poor health/entamoeba therapy questions

[anig]

My female crested gecko stopped eating, became lethargic, and lost weight several weeks ago. She was brought to an exotic veterinarian where it was recommended to force feed daily, give calcium supplementation, and maintain hydration. She did not improve, and then her feces were tested negative for cryptosporidium, and positive for entamoeba. An abdominal ultrasound was unremarkable and showed no signs of impaction/intususeption or other disease.

I have been treating the suspected entamoeba infection in my crested gecko with metronidazole 25mg/kg by mouth every other day for 4 treatments. She is still anorexic, thin (pelvic bones visible, eyes sunken in), lethargic, and is unable to 'stick'. She has not lost any more weight, but hasn't gained any either (still only 9 grams..).

Should the metronidazole dose be increased? The 25 mg/kg dose was chosen because higher dosed have been shown to be fatal in snakes. On this forum it seems that doses of 100mg/kg and higher have been used with little side effects in crested geckos. Has anyone had problems using the higher dose? Has anyone had success with the lower dose of metronidazole? When should I see improvement with metronidazole treatment?

Some other information: the female gecko was purchased at the August Daytona show this year. She was about 10 grams when she was purchased and suspected to be about 5-6months old. Her appetite was great for about 1 month, then slowly declined. She rarely ate the cgd but readily ate crickets. Because of this, crickets were not offered often as to encourage consumption of the cgd. Several weeks ago she stopped being interested in crickets and seemed lethargic and thin. She has been unable to stick to walls for about 2 weeks. She is currently housed alone in a large critter keeper on paper towels, fake pothos plant, and a hide. CGD and water is always available. The cage is misted twice daily. The temp ranges from 72-76F. A UVB light was recently added during the day. She is force fed cgd daily and given calcium supplementation daily. She defecates about once daily and it is slightly watery and mucoid. I own one other female crested gecko who is housed separately and weighs 26 grams. She appears to be in good health.

ANY help would be much appreciated as this has been difficult for both me and my veterinarian. She has been doing very poorly and I am actually surprised she hasn't gotten worse.

Thanks again

[Andrew Gilpin]

I believe we treated our female that had E. invadens at 75mg/kg a couple of years ago. Have you read this information here?
Repashy Ventures - Retail Store - Resources :: Reptile Articles :: Entamoeba invadens-- AKA the Rhacodactylus Plague
Our female came out of it pretty well after probably 3 treatments, and throughout the last few treatments had started to gain weight.
Just be sure to not overly stress the gecko out while trying to treat it. Often times stress will kill them faster then the sickness will.

[JoeGecko]

I just went through the same thing for my male just a few months ago. He was down to 11 grams, pelvic and ribs showing, lathargic, etc..

I treated with metronidazole dissolved in a syrup (from the Vet) daily for 10 days. Sorry I cannot recall the dose but I will look around for the paperwork. I offered cgd and wax worms for 3+ weeks following (2 cans of 50 but I did offer a few to my other crestie) The live prey did help, I think, to stimulate the appitite but weight gain was slow in the begining for me. 1 gram first 2 weeks but had worked his way up to 20 grams near the end of his last batch of wax worms. I now have him switched back to CGD. Also worth mentioning that during this wax worm feast he had, I did not dust them on the idea they might be more appealing without the cal/d3 coating.

[anig]

Thanks for the advice. I have been worried about stressing her out too much - I force her mouth open nightly in order to get the medication and some food into her. I have to use a tongue depressor or ear swab to open her mouth and she really struggles. In the begining I was just dripping the food on her mouth and she would lick it, but she stopped licking and it was a mess. How do you force feed? and how much cgd do you use?

I offered crickets last night and she ate one!! I was very excited as it was the first time she was interested in over a month. She still can't stick to walls, but I guess that will take time? has anyone experienced non-stickyness for a while? She will get a few more days of 50mg/kg metronidazole (increased from 25 per the DVM) and force feedings...

[anig]

Does anyone have any other ideas?? She hasn't eaten a cricket since my post. She has now gotten about 10 days of metronidazole 50mg/kg daily and prior to that she got 25mg/kg every other day for a week. She continues to have no appetite, lethargy, and is unable to stick. Her weight remains at 9 to 10 grams depending on which scale she uses.

We force open her mouth nightly in order to give the medication and force feed about 0.3 mls (or less) of the CGD and a drop of calcium glubionate. She has not defecated since Saturday (3 days ago) and only urinates. Does that mean we should force feed more? Should we get the crested gecko diet e-fix and give that instead of the veterinary recommended dose of metronidazole? How long does the metronidazole therapy need to be given? When should I stop force feeding?

Please any other help would be useful..

[dcarter]

Could she have stuck shed on her feet preventing sticking? Also, are you sure she can't stick? I know that sounds funny, but try leaving her in the dark room for 20 minutes and then peeking- she may just be laying low because your around. I wouldn't stress the weight gain that will happen slowly and 3 mls is 3/4 teaspoon which is a lot at her weight so keep that up. Have you had the vet check for worms and run another fecal to ensure she is clean? Also, during treatment she needs her papertowels changed daily, fecals removed immediately, and the tank disinfected with a bleach water solution daily or as often as possible to prevent reinfection. Give her some time for the weight gain and have nother fecal checed