Milk thistle for green iguana

Question
QUESTION: Hi there,
I have an 11 year old female green iguana name with a possibly serious liver dysfunction. She has had many blood tests over the past 5 months with changing results. At first her bile acid levels were very high and her white blood cell count indicated an infection. After 30 days of antibiotics, critical care supplementation, and daily soaks, her white blood cells look better and her bile acid levels are down to 70 but her GLDH enzymes have elevated immensely. The vet is not sure what exactly to make of it but we have a follow up appointment in 2 weeks for a re-test. The vet said so long as she is still eating, is alert and strong, and is not showing any signs of discomfort, then I should just sit tight for now but it seems to me that there are things I could be doing to at least help in supporting her system. I read that milk thistle is very good for the liver but I do not know if there are any possible risks, though I wouldn't think so. If this is a good idea, then what would be the best way/form to administer it to her and how much should she be given? Do you have any other nutritional/supplemental suggestions for iguanas with poor liver function?
Thank you,
Michelle

ANSWER: Hello Michelle,

That is wonderful you have an 11 year old iguana.  Terrific!  :-)  Sorry she is having some trouble with her liver.
Has she ever laid any infertile eggs?
Milk thistle should not have any side effects at all for her.  Do you have liquid or powder you will give her?  It wasn't noted that she had fatty liver just liver issues in general?  If it is fatty liver, then lactulose can be given short term to help flush out her system a little bit.
Normally on supplements, I recommend 10-15mg/kg for a safe dose.  What is her diet like?  
Is she good at taking oral fluids or not?  If not, then you could get powder & sprinkle it on her food but if she doesn't mind liquids, then you can use a plastic dropper/syringe to give it to her.
Do you use a good UVB light on her also?  If you have any pictures of her & her tank setup that would be great!  
If you have a copy of the blood test I could look over it also if you would like.


Tracie


---------- FOLLOW-UP ----------

QUESTION: Hi Tracie,
Thank you!
She has not ever laid any infertile eggs before.
I don't have milk thistle now, I was hoping you could point me in the direction of a good brand? I know it is important to not give any kind that has alcohol in it to reptiles. She is pretty good at taking liquids so that would probably be a good way to go.
The vet isn't sure exactly what the problem is. Fatty liver was suspected at first but then her bile acids leveled out, its just that now her GLHD is drastically higher than it ever was before and no one seems sure exactly what is going on.
She eats collard greens, turnip greens, mustard greens, arugula, endive and escarole, along with some butternut squash, parsnip, and acorn squash and her favorite fruits are papaya and mango.
Her UVB is a mega-ray mercury vapor bulb. I took over her care only recently so I am working on finishing her new 6ft by 6 ft by 4 ft cage now. In the mean time she has her old cage and access to her own bedroom that has been set up just for her with various humidifiers, a special area in front of the window, and multiple basking spots.
I don't have a copy of her more recent blood tests on me, though I do plan to get copies of all her medical files soon.
Thanks again,
Michelle

ANSWER: Hello Michelle,

Here is a decent brand made with glycerin & all alcohol is removed from the liquid extract.  

http://www.puritan.com/herbal-authority-brand-0218/milk-thistle-liquid-extract-0

Were x-rays done to see if she had any gall stones?  That can cause an elevated GLDH.  
Also, a bile duct obstruction could cause the levels to have increased, too.  I am
anxious to see the overall blood test just to see what the AST & uric acid levels are.
Since you haven't had her for very long, she may have had poor nutrition & husbandry
before you got her which have contributed to this also.  
What type of supplementation are you giving her?  
Since you are using the Megaray, is it a 100 watt or the 160 watt & how close is it
mounted?  When using a MVB light, you wont need to supplement D3 as often but she will
still need calcium several times per week for bone support.  
Her diet sounds wonderful, great job with that!  Hopefully we can get this figured out.

Let me know how she is doing.

Tracie

---------- FOLLOW-UP ----------

QUESTION: Hi Tracie,
Thank you so much for the recommendation, I have ordered a few bottles for her. They should be coming in 2-4 days.
She did have x-rays done about 1 months ago. They wanted to get a look at her bones and liver. Her bones looked  good and strong but her liver was enlarged which at the time they contributed to the high levels of bile acids and thought it could be due to fatty liver from decreased appetite caused by a reproductive cycle, but no mention of gall stones. They also performed an ultra sound to make sure she wasn't gravid and saw a few follicles on her ovaries but nothing of major concern. I am going to call the vets office and request a copy of her last blood test, after which I would be thrilled if you'd be willing to take a look at it.
The strange thing about this sudden increase in gldh is that over the past 2 months she has had about 4 blood tests including the latest one. The first one showed her bile acids were high and a white blood cell count that indicated an infection. They did an ultra sound and saw nothing of concern so I was instructed to bath her everyday to keep her hydrated, give her 10-30ml of critical care 2x a day and to administer a 0.7ml shot of ceftazidime every 3 days for 15 days. I then took her back for a follow up and her bile acids had shot up to 230 and her white blood cell count had not changed. When the vet who has seen her last called, she laid out many scenarios for me but said basically that the infection could be causing the liver dysfunction or they could be two separate issues and since her bile levels were the some of the highest she had ever seen, she thought maybe we should go ahead and do a biopsy on her liver because waiting too long could mean bad news, yet so could anesthetizing an iguana with an unknown degree of liver disfunction also...but at the very least suggested another blood test, a blood culture test, and x-rays. So an appointment was made for a few days later and a new vet took more blood and did the x-rays. Like I said, the x-rays came back with everything looking fine except for her enlarged liver and her blood tests showed that her bile acids had gone down to 130 - still high but optimistic, so the vet said that since it still looked like she had an infection and since the blood culture test came back unremarkable he thought the best thing to do would be to do another round of the same antibiotic but this time every 3 days for 30 days in hopes that if the infection were eradicated, it would mean her liver would also improve. I asked if such a long period of antibiotics could potentially hurt her liver more but he said no. So after the 30 days, we went back on May 12th for her most recent blood test and her white blood cell count has improved, her bile acids are at 70 but her gldh levels are at over 200. I asked what level her gldh had been for every other blood test and he said they were always right around 50. He then said they have studied gldh a lot in birds but not so much in reptiles so he wasn't sure exactly what it to make of it, especially since it seemed the overall function of her liver had improved while the liver cells themselves were dying at an increased rate, but he would ask the pathologist and see what she thought. The pathologist apparently said that the levels seemed high whether reptile or bird, and so he told me that since she seemed to have an improved appetite and was strong and alert, I should simply continue doing what I am doing and bring her back on June 3rd for another blood test unless she appears to be getting worse. No mention was ever made about her AST or uric acid levels so I too am very curious about those.
I have continued with the supplementation of critical care but once she started eating more again, I began giving it to her about once a day instead of twice and added more water to increase hydration. That is the only kind of supplementation she has ever had that I am aware of. Her Mega ray is a 160 watt bulb that is mounted at about 20 inches. I also try to have her outside as much as possible on days that are over 80 degrees.
I know I just gave you a extensive run down of the past 2 months (sorry!) and what my basic understanding is from what I have been told. Have you any thoughts? Also, once I get a copy of her blood test/s I will let you know what the results were for her AST and uric acid levels.
Thank you so much,
Michelle

Answer
Hello Michelle,

Wow, that is great information!  Poor girl, she has been through the mill, being poked & prodded for sure!
Do you think she could have come into contact with any toxic agent that would be damaging her liver possibly?   A few follicles wouldn't affect her liver quite that way.  I agree, a biopsy is a risk, that is a very hard call.
The liver shouldn't just start going bad so quickly.  The greens/vegetation you get, are they organic?  A lot of the foods are genetically modified/engineered which causes great problems with organ function in humans & animals.  Does she like the critical care I hope?  
I will look forward to seeing the blood test results.  If there wasn't any gall stones, or tumors that they could see, then that shouldn't be what is causing the problems.
The milk thistle will hopefully help out for her!  Do you give her calcium several times per week?  The Megaray should be a good bulb at 20 inches & if she gets some sunshine then that is terrific for her if she enjoys it, too.
The Ceftz should be effective for her.  As for using it long term on her, antibiotics can dehydrate & be harsh on their kidneys, but not as much on their liver most of the time.  So she is done with the Ceftz for now?
If you have any pictures of her I would love to see her!  It is a good sign however, that she remains alert & happy right now.  Please keep me posted on her.

Tracie