What are Fractures?
Nutritional secondary hyperparathyroidism is a metabolic bone disease caused by a lack of calcium in the diet, or an excess of phosphorus, which causes the body to be unable to sustain normal function and can lead to a demineralization of the bones. It can also be caused by insufficient amounts of D3, which is directly related to a lack of exposure to direct sunlight. Ultraviolet light from the sun produces D3 in the body, which is an essential vitamin needed to absorb and utilize calcium. Once any of these conditions occur, the bones become brittle and soft, and can more easily fracture, even under normal activity that would not cause damage to a healthy lizard.
Fractures in the bones are seen in lizards, including captive ones, and can occur in various places, such as the spine, limbs, tail, or even the jaw. They are often caused by trauma, or a condition called nutritional secondary hyperparathyroidism. While a broken or fractured bone isn’t necessarily fatal in lizards, they can die from complications, such as bleeding, dehydration, and secondary infections.
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Symptoms of Fractures in Lizards
Symptoms of fractures in lizards can vary slightly, depending on the location of the fracture, but often involve a loss of movement. Symptoms include:
- Visible trauma or bones piercing through the skin
- Leg dragging
- Swollen, deformed limb
- Unable to walk correctly
- Kinked spine
- Tail damage
- Distended abdomens
- Distended bones
- Swollen jaw
- Inability to eat
- Tail necrosis or gangrene
- Osteomyelitis, or a bone infection
Fractures in lizards can be stable, or more rarely compound or comminuted.
- Stable fractures are a more common type of fracture, and refers to when the bone breaks cleanly and lines up evenly
- Compound fractures are when a broken bone has pierced through the skin; this increases the risk of a secondary infection
- Comminuted fractures refer to when the bone breaks into more than two fragments, and is often due to trauma
Causes of Fractures in Lizards
Causes of fractures include:
- Trauma, such as from cars, garden tools, or fighting amongst lizards
- Aggressive lashing of tail against cages or surfaces
- Nutritional Secondary Hyperparathyroidism (NSHP)
Nutritional secondary hyperparathyroidism can severely affect the strength of bones, and can be caused by a number of factors.
- Inability to absorb calcium
- Lack of adequate calcium in diet
- Diet too high in phosphorus
- Lack of exposure to UV light
- Inability to digest food properly
- Low cage temperatures
Diagnosis of Fractures in Lizards
A diagnosis of a fracture is made based on symptoms, a physical examination, and X-rays that can locate the exact place and extent of the break. With a tail fracture, your veterinarian may assess the tail for bleeding and sensation.
Further testing can determine of your lizard is suffering from nutritional secondary hyperparathyroidism. This includes a blood test to measure calcium levels.
Treatment of Fractures in Lizards
Treatment first addresses any open wounds and broken bones. Then, if nutritional deficiencies are involved, those will be addressed once your lizard is stabilized. Any open wounds are cleaned and dressed, often with topical antibiotics. Pain medications can also be prescribed.
For a leg fracture, an external splint, sling, or cast is applied to immobilize the leg, and should be changed every 2 weeks, over a period of 4 to 6 weeks. Cage rest is also prescribed. This method is usually very effective, so long as your lizard’s activity is restricted. This type of therapy, also called external coaptation, is also more effective for fractures associated with demineralization of the bone. At 4 weeks, another X-ray is taken to assess your lizard’s progress.
Internal fixation is the use of pins, wires, needles and stylets that are placed internally to help set the bones. This technique is used in cases of a traumatic fracture of normal bone, where external coaptation is not practical, and in larger, more active lizards. Pins are generally removed after an X-ray shows adequate bone healing.
Spinal fractures call for complete immobilization, and are often fatal. Often, it is best to not splint a broken back. With tail fractures, often the tail is manually twisted to cause a fracture through a fracture plane, and left unsutured to allow regeneration to occur. Often, the tail grows back, but it is usually a different length or color.
Amputation of tails and limbs is also called for in other situations, such as if there is evidence of tissue necrosis, severe infection or tissue trauma in limbs, or gangrene.
If nutritional secondary hyperparathyroidism is the cause of the fracture, internal fixation often cannot be used due to the softness of the bones. External coaptation is a better solution, and is coupled with changes in the diet. Prescription oral calcium supplements are prescribed, either orally or by injections. Severe cases may also need an injection of the hormone calcitriol, fluid therapy, a special liquid diet, vitamin D3 injections, or antibiotics. Your veterinarian will discuss nutritional changes and environmental factors that can both help your lizard’s recovery, and prevent the condition in the future. Once calcium levels return to normal, bony calluses can form within 3 to 4 weeks.
Recovery of Fractures in Lizards
Once stabilized, your lizard will be sent home. You may need to implement nutritional and environmental changes, confine him to cage rest, change dressings, and administer calcium supplements, antibiotics, or other medicines. You will need to return to the veterinarian every two weeks for tests to check on your lizard’s progress, and to know when it is time to remove splints or pins. Depending on the severity of your lizard’s fracture, healing can range anywhere from 4 weeks to 3 months. While many leg and tail fractures carry a good rate of recovery, spinal fractures can cause paralysis, which leads to a recommendation of euthanasia.
While it is difficult to prevent accidents from happening, there are steps you can take to ensure the safety of your lizard.
- Keep aggressive lizards separated
- Address aggression in your lizard if he injuries his tail because of it
- Make annual trips to the veterinarian for check-ups
- Ensure your lizard gets adequate amounts of calcium in his diet
- Ensure your lizard is exposed to true UV sunlight
- Light filtered through cage glass does not produce vitamin D3
- There are, however, special mercury vapor and fluorescent bulbs that can provide the correct light for your lizard