General Diseases of the Turtle and Tortoise:
Shell and Skin: Diseases of the shell and skin can be caused by bacteria, fungal organisms and/or parasites. SCUD, Subcutaneous Ulcerative Disease, is caused by the bacteria, Citrobacter. It presents in turtles, especially those in very damp conditions, as ulcers on the skin. The bacteria, Beneckea, produces enzymes which digest the matrix of the shell resulting in erosions of the shell and secondary infections typically called “shell rot”. Many conditions result in generalized weakness of the shell such as: poor water quality, poor nutrition, calcium deficiency, kidney disease, lack of exposure to natural sun light and trauma. Presence of these conditions may predispose the turtle to other infections by bacteria, fungal organisms and parasites. Shell disease may appear as clear bubbles or blisters under the surface of the shell or scutes, erosions of the shell exposing the underlying bone and pits or loosening of the shell plates. Kidney disease may result in loosening of the scutes and loss of parts of the shell surface. Whitish discoloration of the skin may be normal skin that has failed to shed or may indicate infection. Fungal disease may present as white or gray patches on the skin or shell and may be associated with pits in the shell. The shell should be hard, like bone. Soft shells are usually a result of poor diet and inadequate balance of calcium, phosphorus and Vitamin D. (see metabolic bone disease) Reptiles normally have little odor. Odor often indicates infection, parasites, unclean environment or feces stuck to the reptile. Swellings on the skin may indicate infection, abscess, parasites, fly larvae deposited under the skin, or tumor. Swelling of the membrane over the ear causing it to bulge outward usually indicates an abscess of the middle ear. Most abscesses need to be opened surgically to allow removal of the infectious material in the abscess cavity. Additional treatment involving antibacterial flushes of the wound and antibiotics may be needed. In particularly serious wounds and in reoccurring infections, a culture may be required to identify the bacterial organism causing the infection in order to determine the most effective treatment.
Generalized treatments of skin and shell lesions include:
- Betadine soaks-Dilute betadine to light tea color and use as a soak solution for 20 minutes twice a day.
- Silvadine (1% Silver Sulfadiazine Creme)-Apply to affected areas twice a day
- Keep dry other than during feeding (water turtles only) and between betadine soaks
- Soak in fresh water twice a day to encourage drinking, defecation and urination in most species and to feed aquatic turtles
- Injectable or oral antibiotics may be prescribed by the veterinarian based on observation, clinical signs and bacterial/fungal culture and sensitivity testing results when possible
- Fungal disease may respond to salt water soaks (1/4 cup non-iodized salt to 5 gallons of water) and to dilute nolvasan soaks
Traumatic Injuries: Slow moving chelonians often fall prey to dogs, other predators, lawn mowers, cars, and intentional injury resulting in cuts, abrasions, cracked shells, broken bones and internal injuries. Treatment varies with the severity of the injury and time elapsed since the injury. Animals with non-healing wounds are prone to myiasis i.e. infestation with fly maggots. Many of these cases are considered a true emergency. If unable to obtain immediate veterinary care the following first aid measures are indicated:
- Stop any fresh bleeding by applying direct pressure to the wound
- Clean wounds using sterile saline solution (saline solutions used for contact lens work well) and dilute Betadine solution
- If maggots are present, manual removal of the maggots followed with flushing the wounds with hydrogen peroxide first then with sterile saline solution and dilute betadine
- Silvadene (1% Silver Sulfadiazine Creme) or other topical antibiotic ointment should be applied to the wounds
- Cover with telfa pads and apply pressure type wrap using masking tape or cellophane wrap to prevent oozing and further contamination
- Seek veterinary attention as soon as possible-Injectable or oral antibiotics and surgical repairs are often indicated.
Swollen Eyes/Respiratory Disease: Signs of difficult respiration include stretching the neck, gaping the mouth with labored breathing and pumping their head and legs while breathing. Aquatic turtles may float unevenly with one side floating higher than the other in the water. Nasal discharge is abnormal unless associated with drinking. Bacterial infections are a common cause of infections of the upper respiratory tract and can result in death if not treated early on in the course of the disease. Poor husbandry, suboptimal environmental conditions, and Vitamin A deficiency can predispose to respiratory infections.
Vitamin A deficiency is common in reptiles, especially water turtles on a diet of dried insects and lettuce. Vitamin A is important in the survival and function of the cells that line the respiratory tract, digestive tract, mucous membranes and glands of the eyes. Vitamin A deficiency may present as swollen eyes, increased mucous in the mouth and flaky skin. These animals are predisposed to secondary bacterial infections leading to mouth rot , shell rot and pneumonia. Foods high in Vitamin A include: cooked liver, cod liver oil, yellow vegetables, carrots, egg yolk, and Brussels sprouts.
Nutritional Deficiencies: Vitamin B1 (Thiamin)-Tremors, paralysis, other neurologic signs. Frozen fish contains thiaminase, an enzyme that destroys thiamin. Vitamin C-Increased incidence of infection. Vitamin K-Bleeding problems. Vitamin D-Low Vitamin D causes a lack of absorption of calcium in the intestine. High Vitamin D causes calcification of soft tissues leading to organ failure. Protein-Too little causes poor growth and poor immune function i.e. low disease resistancy. Too much contributes to early kidney disease.
Disorders of the Digestive Tract: Failure to pass feces may be due to dehydration; impaction with foreign material such as sand, gravel, or cage litter; or starvation. Diarrhea may result from feeding foods with a high water content, parasites, overgrowth of abnormal bacterial organisms and lack of adequate roughage in the diet of tortoises. Gas may accumulate in the bowel due to an abrupt dietary change, inappropriate foods (dairy products), low body temperature or secondary to gastrointestinal obstruction resulting in bloat. Infections of the mouth (stomatitis) are usually due to bacterial infections, however, these are relatively uncommon in chelonians. Masses protruding from the rectum (anus) should be considered an emergency. This can be associated with a prolapse of the rectum, bladder, hemipenes (penis) in male chelonians, and uterus in females.
Reproductive Disorders: Egg binding or dystocia, the inability to deliver eggs, is a common problem in captive chelonians. The causes include: absence of normal substrate for turtle to nest in, abnormal shape or size of the egg, soft eggs, broken eggs, disease of the uterus causing scaring or other obstruction, and blockage of the pelvis by bladder stones, intestinal impaction or foreign body preventing normal delivery. The most common signs observed are loss of appetite and straining. Treatment varies with the cause of the dystocia from provision of proper nesting substrate to surgical removal of eggs. Failure to relieve a dystocia can result in death. Straining as a result of eggs, intestinal foreign bodies or bladder stones may result in prolapse of the rectum, bladder or uterus. Treatment involves cleaning the prolapsed tissue with sterile saline solution and coating the tissue with water soluble lubricant such as K-Y jelly to prevent drying and trauma. Granular sugar may be used to draw fluid out of the edematous tissues. Keep the tissues moist and present the animal to a veterinarian as soon as possible. The shorter the time that the tissue is exposed the better the chance that the tissue will survive and be successfully replaced. Male cheleonians often prolapse their penis as a part of courtship display. In these cases, the penis usually returns to its normal position unaided, however if drying or injury occurs, assistance may be needed.
Metabolic Bone Disease: Metabolic Bone Disease (MDB) is the loss or lack of normal bone density resulting from one or a combination of the following factors: low dietary calcium, high dietary phosphorus, low Vitamin D3, and/or kidney disease. Vitamin D3 is required for normal absorption of calcium from the digestive tract. Low Vitamin D3 is caused by lack of exposure to natural sunlight. The body constantly tries to balance calcium with phosphorus in the blood in order to provide appropriate calcium for vital cellular functions. If calcium is not readily available in the diet, then the body pulls calcium from the bones. In growing animals, this results in deformity of bones and shell, stunting and if severe, death. In adults, the bones are brittle and easily broken, shell may become soft, intestinal motility may be reduced and egg binding is more common. Prevention by feeding a feeding a proper diet is best. Foods with a normal calcium balance (2 parts calcium to 1 part phosphorus) include: zucchini, fig, endive, alfalfa hay/pellets, pinkie mice, earth worms, meal worms, crickets and slugs. Many zoos feed rabbit or guinea pig pellets. These alfalfa pellets are good sources of calcium, protein and fiber/roughage.