calcium and multivitamin powder. Therefore, I am attaching a bearded dragon care (husbandry) reference sheet that I put together. Please review it at your convenience and let me know if you have any questions.
For example, if the environmental temperatures are too low, since bearded dragons are cold-blooded, this will negatively affect their metabolism, appetite, digestion and immune function. So start by checking the temperature gradient in the enclosure and, if it's too low, adjust your basking light or get a stronger watt bulb so you are achieving the proper environmental temperatures.
Yes, I completely understand that's why I will provide suggestions on home care until you can get in touch with them. (Some vet offices, even when closed will have an emergency number to reach them, does yours?)
What is Kermit's current tank temperature gradient (cool, warm and hottest basking temperature) and what is the tank humidity level?
Blood contamination of feces or urates is obviously not normal to see. While transient pink discoloration of feces or crates might be related to environmental or emotional stress (make sure his tank temps, humidity, etc. are in the normal range), the most common cause of this is internal parasites though frank blood when eliminating could also be from blockage or internal damage from prey items that are maldigested, too large or building up to a blockage or from inflammation or infection in the urinary or gastrointestinal system. (I wanted to mention this because while this is most likely from the underlying coccidia infection there are other potential causes of blood being passed with stool.)
It’s especially important with a sick bearded dragon to make sure that their tank is clean, food is fresh and prepared hygienically and that the temperature is appropriate and that your UV-B bulb is in proper working condition. Here are some additional recommendations of how you can support your bearded dragon while they are under the weather or until you can contact Kermit's vet to discuss the current treatment.
-Healing and normal metabolism are linked to proper environmental temperature. Provide a daytime temperature range with a cool side at 77-80F (25-27C), a warm side at 85-90F (30-32C) and a very warm, focal basking area of 95-105F (35-41C) for adults and juveniles and a slightly warmer basking spot 95-110F (35-44C) for babies. A nighttime temperature range of 70-75F (21.5-24C) should be provided. 30-40% humidity is recommended.
-Keep them warm. If your bearded dragon is not moving around much on their own, or are unable to move around at all, place them in a location in their enclosure where the temperature is warm but not super hot: 85-90F (30-32C). This will ensure proper metabolism but they won't overheat or chill at this temperature range. Do not put them on a hot rock or under the basking light hot spot if they cannot move off by themself, as they might get overheated or burned.
-To prevent or treat dehydration, especially when/if they are not eating and while Kermit is receiving therapy for coccidiosis, you should give your bearded dragon a soak in a shallow dish of warm water (85-90F or 30-32C) for 30 minutes twice a day. The water should only be shoulder depth and please monitor them while in the bath so their head doesn't submerge. This can be done in a shallow pan inside his enclosure, which is nice because the water still stay warm, or if that's not feasbile, a container outside the enclosure but temperature should be checked every 10 minutes of so and water refreshed if the temperature drops below 85F. Dry them off after the bath so they don't cool off too much from evaporation.
-Limit handling. If they are ill limit handling and limit time out of the enclosure. If you must lift or remove them from their tank, go slowly and support their weight from underneath with your palm.
-Make sure you always wash your hands with soap and warm water after handling your bearded dragon or any cage furniture.
-Make sure the enclosure is clean as built up waste, dust and other irritants can predispose your animal to infection. And since your dragon has diarrhea, increasing the frequency of cleaning inside the cage with a reptile safe disinfectant will help avoid cross contamination and repeat infection (if it is infectious).
Cleaning the enclosure more thoroughly at least once monthly with a reptile safe disinfectant is recommended. F10 Veterinary Disinfectant is a good option, safe with reptiles and comes pre-diluted and ready for use in a spray bottle.
You can also consider lining the tank with disposable unbleached paper towels or newspaper while they are under treatment to make cleaning easier and help prevent reinfection and environmental contamination. The papers should be changed out daily or more frequently if they become soiled. Also, since they defecate into their water bowls often, cleaning the water bowl daily with soap and warm water before refilling it and weekly disinfection of the bowl is a good idea while they are ill (normally, it's okay just to do a daily rinse and refill of the water dish with 1-2x per week washing/disinfection).
-Offer food, even if not eating. If your bearded dragon is having difficulty reaching or getting to their food, put the food dish next to them or you can also hand or tong feed them. Place an insect gently against their lips and if they are hungry, they will bite at it. If not, don’t force it.
If needed for prolonged appetite loss, you can assist feed them an insect (I recommend removing the head first to prevent injury to the bearded dragon). But if his GI tract is irritated from the coccide infection you should consider syringe feeding them a replacement formula like Fluker’s ReptaBoost, EmerAid Intensive Care Omnivore, Oxbow Animal Health Critical Care Omnivore. Or you can make a slurry out of Repashy Superfoods Beardie Buffet Omnivore Gel Premix but go slowly and don't feed too quickly to prevent choking.
If you’ve never done this before there are some good online videos that you can watch first such as these ones:
How to assist feed an insect video by hobbyist Curtis Lasane (2:50 to 3:50 in the video). Note, I recommend if assist feeding insects to a lethargic bearded dragon, that you dispatch the insect first by pinching off it's head.
How to syringe feed (slurry, water or medicine) video by exotic pet veterinarian Dr. Laurie Hess:
-Calcium and vitamin supplementation. It is important to still offer calcium and vitamin supplements if they are eating. This is usually done by gut loading insects with a diet that provides a good source of calcium and vitamins as well as dusting insects with powdered calcium and multivitamins.
There is more specific information about how to properly supplement your bearded dragon in the care sheet I have shared with you.The aforementioned syringe feeding formulae do already have calcium and vitamins in the mix though you can provide additional liquid supplements.
If they are weak because they are experiencing a severe calcium deficiency related to Metabolic Bone Disease or dietary insufficiency, or if they are not getting a lot of dietary calcium because they are not eating well, you can buy a liquid calcium supplement at the pet store and give them a few drops into their mouth once a day and this should help, but this isn't a replacement for a veterinary evaluation and treatment or proper diet and routine calcium supplementation.
Fluker's Liquid Calcium Reptile Supplement
If they are experiencing signs of hypovitaminosis (A or D) or they are not eating, then you can buy a liquid multivitamin supplement at the pet store and give them 2 drops for every 50 grams of body weight. If they are not eating, you can give this supplement every other day for a week before decreasing to twice weekly. The supplement can be placed onto a food item before feeding or dropped directly into their mouthes if they are not eating. Once they are back to eating or no longer have signs of a vitamin deficiency, this liquid supplement should be stopped in favor of multivitamin powder dusting of food and gut loading of insects, as described in the care sheet I shared with you.
Fluker’s Liquid Vitamin (Reptile Supplement)
It is also a good idea to re-evaluate your current husbandry practices as some common disorders, such as metabolic bone disease, are unintentionally caused by deficiencies or imbalances in diet, UVB lighting and calcium/vitamin supplementation. If you have any questions about the general bearded dragon care sheet that I shared with you please let me know. Thanks.
Thanks for the additional information. Yes, humidity and temperature gradient is just perfect. With an ill dragon, I do sometimes like to bump up the temperatures to the higher end of normal, so for basking you could raise it up to 105F but basically your temps are spot on.
I would also avoid feeding any mealworms. They have a rather indigestible exoskeleton and if his GI tract is irritated, best to leave them out for now.
The softer worms are fine as are Dubia roaches or, actually a favorite of mine, are black soldier fly larvae....nutritious with a good level of calcium as feeder insects go. Please continue to dust with calcium, no vitamin D3, (3x/week) and multivitamins (1-2x/week) and consider, if you are not doing so already, gut loading your insects with a good quality commercial gut loading diet to boost their nutrition.
Some good commercial options for gut loading are:
Mazuri Better Bug Gut Loading Diet
Mazuri Hi Calcium Gut Loading Diet
Repashy SuperLoad Insect Gutload Formula
Yes, black soldier fly larvae are also called Phoenix worms. That's great, gut loading really improves the insects' nutrititive value.
So I would focus on keeping him warm, keeping him well hydrated and continue giving the medication but be aware that he might either need a higher dosage (twice as much) or a different medication (toltrazuril or trimethoprim sulfa) if he is not responding to therapy.
If his eyes look sunken or skin seems especially wrinkled, then you can consider, in addition to bathes giving him some water by mouth using a dosing syringe. If he's not eating anything, total water for the day would be 6 ml, but I wouldn't give that all at one, split it up into aliquots of 1.5ml at a time.
They are also sometimes called ReptiWorms or CalciWorms, depending upon the purveyor.
You are most welcome.
I want to reiterate that I am providing the medication dosage for your information, but do not advise changing any dosages yourself until you are able to contact the prescribing veterinarian to discuss it.
I do hope Kermit feels better and please let me know if I can be of any further assistance.
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