PART 2
Why Can't I Just Drop Off The Poop?
Veterinarians cannot dispense medication without actually examining the patient. Drug dosages for reptiles are based on actual and metabolic size, and may be different depending on what species of reptile. This means you can't just take a fecal sample from your new iguana to the veterinarian and expect them to run the test and give you medication if your iguana needs it without your bringing in your iguana for an examination.
Don't cancel your veterinarian appointment, however, if you can't get a fecal sample from your iguana on the morning of your first appointment. Go ahead and take your iguana to the veterinarian. When you are talking with the veterinarian, explain that you were not able to get a fresh sample. Ask if you can drop one off, appropriately identified as to the patient's name and species, in the next day or two. When the testing has been done, if the iguana needs to be treated, take the iguana back to the veterinarian with you. If you have never given oral or injectable medication to an iguana before, this is something you want to be taught how to do, not struggle to do it on your own.
Safely Collecting Fecal Samples
The safest and neatest way to collect a fecal sample is to turn a new zip-lock plastic bag inside out over your hand. With your fingers and thumb protected by the plastic, use them to scoop up the brown fecal mass. While holding the feces in your grasp, use your other hand to pull the zip-lock edge of the bag down and over your hands, turning the bag right-side out. Your grasping hand will now be outside the bag and the feces sitting neatly inside. Zip up the bag, and place that bag inside another zip-lock bag. With a marker, write the day's date, the iguana's name, and the species ("green iguana") on the bag.
You can store the fecal sample in a cool place (in the refrigerator is best, as some organisms can die and start breaking down in warm temperatures) for up to four hours before delivering it to the veterinarian. If you absolutely have to, you can store it overnight in the refrigerator. Since excess heat or cold can kill the organisms in the feces, thus defeating your purpose for collecting it to begin with, don't freeze it, or leave it in your car on even a mildly warm day.
Follow Through On Treatment!
All too often, pet owners fail to follow through in giving their pets each of the treatments prescribed by their veterinarian. Just as it is critical for humans to take the full course of prescribed antibiotics, so, too, it is critical that you make sure your iguana gets every dose of medication prescribed to knock down or out the worm or protozoan mediation. The same holds true for any antibiotics and antifungals your veterinarian may prescribe when needed.
Some drugs kill organisms. Other drugs interfere with critical processes, such as the organisms' ability to eat or digest food or their ability to reproduce. The latter types of drugs then kill by causing the organism to starve to death or die a natural death but not leave any offspring. When only part of the prescribed doses are given, only some of the organisms are killed off or otherwise affected. Those most susceptible to the drug will die. Those who aren't killed or immediately affected can live to reproduce--breeding offspring who may be even more resistant to the drug. This is why we are currently facing a crisis in human medicine: we are now faced with organisms that are impervious to any antibiotic we can throw at it. Don't set your iguana or other pets up for the same situation.
There are two common reasons people and pet owners give for not taking or giving all of the doses prescribed doses. The first is along the lines of "Well, I was feeling better, so I didn't need it any more". In pet owners, the refrain is "Well, my pet was acting like he felt better, so I stopped giving him the medicine." The human and pet were both feeling better because the medication had been knocking out the most susceptible organisms. When the patient "relapses" later, it isn't a relapse: all those resistant organisms that survived have been happily reproducing, breeding generations of resistant bugs. Better to take the full dose prescribed the first time rather than make yourself-or your pet--sicker or more difficult to treat later.
The other common reason is that the patient felt or acted significantly sicker after the first several days (or after the first dose for drugs given at wider intervals). Generally speaking, this is a good thing. The patient is sicker because the drug is doing its job: it is killing or otherwise causing the death of the organisms. As the dead organisms lie around decomposing, they release byproducts of decomposition which, when you think about it, is enough to make anyone sick. If the organisms live in the gut, the dead organisms may hang around for a while as they are slowly shoved along the digestive tract by passing ingesta and, later, wastes. This feeling worse before feeling better actually has a name: Herxheimer, or herx, named after the doctor who first described it. It is a commonly experienced reaction in people who are on antibiotic and antifungal treatment, and is often seen in very young animals who are treated with wormers and other drugs.
There is one drug in particular that often causes extremely bad reactions in very small iguanas, and in young iguanas who are already in a weakened state. Ivermectin, sold under the brand name Ivomec, is an injectable wormer. Despite the fact that it has to be given in much higher, near toxic doses than other, less toxic (to the patient) wormers, I don't understand why so many reptile veterinarians still use it. If your veterinarian says your iguana needs worming, ask what medication he plans to administer. If it is this drug, ask that fenbendazole (for pentastomids) or piperazine citrate (pinworms) be administered instead.
Annual Veterinarian Visits
We tend to think of annual veterinarian visits in terms of dogs and cats who need annual vaccinations. There is another reason for an annual visit: sometimes problems arise that set in so slowly that the pet owner doesn't notice them. The veterinarian, who hasn't seen the pet for a year, is able to spot some of those problems and address them before they become a major health problem.
To better enable the veterinarian to spot problems, have a blood test done every year. Having blood work done when the iguana is healthy provides baseline information against which changes can be compared and assessed. Iguanas are a lot like humans: the "norms" for all the different things tested has a range that is considered "normal" for the species. There are veterinary clinical pathology labs that specialize in exotics; labs that do mostly cat and dog pathology may miss things in blood and tissue collected from reptiles. Some of the data on norms for the different things tested are based on data compiled and published by reptile veterinarians; some comes from information published by the labs. So, getting the same tests done annually when your iguana is health will establish what the norms are for your iguana. Your veterinarian will use that, as well as species' norms and data published in other sources, to assess your iguana.
Confounding Variables
There are a couple of tests whose results may indicate a health problem but, in an otherwise healthy iguana with otherwise normal test results, are nothing for you (or your veterinarian) to worry about. One or more of the following can cause these abnormal test results in these iguanas:
the stress of the trip to the veterinarian, or being at their office;
stress due to the restraint and needle sticking required to get a blood sample for
testing;
using too small a needle for the collection or forcing the blood through too small a needle, causing hemolysis (breaking the cell walls).
The white blood cell (WBC) count can be temporarily elevated as a result of the stress of the visit or blood collection. The white blood cells are part of the immune system's infection-fighting force and so are typically elevated when the body is fighting an infection. It can also become very elevated due to certain blood disorders. When a veterinarian sees a moderate elevation, the first thought is of infection.
Stress can also cause the elevation of creatine phosphokinase (CPK). This enzyme is found in the skeletal, smooth, and cardiac muscles. Its elevation in a sick iguana should set alarm bells ringing. In a healthy iguana, however, a slight to moderate elevation, in the absence of any other signs of illness (excepting the mildly elevated WBC) is nothing to be concerned about.
Emergency Veterinary Care
Any condition that would cause you to get a human being to the emergency room as fast as possible should trigger the same response in you those conditions are happening to your iguana. The following conditions might sound like obvious reasons to get the iguana into the veterinarian right away, but based on email, posts and phone calls from people who ask what they should do in these situations, I decided it apparently needed to be stressed for some people. The emergency conditions include but are not necessarily limited to:
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