Lasix for Edema

[Zoo Nanny]

Has anyone had their snake or lizard treated with Lasix for edema. If so was it given by injection or orally?

[MDT]

Do you know the underlying cause of the edema? Renal? Cardiac? Liver?

[Zoo Nanny]

Not 100% sure but the general concensus is cardiac

[MDT]

IDK about reptiles, however, in human medicine, lasix can be given both routes. The oral route though can be a little "iffy" when bowel wall edema is also going on, this messes up absorption through the bowel and the effect will be lessened. If it's a cardiac origin, i would suppose either way would work. Can you give more info on animal? I would guess your reptile vet would be following renal function and electrolytes (K+, Na+) as lasix can cause a potassium depletion and bring on a whole new set of bad stuff.

[Zoo Nanny]

Potassium depletion doesn't happen in reptiles as a rule from the use of lasix. Renal function would still need to be followed for fear of dehydration. Blue Tongue Skink at least 17 years old. Symptoms of breathing heavy with small amount of mucus on lip seen last Monday evening, Tuesday am appeared to be fine no mucus noticed eating well. Tuesday pm mucus back breathing appeared labored. Vet on wednesday symptoms increased quickly during the day. Blood panels and full body xrays all were inconlusive or within normal "lizard range" Very little research and treatment has been done on BTS once seniors. Currently 2 exotic vets have looked at him with consultation with 2 zoo vets one a specialist in cardiology the other reptiles. Additional consultations done with 4 other local exotic vets and two EKG specialist. All come to the conclusion that it is most likely heart failure due to advanced age. Treated with IM baytril for 5 days. At this point I just would like to make him more comfortable and the one reptile zoo vet has used lasix with positive results to decrease edema.

[MDT]

That's interesting about the excretion of potassium in reptiles with a diuretic. Sounds like you have your bases covered. Keeping comfortable for now sounds appropriate.

[Zoo Nanny]

Sadly that's about all we can do for him. I was really praying that we would find some underlying infection that could be treated. He's a very sweet animal with a really good disposition. The vet and vet tech were intimidated by him initially because of his size and the reputation of skinks being bitey. That I had never heard before. It took some reassuring to them that he was not going to turn and remove any digits! I think they were amazed at how passive he was. He is just over 24 inches and ways 1 kg. There has been a good deal of interest in his case with a number of vets due to the limited numbers of seniors around. I was surprised when the vets were telling me that most BTS die here by age 10. None of the vets here in MA that are involved have even seen an adult let alone a senior.

[marvelfreak]

This as got to be the most educational thing i read on here in a while. Thanks you both.

Nanny keep us updated and i love to see some pictures of him.

[MDT]

Currently 2 exotic vets have looked at him with consultation with 2 zoo vets one a specialist in cardiology the other reptiles. Additional consultations done with 4 other local exotic vets and two EKG specialist.

I would LOVE to see an ECG on a Blue Tongue Skink....
Having said that, I am sorry you are having to go through this.

[Zoo Nanny]

Oops ECG, it would be interesting. Their heart rates are so soft/quiet(?) that they can not be heard with a regular stethoscope. I wonder if they could be heard with a fetal monitor. In the past week I've learned an incredible amount of information on skinks while still learning very little. I've also learned that there are some awesome vets out there that are willing to help even without compensation. To date with all of the vets involved I've only paid one. If anyone in the Northeast is looking for a good exotic vet I can give the names of a few now that are awesome!
This is a picture taken this morning. You can see the edema on his throat.

https://sphotos-a-iad.xx.fbcdn.net/hphotos-ash3/526307_10201613782088601_1136229067_n.jpg

[MDT]

ECG/EKG all the same ;) (Latin or Greek)
It's all good. Sounds as if you're doing the best for him that you can. I hope things go well.

[Starbuck]

I've got to agree with marvel;

these posts are the real reason i'm on this forum. I know not everyone is into the medical stories and vet visits and answers, but it is really heartening to see someone who cares about their animal, is doing everything they can for it, AND is bringing more options to other reptiles owners and vets.
It will be very interesting to see how he responds to the drug, I'm really hoping its able to give him some comfort and you some piece of mind, OP.
Thank ou for sharing this with us.

[Zoo Nanny]

Thank you MDT for the information on the administering of the drug. And thank you all for the support. I'm not doing anything that most folks here wouldn't also do for their charges. It's what we sign up for when we bring them home to live with us.

[Zoo Nanny]

Precious received his first injection of Lasix this morning. 5mg dose per kg is the doseage prescribed. If it's going to help him I should see a diffence in the edema by this evening. I'm keeping my fingers. Enroute home from the vets he pooped in the carrier. It was not of the normal consistency or color and had undigested food in it. I'm not feeling very optimistic at this point. His ambient temps have been an average of 88-90 during the day and 78-80 at night. This has been on the high side due to being in the smaller tank and trying to keep his temps up until we figure out what's going on with him.

[MDT]

ZN....interesting. My question is since reptiles excrete urates rather than urine, how does Lasix exert its effect. In humans, Lasix is acting in the tubules (Loop of Henle) in the kidney and through a butt-load of really boring molecule/electrolyte transporting, it makes you pee. I have zero idea what reptile renal physiology is, but if the desired goal is to increase urine output to eliminate excess fluid, does it work the same in reptiles?

[Zoo Nanny]

Don't quote me on this but my understanding is that it comes out as a clear fluid and not urates. How it interacts with the kidney I believe is still a mystery. There has been so little actual research on reptiles and medications that it seems like it's a shot in the dark by most vets. The lasix was suggested by the reptile vet because he tried it with a few different snakes and a couple of lizards and it eliminated and/or lessened the amount of edema in the animals. The reptile vet also said that it is said that lasix does not work on herps but no one could say why so basically I think he said why not. I don't know the whole workings of the kidney in skinks other than what I was told. There is only one kidney which is elongated as opposed to mammal kidneys bean shape. How it works I'm clueless. I'm not one to have my animals used as guinea pigs but in his case the alternative is euthanasia. If there is no improvement that's my next step. I won't have him put through more test and invasive procedures. They can't read the test as it is because there is nothing to compare to.

[MDT]

I totally understand. I hate that euthanasia is the next option for your skink. I would say that you are providing the best palliative care you can.
Keep us updated on what happens....hopefully this will lessen the fluid load. Thanks for sharing.

[Zoo Nanny]

The lasix had no effect on Precious. This weekend I put him back in his big tank, fed him only his favorite foods and had him in the yard yesterday afternoon. He used to love burrowing through the grass. He moved around a bit but slowly. This morning I took him to Tufts Veterinary School where they helped him pass. The school will be doing research on his remains in hopes of learning more about these amazing creatures as they grow older in captivity. According to the vets very few ever live to see 10 because of misinformation on husbandry. I'm going to miss my sweet boy and his beautiful amber eyes.

[MDT]

ZN...I am really sorry to hear this. :(

[marvelfreak]

So sorry to hear, but just remember thanks to you he had the best life. Plus he will live on in your memories and in the research being done.

[smy_749]

Sounds like he lived a long healthy life. Sorry to hear the treatment couldn't save him.

[Zoo Nanny]

Thank you. It was difficult this morning taking his tank apart. I do hope that the college is able to learn something from him that can help to understand BTS better. The vet that was treating him is going to contact the vet at the college to see if he can get information on what they are able to find. He was disappointed that I did not have a necropsy performed. I felt it more important for students to learn than what was wrong. The information that I did get from his blood work and xrays was enough for me. He had no signs of MBD or fatty liver disease. Concerns of all herp keepers.