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Common diseases of Tortoises

Misty Corton, The Care Centre, Natal, South Africa



On obtaining your tortoises, ask around until you find a capable veterinarian who is familiar with treating these animals. Pay him a visit and get him to check your animal over to ensure that there are no obvious problems. Ask him/her to do a fecal to check for parasites and if necessary to de-worm the tortoise. Record their weight, origin and the date you received tortoises for future reference.

It is outside the scope of this web site to give details of all diseases that these reptiles can acquire. The following are the most common problems encountered and will give you some idea of what to do should the worst happen.

Without a doubt "runny nose syndrome" is the most frequent complaint encountered in South Africa, therefore, this is covered in some depth.

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Respiratory disease: "Runny nose syndrome" RNS is not a disease, but rather a term used to describe an upper respiratory tract infection which may have several causes. It can occur in any species, but seems to be especially prevalent in Geochelone pardalis, the Leopard tortoise. It can occur at any time of the year, can be fairly difficult to spot in the early stages, and has a nasty habit of recurring, despite treatment. Any animal that has been infected can, and often does, become a carrier. They may not display any symptoms, but can infect any tortoise that comes into contact with them. Leopard tortoises are the worst affected, perhaps because of their size, nutritional state and a general inability to cope with our humidity and dampness. Those that recover often relapse, especially if treatment is stopped because "he seems much better now".

RNS is more common in large and mixed collections, and can spread alarmingly quickly if prompt action is not taken. Never ignore a runny nose in the hope that it will clear "when the weather improves". If no treatment is obtained, RNS can develop into chronic or acute pneumonia which can be extremely difficult to cure. Quite often stomatitis (mouth rot) accompanies RNS which can complicate matters even further.

There are several factors that increase the chances of your tortoise developing a respiratory tract infection: dusty conditions (resulting in irritation of the mucus membranes), foreign bodies lodging in the nostrils, inappropriate humidity or temperature, lack of sunlight, confinement in damp grassed areas with no access to sand, overcrowding, malnutrition, and stress.

Prevention: A natural diet will go a long way in keeping your tortoise healthy. Tortoises love "junk" food in the same way that humans are addicted to hamburgers and hot-dogs. In supplying them with a pile of readily accessible kitchen food you are doing a lot of harm. You go to bed at night feeling good - "My tortoise ate a good meal today!". Over the years the damage creeps on, undetected, and the problem ignored. Your tortoise lies around all day sunbathing, eating, sleeping - seemingly healthy, when in reality his body is slowly deteriorating to a point where things start going radically wrong. If, or more likely when disease strikes, your tortoise has more chance of dying than one who is active all day seeking out natural food.

This active tortoise will have muscles that are firm and strong, his metabolism will be functioning in top gear, and his vitamin/mineral intake sufficient to ensure that his immune system gives him sound protection against invasion of disease causing organisms. A tortoise suffering from malnutrition has no such protection against disease, he has no defenses left to fight invaders, and will often succumb to a minor infection.

Do not add any new tortoise to your existing collection without a quarantine period - 6 months is the minimum recommended. Your new tortoise may have had RNS or some other bacterial, mycoplasmic or even viral disease and may now be a carrier. There is no way of identifying a carrier with any certainty.

Avoid stress - dogs or other animals worrying your tortoise, overcrowding, competition/aggression from other tortoises, or children allowed to "play" with the animal is stressful. Stress causes a number of biochemical changes in the animal, among them the production of steroids which in turn suppresses the immune system - such animals are more likely to succumb to an infection than a healthy non-stressed tortoise exposed to the same infectious agent. Stress is almost impossible to detect until it is too late, and can have serious long term effects on the general health and resistance of the animal.

Avoid sleeping quarters that are in a damp area. Provide a dry, snug bed at night.

The single most important thing you can do to prevent RNS (and many other equally serious diseases) is NEVER TO ALLOW CONTACT BETWEEN DIFFERENT SPECIES. Animals from different areas have different abilities to resist 'alien' pathogens; an organism which may be harmless to one can kill another.

Treatment: The worst has happened, your tortoise has a runny nose - what should you do? First check that there is no foreign body lodged in the nostril - grass seed, grass etc. If one is found it should be removed without delay and drops used as outlined below to clear up any infection it may have caused.

If a foreign body is not the culprit, ask your vet (or your normal doctor or pharmacy) for a sterile swab. Take a smear of mucous from his nose and get this sample in to your vet or doctor for immediate testing. The results of this test will tell you which organisms are causing the infection and which antibiotics will work effectively against them. This is most important, it is unrealistic to expect a single antibiotic to work against all "bugs". Most infections in reptiles are caused by what are known as "gram-negative" organisms, and this knowledge enables a vet to hazard a pretty good guess as to what will work. Thus, if testing is out of the question, and/or while you are waiting for the results of the testing, treatment is commenced with an antibiotic effective against gram-negative organisms.

In mild and short-standing infections, treatment consists of antibiotic drops given into the nasal chambers once daily. Those most often used are Oxytetracycline (Terramycin), Tylosin, and, especially, Enrofloxacin (Baytril). First wipe the animal's nose with a disposable paper towel to remove as much mucous as possible. Then a syringe with a short rigid tube is used to instill one drop of antibiotic into each nostril once daily whilst holding the animal in an upright position (to ensure the drug goes well into the nasal cavity).

This is best done toward late afternoon before the animal beds down for the night. If the weather is damp or cold it is preferable to place the tortoise in a box indoors at night in a warm area. Beware of using clip-on lamps as these can be dislodged, causing a fire hazard. Severe cases will need to be kept under heat for the duration of treatment. Heaters mounted onto the wall are best for this purpose as they cannot be dislodged.

This simple treatment is continued for a week or two after symptoms have disappeared to prevent relapse. Whilst on the subject of antibiotics, bear in mind that some tortoises (Leopard and Cape angulate tortoises in particular) can be allergic to Baytril. Most allergic responses are vomiting and/or frothing at the nose and mouth. If, of course, the results of the test come back indicating that a different antibiotic is required, you should switch over immediately. Cortisone should never be used as it suppresses the immune system of an already compromised animal.

While this treatment usually works, remember also that the conditions that initially caused the infection may still prevail (stress, malnutrition, dampness etc.) and that this should be rectified if you wish to avoid relapse.

This isn't working! You have tried the drops, and they don't seem to be working. Now what? Some infections are complicated. More than one organism could be involved, necrotic stomatitis could be complicating the infection, acute or chronic pneumonia could be setting in. There are any number of reasons, and whatever the cause prompt action must be taken. Veterinary advice must be obtained without delay as a course of injectable antibiotic will usually be necessary. These injections are usually given every 48-72 hours because metabolic take-up is slow and the drug could build up in the tortoise's system and reach toxic levels.

It is vital to keep the tortoise at a higher temperature for the duration of treatment, this speeds up metabolism and drug distribution and also boosts the animal's immune system. A temperature of around 28-30 degrees is usually recommended. It is most important that hydration be maintained, if the animal is not drinking water your vet can inject fluids subcutaneously (under the skin) or intracoelomically (into the space between the intestinal canal and body wall). Some drugs affect the renal system and renal failure can result if hydration is not maintained. A course of five to ten injections are usually required, depending on the drug used. Where nephrotoxic drugs (damaging to the renal system) are used they should be injected into the forelimbs, otherwise severe kidney damage could result. With other drugs the rear limbs can be used. In severe cases nebulisation can be used to aid treatment, using the antibiotic recommended by your vet, mixed 1/2 ml antibiotic with 5ml saline. This should be done 4 times daily if possible. Yes, a tortoise can stop breathing for a considerable time, but a sick animal usually hasn't the strength to do so and therefor nebulising does work in a number of cases and certainly should be tried.

Finally, do not make the mistake of comparing RNS to the human common cold or flu, and think that it will clear by itself if given time. It won't. Treatment is essential, and as soon as possible. The longer RNS is left the more difficult it is to clear. RNS can and does kill, don't let your tortoise become a victim. Inspect nostrils daily if possible and get expert help fast if you spot any nasal discharge.

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Constipation: Soak the tortoise in a bath of tepid water for 30 minutes, with the water level just covering the plastron. If this does not work, consult your veterinarian for advice. This condition is almost invariably the result of poor dietary management. Increase fibre intake substantially. Laxatives commonly used are liquid parafin and lactulose. Dandelion root added to feed will often work here too.

Diarrhoea: Add alfalfa (rabbit pellets are compressed alfalfa) to diet as a temporary measure (they are rather high in protein for routine use) and change to a less hydrated food. Overfeeding of fruit is a common cause. Use drugs only if an infection is present, consult your veterinarian. Any foul smelling diarrhoea should be reported to your vet without delay. A fecal sample should be checked for evidence of worms or flagellate organisms.

Vomiting: is a serious sign, consult your vet without delay. Can also indicate a very severe worm infestation.

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Abscesses: These are quite common in tortoises, especially in the ears. Take your tortoise to your vet at the first sign of any abnormal swelling. Abscesses can also follow minor bites or other injuries, such as a thorn penetration. Abscesses in tortoises will not respond merely to antibiotic treatment; they must be physically drained and all necrotic material removed surgically and the wound left to drain without stitching. Good post-operative follow-up is vital.

Pneumonia:The most common causes of respiratory disease are: unhygienic and damp conditions, overcrowding, inadequate temperatures and exposure to "carriers".

Symptoms: Acute - gaping, stretching neck and respiratory difficulty, often mucous in nostrils and mouth, leg weakness and poor retraction, dehydration, depression, open mouth breathing. Some tortoises run about blindly. Urgent veterinary help is needed if the tortoise is to survive. Begin injected antibiotics at once. Even a few hours delay can prove fatal.

Symptoms: Chronic - persistent low level discharge from nose, weakness, poor head and limb retraction. Probably the most common disease found in tortoises. The tortoise should be treated by a competent veterinarian immediately.

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Eye infections: Infections usually respond to treatment with either Genoptic (gentamycin) eye drops or terracortril eye suspension. Mild cases respond to Neomycin or Chloramphenicol eye ointment. Where you see severely swollen eyelids there is usually a primary bacterial infection in which case a course of antibiotics will be essential. Some eye problems are simply an indication of vitamn A deficiency. Supply vitamin A and use a mild eye ointment, if the condition does not respond fairly quickly get veterinary help.

Impacted colon: Occasionally encountered, usually through incorrect diet or accidental ingestion of foreign material, and can develop into septicaemia if untreated. Severe worm burdens can also cause gut impaction. Distension of the gut affects lung capacity and inhibits respiration leading to rapid death. Gut impaction should be suspected if the animal does not pass droppings, is lethargic and having difficulty breathing. Soaking the tortoise in a bath of tepid water will encourage defecation. Severe cases need veterinary treatment immediately. An x-ray and even surgery may prove necessary.

Septicaemia: Signs include vomiting, lethargy, distinct reddish flush or tinge on the plastron or under carapace shields (except in angulates). Haemorrhages of tongue and oral mucous membranes occur, jaundice, and the animal drinks excessively. This is sometimes caused by egg retention/rupture, or gut impaction. Obtain veterinary help immediately.

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Egg retention: Signs include reluctance to walk, lethargy and general signs of septicaemia. Here prevention is better than cure - provide good nutrition with plenty of calcium, the correct laying environment for the species, and keep levels of stress to a minimum. X-rays can be taken to confirm diagnosis and your vet can then determine the best treatment. Laying can be induced using a combination of injected calcium and oxytocin.

Renal dysfunction: Signs include oedema (water retention), pale mucous membranes, lethargy, reluctance/inability to urinate, weight increase due to fluid retention. Often seen following long term anorexia, dehydration and bacterial infection. Get veterinary help immediately. In early stages, regular warm baths and physiotherapy of back legs can help release any blockage. Always ensure that your tortoise has access to clean, fresh water. Diabetes: Symptoms include lethargy, anorexia, weakness. Your vet can do a blood test to ascertain whether diabetes exists.

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Shell rot: This is often caused by injuries and sometimes ticks. Treatment includes the removal of any loose shields and thorough cleaning daily with a solution of Nolvasan or Betadine. Exposure to air will aid cure. Where this treatment fails, flamazine can be applied once daily after thorough cleaning. Advanced cases may need simultaneous administration of an injectable antibiotic from your veterinarian.

Skin infections: Treat early! Clean with betadine or chlorhexidine (Nolvasan) twice daily and apply betadine ointment as necessary. Consult your veterinarian.

Septic arthritis and articular gout: Usually seen together. There will be swelling of limbs/joints, stiffness and pain on locomotion. This is usually caused by a diet too high in protein, which in turn elevates blood urea to dangerous levels. Consult a veterinarian immediately.

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Anorexia: Observe closely for other symptoms. May indicate a severe parasite infection, a metabolic problem such as renal or liver dysfunction, or even a broken jaw or ear abscess which causes pain on eating. Requires further investigation by your veterinarian.

Stomatitis: If caught early, swab mouth twice daily with diluted Nolvasan or povidone-iodine (Betadine liquid). Severe infections need urgent veterinary treatment. Regular beak maintenance is important to prevent stomatitis. Some forms are caused by a herpes-group virus. Mixed colonies are much more at risk than small same-species groups maintained in isolation. Treatment is prolonged and often the prognosis is poor.

Sterile gut syndrome: Can be caused by antibiotic therapy (usually Tetracycline or flagyl). Symptoms are intense diarrhoea, often with undigested food being passed. Often follows a severe flagellate infection. It is an indication that beneficial bacteria in the intestinal system have for some reason been eliminated or reduced. Remedies include feeding Benebac with food, live natural yoghurt or screened droppings from a healthy tortoise of the same species. Consult your vet about treatment if you are unsure about this.

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Parasites: For any external parasites you can dip the tortoise in Alugan or diluted tritix (Amitraz) 1-2ml/litre. Ticks can be removed manually - coat with alcohol or vaseline, turn on its back to loosen its grip and pull off. Apply a little betadine to the spot where the tick was attached.

Symptoms of worms: diarrhoea, anorexia, sometimes vomiting, Some tortoises splutter small volumes of liquid from the mouth. If left untreated, infection with worms can cause serious perforation of the intestine or intestinal blockage.

Treatment and prevention: Avoid overcrowding. Worm eggs can survive on the ground for long periods and can infect other tortoises feeding in the area. It is recommended that routine worming with Panacur or Oxfen be carried out twice yearly, once in the spring and once in the autumn. Never - ever - try to worm tortoises with any preparation containing Ivermectin - this product has proved consistently FATAL in tortoises of all species. Dog or cat wormers based upon piperazine should also be avoided. Required dose rates are high compared to mammals: 3 ml of a 2.5% solution per kilogram of the tortoise's bodyweight. Recommended dose of panacur is 25-50mg/kg, dose again after two weeks and have a fecal done two weeks later to check that you have in fact eliminated the infection. Infestations of hookworm are better treated at weekly intervals with the lower dosage rate until a fecal tests clear. All companions should be treated at the same time.

Worming should be achieved by oral means only - use of a stomach tube is generally recommended. In all cases, where a bodyweight is cited for dosing purposes, this should be understood to include the tortoise's shell - this is also living tissue and must be included in all drug dosage calculations. If you are fortunate enough to be able to obtain Panacur paste then this is ideal for de-worming as the dose is small and can be offered on a titbit of favourite food.

To deworm hatchling hingebacks: inject the correct dose of dewormer into an earthworm and feed this to the tortoise. This saves them the stress of tube- feeding.

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