We're going to the vet

[aggiegirl]

As a paying client, you need and deserve to be informed of the tests/treatments that will be performed. Next visit, make sure to inform them that you would like to be involved in all decisions. I like it when they have forms that you sign to give permission before diagnostics/treatments are performed. However, as Kristine mentioned, if it is perceived as an emergency, sometimes time is an issue and these protocols are are not followed...

[Hijinks]

The vet called me with the blood results.

They said uric acid levels were elevated. They also said they saw bacteria and believe he is a bit septic. They want to see him every three days for antibiotic injections (starting tonight).

And Kristine, you are right. This facility isn't shabby by any means and while I still don't remember being asked if they can do any injections, I ran in there under the premise of "EMERGENCY!!!" and I'm sure they operate a little differently under those circumstances. I could indeed have been so worked up I never heard it. My poor guy!!!

[Marie]

I just thought of a few things you might want to consider/ask when you return to the vet. Maybe others who have had bluey vet experience can add additional comments. It sounds like last time you were a little over-whelmed by the entire vet experience. It might help you understand more (and avoid future expensive bills) if you were prepared when you went in.

1. If your budget is tight, you might want to ask how much it will cost for them to give your bluey injections. Giving injections is something that you can do at home. Maybe they could show you how to do the first one, and then you could do it from then on out.

2. Ask why they are giving the antibiotic via injection rather than orally. If they think it would be just as effective to give it orally, you might find this an easier option on yourself.

3. What antiobiotic are they prescribing and what are its side effects?

4. Did the bacteria cause the eye problem or did the eye problem lead to a systemic infection?

5. If they think the eye problem is a bacterial infection, can they prescribe an ointment for the eye? The systemic antibiotic should theoretically treat an eye infection, but in reality, very little of the antibiotic actually reaches the eye.

6. Can they culture the bacteria and determine what antibiotic works best? I'm guessing they will give you a broad-spectrum antibiotic. However, if this antibiotic doesn't work, they will know what willl work the next time (w/o having to bring your reptile in for another blood draw.) The sensitivity screens will cost more money though, so if you opt for this, make sure you ask the cost.

7. How do they know what a "normal" uric acid level is for bts? My reptile vet said he could draw all the blood he wanted, but he can only guess at what all the values mean. He said there was no standard to compare the values. Just curious where they got their info.

[suez]

hope everthing turns out ok for you ,good luck with the test results

[Hijinks]

Thank you so much, Marie. I will keep all of these things in mind tonight. When we were on the phone, the vet did say she'd feel comfortable showing me how to do the injections myself. I thought to ask whether the infection could have stemmed from the eye, but she said it's hard to say at this point. After examining his eyes, she didn't seem very worried about them. I'll press on this issue even more tonight.

How else do they get such infections? Could he have gotten something from roaming around outside?

[Hijinks]

I am to administer .02ml of Ceftazidime every 72 hours in the muscle of the front limbs.

The vet basically told me to chill about the light and the eye, and there's no telling where he got this infection...IF there is in fact an infection!...she did admit there is always a chance there was contamination of the blood sample. I was drawing all kinds of crazy conclusions about how I had fried my skink. She assured me that the antibiotics will not hurt if there's no infection after all.

At the office, he pooped, and it was extremely runny. This is the first time I have ever seen a runny poo from him. Since we had it in front of us, they are going to go ahead and also do a fecal float and smear.

I asked how they know what is "normal" for a BTS. She said they have a database of averages from skinks over the years, and his uric acid level was well out of the normal range.

I asked about a correlation between the uric acid and the infection. The answer was maybe/maybe not. Having read about the case of Barley, I'm so very worried.

[SailleSkinklover]

Did you ask your vet how much personal experience she has with Skinks?
It just seems to me that her answers are very vague, especially regarding the infectiojn/eyes/antibiotics. At least she was up front about the possibility of blood-work contamination.
Is she treating for the twitch symptom then? I'm just wondering if I missed something.
Now this is a personal opinion/experience: I generally never advocate using antibiotics just for the "possibility" of infection. That's how "Superbugs" are born. I think antibiotics are wayyyyy over-prescribed, both for humans and animals, and I personally know sombody (ex-co-worker) whose immune system got completely screwed because of an OD of antibiotics prescribed to her for a "possible sinus infection".
I don't know if there are any online Herp vets you could ask, but to me, the vague answers and the easy prescription of antibiotics would warrant a second opinion and/or more questions if it were me. You are, after all giving this vet your business, and you deserve to know the credentials/experience of the people treating your precious pet.
As I said, this is only my opinion, and I tend to be a very over-protective Skink-mum! I truly hope your Skinky gets well very soon.

[Hijinks]

Hi, Saille - I did ask on my first visit if she has owned a BTS. The answer was no, but her vet school had one. I think I actually came across as insulting when I asked how they determined what is normal in their blood levels, since BTS aren't so popular. I'm really bad with tact.

She was actually excited to see a BTS, and really compassionate. But here's a funny thing: I don't think this animal hospital had ever admitted one before, because the people at front desk had to enter Blue Tongue Skink as a new breed in their registration system.

I am keeping the appointment I had at another clinic (for the eye) before I noticed his twitch. That's tomorrow, so I guess it will become a "2nd opinion" appointment. And I am supposed to go back in two weeks to have his blood tested again... the vet said she was going to be out, and I am to schedule the appointment with another herp vet at the clinic (who also works at a zoo, I hear). That's a 3rd opinion!

I really hope I don't mangle this, so someone please jump in and correct me if this doesn't make sense...I don't want to spread misinformation... As I understand it, the antibiotics were prescribed because of the bacteria seen in the blood. And then when/if the infection clears, it's time to check the uric acid levels again to see if the infection is what's messing with his kidneys. And messed up kidneys could mean problems with calcium, which would explain the twitch. Unfortunately all of the simple causes she suggested for the twitch don't apply to my skink -- dehydration, aromatic oils from substrate, living with a smoker.

<- me. This being my first skink, and indeed my first pet that's truly MINE (aside from a betta), I'm very deer-in-the-headlights about this. I have not seen another twitch, and he is still pretty active, alert, and he eats and drinks.

[Leigh]

The trouble with some vets is that they think they know it all, skinks aren't JUST ANOTHER HERP, if she's never treated one before she could be making educated guesses, dont worry about seeming to be insulting, if all you did was ask a question, she shouldnt be so defencive if she knows all that.I find they want to be ninjas and give it the big un . Have I ever treated a frog, no, but there's seven in my pond, doesnt make me an amphibian expert does it?I'm not trying to worry you, and any question you ask should be answered TRUTHFULLY, try "have you ever TREATED a BTS before" see what she replies and ask where her diagnosis and information came from, if its "the eye spy book of reptiles" its time to go else where, good luck and I hope your vet is cleverer than I'm giving her credit for.

[Zach]

Any new news?

[Lisa]

Best wishes I hope everything works out alright.
Aust herp vets have much more experience in blue tongues, and most have email and websites these days. You could always try contacting one of them for advice.

[Arkangel]

Give the vet the benefit of the doubt and trust in the decision making process. This vet was put into a position of an emergency and handled it well. Yes a person should have an experienced reptile (preferably BTS) vet on call, but that is not always possible, and was not the case here.

Injectable antibiotics are always recommended for severe infections and septicemia. (evidence of bacteria in blood) They are much more powerful and effective than oral antibiotics.

Good decision to give the shots yourself if you are comfortable doing so.

Did the vet mention gout?

Gout causes high uric acid levels and can cause systemic joint infections which may be evidenced by the septicemia and eye inflammation.

Since you are not able to see the original vet who treated your skink for a post visit followup, I would make the effort to track down a recommended reptile vet (possibly the eye appointment vet?) and stick with that vet if you like him or her. Good luck!