UT-VMC emergency room tails: “Puff,” the not so magic Dragon

UTVMC COLUMN HEADER  2By Dr. Amanda Rainey

We see all kinds of animals through the UT-VMC ER Service.  This includes exotic species such as reptiles, birds, and small mammals like rabbits, guinea pigs, and ferrets.  So I shouldn’t have been surprised when I found myself the doctor in charge of a type of lizard known as a bearded dragon last Saturday.  It was just before lunchtime when we received an ER page from the reception staff.  When I called up front to inquire about what had arrived, I was informed that it was a bearded dragon that had possibly had a seizure and was now having trouble breathing.  As this sounded very serious, I immediately sent one of my students to obtain the patient and bring it back for evaluation.  Little did I know how much I was about to learn!

I met my student over in the exotics ward, where she had placed the lizard in the carefully climate controlled reptile holding area.  We peeked into the glass cage to watch the patient, as I tried hard to assess its respiratory rate and effort.  The bearded dragon stared back at me unblinkingly, and seemed frozen in space.  I now know they do this when on the offensive, but at that moment I was concerned for its livelihood and with a tentative grasp reached into the cage to examine it more closely.  During this time the student relayed to me that it was a female named “Puff”, and she was roughly 6 months old. The owner saw her flopping around her cage for a short period of time and then when she righted herself she was opening and closing her mouth, with the spiky beard that encircles her neck waving back and forth. Puff was about as long and wide as my hand, and I gingerly placed her on the exam table to get a better look. All of a sudden, she began to open and close her mouth rapidly, flapping her beard furiously as it turned a dark brown, which was different from the sandy hue she had been moments before.   I was brave enough to get a peek inside her mouth and noted that her gums were pink, but threatened by this display I quickly put her back in the cage.  

Feeling out of my league in this situation, I phoned our exotics clinician on call for some guidance.  I was comforted by the fact that per the expert, Puff’s behavior seemed completely normal, and the open mouth with waving beard was meant to scare me off, which is exactly what it had done. She recommended we take radiographs of the lizard, as sometimes they can become constipated and when they strain to have a bowel movement the appearance can be quite alarming. Speaking with the owners provided a bit more information, as they informed us that they had recently begun feeding her larger crickets, and the exotics clinician had specifically mentioned that the hard outer skeleton of insects could lead to impaction in this species. Performing radiographs of a lizard was another first for me, but thankfully Puff lay quietly in a small box while we took a whole body shot.  Her GI tract did look quite distended, so our tentative diagnosis was nothing more complicated than a bout of constipation. We instructed the owners to administer a stool softener, feed smaller insects, and soak her daily in some warm water, as these animals absorb water through their skin. Puff was returned to her relieved owners, and I felt like I had been quite educated by the end of her visit!

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