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Category: Vet
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Experience:  dasdasd
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We adopted a Leopard Geko from a friend's son who was going

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We adopted a Leopard Geko from a friend's son who was going off to uni. The gecko wasn't in the best condition, very skinny and where it hadn't shedded properly it has lost some toes. Gecko in much better shape now and has put n weight and is shedding OK but we are concerned that it might be constipated as it is not eating (for 4 days now) and only white faeces.
JA: I'll do all I can to help. A lack of appetite can seem worrying. Does the gecko also seem more tired than usual?
Customer: Yes less active for sure and spending more time in his cave
JA: Does the gecko seem to be in any pain?
Customer: Not really, no gaping and happy to be held (and bathed)
JA: And what's the gecko's name and age?
Customer: Randell and we think 6 years old
JA: Is there anything else the Vet should know about Randell?
Customer: He also has metabolic bone disease where previous owner had not provided calc and vits

I am sincerely ***** ***** there was a delay in someone responding to your question. (Experts are independent contractors and as such are online based on their own schedules.) However, I am available and can assist you if you still need veterinary advice.

Hello and thanks for posting your question on My name is***** and I have been a licensed and accredited veterinarian in the US for over 22 years, specializing in aquatics, reptiles, amphibians, avian and other exotic species. JustAnswer is a question and answer service, not a veterinary telemedicine or emergency service. On this platform veterinarians can provide insight and advice based on the information you provide, but as this is not considered a legal client-patient relationship and we cannot examine your pet, we are unable to provide definitive diagnoses, prescribe medications, provide medical records or sign documents for your specific pet. For any of those you would need to make an in person visit with a local veterinarian. If your pet has a serious illness or life-threatening emergency, I strongly recommend you obtain hands-on veterinary care with a local veterinarian or veterinary emergency service as soon as possible. In the meantime, I am putting together some questions and/or suggestions to help with your pet’s concern.

Thanks again for posting your question, I’m sorry that your leopard gecko Randell is under the weather, not eating or defecating for the past 4 days (only producing white urates/urine). I have some questions that will help me get a better idea of your pet’s environment and what may be going on with them:

-What is the current tank set-up, e.g.,

Temperature (cool side, warm/main area, hottest basking temp) and humidity?

-Do they receive any access to UV light? When was the UVB bulb last changed out?

-What do you usually feed them?

-Do they receive any calcium or vitamin supplements? If so, which ones can how often?

-When was the last time he pooped and how did it look?

-Any other signs such as straining to defecate, weight loss, bloating, sunken eyes, wrinkled skin, lumps/bumps, blood or discoloration of urine or feces, etc.?

Thanks very much for providing additional information, it is very helpful for me to try and figure out what is going on with your gecko and the history information will help me to do that.

With any sick gecko, it is always a good idea to start by checking that their environment and husbandry are proper for their species. Taking a physical measurement of the temperature gradient within the enclosure and measuring humidity with a hygrometer are a good idea. Making sure the UVB bulb is appropriate for the size of the space and has been changed regularly. Even if they are still producing visible light, UVB bulbs have a limited lifespan and need to be changed every 6-12 months, depending upon bulb type. Making sure diet is varied and the insects have been gut loaded with a nutritious gut-loading diet as well as dusted regularly with calcium and multivitamin powder. Therefore, I am attaching a leopard gecko care (husbandry) reference sheet that I put together. Please review it at your convenience and let me know if you have any questions.

For example, if the environmental temperatures are too low, since geckos are cold-blooded, this will negatively affect their metabolism, appetite, digestion and immune function. So start by checking the temperature gradient in the enclosure and, if it's too low, adjust your basking light or get a stronger watt bulb so you are achieving the proper environmental temperatures. Also proper humidity is very important for overall and skin health, with 30-40% humidity in the main enclosure and 70-80% in the moist hide.

In the meantime, I will give you some information about what may be causing these signs, a care sheet with recommendations about environment and diet as some common medical conditions are unintentionally caused by improper husbandry (such as too low temperatures, humidity, UVB lighting or calcium and vitamin supplementation) and some suggestions for home care and support of your ill gecko.

Sounds like Randell has had a lot of historical problems. Thank you for adopting him and providing a better level of care!

There are a number of reasons why your leopard gecko may not be eating a normal amount of food. I do not know if the lack of appetite is causing the lack of fecal output (because they are not eating) or vice versa, if they are having difficulty pooping so they are not feeling well so are not eating.

Some of the causes for lack of appetite are transient/temporary and may be normal while others are more concerning and warrant a veterinary evaluation.

-Leopard geckos may not eat normally due to emotional or physiological stress. Changes in environment such a new tank or changes in décor, or changes in lighting, temperature or diet might trigger temporary disinterest in food.

-Brumation, a normal, seasonal depression of appetite and energy that leopard geckos can (but may never) experience especially if not exposed to lower temperatures or shorted light cycles. -During brumation, appetite and activity are depressed, they seek out dark, cool areas of the tank to sleep and will not eat or defecate, though they do occasionally rouse briefly to drink. They often will eat more food prior or seem hungrier prior to the start of brumation. Brumation is not the same as hibernation and they can rouse and move if needed. They should look fairly normal, no discoloration, or visible weight loss, in fact their weight should remain fairly stable during this time even though not eating. So taking regular, weekly weights is important during brumation. If they lose more than 5-10% of their body weight, then this is not likely brumation and a veterinary evaluation should be obtained. If you are unsure if this is sickness or brumation, then keep the lighting and temperature cycle normal, do not decrease either. Decreasing lighting and temperatures may worsen sickness in an ill gecko but keeping the lighting and temperature in the normal range will not injure a brumating one.

-Geckos kept with other geckos may be bullied by a more dominant individual. The stress or physical intimidation may prevent a more submissive gecko from eating. Close observation of interaction between geckos is important and this may require separate feeding bowls, tank partitions or even separate housing.

-Improper lighting (too little visible light or UVB light) or temperature can negatively impact appetite. As cold-blooded animals, leopard geckos require a specific temperature range for proper digestion.

-Before and after shedding, appetite may be down. Shedding is energy intensive and potentially itchy and uncomfortable so while they will commonly not eat during the shedding process, their appetites may be depressed just before and after shedding as well.

Some abnormal causes for appetite depression include inappropriate environmental temperatures (usually too cool), mouth rot (infectious stomatitis), trauma, sickness or infection (bacterial, parasitic, nutritional (metabolic bone disease, hypovitaminosis A)), indigestion or maldigestion, reproductive disease (egg binding in a female) and gastrointestinal impaction.

The bottom line is that if your leopard gecko is otherwise acting and looking normally and the appetite depression is temporary then it may be normal. However, if the leopard gecko is displaying any other signs of illness such as weakness, lethargy, sunken eyes, skin discoloration, abnormal defecation or urination or the depressed appetite persists more than a few days, a visit to a local veterinarian with experience in reptile medicine is recommended.

To help find a local veterinarian with reptile experience, here is a useful website you can use to search for a local reptile veterinarian. These veterinarians are active members of the Association of Reptile and Amphibian Veterinarians, which means they have interest and experience in treating reptile patients:

(please note this site may not work on older browsers like Safari)

Please note that since you are outside the US, you will need to choose Advanced Search.

Advanced Search: Step 1 of 2, Member status

Select/toggle honorary member, life member, new grad, active veterinarian, and associate.

Press Continue.

Advanced Search: Step 2 of 2

Use the drop down menu in Country to select your country. Press Search.

CarynP625 and other Vet Specialists are ready to help you

Do you suspect Randell might be constipated (bloated, straining to defecate, history of exposure to particulate substrate like sand or crushed walnut shells, hard or infrequent poops even when he was eating, etc.)?

There are a number of reasons why a leopard gecko may fail to defecate or become constipated. Some underlying factors that may contribute to constipation are poor diet (poor quality, lack of variety, too many mealworms) or insufficient dietary calcium, inappropriate temperature (too cool), lack of access to or insufficient intake of water, trauma or stress from changes in the environment such a recent move, unusual activity in/near the cage, or the presence of new tank-mates. However, there are a number of conditions that may cause similar signs which include, but are not limited to, parasite infection (e.g., coccidia, protozoa or amoeba), dehydration, impaction or foreign material in the GI tract, metabolic bone disease, infection/abscess or cancer.

If your leopard gecko is continuing to act otherwise normally, it’s a good idea to look at husbandry practices (e.g., temperature, diet, calcium supplementation, etc.) to make sure they are appropriate. Re-examine your tank to rule out our environmental causes, e.g., using a good quality thermometer and a hygrometer so tank conditions can be accurately measured and monitored is very important.

At home, you can help with hydration by soaking them in warm (85-90F, 30-32C) water for 15-30 minutes once or twice day. If they may be having GI issues, then every 5-10 minutes during the bath you can gently massage the tummy from front to back to help promote GI motility and defecation.

If they are eating, dusting their insects with up to 1/8 teaspoon per day of methylcellulose fiber (“Citrucel”) for a few days may help loosen stool so it will pass. If you can’t get methylcellulose fiber you can use an alternative such as psyllium husk powder (Metamucil or generic) or Ispaghula husk powder (Fybogel Hi-Fibre Ispaghula husk). If they continue to be constipated, then scheduling a physical examination with a local veterinarian is advised. (If they are not eating, this can also be mixed into a syringe formula or even just water for oral administration.)

If your leopard gecko is showing any other clinical signs, such as decreased appetite, weight loss, lethargy, etc. then I would strongly recommend you make an appointment for your leopard gecko to be evaluated by a reptile veterinarian to try and find the cause for the abnormal elimination and the clinical signs. They will likely do a physical examination and may also do a fecal analysis to look for parasites and might do some imaging (x-ray or ultrasound). They can also give your leopard gecko fluids and medications to help the underlying cause and to treat any secondary symptoms they may have.

It’s especially important if your leopard gecko is sick or injured to make sure that their tank is clean, food is fresh and prepared hygienically and that the temperature is appropriate and that your UV-B bulb is in proper working condition. Here are some additional recommendations of how you can support your ill leopard gecko while they are under the weather or awaiting a veterinary evaluation:

-Keep them warm. Temperature is very important for keeping your gecko healthy with a gradient of temperature from cool to warm. Daytime temperature range with a cool side at 78-80F (25.6-26.7C), a warm side at 85-90F (29.4-32.2C) and a very warm, focal basking area of 90-94F (32.2-34.5C).

But if they’re not moving around much on their own, place them in an area of the tank that is around 85F (30C), but not on top of a hot rock or under the hottest basking area as they can overheat or get burned.

-To prevent or treat dehydration, you can give your gecko a soak in a shallow dish of warm water (85-90F, 30-32C) for 15-30 minutes twice a day. Or if they are too weak to be in water, you can help with hydration by placing them in a small, plastic or glass container lined with moistened paper towels for 15 minutes two to four times per day. Cover the container with the snap on lid or with clean cling film and poke holes in the lid or cling film to allow for air flow. Place the container into the enclosure where the temperature is around 85-90F for the 15 minutes so they stays warm. Then remove them from the container and put them back into the enclosure where the air temp near the surface is 85-90F.

Dry them off after the soak so they don't cool off too much.

If they might be having GI issues such as severe constipation or GI impaction, you can help promote GI motility and defecation with gentle tummy massage during the warm water soak. Be gentle and stroke the tummy from front to back a few times every 5-10 minutes during the warm water soak.

-Make sure you wash your hands with warm water and soap after handling your gecko or their cage furniture.

-Make sure the enclosure is clean as built up waste, dust and other irritants can predispose your animal to infection. Spot cleaning daily but cleaning the enclosure more thoroughly at least once monthly with a reptile safe disinfectant is recommended. F10 Veterinary Disinfectant is a good option, safe with reptiles and comes pre-diluted and ready for use in a spray bottle. You can also consider lining the tank with disposable unbleached paper towels or newspaper while they are ill to make cleaning easier. The papers should be changed out daily or more frequently if they become soiled. Also, since they defecate into their water bowls often, cleaning the water bowl daily with soap and warm water before refilling it and weekly disinfection of the bowl is a good idea while they are ill (normally, it's okay just to do a daily rinse and refill of the water dish with 1-2x per week washing/disinfection).

-Offer food, even if not eating. If your leopard gecko is having difficulty reaching or getting to their food, put the food dish next to them or you can also hand or tong feed them. Place an insect gently against their lips and if they are hungry, they will bite at it. If not, don’t force it.

If needed (if inappetence is prolonged), you can assist feed whole, calcium or multivitamin dusted insects (I recommend removing their heads first) or you can syringe feed them a replacement formula like Fluker’s ReptaBoost, EmerAid Intensive Care Carnivore, Oxbow Animal Health Critical Care Carnivore.

Outside the US if these options are not available you can try Vetark Critical Care Formula (not ideal as a long term replacer as it is grain based).

Another option is to assist or syringe feed Repashy Grub Pie for reptiles. It's a diet that is normally mixed with boiling water and then allowed to set up into a solid to make a gel food to feed to insectivorous reptiles. But if you mix it with room temperature (not boiling) water, more water than the package recommends, to make a slurry that is thin enough to go through a syringe, it can be used for syringe feeding. Or you can make it according to the package directions, using boiling water to make a gel that sets up, then cut the gel into pieces that you can then assist feed (like you would assist feed an insect). This formula is nice because it's based on insect and fish based protein and has a good variety of vitamins. Treat any gel you make like you would fresh fish, store leftovers in the refrigerator and discard after a day or two.

With any assist or syringe feeding, go slowly and don't feed too quickly to prevent choking. If you’ve never done this before there are some good online videos that you can watch first such as these:

Assist feeding an insect by hobbyist Garrett Rose (I do recommend pinching the insects head off first so it is dead before assist feeding if your gecko is sick or lethargic so they are not injured by the insect):

Syringe feeding by exotic pet veterinarian Dr. Kristin Britton:

-Limit and be gentle with handling. If they are ill or injured, limit handling and limit time out of the enclosure. If you must lift or remove them from their tank, go slowly and support their weight from underneath with your palm.

-Calcium and vitamin supplementation. It is important to still offer calcium and vitamin supplements if they are eating. More information about supplements is in the care sheet I shared with you. An excellent brand of multivitamins I highly recommend is ZooMed Reptivite with D3. There are a number of good reptile calcium brands on the market, if you need a recommendation on those, please let me know.

If they are not eating or pooping because they are experiencing a severe calcium deficiency related to Metabolic Bone Disease or dietary insufficiency or if they are not eating for another reason, you can buy a liquid calcium supplement at the pet store and give them a drop into their mouth once a day and this should help, but isn't a replacement for proper nutrition and a veterinary evaluation and treatment.

Fluker's Liquid Calcium Reptile Supplement

If they are experiencing signs of hypovitaminosis (A or D) or if they are not eating for another reason, then you can buy a liquid multivitamin supplement at the pet store and give them 2 drops for every 50 grams of body weight, twice a week. If they are not eating, then you can give this supplement every other day for a week before decreasing to twice weekly, while they are not eating. The supplement can be placed onto a food item before feeding or dropped directly into their mouth if they are not eating. Once they are back to eating or no longer have signs of a vitamin deficiency, this liquid supplement should be stopped in favor of multivitamin powder dusting of food and gut loading of insects, as described in the care sheet I shared with you.

Fluker’s Liquid Vitamin (Reptile Supplement)

It is also a good idea to re-evaluate your current husbandry practices as some common disorders, such as metabolic bone disease, are caused by deficiencies or imbalances in diet, UVB lighting, calcium/vitamin supplementation or improper environmental temperature or humidity. Therefore, I have already attached a general leopard gecko care sheet for you to review. Thanks.

I should be notified if/when you respond with additional information so we can connect about your leopard gecko Randell but, in the meantime, I hope this information is helpful and I wish you both the best. Thanks again for posting your question to Sincerely, ***** *****

Customer: replied 5 days ago.
Hello Dr. Caryn,Thank you so much for all your amazing feedback, this has been very helpful. We have a few further questions. First of all, we currently have been attempting at a bio habitat, as when we researched into substrate, this was the most consistently good option. Would you recommend that we keep this, or due to Randell being particularly needful that we switch to paper towels? We have changed his substrate from when we have first got him which made him slightly anxious, would another change in environment be too confusing for him? We currently have a heat mat which came with his setup. We will definitely get a UV light as you recommend, however should we get a bulb, providing just light or one emitting heat to? Also what is the difference between UVA or UVB? We currently have been switching between locus and mealworms/ super mealworms, however Randell has always been a particularly fussy eater. We wonder whether he may be poor sighted. His pupils do dilate with light and he does react to visual stimulus but sometimes it seems he doesn't recognize the food in front of him and almost zones out. We have just successfully syringe fed him with a grub supplement also containing vits called Leopa Gel. Shall we keep this up until his eating patterns return to normal or should we do this regularly? The bugs we have previously fed have been gut loaded with bug grub, should we feed them veggies in the future too or is this enough? They have also been dusted with calc and we have a calc tray in his setup too. He has 3 hides, a moist, wet and dry, would you like to see a picture of his habitat to recommend any alterations? We need to get a hydrometer, do we need to provide any other source of humidity as well as spraying his moss etc.? He hasn't pooped for over a week, just the white urine. Is this concerning or just due to his current eating problems? Out of the signs you provided, he doesn't seem to be constipated, rather than the fact he hasn't defecated recently.Thank you so much, Lottie
Hello Lottie. You are most welcome, I am glad the information has been helpful.

A bio active habitat is a fine choice for a leopard gecko, as long as humidity and temperature gradients are maintained within the proper ranges. The challenge with a bio active habitat is that it is more difficult to clean, so fecal material and bacteria can buildup over time. Using a live moss top layer or changing out some of the surface substrate periodically are options for trying to prevent secondary skin problems from build up waste or bacteria. Paper towels are an option to use if he has any skin, eye or vent issues or has diarrhea, as these can be more easily changed out daily while he has these issues.

So there are different opinions as to how to properly heat a leopard gecko cage. Personally I prefer basking lights to heat mats (and I recommend NOT using an hot or heated rocks as these will often lead to burns), since they produce a safer gradient of heat without risk of burns and also heat the air, which mats don't do. UVA refers to visible light and UVB to ultraviolet light which is not visible. The most common type of UVB light used for geckos, fluorescent UVB bulbs or lamps, produces some UVA/visible light but also UVB light and no heat. There are bulbs, called mercury vapor bulbs, which produce UVA/visible light, UVB and heat but, in general, these are too hot and produce too much UVB to use with a leopard gecko.

So best option is a separate basking light (halogen or incandescent) to prroduce heat and visible light and a separate UVB lamp (5.0 or 5% fluorescent is most typically used for geckos). They should both be set up above the basking spot.

Hikari does make some good products. However the Leopa Gel, which good for some vitamins, doesn't list calcium content (it's in the ingredients but not in the nutrition information) and is rather low in protein, only 10%. This is low for a leopard gecko diet, which is normally insects. The Leopa Gel has bran as the second ingredient, so there is a lot of fiber, probably to make up for mealworms as the primary ingredient, as mealworms can be somewhat indigestible.

So if you are hand feeding a gel as a replacement diet, I would recommend Repashy Grub Pie instead. It's good 43% protein and decent fat percentage, so it's more caloric dense. The downside is that you have to mix and make the gel yourself. But an advantage is that it comes in powdered form, so to make a gel you mix with hot water and let it set up. But if you need to syringe feed a more liquid diet, mix with cool water to make a slurry.

ProRep BugGrub is not a great insect gut loading diet, calcium levels are very low, only 0.39% (3.9 gm/kg), and phosphorus content is twice the calcium content. So I would not recommend using that to gut load insects. Other better options include:

Mazuri Better Bug Gut Loading Diet

Mazuri Hi Calcium Gut Loading Diet

Repashy SuperLoad Insect Gutload Formula

I think getting one of these good quality gut loading diets is preferable to home made or feeding just veggies, which won't boost their calcium content enough.

Leopard geckos don't need high humidity, the tank should only be around 30-40%, but they need one moist hide (not a wet hide) located in the warm zone (around 85F, 29.5C) that is lined with damp substrate. Moisten until damp but not soaking wet. This will create a local humidity inside this hide of around 70-80% which is needed for proper hydration and skin health. If the humidity in the main enclosure is lower than 30% then you can mist occasionally or try moving the water dish closer to the warm side/basking light to bump up the humidity.

He may not be pooping if he's not eating anything. But if appetite doesn't return, then I would recommend a hands on assessment by a local reptile experienced veterinarian to try and figure out the underlying cause of the appetite loss.

My sincere best to you and Randell.

Sincerely, ***** *****