Common health problems in tortoises include upper respiratory infections from mycoplasma bacteria, nutritional secondary hyperparathyroidism from calcium deficiency, intestinal impactions from ingesting gravel, cystic bladder calculi from inappropriate diets, retained follicles in females, and herpesvirus infections. Diagnosis involves physical exam, radiographs, endoscopy, cultures, and biopsies. Treatment depends on the underlying cause but may include antibiotics, calcium and vitamin supplementation, fluid therapy, endoscopic procedures, and surgery.
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Common Problems of Tortoises SDT&TS
1. Common Problems of Tortoises (Chelonians) Thomas H. Boyer, DVM, DABVP, Reptile & Amphibian Practice Pet Hospital of Penasquitos 9888-F Carmel Mountain Road, SD, CA 858-484-3490 www.pethospitalpq.org
5. Diagnostic Challenge History – If owner feels something wrong, there generally is. Must know husbandry. PE - Do not delay workup Bloodwork – CBC, chemistry panel, protein electrophoresis, thyroid Fecal – Direct & Flotation 3 view radiographs Laparoscopic biopsies
20. Mycoplasmaagassizii, M testudineum Clinical signs – Clear serous to tenacious mucous nasal discharge, bubbling, clogged nares, nare erosion, rhinitis, caseous blockage, palpebral edema, conjunctivitis, decreased appetite, weight loss, death Extremely contagious via nasal exudates, horizontal, direct or short distance (< 0.5 m) Indirect & vertical unlikely More common in winter
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23. Diagnosis Clinical signs suggestive – Push head into shell, nasal discharge abnormal! DDX – Herpesvirus, iridovirus, IN cocidiosis, oronasal fistula, nasal foreign body, GI impaction & regurgitation ELISA Ab test (serum, > 8 wks), PCR (discharge) U of FL Culture – Not rec’d
25. Mycoplasmosis TreatmentSanibel Island - Untreated mortality 30% (50%?) Antibiotics for 3-6 weeks Enrofloxacin, danofloxacin, clarithromycin, tetracyclines Neomycin-Polymyxin B-Dexamethasone nasal drops for 3 weeks Nasal flushes Supportive care if indicated Isolate from other tortoises, chronic carriers Relapse common but less severe
32. Chronic malnutrition Dietary history & R/O other disease Hypoalbuminemia < 1.0 mg/dL (normal DT > 2.5 mg/dL) or anemia (PCV < 15%) Suggestive for hepatic lipidosis or other chronic disease – mycoplasmosis, intestinal impaction, bladder stones Dx – Endoscopic liver biopsy Tx – Based on underlying ds, will need esophagostomy tube , no surgery until liver recovered
34. Nutritional secondary hyperparathyroidism Dietary history Small tortoises – Fail to grow or gain weight, soft shell, splayed legs, fail to lift plastron while walking, poor to no appetite Prognosis If not eating don’t survive (kidney failure?) If eating much better prognosis
46. Shell Trauma Dog gnaw trauma Stabilize patient, AB’s, pain meds, nutritional, fluid support, th0roughly clean & flush wounds, wet to dry bandages, Once stable & wounds clean (1 wk) repair shell fractures with metal wires, bridges, suture, 5 min epoxy & polypropylene gauze Severe cases often fatal
47. Shell Trauma Coelomic punctures most serious, no pneumothorax Shell heals inside out, new shell forms under damaged shell Chelonians capable of regenerating most of shell
55. Cystic calculi Uric acid & ammonium acid urate Generally palpable Predominate in left lobe of bladder Inappropriate diet & lack of access to water Definitely a problem Obstruct or torse colon, bladder necrosis or torsion, gradual decline, weight loss, death
59. Intestinal impactions Ca deficient diet – Will seek rocks Anorexia, listlessness, lack of defecation, regurgitation, straining to defecate Small amounts of gravel in GI tract normal as long as appetite & defecation normal Most commonly at distal transverse colon as it turns posteriorly into descending colon (caudal left coelom) If eating – Pysllium fiber on food or via ST, repeat rads q 2 -4 wks
65. Egg retention Palpable in inguinal fossa Female often pacing, several false nests Oxytocin 1- 3 tx’s q 90 min Calcium, fluids Make sure area to dig Celiotomy if not responsive except if egg in pelvis
68. Post-hibernation anorexia Hibernation emergence is common time for other ds. to manifest – Mycoplasmosis, hepatic lipidosis, renal ds. More common in northern latitudes Hibernation - Tortoises should loose < 6-7% BW (1%), < 3 months, soak q 2 wks Should start eating, drinking, urinating within 1 wk of emergence, no urination poor prognostic sign Workup – CBC, Chem panel, PE, urinalysis, rads, fecal
69. Post-hibernation anorexia Abnormalities – Hyperuricemia, hyperkalemia, hypoglycemia, hypoproteinemia UA > 34 mg/dl, K > 35 mg/dl will die Acidic urine Treatment – Directed at underlying ds., AB’s Fluids via ST, epicoelomically, intracoelomically until urinating well Shallow lukewarm water soaks BID Anorexia – Esophagostomy tube
70. Retained follicles Follicles that fail to ovulate or undergo atresia remain stagnant for months become necrotic, inspissated, or rupture & cause egg yolk coelomitis Females often anorexic w/ hepatic lipidosis Chemistry – Elevated Ca, Alb, TP, AP CBC – Anemia with heteropenia DX – Celioscopy or US Tx – Oophorectomy, supportive care. Avoid CI’s Plastronal celiotomy Endoscopic flank incision
77. Ectoparasites Ticks are rare, don’t see in San Diego Amblyomma ticks harboring heart water disease, Erlichia ruminatum, found in environment around imported tortoises in FL 2000 - Ban on importation & interstate sale of Geochelone pardalis, G. sulcata, Kinixys Later determined tortoises were not a heart water vector
78. Herpesvirus Necrotizing stomatitis, glossitis, pharyngitis, diptheritic plaques, nasal discharge, anorexia, cachexia, rapid death (esp. w/ die offs) Eosinophillic intranuclear inclusions Russian tortoises, Testudo horsfieldi – Carrier? Acyclovir PO TID x 21 days. E-tube
80. Alphaherpesvirinae Herpesvirus of tortoises Fibropapillomatosis Grey patch disease Lung eye tracheal ds. Hepatic necrosis in freshwater turtles (Clemmys, Chrysemys, Graptemys)
81. Intranuclear coccidiosis Rare, unidentified species of Coccidia Contagious fatal epidemic disease Sudden death, rapid weight loss, weakness, gasping respiration, swollen erythematous, necrotic cloacal crusts. Gets into all tissues. Diagnosis typically post-mortem PCR UFL
82. Exuberant epiplastron Male Geochelone sulcata, Gopherus agassizii Dx & Removal rarely indicated Only remove if interfering with eating Amputate sterilely, seal with polypropylene gauze & epoxy
83. Drowning Found at bottom of swimming pool Can survive long periods underwater If unsure alive – ECG or Doppler US Hold head down, pump legs, IPPV Ab’s for 3 wks Furosemide not effective in reptiles (no loop of Henle)
