Lung hemorrhage in a green iguana (Iguana iguana) with chronic metabolic failure: a case report

A six year old male iguana (Iguana iguana) was brought to our clinic after a fall from a height of 1.5 meters. The patient showed apathy, dehydration, and paresis of all the limbs. Postural reflexes, palpebral reflex, and response to painful stimuli were minimal. The patient had extremely high levels of uric acid (1 734.0 μmol/l) and phosphorus (9.80 mmol/l), ratio of calcium to phosphorus (0.18), leucocytosis (23.3×109/l) with heterophilia (17.10×109/l), and high activity of ALT, AST and CK (2.09, 6.59, and 260.0 μkat/l). Tracheoscopy and pneumoscopy revealed presence of blood clots in the trachea and lungs with haemorrhage within the parenchyma. Based on the results of the clinical examination, endoscopy and laboratory diagnostics, the clinical diagnosis was chronic kidney failure, liver lipidosis and lung haemorrhage. Because of a very poor prognosis, the patient was euthanised. At necropsy, the signs of visceral gout and hepatomegaly with diffuse yellowish white discoloration and with dotted brown pigmentation were also observed. The kidneys were enlarged, and stained brown grayish. The gross and histopathological examination confirmed the clinical diagnosis of visceral gout, chronic kidney failure, liver steatosis and granulomatous pneumonia, with lung haemorrhage associated with urate deposits in lung tissue and posttraumatic status.