Antibiotics for a gum problem?

Oreo · Member Joined: Sep 27, 2005 Posts: 10

Does anyone know what antibiotics are safe to give a tegu? I have a vet that is wanting to give my tegu Amikacin(an aminoglycoside) for something that looks like a mild stomatitis. My tegu is still eating but his left lower gum is swollen and has been for a while. If anyone has any ideas besides antibiotics please let me know. Thanks.

alex · Valued Member Joined: Aug 03, 2005 Posts: 106

What's your objection to amikacin? It's almost certainly a bacterial stomatitis in a reptile, so why not treat it before your tegu is no longer wanting to eat? Home remedies like H2O2 or tea tree oil or chlorhexidine as an oral scrub range from a tissue irritant (which won't resolve the problem) to outright toxic (the tea tree oil) Aminoglycosides are safe, effective and require fewer doses. If you're looking for antibiotics that are specifically approved for reptiles, even enrofloxacin (Baytril) isn't approved for them. Nothing is, it's all off label when it comes to exotics (actually, amikacin isn't on label for anything beyond a post-parturient metritis in mares, but we use it in everything).

MO · Posted: Tue Sep 27, 2005 5:04 pm Post subject:

Hey Alex, are you a vet student or vet tech or vet? I'm a vet tech and you seem pretty educated about drugs ect.....

alex · Valued Member Joined: Aug 03, 2005 Posts: 106

I am an undergraduate vet... I can't practice yet, but I'm almost done classes. Before this I did a BSc in animal biology and I've worked in clinics each summer from when I was 13 until I finished my first undergrad... I've also dealt with rescued and often quite sick RES for years and years... there was a two year period where I continuously was treating at least one turtle for shell rot.
What kind of practice are you in?

Oreo · Member Joined: Sep 27, 2005 Posts: 10

I am not objecting to the Amikacin. I was concerned regarding the nephrotoxic effects and if it was safe in my pet. I am a Physician Assistant and treat people with different parenteral antibiotics on a regular basis and if possible I try to avoid aminoglycosides due to the risks of nephrotoxicity and ototoxicity. I have never tried to give injections of the stuff to my lizard, thus my concern. Thank you for the information.

alex · Valued Member Joined: Aug 03, 2005 Posts: 106

Then as you should know, all the aminoglycosides have nephrotoxic effects based on length of exposure due to poor dosaging rather than whether they're inappropriate for therapy. You tend not to need much therapy with them (i.e. every other day is typical in reptiles), and they're dosed far less aggressively than I've ever found in human medicine (I've rarely found a doctor who actually understands what their drugs do in the body and dosed me based on the fact my body weight is 40% below the 70 kg human pills are formulated fort) and usually you're told to keep the animal hydrated. Less frequent higher dosing is much safer than low daily doses since nephrotoxicity is culmulative. Feed a high calcium and protein diet and the risk of nephrotoxicity is negligible. With my turtles I used to give amikacin or gentamicin only after I'd seen them eat in the water, if you're super concerned either give a few cc's of water orally with a syringe with the administration of ABs, or if you can get sterile lactated ringers from work give a cc or 2 SQ with administration of the drug.

Any of your other antibiotic choices for the stomatitis, given it's likely gram negative, will have other side effects that do vary from species to species, but the exciting stuff is rare. I've taken ciprofloxacin and not yet had my calcanean tendons spontaneously rupture, but you give me sulphonamides and I go into anaphylaxis. Look at polymixin B, which is extremely toxic but people smear it on themselves as part of polysporin all the freakin' time 'cause they're probably happily unaware. It all depends on understanding how you're supposed to use a pharmaceutical.

Teiidae · Posted: Tue Sep 27, 2005 9:45 pm Post subject:

^^^ - That's exactly what I was going to say lol - Is good to have you here Alex

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MO · Posted: Tue Sep 27, 2005 9:52 pm Post subject:

Hi ALex,
I've mostly worked in small animal practices, recently joined a team that treats excotics. It's been really fun. Removed eggs from an eggbound Iguana yesterday. Fun times that one!

Did a fecal on my new beardie the other day and he was loaded with Coccidia! Going to start the whole Albon process and repeat fecal in 10 days. I talked with the breeder at Sunshine dragons who told me that most beardies have low levels of Cocci. Don't they reproduce and multiply? She also told me that Albon dehydrates beardies so they treat theirs with 3 days on Albon and then 3 days off. I would think that treating them that sporadically would kill off the weaker bacteria first and leave the stronger ones around to multiply. Does that make any sense? I'm kind of new to the whole reptile thing so feel free to correct me if I'm wrong. My herp vet is recommending to treat for 10 days then repeat fecal to see where were at. Any comments?

alex · Valued Member Joined: Aug 03, 2005 Posts: 106

Weee.... you're braver than I. I want nothing to do with clinical practice. Disease is more interesting after the animal is dead from it from my point of view...

Anyway, any idea what genus you had in your beardie? Some coccidia are more pathogenic than others (like Eimeria) but lizards contain a whole spectrum... some are non pathogenic, some are (kind of like the situation in chickens, if you have any poultry background). Mostly the problem occurs when the animal is compromised and everything gets out of whack... that's why healthy animals can carry around a low level burden and they're okay until something happens. One of my turtles was nearly completely starved when I found her (so thin she couldn't have IM or SQ drugs!) and she had coccidial overgrowth into her stomach, which was bad but resolved quite quickly with one of the sulfas (can't remember anymore which one she was on)

Anyway, I can't see how treating with sulfadimethoxine (I think that's Albon, isn't it?) would really be bad. While intermittent treatments would promote bacterial resistance in the method you describe, coccidia aren't bacteria, they're protozoal parasites with a rather complex lifecycle that can involve a few organ systems (sulphonamides are actually antimicrobials rather than antibiotics due to a wide spectrum of non-bacterial killing). The 10 days is certainly reasonable, but bear in mind that fecal shedding is supposed to be quite rare... you might have to do a few fecal followups at intervals to declare it truly negative. I don't know if sulphas dehydrate beardies, they certainly can have some side effects... mild fluid therapy would be good if you see signs of dehydration. Clean the cage really well during and after therapy and you should be okay.

I like parasites. They're so fun and complex...