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 Possible genetic metabolic/malabsorbtion disorder????

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PostSubject: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 8:24 am

Though it still pains me to talk of it, I am going to share a few stories with you. I have an issue going on in my home, and a recent inquiry on the boards has convinced me that I am not alone in the issues that we are facing.

I recently asked if anyone had any evidence of any mal-absorbtion disorders in their gliders (other than cancer). I am suspecting that this is the case in two of my gliders – possibly a third.

Here are the details as best as I can remember. Because I don't know what is relevant and what is not, I'm putting down everything I can remember. This is LOOOONG. I apologize.



Dumplin – OOP 10/24/09
Parents: Morsel & Kibble


Dot Com & Encore – OOP 02/07/10
Parents: Morsel & Kibble


All of these gliders were born in my home and handled by me from day one.

All of these gliders have the same parents. Morsel and Kibble had 6 joeys total before Morsel was neutered:
Smidgen (WF M) & Dollop (WF F)
Drizzle (Mosaic F) & Dumplin (WF F)
Dot com (Gray F) & Encore (Leu F)

When Dot and Encore were 6 weeks OOP, Kibble was killed in an accident. They transitioned very easily to eating well with the family, and I supplemented them both once daily for one week with joey BML.

Dumplin’s development was unremarkable. She developed normally and I was never given cause for concern. There were two things to note with her: her nails grew very quickly and were very, very thin and soft. I could bend them. Cutting them was much like cutting paper. They were very strange. Also, she was pretty small – weighing 65 grams at her largest.

Dot was always very small. She continued to grow, but she was 7 grams when she came OOP. I didn’t worry too much about it because, even though everyone told me it was very small, ALL of Kibble and Tid-bit’s joeys were 7-10 grams the day they were OOP. At the time of Kibble’s death, (at 6 weeks OOP), Dot weighed only 20 grams. Her twin, Encore, was 39 grams at that time. They were both small, but Dot way much more so.

Nonetheless, Dot and Encore both developed normally and had a clean bill of health upon their first wellness exam (May of 2010). Neither of them ever gained a lot of weight, though. They played well, ate well, moved well. They were beautiful little babies – little being the operative word.

Dot remained very small. Encore grew much more than Dot, but today she weighs only 52 grams. I used to show dot to people and comment that she still looks like a joey.


In March of 2011, I noticed that Dumplin was having a difficult time getting around in the cage. I thought that it was because I had been neglectful in doing nails on time. So, I clipped her nails and didn’t think much more about it. I left for the RRRoundup. I returned two days later and found that she could hardly climb at all and was unable to grip anything. Dot was showing signs of this as well. So, I pulled them from the colony and put them both in a hospital cage in my bedroom where I could keep an eye on them.

They went to the vet in Amarillo and got started on antibiotics (amoxi) until I could get them to Tulsa the next weekend.

That week I watched them closely and was horrified to realize that Dumplin was much worse off than I thought. The colony they had lived in had 5 WF gliders in it – 4 of which were girls and one of which looks identical to Dumplin (I can only tell them apart by personality). I believe now that the glider I THOUGHT I was seeing eating and playing as Dumplin and Tid Bit was always just Tid-Bit. So, I believe that I missed Dumplin’s decline. :(

Dumplin was unable to grip anything with either hand. She also had a very odd gait – her legs were turned out at the hips and her arms were turned out at the shoulders. She waddled and was unable to get her belly off the ground.

Dot was able to climb and grip, but it was very slow going. She did get in the wheel every night and go for a stroll. I never saw her run.

Neither girl ate very well. I suspected that they had metabolic bone disease from either an infection or from being chased away from the food by their daddy who is very food aggressive.

We went to see Dr. Walsh. We decided to do bloodwork on Dot and x-rays on Dumplin and use those to make a diagnosis. They also had a group fecal and urinalysis.

Bloodwork came back very strange. Calcium was very low, as was Magnesium and a few other minerals (can’t remember which) and then there were things that were normal.

Nothing turned up on fecal float or smear. We collected more poop at the vet office which I took to the lab for centrifuge testing and SNAP test and still both were negative.

Urinalysis was also normal.

-----------♥♥♥♥♥♥♥♥-----------
~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.


Last edited by Something_To_Believe_In on Sun Nov 06, 2011 8:55 am; edited 1 time in total
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 8:27 am

X-rays were very telling. They revealed very poor bone density and curved long bones!


OK, so I had a diagnosis. I have treated HLP here 15+ times successfully. 3 of those gliders were so advanced in their Metabolic Bone Disease that they were unable to use ANY leg appropriately. So, I felt confident.

On the date of this vet visit, Dot weighed 42 grams and Dumplin weighed 63 grams.

So, I was encouraged that these girls would get better. We decided to treat with a few days of Panacur just to be safe. We also treated with Clavamox, a shot of convenia to each girl and liquid calcium supplements. The thinking was that there might be an underlying infection contributing to the metabolic bone disease.

I began feeding the girls a pureed diet because they would not eat well. They ate this much better. I was giving them the extra calcium and using critical care in their food.

I noticed no change in their mobility, but both girls did have increased (slightly) appetites.

For 6 weeks we kept this up, but I was not seeing much difference. We returned to the vet on May 13, 2011 for follow up x-rays. The x-rays did not show much improvement. There was SLIGHT improvement in that the joints/ends of the bones were more dense now. WTH? Most gliders that I have treated were much improved after just a few weeks. These girls were not responding to treatment.

I was quite despondent at the time. We discussed euthanasia and I just could not do it. Dr. Walsh said that there was SOME improvement, so let’s try calcium injections AND oral calcium supplements and see how that works.
So, that is what we did.

The next 3 months are a blurry mess for me due to a number of personal tragedies, a significant lupus flare up, some issues at work, issues with my son and a large number of animal emergencies (I had 6 emergency vet visits in 7 weeks). I take full responsibility for not putting two and two together before this point. But, upon the death of another of my gliders, I had one of those “Ah-ha” moments that made me think that this might be a malabsorbtion problem.

During this 3 months, Dot had declined. She was no longer climbing at all and rarely got in the wheel. They still did not eat great, but they would eat soft solid foods now (veggies and fruits). Dumplin had lost weight. They were happy girls who loved to snuggle in my bra and LOVED, LOVED, LOVED yogurt drops. They both came running (as best they could) each morning for their yogurt drops and they would chirp and chirp for them.

At the same time as the “ah-ha” moment, Dot began straining to poop. So, we returned to Tulsa again on August 20. I was concerned that she was impacted, and I know too well how very poor the prognosis is if a glider is impacted. However, while Dr. Walsh was examining her, she pooped. It was a very tiny poop, but it was poop – three times. So, he said she was not impacted, but he could tell that she was full of poop and it didn’t feel like she had good motility. We talked about the malabsorbtion theory and about possible dismotility in the digestive system. Again, we discussed euthanasia.

I don’t know why I decided not to euthanize except they were active and happy. They just were not able to live WELL. But, I had hope. Dr. Walsh is always great about giving hope and reminding me of all the “hopeless” cases in my home that are thriving now. Dr. Walsh felt that we could make progress and he said he was going to do some research on things that might help improve their gut motility and then encouraged me to continue mixing the critical care into their food. We also discussed some other enzymes that might help. They were given calcium EDTA shots and we also decided that I would feed them pumpkin regularly and utilize a bit of mineral oil to get their bowels moving a bit.

The mineral oil resulted in massive bowel movements from both girls and they both started eating much better. I thought we were on the right track finally!!! By Labor Day (2 weeks later) the girls were eating almost full servings of their food. Previously, they did not eat one full serving between the two of them, so this was a great improvement.

On Saturday, Sept. 10 (three weeks after vet visit), I got up in the morning and found Dumplin cold and seizing. Before I could unload my emergency kit, she passed away. I could feel what I thought was a mass in her stomach.

I took her in for a necropsy and histopathology on Monday.

Monday night, Dot Com cleaned her plate AND ate 2 yogies Tuesday morning.

Four days after Dumplin’s death, on Wednesday, Sept. 14, Dot Com passed away. Again, her stomach felt like there was a mass in it.

I was just devastated and felt like such a failure. I took Dumplin in for necropsy and histopathology as well and asked for a different pathologist to perform her testing (different from the pathologist that did Dumplin’s). I did this so I could compare what they found.

Here are excerpts from Dumplin’s necropsy:
Dumplin weighed 50 grams upon her death.

Quote :
Digestive System:
The large intestine is quite distended with inspissated fecal material. The distention extends the entire
length of the colon, proximally to the cecum. The stomach contains fluid grumous material and the
gastric wall is reddened. The small intestine is empty.
Quote :
Musculoskeletal System:
There is mild curvature of the femurs and humeruses. The mid shaft of these long bones are thickened.
The radius/ulnas and tibias are softened and can be bent to an acute angle without fracturing.
Quote :
Long Bones (findings similar in all) - The cortex is quite thickened but porous with intra spicular space.
The bone consists of osteoid but reduced mineralization is present

Quote :
The histologic findings are interpreted to represent a metabolic bone disease resulting in reduced bone
density. This could be due to dysplastic bone formation or bony resorption. A metabolic disease or
nutritional defect is considered most likely

These are excerpts from Dot Com’s reports:
Dot weighed 39 grams at the time of her death.

Quote :
Digestive System: Diffusely the large intestine is moderately distended with pasty fecal material. The
small intestine is dilated with gas.

Quote :
Musculoskeletal System: The long bones of the limbs are pliable and curved with an increase in
thickness of the cortex.

Quote :
Comment:
The diffuse intestinal dilatation is presumed to be the result of an impaction and is likely the immediate
cause of death of this animal. The long bone pathology is presumed to be the result of a metabolic bone
disease although given the age of the animal a congenital factor cannot be excluded.

****************************************
Why did these girls not respond to treatment? What caused them to be unable to absorb nutrients from their food?

It is too late for these two, but not for others. When I asked on the boards about malabsorbtion disorders, I had a few people contact me. I hope they will learn from my loss and gain knowledge that I did not. There has to be an answer for these babies.

Looking back, there are things I would do differently and other tests I would have run. I just didn't put it together fast enough for these two girls.

As an aside, during this time, Dollop (also born to Morsel and Kibble) was attacked by the colony and sustained a very large wound – so large that infection set in and she went septic despite two convenia shots, oral antibiotics, a topical antibiotic and QuickDerm. She passed away on August 14. Cause of death on her necropsy was sepsis. Her wound was very large and very deep, but I wonder if she just had no immune defenses to fight against infection. With all that she was given, infection should not have been the cause of her death. I just include this in case it becomes relevant later on.

Dollop was not tiny. LOL. She weighed 115 grams upon her death.

*******************************************
Recently, Encore began to move irregularly and to have poor grip on her front left hand. My heart dropped. I took her in and Dr. Walsh found a fracture of her arm near the shoulder. Her bone density was slightly poor, but nothing like Dumplin’s. So, for right now, I am treating her like it is a fracture, but I am still concerned. She is small (52 grams) and does not climb well at all. With the decreased bone density, will she heal? She still runs in the wheel and plays with toys and eats very well, but I have pulled her from the colony and have her in a hospital cage in my bedroom now.

When she returns for a follow up visit, she will undergo some thyroid/parathyroid testing.

Morsel and Kibble had 6 babies. 3 of them are now deceased. 4 of them (all female) have shown difficulty healing and/or poor bone density. 3 of them were/are very tiny.

In case weight does play a part, here are the other two babies’ weights:
Drizzle: 76 grams
Smidgen: 127 grams

********************************************
Morsel also had 4 babies with Tid-bit.
None of these babies have shown any signs of illness. ONE of those babies (CASH) went to live with Roya and was mated to Moxy and Mojo. They had several babies that Roya sold or gave away. To be honest, I don’t yet know how many babies or where they are (except one of them). Last year, Cash, Mojo and Moxy came back to live with me with two of their sons (Gotham & Gable). They then had 6 more joeys before Cash was neutered (Pogo, Vittles, Scraps, Spendy, Gimme and Gotcha). All of these gliders are still in my home. All males are neutered. All will be staying here.

-----------♥♥♥♥♥♥♥♥-----------
~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.


Last edited by Something_To_Believe_In on Sun Nov 06, 2011 9:08 am; edited 1 time in total
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 9:23 am

I know this has been such a struggle for you, Val.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 9:26 am

Val, have you done a bile acid test on any of these gliders? Just to make sure everything was processing correctly? Gosh, I feel absolutely horrible for what you are going through.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 10:24 am

No, they did not, Peggy.
Hind sight and all.

I know that I failed Dot and Dumplin. I'm determined to do better for Encore. I will try any and everything from this point.

I'll add that to the list of things for Encore.


-----------♥♥♥♥♥♥♥♥-----------
~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 10:31 am

You did not fail them. I know you feel that way and nothing I say will change your mind - but it happens. We miss things. We're human, Val.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 10:34 am

Val Betts, You did NOT fail ANYONE do you hear me?

This is how we learn. Sometimes it is the hardest thing in the world for us to do, but it doesnt matter how good we are, we are not miracle workers and we cant know everything or how to fix everything. Sometimes our little ones are just instruments sent to us to teach us more so we can build the knowledge.

As hard as it is you visualize a good outcome. See it, feel it, claim it, believe it and it shall happen.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 1:02 pm

Quote :
Bloodwork came back very strange. Calcium was very low, as was Magnesium and a few other minerals (can’t remember which) and then there were things that were normal.

My first thought was the low magnesium might have contributed to the decrease in the gut mobility. I did some quick reading on magnesium deficiency and found it is hand in hand with calcium in bone strength. One article also mentioned that low magnesium in children can present as failure to thrive.

It might be worth looking into the combination of the low calcium and low magnesium for future reference - there may be a need to supplement both calcium and magnesium in gliders with similar symptoms.

Don't beat your self up Val. You did the best for these little ones, but we are still learning about them.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Sun Oct 30, 2011 11:35 pm

Val, you might want to give virgin coconut oil a try for the malabsorption. I recently started giving it to my gliders. I have always given my gliders more high fat foods than most people do. I simply grill skinless chicken thighs in the coconut oil. I think your gliders will like it. Most of mine will lick it off my finger. Just a suggestion.
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Mon Oct 31, 2011 7:41 am

Val you did not fail them. You do everything you can for any glider.
We as humans learn everyday and you have been handed another medical issue to learn about so you can help other gliders. Sadly you lost sweet Dumplin and Dot but Val knowing you you will not rest until you have learned from it and are able to help other gliders in the future.

We love you
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PostSubject: Re: Possible genetic metabolic/malabsorbtion disorder????   Thu Nov 03, 2011 6:56 pm

You didn't fail anyone, Val. You did everything you could.

From my research and speaking with vets at Oklahoma State and the Ayurvedic Medical Services in India, for dogs and humans, when malabsorption is found to be lack of enzymes or bacteria in the stomach to properly break down food, raw goat milk or another bacterial replacement may be necessary. Benebac has been given if you cannot find raw goat milk. It must be raw and unprocessed to still contain the bacteria needed to break down proteins in the gut.

Does Dr. Walsh know of a good nutritionist? Or, I know that Oklahoma State University (one of the leading Veterinary schools in the US) is always looking for more challenging cases if you could get referred there. It's almost like talking to Dr. House without the cane or bad attitude!
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