Symptoms and Treatment of Lizard Metabolic Bone Disease

Symptoms and Treatment of Lizard Metabolic Bone Disease (MBD)

Lizard Metabolic Bone Disease Can Cause a Smile Like Appearance

Lizard Metabolic Bone Disease Can Cause a Smile Like Appearance

One of the most common medical conditions is lizard metabolic bone disease due to a problem with nutrition or breeding. The disease is also referred to as Nutritional Secondary Hyperparathyroidism (NSH)).

The nutritional imbalance results from a calcium deficiency as well as an imbalance between the ratio of phosphorous to calcium, or when there is too much dietary phosphorus. The ratio of phosphorus to calcium should be 1.1 to 2.5.1.

Other vitamin deficiencies might also be present such as Vitamin D. Vitamin D is essential in the diet for bone formation and in helping calcium absorb through the intestinal tract. Without vitamin D, the lizard would not be able to absorb needed calcium.

Lizard Metabolic Disease Symptoms

Symptoms of lizard metabolic disease include two types of symptoms:

1. Lizard body tremors or spasms for a condition called Hypocalcemic Tetany. Symptoms appear immediately after a problem occurs. These MBD symptoms often appear after a female delivers an egg clutch. If you see these symptoms immediate veterinary care is required since the condition is life threatening.

2. Lizard MBD symptoms in the jaw indicate the chronic form of the disease. Other bones affected include the long bones of the legs or ribs. Lizard Metabolic Bone Disease replaces calcium salts in the bone with softer fibrous tissue. This results in a pliable lower jaw. The tongue muscles deform the lower jaw causing a "smile" like appearance. If symptoms in these areas are present, then the cause is often poor diet, a need to correct vitamin supplements and not enough exposure to natural ultraviolet light.

Lizard MBD Treatment

A veterinarian will work to quickly correct any life-threatening conditions such as dietary deficiencies and any related bone fractures. Fractures are set with splints.

A veterinarian may inject vitamin D3 and provide oral or injectalizarble calcium supplements. In lizards that are suffering from jaw problems, the veterinarian may recommend therapy with Salmon Calcitonin 1x per week during the recovery process.

For more information see Identification and Treatment of Metabolic Bone Disease by Melissa Kaplan.

Reader Questions and Vet Suggestions for Lizard Metabolic Bone Disease Below

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Lizards with Rubbery Digits Might Have MBD

by Teresa

Our Bearded Dragons have developed extremely weak and rubbery digits. What could cause profound weakness in Pogona Vittaceps metacarpals and metatarsals? They also have an occasional tremor in the muscles.

There are no other obvious problems, other than possibly stunted growth. They are male. Approximately two years of age. Housed separately in 40 gallon vivariums. Each has been treated exactly the same way regarding diet, lighting, handling. They have Mercury Vapor Bulbs, 120 watt (I think). They have a twelve hour light dark cycle.

We feed them calcium dusted crickets, occasional super worms (beheaded). Green beans, sugar snap peas, watercress, sweet potato, snow peas, and an occasional berry. Since they have developed the twitching and digital weakness, we have started including a multivitamin in their diets.

I had been erroneously feeding them previously frozen vegetables, before I realized that the destruction of thiamine was resultant. They have since been fed only fresh produce.

When the tremor and weakness was first noted, we had a blood test run, suspecting the possibility of hypocalcimia. This was negative.

They did a culture that revealed an overgrowth of (normally symbiotic) parasites, and we did a course of antibiotics.

BUT, the weakness still remains. Their toes are very weak and rubbery, and we have to be constantly aware of their positioning when we hold them. The tremor has decreased, but seems to become more apparent when they are agitated.

We have no idea what to do, and are greatly concerned.

Any insight you could give would be appreciated.

Thank you.

Vet Suggestion: Check for Lizard Metabolic Bone Disease

Hi Teresa,

The description you give of your bearded dragons’ symptoms immediately bring to mind metabolic bone disease. This still seems like the most probable diagnosis despite the fact that you had their blood calcium levels checked previously and they were normal. It certainly wouldn’t hurt to recheck their calcium status. Perhaps it has worsened with time. Another possibility that comes to mind is kidney disease, but this is not as common as is metabolic bone disease.

Your husbandry sounds excellent, but sometimes very subtle errors in temperature, humidity, the placement of lights (or failing to replace light bulbs on a regular basis), can have a big effect, and I am unable to evaluate your set up from afar.

Make sure your veterinarian has expertise with reptiles (many don’t). The Association of Reptile and Amphibian Veterinarian’s website includes a searchable database of vets that specialize in the treatment of these unique animals.

Best of luck,

Jennifer Coates, DVM

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Treating Lizard MBD (Metabolic Bone Disease)

by Gage
(mcr, england)

Hello, I hope you can help me. My lizard has MBD. I am sure because her head is tilted 24/7 and she moves in circles most of the time, she cannot swim in the bath. I have tried to do everything, but she seems to be getting worse.

Her eyes looked swollen the other day, but then it went back to normal (the 1st time I have seen it). I think she is dying! She is an adult red moth. Also she is always lying down, never upright and her left arm is always tensed up which brings me back to her moving in circles (to the left). She does it so much that she ends up on her back tripping over her tail.

I think she needs to be put down. Is that right?

Please help.

Veterinarian Suggestion for Lizard MBD


Based on your description of your lizard’s symptoms, metabolic bone disease is certainly a possibility. The diagnosis would have to be confirmed with a physical exam performed by a veterinarian, knowledge of your lizard’s diet and exposure to ultra-violet light, and possibly x-rays and/or tests to measure blood calcium levels.

Lizards with mild symptoms of metabolic bone disease often recover once their diets and/or exposure to ultraviolet light are improved. More severe cases may also require injections of vitamin D, calcium, and calcitonin (a hormone that controls the amount of calcium in the blood and bones); fluid therapy; nutritional support; and stabilization of fractures.

I would only recommend euthanasia if a veterinarian determined that the likelihood of treatment success was low.


Jennifer Coates, DVM

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