She’s recently lost her appetite and stopped pooping. Her urates also appear smaller than normal. I took her to a vet

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Customer: She’s recently lost her appetite and stopped pooping. Her urates also appear smaller than normal. I took her to a vet earlier in the week and it didn’t look like she was impacted or had any eggs.
JA: I'll do all I can to help. What type of reptile are we talking about?
Customer: A leopard gecko
JA: A lack of appetite can seem worrying. Does the leopard gecko also seem more tired than usual?
Customer: Not from what I can see. She still walks around her enclosure and I’ve seen her climb on top of her cool hide from time to time.
JA: Does the leopard gecko seem to be in any pain?
Customer: I can’t tell. Her walk looks normal, I thought I heard her chirping a few minutes ago.
JA: And what's the leopard gecko's name and age?
Customer: Dexter, about 3 years old.
JA: Is there anything else the Vet should know before I connect you? Rest assured that they'll be able to help you.
Customer: Not that I can think of.
Answered by Dr. Caryn – Vet in 13 hours 8 months ago
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Dr. Caryn – Vet
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2,200 satisfied customers

Specialities include: Reptile Veterinary, Herp Veterinary, Exotic Animal Medicine, Amphibian Veterinary

I am sincerely ***** ***** there was a delay in someone responding to your question. (Experts are independent contractors and as such are online based on their own schedules.) However, I am available and can assist you if you still need veterinary advice.

Hello and thanks for posting your question on JustAnswer.com. My name is***** and I have been a veterinarian in the US for over 21 years, specializing in aquatics, reptiles, amphibians, avian and other exotic species. You may already be aware, but on this platform veterinarians can provide insight and advice, but as this is not considered a legal client-patient relationship, we are unable to prescribe medications, provide medical records or sign documents for your specific pet. For that you would need to make an in person visit with a local veterinarian. I am happy to chat with you via text but if you are interested in a phone call instead that is an option you can choose for an additional charge. In the meantime, I am putting together some questions and/or suggestions to help with your pet’s concern.

Thanks again for posting your question, I’m sorry that your leopard gecko Dexter is under the weather and is not eating or pooping. I have some questions that will help me get a better idea of your pet’s environment and what may be going on with them:

-When did you first notice this current problem?

-What is the current tank set-up, e.g.,

Temperature (cool side, warm/main area, hottest basking temp) and humidity?

-Do they receive any access to UV light? When was the UVB bulb last changed out?

-What do you usually feed them? Do they receive any calcium or vitamin supplements?

-When was the last time Dexter pooped and did it looked normal?

Thanks very much for providing additional information, it is very helpful for me to try and figure out what is going on with your leopard gecko and the history information will help me to do that.

So I am not sure if I can tell you any more than the veterinarian who already examined Dexter since I cannot examine her but I can certainly go over what potentially could be causing these signs.

What did the vet find on their examination and what tests did they perform?

With any sick gecko, 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 leopard gecko 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 geckos 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. Also proper humidity is very important for overall and skin health, with 30-40% humidity in the main enclosure and 70-80% in the moist hide.

In the meantime, I will give you some information about what may be causing these signs, a care sheet with recommendations about environment and diet as some common medical conditions are unintentionally caused by improper husbandry (such as too low temperatures, humidity, UVB lighting or calcium and vitamin supplementation) and some suggestions for home care and support of your ill gecko.

Did Dexter stop pooping before or after she stopped eating? If afterwards it may be because she is not eating but if she was still eating and not pooping then that suggests something else.

Customer
I first noticed this problem about 5 days ago, around the last time she pooped. It looked small so I took her to the vet to check for impaction and she came back clear. The temperature in her tank is 85-90 on the warm side and 70-80 on the cool side. She also has a UVB light and day lamp. I usually feed her crickets dusted with calcium, but I’ve cut back on the supplements a bit since she started developing underarm bubbles. The vet checked her for impactions and eggs and found neither. He also noted that she showed no signs of mouth or tail rot either.
Customer
This is a picture of the last urate she passed. I try to keep the humidity in her tank around 40-50% by spraying and she usually has a dish I keep filled (filtered water, not tap.)

Okay, thanks for the additional information. A couple of things - I would recommend bumping you environmental temperatures a bit. 70 is too cool for the cool side and you need a warmer basking spot:

Daytime temperature range with a cool side at 78-80F (25.6-26.7C), a warm side at 85-90F (29.4-32.2C) and a very warm, focal basking area of 90-94F (32.2-34.5C).

Humidity is interesting with leopard geckos, to help prevent respiratory and skin issues, humidity in the main portion of the tank should only be 30-40%. That being said they do need a warm, humid hide where the humidity inside the hide is high 70-80%. This can be achieved by having a hide with a side hole that is lined with moistened substrate like paper towels, moss or vermiculite. It should be moistened to the point of dampness but not soaking or dripping wet.

If those are her urates, then Dexter is likely quite dehydrated. I would recommend doing twice daily warm water soaks. You can give your leopard gecko a soak in a shallow dish of warm water (85-90F, 30-32C) for 15-30 minutes twice a day. Only shoulder depth and monitored so their head is above the water. And, if they will allow it, dry them off after the bath so they don't cool off too much.

If they are might be having any GI issues, you can help promote GI motility and defecation with gentle tummy massage during the warm water soak. Be gentle and stroke the tummy from front to back a few times every 5-10 minutes during the warm water soak.

There are a number of reasons why your leopard gecko may not be eating a normal amount of food. Some of them are transient and may be normal while others are more concerning and warrant a veterinary evaluation. Leopard geckos may not eat normally due to emotional or physiological stress. Changes in environment such a new tank or changes in décor, or changes in lighting, temperature or diet might trigger temporary disinterest in food. Brumation, a normal, seasonal depression of appetite and energy that leopard geckos can (but may never) experience especially if not exposed to lower temperatures or shorted light cycles. With brumation they will tend to sleep more and seek out the cooler, shadier areas of the tank. They will look otherwise normal and will not lose weight will not eating, though they make still drink. So monitoring Dexter's weight, at least weekly on a good kitchen scale is a good idea. If she starts losing weight then you know this isn't from brumation.

Geckos kept with other geckos may be bullied by a more dominant individual. The stress or physical intimidation may prevent a more submissive gecko from eating. Close observation of interaction between geckos is important and this may require separate feeding bowls, tank partitions or even separate housing.

Improper lighting (too little visible light or UVB light) or temperature can negatively impact appetite. As cold-blooded animals, leopard geckos require sufficient temperatures for proper digestion. Before and after shedding, appetite may be down. Shedding is energy intensive and potentially itchy and uncomfortable so while they will commonly not eat during the shedding process, their appetites may be depressed just before and after shedding as well.

Some abnormal causes for appetite depression include inappropriate environmental temperatures (usually too cool), mouth rot (infectious stomatitis), trauma, sickness or infection (bacterial, parasitic, nutritional (metabolic bone disease, hypovitaminosis A)), indigestion or maldigestion, reproductive disease (egg binding in a female) and gastrointestinal impaction. The bot***** *****ne is that if your leopard gecko is otherwise acting and looking normally and the appetite depression is temporary then it may be normal. However, if the leopard gecko is displaying any other signs of illness such as weakness, lethargy, sunken eyes, skin discoloration, abnormal defecation or urination or the depressed appetite persists more than a few days, a visit to a local veterinarian with experience in reptile medicine is recommended (I know you recently took her to the vet, was that person experienced with reptiles?)

Customer
From what I can tell, her vet is experienced with reptiles. What would you recommend for setting up a basking spot?

The basking spot is best achieved with a basking light. For a leopard gecko since they don't need strong UVB light (2-5% is fine), I recommend using an incandescent or halogen basking bulb, since those don't produce UVB light, like a mercury vapor bulb would. Place it over the end of the warm side of the enclosure. Depending upon the size of the tank, usually a 100w bulb is fine for a leopard gecko. When you have the basking spot set up, you'll need to physically check temps under the basking bulb, just above the surface where Dexter would be, and also in the middle of the tank and on the cool side, also just above the surface. If it's too warm, you can raise the basking bulb up or if it's good but the cool end is still too cool, you can move the position of the basking bulb a little closer to the center.

And can you tell me more about the underarm bubbles? Leopard geckos can store a number of things in the armit "bubbles" fat, calcium, etc. It's not necessarily a sign of pathology. I would still supplement her with calcium and multivitamins, but as an adult, the calcium only needs to be given 2-3 times per week if normally fed daily and 3 times a week if normally fed every other day. And multivitamins, containing calcium, vitamin A and D3 should be given 2 times per week if normally feeding daily and 1 times per week if normally fed every other day

Customer
I used to dust crickets with every other feeding, but noticed that she’d begun to develop bubbles under her arms. I started dusting her crickets back once or twice a month and noticed that the bubbles receded. The vet also noted that she was leaning towards being overweight, so I’ve tried reducing the number of crickets she’s gotten with feeding (about 2-3 every other day, gut-loaded beforehand) to try and get her back to a healthy weight.
Customer
I’ve also tried using incandescent bulbs as a heat source with a ceramic heater connected to a thermostat, but the incandescent caused the warm side of her tank to go up to about 100 degrees and I thought that would be way too hot.

So the bubbles could be from her increased weight, I would be very cautious about that infrequent adminstration of calcium.

If you are using both the incandescent bulb and the ceramic heat emitter and it's too hot, then your options are to use a lower wattage basking bulb or to move it up farther away from the basking surface or you can try heating without the ceramic heat emitter. You need to figure out what works best but typically a 100 w incandescent without a heat emitter is sufficient but it does depend upon tank size and ambient temperature.

Also, what type of UVB light do you have and when was the bulb last changed? If it's a fluorescent bulb (the most common type used with leopard geckos), it should be changed out every 6 months even if it is still producing visible light, the UVB light output decreases over time. There is more detailed info about UVB lighting and other husbandry recommendations in the care sheet I shared with you.

So I would continue weekly calcium supplementation, continue with your weight loss plan, install a moist hide (if you don't already have one) somewhere in the tank where the temp is mid 80s, monitor weight and start doing twice daily warm water soaks. If her appetite still doesn't pick up and you don't think this is brumation then I'm afraid a return call or visit to the vet for another hands on assessment, bloodwork, imaging, etc. might be in order.

Customer
I have a fluorescent UVB that was replaced in January. I can try to switch between heat sources for day/night as well. Would it be safe to leave a calcium dish in her enclosure?

That's great, so your UVB is in date.

I think if you are supplementing her food and gut loading her insects with a good quality commercial gut loading formula such as

Mazuri Better Bug Gut Loading Diet

Mazuri Hi Calcium Gut Loading Diet

Repashy SuperLoad Insect Gutload Formula

Then you don't have to.

Customer
Would TotalBites be alright?

I would have to look up the ingredients. I'm not a huge fan of these cricket wet diets, they typically are more insect food rather than an actual gut loading diet. I like Mazuri, in particular, because they do lots of great nutritional testing and research to back up their products.

Customer
Will do. Any ingredients I should look out for?
A gut loading diet should have good amounts of calcium and vitamin A, especially vitamin A since the insects themselves aren't particularly high in it. So calcium should be around 8-10% and phosphorus should be really low, less than 1% of the diet, if they have a nutritional analysis.
Customer
Alright. And thank you for your help!

So I looked up the Total Bites ingredients, it's mostly water and doesn't have vitamin A, it has the pre-vitamin beta carotene, so I wouldn't recommend this as a gut load formula.

You are most welcome. If you do need to go the route of assist feeding, I can recommend some products, if you'd like?

Offer food, even if not eating. If your leopard gecko 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 (if inappetence is prolonged), you can assist feed whole, calcium or multivitamin dusted insects (I recommend removing their heads first) or you can syringe feed them a replacement formula like Fluker’s ReptaBoost, EmerAid Intensive Care Carnivore, Oxbow Animal Health Critical Care Carnivore. Or you can make a slurry out of Repashy Superfoods Grub Pie for Reptiles 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:

Assist feeding an insect by hobbyist Garrett Rose (I do recommend pinching the insects head off first so it is dead before assist feeding if your gecko is sick or lethargic so they are not injured by the insect):

https://youtu.be/cN5Uaoqmrg4

Syringe feeding by exotic pet veterinarian Dr. Kristin Britton:

https://youtu.be/Fq0fGmLNP-4

Another option is to assist or syringe feed Repashy Grub Pie for reptiles. It's a diet that is normally mixed with boiling water and then allowed to set up into a solid to make a gel food to feed to insectivorous reptiles. But if you mix it with room temperature (not boiling) water, more water than the package recommends, to make a slurry that is thin enough to go through a syringe, it can be used for syringe feeding. Or you can make it according to the package directions, using boiling water to make a gel that sets up, then cut the gel into pieces that you can then assist feed (like you would assist feed an insect). This formula is nice because it's based on insect and fish based protein and has a good variety of vitamins. Treat any gel you make like you would fresh fish, store leftovers in the refrigerator and discard after a day or two.

Customer
Sure. I don’t know if I need to assist feed just yet, but better safe than sorry!

Yes, hopefully you won't need to!

My best to you and Dexter. Please let me know if I can be of any further assistance.

Sincerely, ***** *****

Customer
Thank you! I just have one more question about lighting. Would these bulbs be appropriate for day use? (I know red light is detrimental to their eyesight, but I haven’t found much about blue light.)
Customer
File attached (1MPGMML)
I don't recommend the blue lights, full spectrum UVA is better, so visible light,
Customer
Got it
Customer
Dexter’s pretty grateful too!
He is very cute! You are most welcome Dexter! :-)
Customer
Good news, she seems to have gotten her appetite back. I was giving her a warm soak earlier to help with shedding and she turned over onto her side. She didn’t get fully submerged, but I am wondering what steps I should take in case any water got in her ears because of it.
glad Dexter is eating! If it was a quick dip she should be fine no need to do anything. If you are seeing a lot of water in her ear you can gently touch the outside opening of the ear with a cotton swab and that will soak up any water but I wouldn’t do anything more than that.
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