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Shell injuries - practical guidelines for vets.

A. C. Highfield

General information
Damage to the carapace is a quite frequent occurrence; most cases are relatively minor however. One area of shell to inspect frequently is just above the tail - especially if you have more than one tortoise. This area is usually the first to get battered during fights between males or during mating behaviour. If it becomes loose or flaky, keep it very clean and separate the animals for a while. More serious shell injuries caused by dropping or crushing need urgent veterinary attention. We see tortoises regularly which have suffered sometimes quite horrendous carapace injuries as a result of accidents with lawnmowers and similar garden machinery - this sort of accident could be prevented with a little more care on the part of owners.

If the worst should happen, the severity of the injury will need to be expertly assessed - although it is important not to panic and be too dismayed by something that might look far worse than it actually is. Tortoises can recover from some pretty spectacular damage given good care. Really severe carapace damage can sometimes be repaired using special medical grade plastics and epoxy cements - ordinary fibreglass material is not usually suitable and should not be used. A few years ago one of our more memorable patients was a little terrapin which was found wandering with a severely cracked shell miles from the nearest water. This was successfully repaired by pinning the shell and cementing everything back into position with a medical epoxy compound. Fortunately, the back legs, although very weak, remained usable indicating that terminal spinal damage had not occurred. The most likely cause of this injury was that the terrapin had been kidnapped from its pond by a heron or similar large bird, struggled free in flight, and fallen to the ground! Fortunately this very lucky little turtle went on to make a complete recovery despite incurring what at first looked like dreadful and quite probably fatal damage.

SERIOUS SHELL INJURIES: practical guidelines for vets
The following guidelines are for the repair of severe shell trauma and must not be carried out by anyone other than a qualified veterinary surgeon. The details are included here not as an encouragement to "do-it-yourself" but to illustrate the techniques employed by specialists in this field. The procedures involved are advanced and demand a high level of technical knowledge and experience as well as access to specialist drugs and equipment only available to veterinary surgeons.

These procedures will normally require that the animal is anaesthetised:

  • Flush wound with lactated Ringer's solution; follow with topical (dry) antibiotic; suture if coelomic cavity ruptured.
  • If muscle tissue is involved, remove tension.
  • If a fragmented injury, remove loose pieces in preparation for replacement by inert fibreglass mesh. Plastral injuries where a considerable amount of tension occurs may require drilling and pinning with small steel sutures.
  • Smaller cracks may only require binding with adhesive tape until natural healing occurs; adhesion of tape to the surface of the shell can be improved by prior swabbing with acetone.
  • Where a large piece of shell is missing, bridging with fibreglass and epoxy will often be required - however, this is usually best accomplished later on in the healing process rather than immediately. At all times ensure that continued access to or drainage from the wound site remains possible. There is nothing worse than sealing a wound which still contains an active infection. With most tortoise and turtle injuries, it is advisable to maintain full access to the wound area until it is evident that all is well. The physical repair to the shell can then be undertaken in safety. A temporary dressing or reinforcement should suffice initially. Only when healing is advanced is a permanent plastic or fibreglass repair made.

These fibreglass-epoxy repairs can be highly successful, but they are by no means easy to accomplish; by far the greatest practical danger is that of `trapping' infection inside the injury. Provided this is avoided, victims of some very major and otherwise probably fatal accidents can be salvaged. A second problem is obtaining good adhesion to the often slightly greasy surface of the shell; a thorough cleansing with acetone immediately prior to application of the epoxy certainly helps here. Large areas of missing carapace can be effectively reinforced with a combination of fibreglass matting and surgical steel wire. The outer coating of plastic should be as smooth as possible to prevent any accumulation of dirt.

Young and rapidly growing turtles pose special problems; generally the best results tend to be obtained with adults whose growth has stabilised. However, we have seen some good repairs made on young tortoises and the attempt is certainly worth making.

Dog bites
These injuries are often severe: and even minor cases can rapidly degenerate into generalised septicaemia. The injury site should be cleaned as well as possible immediately following the attack, and we would recommend a course of antibiotic injections even if the tortoise is symptomless. In our experience 80% of such bites do become infected.

(c) 1996-98 A. C. Highfield