Draco and Damian - Kidney Failure and Cancer

We took on Draco and Damian as a favour for an old friend. They were elderly males who meant a lot to them, so we were really pleased we could help them.
They were extremely friendly and loving degus, so they were an absolute joy to keep.

Draco:

Draco had chronic struggles with corneal ulceration from his arrival. We've actually written blog posts regarding Draco's health previously (click here to read the previous post about Draco).

Ultimately, Draco ended up having eye enucleation surgery once his condition was no longer manageable.

Draco adapted brilliantly to life with one eye. In fact, it was highly likely he had little eyesight in the enucleated eye anyway. He seemed to be much happier once he was no longer dealing with chronic pain.

Rhinorrhea:

Rhinorrhea is informally referred to as a 'runny nose'. It describes a build-up of mucus in the nasal cavity. It's commonly triggered by allergies and infections.

Whilst you can develop allergies at any point, we believed it was more likely Draco had an upper-respiratory infection.

He was introduced to a short course of oral Baytril.

Acute Renal Failure:

Shortly after Draco recovered from a URI, he seemed to get more and more infections. We became very concerned about there being a larger issue than reoccurring infections.

Draco had been eating more selectively, he had lost 50g over 8 weeks, had a discharge of his left eye (right eye had been enucleated), secondary infections (?), was polydipsic (increased thirst), as well as signs of pain; piloerection, squinting eyes, and avoidant behaviour and decreased exploring behaviour.

The vet took a lateral X-ray which helped rule out root elongation. Draco had excessive fat and minor molar spurring and slight malocclusion, his molars were filed at lingual buccal aspects.

Ophthalmoscopy of his eye was unremarkable, but he was introduced to topical Isathal antibiotic drops as a precaution.

Urinalysis was grossly abnormal; proteinuria (++++) and hypostheuria indicative of renal disease. Poss immunosuppressive illness such as Leukemia. Above normal Leukocytes present, so Draco was introduced to oral Baytril.

We all agreed Draco needed a blood test. Obtaining a venous blood sample proved to be quite difficult, numerous vets tried to obtain a sample from Draco's legs and tail (not ideal in degus but needs must). Eventually, we went to a vet confident enough to extract blood from his cranial vena cava.

The first attempt provided enough blood to perform microscopy and check for leukemic cells, but not enough to send for haematology and biochemists at the exotic lab. 

Draco had very low blood pressure (hypotension); perhaps secondary to dehydration. 

Draco was introduced to subcutaneous fluid therapy and syringe feeds. We would attempt to obtain another cranial vena cava sample to send off for analysis and diagnostics.

Fortunately, the second attempt was successful and Draco had bloods sent off.

Meanwhile, microscopy findings made leukaemia less likely as there were not significantly high levels of white blood cells. There were also no abnormal/cancerous changes to the cells present.

The blood results showed that Draco was severely anaemic, had low protein, high creatine kinase, and low creatinine: suggestive of advanced kidney failure.

Furthermore, Draco had become increasingly unwell within himself:

• Rectal body temp of 33.611°c (normative values for Octodon Degus are between 37.9°c and 38.3°c). External heat source was offered.
• Further -4g loss of bodyweight
• Lateral, anterior, and posterior lung auscultation revealed clicking-noise in lower-airways: pneumonia?
• Severe dyspnea. Oxygen therapy was given as and when required.

We believed Draco's quality of life was irretrievable and that humane euthanasia was Draco's kindest option. 

Draco passed away on the 2nd of November 2019.

Damian:

We kept a close eye on Damian after the loss of his lifelong friend, Draco.

Oral Infection:

Damian had developed signs of pain and had lost 30g in bodyweight. We booked Damian in to be reviewed in clinic.

Upon examination with an otoscope, the vet could see Damian had inflamed and bleeding gums. He was introduced to oral Baytril and oral Metacam. He would be reviewed in 2 weeks.

By the time of Damian's review at the vets, the inflammation and blood within his mouth had improved. Unfortunately, Damian had continued to lose weight and was very bloated intestinally.

The vet advised discontinuing antibiotics, but continuing with non-steroidals. We also introduced Damian to a supportive recovery diet and Infacol; containing Simeticone which can reduce bloating.

Damian's weight had stabilised, but his bloat remained, and he'd become dyspnoeic. Damian's worsening symptoms had become concerning. Ourselves and the vet agreed further investigation was required. We agreed on radiographs of the chest and skull and reintroduced Damian to oral fluoroquinolones.

X-rays ruled out tooth root elongation but highlighted mild uneven wearing of his molars. Intervention was discouraged as it can exacerbate dental issues if you intervene when not needed.

No changes could be seen to Damian's heart.

Intestinal bloat was suggestive of aerophagia (swallowing air) secondary to pain or abnormal breathing.

There was a clear disparity between Damian's right and left lung; indicative of fluid and/or inflammation. 

Potentially a very discrete nodule, but it's very easy to over-interpret small animal X-rays.

It's also worth noting that Damian became very over-sedated with a small dose of anaesthesia, suggestive of immunocompromisation. 

The findings were suggestive of something sinister, such as cancer.

We knew Damian would be receiving palliative care from that point. We kept Damian's quality of life close to heart throughout.

Damian was a fighter throughout!

Damian enjoying his recovery diet.

Damian in the nebuliser chamber.

As the weeks went by, Damian developed what appeared to be a melanoma on his lower lip and there were signs of pathology.

More time went by, and Damian became very tired and weak. We're always particularly concerned when prey-species struggle to hide signs of illness. At Damian's final vet appointment, we agreed it was kindest to let Damian go now before his character was robbed by his illness.

Damian passed away on the 11th of March 2020.