Background Chronic lymphocytic leukemia (CLL) is a diagnosis of exclusion in bearded dragons. To date, information about the disease in this species is limited and no gold-standard treatment has been established. Case description A pet bearded dragon presented for evaluation of lethargy, intermittent episodes of forceful swallowing, mild conjunctivitis with blepharospasm in the left eye, and neurological signs. Initial bloodwork revealed anemia as well as lymphocytosis which persisted despite a prolonged course of treatment with two broad-spectrum antibiotics. Additional diagnostics including MRI, CT scan, plasma biochemistry panel, fecal sedimentation, and adenovirus PCR were performed and results were unremarkable. The collection of findings, most notably persistent lymphocytosis of small-cell morphology, led to a presumptive diagnosis of CLL. Chemotherapy treatment with cyclophosphamide was instituted at 5 mg/kg and the patient received three treatments, two treatments two weeks apart and a third given twelve weeks after the second. One week after the first dose, neurological signs improved, anemia resolved, and lymphocytosis resolved. The patient remained stable until shortly before the third dose was administered. The patient died shortly after the third dose. From the time of initial presumptive diagnosis to death, the patient lived 115 days. From the time of initial cyclophosphamide treatment to death, the patient lived 107 days. Conclusions and clinical relevance Cyclophosphamide may be considered a non-invasive and potentially effective first-line cytotoxic chemotherapy option for CLL in bearded dragons. Treatments at intervals of no longer than two to four weeks may be beneficial for improved disease management.
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