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[[Image:Renomegaly1.jpg|300px|thumb|right|'''Massive renomegaly in an iguana. Note the possibility of colonic obstruction.''' (Copyright © RVC)]]

[[Image:Renomegaly1.jpg|300px|thumb|right|'''Massive renomegaly in an iguana. Note the possibility of colonic obstruction.''' (Copyright © RVC)]]

==Introduction==

==Introduction==

Kidney disease in snakes and lizards is not uncommon; the main causes include gout, infectious agents and toxicoses. In an advanced state it may also be associated with metastatic soft tissue calcification, where([[Calcium|calcium]] is deposited in many tissues throughout the body) leading to a renal osteodystrophy. Kidney disease is common in iguanas and is a frequent cause of death in captive iguanas; most fatalities occur between 2.6 and 5.8 years, with 4.2 being the mean age with equal sex ratios. Associated terms include renal osteodystrophy, paradoxial metastatic calcification, metastatic mineralisation syndrome in [[Green Iguana|green iguanas]], and tubulonephrosis of iguanas.

Kidney disease in snakes and lizards is not uncommon. In the progressed state it is associated with metastatic soft tissue calcification.  

The exact aetiology is unknown but has historically been associated with:

The exact aetiology of renal disease in lizards is unknown but has historically been associated with:

* hypervitaminosis D or diets too high in protein, or

* hypervitaminosis D or diets too high in protein, or

* visceral gout ([[Tophi|tophi]] deposition), which may occur secondary to dehydration.

* visceral gout ([[Tophi|tophi]] deposition), which may occur secondary to dehydration.

==Dealing with renal disease==

==Dealing with renal disease=

[[Image:Kidney.jpg|200px|thumb|right|'''Histology of a normal iguana kidney. Note the clearly distinct cells of the glomerulus''' (Copyright © RVC)]]

[[Image:Kidney.jpg|200px|thumb|right|'''Histology of a normal iguana kidney. Note the clearly distinct cells of the glomerulus''' (Copyright © RVC)]]=

[[Image:Dis_kid.jpg|200px|thumb|right|'''Histology of an iguana kidney with gout. Note the darker staining tophus and indistinct glomerulus''' (Copyright © RVC)]]

[[Image:Dis_kid.jpg|200px|thumb|right|'''Histology of an iguana kidney with gout. Note the darker staining tophus and indistinct glomerulus''' (Copyright © RVC)]]

===Examination===

===Examination==

History may indicate husbandry problems such as lack of adequate water or recent treatment with possible nephrotoxic drugs. The presenting complaint is usually non-specific such as anorexia, weight loss, tremors, lethargy, flaccid paresis, distended abdomen and constipation. Physical examination may reveal nephromegaly (one or more lumps in the caudal third; in lizards, it may be palpable anterior to the pelvis or per [[Cloaca|cloaca]]) but there is often nothing significant found.

History may indicate husbandry problems such as lack of adequate water or recent treatment with possible nephrotoxic drugs. The presenting complaint is usually non-specific such as anorexia, weight loss, tremors, lethargy, flaccid paresis, distended abdomen and constipation. Physical examination may reveal nephromegaly (one or more lumps in the caudal third; in lizards, it may be palpable anterior to the pelvis or per [[Cloaca|cloaca]]) but there is often nothing significant found.=

===Diagnosis===

===Diagnosis==

Diagnosis of renal disease may be suspected on history and physical examination. Diagnosis includes the following:

Diagnosis of renal disease may be suspected on history and physical examination. Diagnosis includes the following:=

*History  

*History  

[[Uric acid|Uric acid]] is also not a specific test for renal disease since other factors such as diet and ambient temperature also affect the levels. Increased plasma phosphate levels and a reversed [[Calcium|calcium]] to phosphate ratio are seen prior to changes in the [[Uric acid|uric acid]] level. [[lizard and Snake Imaging|Imaging]] may be useful and biopsy of the kidney gives the definitive diagnosis.

[[Uric acid|Uric acid]] is also not a specific test for renal disease since other factors such as diet and ambient temperature also affect the levels. Increased plasma phosphate levels and a reversed [[Calcium|calcium]] to phosphate ratio are seen prior to changes in the [[Uric acid|uric acid]] level. [[lizard and Snake Imaging|Imaging]] may be useful and biopsy of the kidney gives the definitive diagnosis.

===Therapy===

===Therapy==

Correct diet and environmental conditions may limit the progression of the disease. Consider a low [[Phosphorus|phosphorus]] diet. Supportive therapy is especially important since there is often no specific treatment. The most important factors include fluid therapy and being kept within the [[Preferred optimum temperature zone|POTZ]]. Allopurinol and phosphate binders have been advised but are often ineffective.

Correct diet and environmental conditions may limit the progression of the disease. Consider a low [[Phosphorus|phosphorus]] diet. Supportive therapy is especially important since there is often no specific treatment. The most important factors include fluid therapy and being kept within the [[Preferred optimum temperature zone|POTZ]]. Allopurinol and phosphate binders have been advised but are often ineffective.=

[[Lizard and Snake Euthanasia|Euthanasia]] is often the final outcome.

[[Lizard and Snake Euthanasia|Euthanasia]] is often the final outcome.

===Prevention===

===Prevention==

As with [[Lizard Metabolic Bone Disease|MBD]], appropriate housing and diet will help with prevention.

As with [[Lizard Metabolic Bone Disease|MBD]], appropriate housing and diet will help with prevention.=

Renal failure is often seen when there is some insult such as dehydration or nephrotoxic drugs. Care must be taken when drugs are prescribed to ensure that the patient is adequately hydrated. As usual good husbandry practices are essential for the optimum health of captive reptiles.

Renal failure is often seen when there is some insult such as dehydration or nephrotoxic drugs. Care must be taken when drugs are prescribed to ensure that the patient is adequately hydrated. As usual good husbandry practices are essential for the optimum health of captive reptiles.

[[Category:Lizard_Urinary_Diseases|R]]

[[Category:Lizard_Urinary_Diseases|R]]

[[Category:Snake_Diseases]]

[[Category:Snake_Diseases]]