Hind Leg Paralysis

Special Thanks is given to Lori (Bourbon), Teresa (Dancing), Chris (glidrz5) and Jen (Xfilefan) for their assistance to me in compiling information for this article.

Also known as HLP, Secondary Metabolic Bone Disease, Hypocalcemia or Calcium Deficiency... all these terms refer to the same condition - the body's inability to properly synthesize calcium, resulting in the bones not getting enough calcium. In severe cases, the calcium is also leached from the muscles, causing paralysis of the hind legs. Although a diagnosis of HLP used to be considered an automatic death sentence, if caught early and proper treatment is administered, HLP can be healed and the sugar glider can continue to lead a long and productive life.

Pika's rear leg is unusually angled at 90* due to HLP.

If you look closely, you can also see that her knuckles are swollen.

Symptoms:

  • Severe shaking
  • Apparent dizziness
  • Lack of coordination
  • Lethargy
  • Limping
  • Weakness
  • Loss of use of hind legs (dragging one or both legs)
  • Swollen toes and/or fingers
  • Sudden broken bones with no apparent cause
  • Joint stiffness
  • Sudden, inexplicable weight loss

   

These pictures show Pika's swollen fingers and toes - our first indication that something was wrong with her.

Please note that many of these symptoms listed can also be

 indicative of other serious health issues. Self-diagnosis of any

 medical condition can be harmful to your glider. Make sure that

if you see any of these symptoms in your glider that immediate

veterinary care is obtained for proper diagnosis and treatment.

Cause:

Primary bacterial or parasitic infection

For many years, diet was targeted as the cause of HLP. However, in recent years it has become apparent that HLP is actually always secondary to a primary bacterial or parasitic infection. 100% of all recorded cases where gliders with HLP were tested for primary infection came back positive for infection.

Although diet is not a direct cause of HLP, you should make sure that your glider is being given a nutritionally complete diet with a balanced Calcium to Phosphorus ratio of 2:1 and that all components of the diet are being eaten. If a glider is picking and choosing their foods and not eating one of the components, the nutritional balance can be thrown off. This was the case with my Pika. She would only eat the proteins being provided and did not eat her fruits and vegetables very much. This over-balance of protein in her diet actually inhibited her body's ability to synthesize the calcium so that although her blood level of calcium was elevated above the normal level, her bones were not receiving that calcium and HLP was the result.

The Calcium to Phosphorus ratio of the diet is not the only one to be concerned with. Many vitamins can react adversely with each other. Some will prevent the absorption of certain minerals and vice versa. For example, too much Vitamin C will prevent the absorption of Calcium.

In addition, it should be noted that too much Calcium is just as harmful as not enough. When too much Calcium is given to a sugar glider, the result can be kidney stones, crystals in the urine, gall stones and/or Calcium deposits on the bones, joints, muscles and organs.

Diagnosis:

Veterinary diagnosis is needed to determine whether or not a glider does or does not have HLP. A number of tests need to be run at the time of the veterinary examination. The most important tests include:

  • Urinalysis - to determine whether or not a Urinary Tract Infection (UTI) is present which could be the primary cause.
  • Fecal Float & Smear - to determine whether or not any parasitic infection is present which could be the primary cause.
  • Fecal Culture & Sensitivity - to determine whether or not any bacterial infection is present which could be the primary cause
  • Xray - to look for calcification of the joints or weak joints. In a glider with HLP, the joints will appear cloudy and indistinct -as shown in this xray of my glider Pika. (For a more detailed view and analysis of the xray, click on the image below.) 

  • Complete Blood Analysis. One of the things that the veterinarian will evaluate from the results is the overall Calcium:Phosphorus ratio. Blood testing can be difficult with gliders since a maximum of 1% of the total glider's mass can be safely withdrawn, so for a 100 gram glider, only 1 gram of blood can be taken. Gliders oft-times lose weight quickly after the onset of HLP and if the glider is not heavy enough, it is possible that not enough blood will be obtained for the tests to be run.  In addition, due to their weight loss, sometimes the arteries will collapse as the veterinarian tries to withdraw the blood from the normal areas; in that situation, the veterinarian may attempt to withdraw blood directly from the Vena Cava (the main artery to the heart) - which is a very risky procedure. Discuss the condition of your glider and the risks vs. benefits of this test with your veterinarian so that you can make a decision about whether or not to proceed with this test.

Treatment:

Gliders that have been diagnosed as having HLP should be treated with an oral calcium supplement, such as Neocalglucon (only available through a licensed veterinarian). The actual amount administered is determined by the veterinarian based upon the glider's weight. Normal course of treatment with oral calcium supplement is two weeks - although this time may be extended in severe cases. In some cases, the veterinarian will administer an injection of calcium to jump-start the healing process.

In addition, an antibiotic should be prescribed. If a specific infection has been found during veterinary examination, an appropriate antibiotic will be prescribed accordingly. If no infection can be found, a broad-spectrum antibiotic (such as SMZ-TMP or Clavamox) should still be prescribed as a prophylactic for a course of 7-10 days since primary infection is the leading cause of HLP in sugar gliders. Again, the veterinarian will determine the dosage based on the glider's weight. Along with the antibiotic, an antiparasitic should be prescribed (such as Metro) in case the infection is parasitic in nature, rather than bacterial.

The veterinarian will continue to examine the glider regularly to monitor the glider's progress. All appointments for follow-up care should be kept. Follow up x-rays should be performed 2-3 months after the beginning of treatment to analyze the progress of treatment. Other diagnostic procedures may also be performed at the recommendation of the treating veterinarian.

Pika is pictured here at Thanksgiving, 2006, just a year after her initial diagnosis of HLP. Although her mobility was limited by the permanent damage to her hind legs, she did very well in getting around. Pika passed away on March 12, 2007 from an unrelated neurological problem. I will forever miss her and her gentle, loving nature.  This article was written as a tribute to my beautiful Pika.

If you feel your glider is sick, please seek immediate veterinary

assistance. The information on this page and in the correlating

articles is for general educational purposes and is not intended

to replace proper vet care. Please do not try to self-diagnose or

self-treat your glider.

Site most recently updated in October, 2016