 Health Concerns and Drug Sensitivity
Baytril... commonly prescribed broad spectrum antibiotic. In melleri, it can cause edema, lethargy, anorexia1, and in anaphylactic reactions, immediate fatality.2 Any melleri patient on Baytril should be kept very well hydrated and kidney function (uric production) and appetite should be watched closely.3 Common sense says it is safer to have a culture and sensitivity done to determine the best antibiotic for the job, rather than waste time and risk by "shotgunning" with Baytril first. Up to two weeks is the standard duration a chameleon should get Baytril.4 A melleri has died of renal complications after three weeks on Baytril.5
Ivermectin...anthelmintic (parasite control). First reaction is that of the worms to the drug, which causes an inflammatory response throughout the chameleons' body. This can be fatal with or without steroid support. If the animal survives the inflammatory response, the suddenly dead load of parasites goes toxic inside the body (sepsis or bacteremia), or clots/blockages of young microfilaria, causing death of the animal.6 A safer method is to use fenbendazole to reduce parasites over several weeks, then try a low dose with ivermectin to remove any remaining parasites. Other vets recommend never using ivermectin (nor moxidectin or any of the "-ectins") for parasites in Old World Chameleons.
IMPORTANT: During any drug regimen, increase hydration and use rain chamber/shower methods to assist the kidneys. After any drug regimen, replenish the natural intestinal flora with commercial reptile probiotics like NutriBac df or milk-free Acidophilus powder. Dust on prey once a week. Failure to restore digestive beneficial bacteria can result in increased weakness or illness.7
Vitamin injections... Old World (True) Chameleons have a record of fatality within 48 hours of receiving Vitamin injections.8 These animals should only get vitamins through a nutritious prey gutload, fresh fruits and vegetables, and the very careful use of Minerall or similar prepared reptile supplements. Oral dosing of calcium liquid (Neocalglucon, etc.) is safe, but is only for use in extreme circumstances. At-risk animals that can benefit from calcium solutions are fresh imports, gravid females, and for females in oviposition contractions. It should be used with the advice of a veterinarian. Routine use of Neocalglucon or other liquid Calcium products should not be considered a replacement for routine supplementation and/or gutloading.
Other Common Health Issues in Melleri
Parasites
All wildcaught (WC) melleri come with a range of parasites. Younger and smaller specimens usually have less severe infestations. Melleri from pet shops or internet dealers will need to be seen immediately by a vet for skin and fecal parasite exams. Many dealers only give one low dose of fenbendazole (Panacur or Safeguard dewormer) prior to sale, and expect you, the consumer, will do the rest. Melleri are a special parasite concern because
1. Ivermectin can only be used on them after several fenbendazole treatments (see Drug Sensitivity above)
2. Melleri carry some new intestinal parasites some vets have never seen before
3. They come in such a range of weights-to-lengths, you should have a vet calculate dosage for safety
Two new parasites, discovered in 2000, in melleri are Eimeria bohemii and Isospora necasi. Please direct your vet to this link for identification.
Animals from all over the world pass through import facilities, and not all facilities have been able to keep pathogens from spreading between species. WC chameleons are contracting parasites which are not natural to them via the importation process and cross-contamination. Two extremely deadly and highly transmissible parasites that have reached the chameleon community are Reptile Cryptosporidium and Hexamita salmonis. Crypto is particularly difficult to spy in fecal exams, which can result in false "clean" fecal results. Internally, it causes fatal intestinal inflammation, but externally, it looks like a rapid wasting in some patients. Others are asymptomatic carriers. It is transmitted by fecal-oral contamination, and none of the standard cleaning agents will kill the oocysts. One gecko forum indicates that the veterinary disinfectant Neopredisan 135-1 is effective. Disinfectant solution must have 20 minutes direct (wet) contact with surfaces, as the oocysts are extremely tough. The oocysts can persist for months on improperly cleaned surfaces and substrates. One keeper reported a CB melleri that contracted Crypto from an asymptomatic WC, possibly by eating a prey item that came into contact with feces. The WCs in the collection had already passed three fecals by a herp vet, and these were the only reptiles in the collection. After the CB had been introduced for breeding, another vet's parasitologist found Crypto oocysts in a fecal when the CB melleri was seen on referral for an unrelated issue. Many recommend immediately euthanizing any infected animals to avoid spread of the parasite, but the referral vet prescribed oral Paromomycin. This has been used to control (but nothing cures) Crypto in reptiles. The CB died on the second day of treatment. Reptile Crypto strains have not yet become zoonotic to humans and other mammals. It should not be confused with mammalian Crytpo strains.
Hexamita salmonis has not yet been reported in melleri, but has come in 2007 WC Johnston's chameleons. This flagellate originates from live fish imports, illustrating an even greater cross-contamination problem before retail. H. salmonis has been called a "collection killer". It can be cured with Ronidazole with low risk of side effects, but requires thorough sterilization of cages and surfaces.
In sterilizing both types of tenacious parasite infections, all permeable surfaces, including plants, must be discarded. Since WC chameleons are distributed to retailers by a finite number of import facilities, it is only a matter of time before it contaminates other imported chameleon species. These two parasites are strong reasons to have your next WC melleri fecals sent to state parasitologists or university parasitology departments to be absolutely certain they are clean.
After each parasite treatment phase, it is normal for melleri to show a temporary collar edema from the burden of parasites dying (and possibly going septic) in the body. If edema does not subside a few days after the final round of treatment, the animal may be dehydrated and in renal failure. Increase hydration and alert your vet.
WC melleri can host various blood parasites, such as pyroplasms and hemoplasma. If you have blood drawn or smeared from your melleri, your vet may find blood parasites, but current veterinary technology may not be able to eradicate them all. Some are newly discovered and drug sensitivity is unknown. Your vet will advise you if the blood parasite load is enough of a threat to warrant experimentation with medications. A major problem in WC melleri are Microfilaria, worms that are spread via mosquitoes and other arthropods. Most pet owners are familiar with heartworms in dogs, which are similar but less savage to their hosts. Microfilaria of the Foleyella family have subadult and adult stage worms that do not restrict themselves to the cardiovascular system. These worms burrow throughout the chameleon's body organs, and depending on where they go, can kill it slowly over years or suddenly by cutting an artery. There is conflicting opinion on whether or not Ivermectin is a good gamble for destroying these worms in WC captives. Some keepers use a system of several high doses of fenbendazole, followed by two low doses of ivermectin. Some veterinarians say that repeated surgical removals via endoscopy is the only safe option. The most frustrating part about WCs infected with Foleyella is that they can have clean fecals and appear in perfect health right before sudden death by a wayward worm. The only way to detect these worms, apart from a lucky ultrasound, is to do repeated blood smears over several weeks to catch any eggs and early stage worms in the blood, during each lifecycle. At some stages, there may not be any signs in the blood because all are mature. If you are wondering why a parasite would harm its host, it appears that these worms live on at least several days past the death of their host. If they aren't affected by the adverse effects of refrigeration and decay of the host, it's a reasonable guess that in the wild, they may live on to parasitize whatever eats the chameleon.
The Infamous Skin Necrosis
There are a lot of rumors about the disfiguring skin malady known as "the melleri necrosis" or "dorsal necrosis". Despite this label, it commonly occurs on the caudal crest, dorsum, and occipital lobes. It starts as a slight discoloration of the affected area. The area loses color changing capability, turns brown, dessicates, and sloughs off. Severe and long-term infection can result in loss of the entire dorsal crest, down to muscle or spine, and complete loss of the occipital lobes. Fungal infections use their mycotoxins to dissolve cell walls, consume the cell contents, and the sloughing continues to each new limit.9 Surgical removal of the affected areas can exacerbate the condition, as loss of circulation continues at the new wound limits. The decorative elements of the melleri's anatomy appear to have reduced circulation in the best of conditions, let alone under duress.10 The infecting culprit must be pinpointed and treated. Loss of lobes is of great concern for breeders because occipital lobe flipping is an important courtship cue of male melleri.11 This skin condition is not limited to wildcaught melleri, it can occur in all melleri. It starts as a mild abrasion, lesion, or burn of the skin, which is then infected by opportunistic bacteria or fungi. It can spontaneously appear (fungi only) in immunocompromised animals (and humans), without a prior skin injury. Stress suppresses the immune system.12 Course of treatment is to apply topical antiseptic solution (chlorhexidine) and Silvadene cream; if it shows no improvement, it may be fungal. If fungal, treat topically with Betadine gel, or a stronger fungicide ointment.13 Have your vet peel back some of the crust or attached shed, dab the fresh surface against a slide, and do a gram stain to determine what is present.14 Putting the chameleon under and taking a biopsy is not necessary. Past keepers have found necrosis caused by Staph infections15, Fusarium oxysporum16, and yeast17. Reduce risk of your melleri developing this condition by keeping your heat lamp bulbs at least 6" from the top of the cage ceiling screen, rearrange lower basking perches to suit the growth of your young melleri, and check the entire skin surface as part of your once-a-week melleri home exam. In the past, owners have let it go too long untreated because the melleri does not show any discomfort from the condition.18 Early detection saves lobes!
Early stage of lobe necrosis in CB, caused by yeast infected abrasions/photo K. Francis |
Edge and underside of affected lobe/photo K. Francis |
Same animal after 1 month of treatment, necrotic progress halted; red and orange is betadine stain /photos K. Francis |
Necrosis healed, scab lost months later / photo K. Francis |
Necrosis Myths
Dorsal necrosis is highly contagious disease from Africa; it will disfigure your entire collection.
It is not a disease from the wild that will spread to other melleri. Melleri kept in pairs or groups that exhibit the same area of infection have all burned themselves on the same basking perch. One melleri in a group had a unique habit of squeezing into a space too small for it, abraded the topmost edges of its lobes, and was the only one to get necrosis. No wild animals were even owned prior to nor at the time of detection. There are opportunistic organisms even in the most controlled of captive environments; an immune-suppressed chameleon or an opening in otherwise healthy skin is prime real estate for them.
This condition is how to tell WC from truly CH or CB melleri.
No, it can occur in the cleanest of CBs, too. Bacteria and fungi are present in all environments, and when skin of any melleri is compromised, these organisms move in. It is most commonly seen in captive burn victims and in WC specimens' importation injuries. Breeding adults are at risk, as the courtship ritual involves paw slapping and rostral butting that could open the skin. Check your breeders daily while they are in courtship season.
Fungal Infections
There is a deadly fungal infection that is seen on WC imports of various species of reptiles. No one has done lab tests to prove if the condition called "yellow fungus" in bearded dragons, or CANV in other reptiles, is the same as this condition. It is suspected to be CANV because both types of its lesions meet the CANV description. It presents symptoms the same way in each chameleon species. A WC may be asymptomatic while infected, and only importation stress over months creates the lowered immunity needed for the disease to take hold. The infected chameleon in its early stage cannot hold hydration, no matter how well acclimated it was, no matter what veterinary support. The parietal areas of the head sink. The lateral portions of the body, particularly the flanks, break out with fine, raised pale pink, yellow, or peach-colored "warts". These fleshy growths can be peeled back to reveal bleeding tissue beneath. This spreads overnight to warts on the limbs, face, turrets, crests, etc. Some chameleons only get warts restricted to one area, such as the turrets, for the duration of their illness. Other growths, appearing as fluid-filled blisters, may appear in addition to, or instead of, the warts. Any chameleon showing either type of growth needs to be quarantined and started on appropriate oral meds immediately. Disease progression to death is remarkably fast without proper drugs, and some chameleons will keep eating as normal even though covered with warts. WC sellers have advertised infected chameleons for sale, they hide their other symptoms so well. Some chameleons die within a week or so of showing symptoms. Morbidity (infected number) is very close to mortality rate (death from infected) with this condition, if left untreated. Drugs known to have cured melleri with this condition are Fluconazole oral, with Amakacin antibiotic injectable to target opportunistic bacteria; drugs that worked for other chameleon species are topical Miconazole and Itraconazole; a drug that did not work on a chameleon was topical over-the-counter antifungal with a Baytril oral for bacteria. Properly medicated chameleons can recover in about 30-60 days with minimal to zero scarring.
"The treatment that seems to work is treating with Flagyl and Baytril internally and Surolan (Miconazole) externally. What kills them is dehydration. They have to be hydrated every day for at least 30 minutes." - Brion Miller
Fungal "warts" lesions in flank /photo K. Francis
More lesions on head /photo K. Francis
Recovery shedding scabs of fungal lesions /photo K. Francis
Preventative caging
Melleri are prone to falls, clumsy in the best of conditions, and there is even a legend "explaining" their falls in their homeland.19 They are big, heavy, they assume they can fit through tiny spaces, and perch on weak plants. To reduce injury, consider attaching soft neoprene foam rings over the top edges of your live plants' pots, add Equirap injury wrap to branches for grip, and either moss or foam under plastic on the cage/free-range floor. You may have to cut your own materials to cover all hard surfaces and edges, use care. Young people, please have adult supervision when cutting (even adults may find it necessary to have help when cutting large sheets of foam). Falls are frequently fatal in melleri.
If you witness the fall or find a fallen chameleon: let the chameleon take a breath, right itself, and test its limbs. Do not grab it or place it on a perch until you can see that it has no broken limbs. If you see a leg that won't grab or see an obvious fracture, seek immediate veterinary help. Bones can be set and there are low-impact methods of bracing the break that allow a chameleon to live normally while it heals. Paralysis in melleri has occurred.20 If the animal doesn't start moving its entire body after 30 minutes, it is in need of veterinary intervention (euthanasia).
Use coated screen, shadecloth, or free-range indoors to reduce the occurrence of foot injuries. These can go unnoticed, and result in severe infections in less than a week. These infections are impossible to overcome without immediate and aggressive drug therapy, and frequently result in the animal's death.
Advanced ulcerative pododermatitis from incorrect caging / photo K. Francis
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Fatty Liver Disease
Hepatic lipidosis can occur as a result of an excessively fatty diet, or in conjunction with starvation or anorexia. There may be liver damage from a back-up of excess gall fluid (an enlarged gall bladder may be evident). The affected liver becomes extremely swollen and turns a pale or splotchy color. Female chameleons with this condition may have excessively large abdominal fat pads. Chameleons that eat large amounts of fatty prey like beetle larvae, caterpillars and moth worms (silk, horn, wax), without a low fat chitin and veggie balance, are prone to this condition. Two keepers, living hundreds of miles apart, compared livers of clutchmates that died about 2 weeks apart, of different causes. Each keeper fed different amounts, frequencies, and species of prey, which appear to be key to prevention. See Feeding for the recommended quantity, schedule, and gutload. More about this condition will be posted as it becomes available.
Here is a French paper on hepatic lipidosis in melleri.
1. Pale, enlarged liver in melleri yearling. /photo private keeper
2. Fatty liver in related species, deremensis. /photo private keeper
3. Healthy liver of melleri yearling (clutchmate of first photo). /photo K. Francis
Reptiles Feel Pain, Too!
One of the most important medical improvements for chameleons in a long time is the recognition that they experience pain, and the management of their pain. For melleri, continuous and severe pain induces stress that cannot be alleviated with ordinary care. This stress speeds the downward spiral that kills so many melleri, particularly fresh and injured WCs. Two veterinarian-provided prescription drugs that work well for pain management in melleri are Rimadyl liquid and Bupiricaine injectable. The Rimadyl is oily, which means it cannot be dependably diluted into a flavored solution in a bottle. One option is to load an oral dosing syringe with 0.05 of fruit juice or Pedialyte, pull back the plunger just enough to allow a tiny air bubble in the nozzle of the oral syringe, and using a needle syringe loaded with Rimadyl, float the dosage of the oily Rimadyl on top of the juice. This makes oral dosing of a single drop of Rimadyl safe and pleasant for the patient, no needle. The difference after a single dose of Rimadyl is readily apparent within 3 hours. A treated melleri can go from lethargic, anorexic, aggressive, and stress colors to relaxed colors, active, tolerant, and hunting.
A Google search for Rimadyl will turn up at least three different web sites warning of adverse side effects in canines. If you look at each one of the sites, you'll note that they are all owned by one competing drug company. It is wise to be alert for bad reactions to any drug, but take the source of some warnings into consideration.
The Bupiricaine is not only useful as a local injectable anaesthetic for minor procedures, but a single drop can be applied topically to skin to provide pain relief. Pain medication is not meant to be a long-term solution, but a short-term assist until the patient is well on the way to healing.
1. multiple pers. comm. E. Adrignola, C. Carne; pers. exp. K. Francis
2. pers. comm. C. Carne
3. multiple vets' recommendation
4. "Baytril/Enrofloxacin... and the Bacteria that Fear It" by Bill Strand, Chameleon News Ezine, 1/2003.
5. pers. exp. K. Francis
6. pers. comm. C. Carne
7. http://reptileuv.tripod.com/probiotics.htm
8. pers. comm. Joe (JOEJAMR1432) 6/17/2005; ADCHAM Yahoo group messages #12493-12502
9. http://www.narconews.com regarding fungal infections
10. http://my.execpc.com/~jkrolik/Paleoneurophysiology.htm Of interest to melleri keepers, the discussion of how stress leads to loss of sexual ornamentation ( horns, occipital flaps, dorsal crests) due to constricted circulation and hypertension. We all know melleri are among the most easily stressed chameleons, and that the rostral "horns" (annulated conical scales) produce little or no blood when they are knocked off.
11. mention of lobe flipping in courtship context: M. Corraggio, Meller's Chameleon Caresheet, p. 2, 1/28/2000;
K. Kalisch, "Meller's Chameleon profile, Part II", Chameleon information Network, newsletter #21, p. 25;
http://www.chameleonnews.com/year2002/nov2002/melleriprofile/melleri_profile.html; and pers. exp. K. Francis.
12. The Chameleon Handbook, LeBerre et al, Barron's, 2000, p. 86
13. The Chameleon Handbook, LeBerre et al, Barron's, 2000, p. 86
14. Dr. Hall, 11/22/2005
15. pers. comm. C. Carne
16. The Chameleon Handbook, LeBerre et al, Barron's, 2000, p. 86
17. identified by Dr. Hall, 11/22/2005 Note: yeast infections in animals are caused by Candida species, not by the kind of yeast used in baking. It is safe to use active dry baking yeast or Brewer's Yeast as gutload supplements.
18. pers. exp. K. Francis; multiple pers. comm. and group posts from other keepers
19. A. Abate, "Meller's Chameleon profile, Part I", Chameleon information Network, newsletter #21, p. 22
20. pers. comm. C. Carne; pers. exp. K. Francis 2/18/2005 |
