Oral Abscess

This is one of the most challenging cases I've had and it so happens to be one of my own animals.

I obtained a WC male C. hoehnelii in March 2001. He seemed surprisingly healthy and had a good appetite. His fecal sample showed some hookworms and he was treated for those. No musculoskeletal abnormalities were noticed and his oral cavity seemed in good shape.

Around early August 2001, I noticed that he started to close his right eye, but kept his left eye open and his appetite was decreasing. I checked his mouth and found what looked like an abscess on the right side of the upper lip. I took a sample of the debris and submitted it for culture and sensitivity. I debrided and cleaned the area and started broad-spectrum antibiotic therapy. Results returned about 3 days later and showed a significant growth of Pseudomonas that was sensitive to Baytril and sulfa drugs among other medicines. I continued systemic antibiotic therapy with Baytril and applied Silvadene cream to the affected area of the oral cavity.

The little male showed improvement after 14 days of therapy and gained back almost all his lost weight. Both eyes were open and the abscess site looked great. Two weeks went by and I started to notice that my C. hoehnelii was rubbing the right side of his mouth against some branches. When I checked his mouth again, the previous abscess was now a foul smelling, rotten area in the bone. I felt devastated but immediately rushed him to the clinic. When I started to debride the area, a piece of the maxilla (jaw bone) broke off. The bone looked devitalized and very friable. I sent the piece of maxilla for histopathology and started Clindamaycin (another antibiotic drug) therapy in the meantime.

During the 3 days I waited for results, the chameleon responded to the antibiotics and ate a few times on his own. The results from histopathology showed necrotic bone tissue with concurrent osteomyelitis (infection in the bone) caused by Pseudomonas sp.

Apparently the Pseudomonas that caused the abscess spread to the bone before I treated it. I decided to euthanize my chameleon since the condition could only become worse, but he beat me to it by dying that afternoon before I could go home and get him.

It is very difficult to see signs of illness in chameleons until they are very obvious. It is unknown to me what the cause of this infection was, but it taught me to do full physical exams on all my animals at least twice a week to try and diagnose any problems at an early stage.

Ivan Alfonso, DVM