What Causes Gout in Bearded Dragons?

One of the most common health problems seen in bearded dragons in the US is gout. Gout is known as a devastating condition that severely compromises quality of life for these animals. But what is gout, exactly? And how can it be prevented?

What is gout?

You may have someone you know that was diagnosed with gout, probably in their big toe. Gout is a form of arthritis that causes sudden swelling and intense pain in joints. On some days the affected area feels fine, but on other days, the joint feels like it’s on fire. As the condition progresses, range of motion usually becomes compromised.

This is how gout is described in humans, but it is assumed to be very similar for reptiles. Symptoms in reptiles include:

• visible uric acid crystals in the mouth
• swollen, stiff joints
• lethargy
• enlarged kidneys

What causes gout?

Gout can be caused by several different factors, including a diet high in animal protein and/or purines, dehydration, starvation, obesity, kidney disease/failure, and genetic predisposition.

All of these factors have a hand in how well a reptile’s body is able to process the uric acid produced as a byproduct of purine metabolism. When, for whatever reason, the body finds itself overwhelmed by uric acid, it becomes unable to excrete the uric acid effectively, leading to it accumulating in the joints, organs, and sometimes mucus membranes. This accumulation of uric acid crystals causes the pain and inflammation characteristic of gout.

Purines are found in high quantities in certain foods such as eggs, red meat, organ meats, edible insects, and certain types of seafood. Purines themselves are unavoidable, but it’s important to take steps to help prevent your bearded dragon’s body from getting overwhelmed. 

Can gout in bearded dragons be cured?

If you suspect that your bearded dragon may have gout, it’s important to get them to an experienced reptile veterinarian for formal diagnosis before taking further action. The vet visit will likely involve x-rays, a blood test, and/or a biopsy of fluid from the affected joint. If your dragon is diagnosed with gout, they will receive a prescription medication that will help mitigate the symptoms. In severe cases, surgery may be recommended to remove uric acid crystals from the joint and reduce long-term discomfort.

Once gout has taken hold in your bearded dragon, however, there is no cure. You can only take measures to reduce discomfort and slow the gout’s progress. Eventually, they will likely need to be euthanized when the pain becomes unmanageable.

How to manage gout in bearded dragons

Adult bearded dragons with gout will require a special diet to compensate. Offerings of feeder insects and other sources of animal protein will need to be substantially reduced, with plenty of vegetables to compensate for lost calories and help with hydration. If your dragon does not readily drink water from a bowl, you may need to administer fluid from a syringe every day. Black cherry extract may also help, but it is not a substitute for prescription medication.

Most edible insects are unfortunately high in purines, but there are some that are lower in purines than others, and these are going to be the best way to fulfill your bearded dragon’s nutritional requirement for insect protein while minimizing the risk of aggravating their condition. According to Bednarova et al., mealworms and superworms are relatively low in purines. Crickets are very high in purines, and it is assumed that purine content in roaches can be mitigated by feeding nymphs rather than adults and using a very low-protein diet.

Juvenile bearded dragons that develop gout usually develop this condition as the result of a genetic defect rather than lifestyle factors. Because they are growing and their bodies require a high-protein diet to fuel that growth, your vet may recommend euthanasia upon making the diagnosis.

Ask your vet for approval before attempting any treatment beyond what has already been prescribed.

How to prevent gout

One way you can prevent gout is by gutloading your feeder insects correctly. The foods that you give to your feeders affect their nutritional content, and therefore you have some control over how much protein your bearded dragon is getting from its feeders. Never use high-protein foods such as dog food, cat food, fish flakes, or carnivore/insectivore meal replacement powders. Instead, look for plant-based foods with a protein content of 12% or less. Low-protein insect gutloads include:

• Dubia Diet
• Arcadia InsectFuel
• Repashy Bug Burger

Make sure to feed appropriate proportions of insects and vegetables based on its age. According to ReptiFiles, 60-80% of a hatchling’s diet should come from feeder insects, 60% for juveniles, and 15-30% for adults. You can also avoid nutritional imbalance by using a rotation of as many different types of feeder insects as possible. 

Obesity increases your dragon’s risk of developing gout. Aside from making sure to provide a balanced diet, avoid offering too many treats and occasionally skip meals to help keep your dragon at a healthy weight. It’s also best practice to monitor your dragon’s weight with a kitchen scale. Adult bearded dragons should not consistently gain weight unless cycling eggs.

Most importantly, keep your bearded dragon well hydrated! There is a rampant myth in the bearded dragon community that they can’t handle any kind of humidity in their enclosure, and that they shouldn’t even have a water bowl. This is a great way to ensure that your dragon is dangerously dehydrated. Dehydration can be attributed to many health complaints in bearded dragons, including lethargy, impaction, and organ failure. And no, routine soaking does not solve this problem, since bearded dragons are unable to absorb water through their skin or cloaca. 

Bearded dragons easily tolerate humidity levels up to 60% on a regular basis, and occasional spikes of as high as 100% simulate a rainy day and are perfectly acceptable as long as your dragon has a chance to warm up and dry out soon after. If your bearded dragon doesn’t seem to be willing to drink from a bowl of water, you can help stimulate them to drink by placing an aquarium bubbler in the bowl to make the water move.

Conclusion

The best way to deal with gout is to understand how it happens and take measures to prevent it through good husbandry. If you suspect that your bearded dragon has already developed gout, get them to an experienced reptile vet as soon as possible to help ensure the best outcome possible.

References

• Bednářová, M., Borkovcová, M., & Komprda, T. (2013). Purine derivate content and amino acid profile in larval stages of three edible insects. Journal of the Science of Food and Agriculture, 1, 71–76. https://doi.org/10.1002/jsfa.6198
• Gout - Symptoms and causes. (2021, March 6). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897
• He, Z., Zhao, M., Wang, C.-Y., Sun, L., Jiang, Y. Y., & Feng, Y. (2019). Purine and uric acid contents of common edible insects in Southwest China. Journal of Insects as Food and Feed, 4, 293–299. https://doi.org/10.3920/jiff2018.0023
• Healey, M. (2021, December 9). The Ultimate Bearded Dragon Care Guide. ReptiFiles; https://www.facebook.com/reptifiles. https://reptifiles.com/bearded-dragon-care
• Repashy, A. (n.d.). Can Feeder Insect Diets Contribute To Gout In Reptiles? Repashy Ventures - Specialty Pet Products. https://www.store.repashy.com/can-feeder-insect-diets-contribute-to-gout-in-reptiles.html