Turtles have several unique problems. Understanding these problems will allow you to better care for your pet and minimize future health care issues.
Cystic Calculi
Commonly called bladder stones, cystic calculi occur when minerals from the diet form crystals in the urinary system. When these crystals are present in large concentrations, they tend to bind to each other and form concretions (stones). Stones usually result from improper nutrition and/or limited access to fresh drinking water, which leads to persistent dehydration.
If your turtle has cystic calculi, you may see blood in your turtle's droppings. Your turtle may also exhibit straining sounds while trying to defecate. Your veterinarian can diagnose this problem through a physical examination, digital palpation, and radiographs (X-rays). Treatment often involves surgical instruments to help crush stones and assist with their removal; fluid therapy to prevent kidney damage and flush the urinary system; and antibiotic therapy. Your veterinarian will discuss dietary changes that will help prevent future stone formation and proper hydration via regular soaks or humidity control.
If the stone(s) cannot be reached from the vent opening, surgery may be necessary. A turtle’s protective shell makes surgery difficult. Two techniques are available for performing internal surgery: one involves cutting the shell and then repairing it after the procedure; the other involves making an incision in front of the pelvis and hind limbs. Both procedures should be performed by an experienced veterinary reptile specialist.
Prolapses
In turtles, a prolapse occurs when an organ (intestine, cloaca, urinary bladder, uterus, or penis) protrudes from the vent (the opening in the underside of the tail, where the turtle eliminates its waste products). In male turtles, the penis (a large, black organ with a spade-shaped end) may periodically be everted and become visible outside the body. Prolapse of the penis is not a problem if the turtle can retract the penis. If the penis stays out, it can become traumatized or can be bitten by another turtle. Penile trauma is a serious problem and leads to life-threatening infection if not attended to.
Any tissue or organ that is prolapsed can be traumatized, desiccated (dried out), or suffer from compromised blood flow. An organ prolapse is a potentially life-threatening problem and must be immediately assessed by an experienced reptile veterinarian.
Irregular Shell Growth
If you notice that your box turtle's shell is growing irregularly, it may be a sign of malnutrition causing metabolic bone disease (MBD). By the time you notice this problem, it has been going on for a while and may have serious long-term effects on the box turtle’s health.
The shell may be soft, may appear lumpy, or may no longer be symmetrical. This problem is often caused by an inappropriate diet, which may be too high in protein and fats, or may have an incorrect vitamin/mineral balance. The turtle’s lighting and environment may need adjusting. It is essential to bring this problem to the attention of a veterinarian familiar with box turtles.
Shell Fractures or Trauma
A box turtle’s shell is remarkably strong, but it can be traumatized. Wild turtles may be found on the side of the road with serious shell fractures, having been hit by a car. Pet turtles may be dropped accidentally or may fall off a table if they escape from their cage or are left unattended. The family dog may chew on a helpless turtle, causing severe damage to the shell (or legs and head). Although these are serious injuries, the shell is a type of bone and can be repaired.
Any trauma to the shell should be brought to the attention of a veterinarian immediately, as open wounds can become infected and cause serious infections. Bacteria from a dog’s mouth can be deadly for all reptile species, even if the bite wound does not appear serious.
Salmonella
Turtles are commonly noted as a cause of salmonella infections in children. Salmonellosis is a zoonotic disease, meaning it can be transmitted from animals to humans. Infected animals and people shed the bacteria in their feces, serving as a source of infection to others. In susceptible people and animals, salmonellosis causes gastrointestinal disease, with symptoms such as nausea, vomiting, diarrhea, abdominal pain, cramping, fever and/or septicemia (blood poisoning). Young children, the elderly and people who are immunocompromised are most at risk for developing severe disease. Although turtles are not the only pets or reptiles that can carry salmonella, many turtles carry the infection asymptomatically, which means that they do not show signs of illness.
"Turtles are commonly noted as a cause of salmonella infections in children."
Prevention, through proper hygiene, is the best way to control salmonella infection. Properly clean and disinfect the cage every time it is soiled. Clean up all feces right away. Have a separate cleaning area for people and reptiles. Most importantly, wash your hands thoroughly with disinfectant soap every time you handle, clean, or feed your box turtle to help minimize the risks. Since most box turtles that carry salmonella are not ill, they usually require no treatment. Additionally, treatment often does not remove all the bacteria from the turtle’s body.
Aural (Ear) Abscesses
A firm swelling on the side of the face, at the level of the tympanic membrane, is generally an abscess of the tympanic cavity. A vitamin A deficiency is thought to be the underlying cause of this condition, because a lack of vitamin A negatively affects a turtle’s protection against invading bacteria that create abscesses. This condition happens in wild-caught as well as indoor and outdoor domestic-bred box turtles. Treatment requires lancing and flushing the abscess under general anesthesia, antibiotic therapy, and supplementation with a vitamin A injection.
Hybernation/Brumation
If given the opportunity and the proper cold environmental temperatures, most wild box turtles attempt to brumate (hibernate),depending on the subspecies and its native locale. In captivity, if the photoperiod (day length) is kept at 12–14 hours and the environmental conditions are warm, then brumation is skipped.
Many veterinarians feel it is not necessary for the turtle’s health to undergo brumation, but some owners wish to provide suitable conditions for brumation. In this case, you should thoroughly discuss brumation with your veterinarian. Brumation is very stressful, and sub-clinical illnesses can manifest themselves during hibernation.
Only turtles that are well fed and in good health should be allowed to brumate. Prior to brumation, it is essential for the turtle to have a thorough examination and appropriate laboratory tests, including a fecal analysis for intestinal parasites.
A common problem in turtles is "pseudohibernation". True hibernation/brumation requires a constant temperature between 40°F and 60°F (10°C and -16°C). Persistent temperatures above 60°F (16°C) are not cool enough for true hibernation. Box turtles undergoing pseudohibernation appear as if they are hibernating; however, the turtle’s metabolism does not decrease, and it slowly starves.
Dystocia
Dystocia, or egg binding, happens when the female box turtle is unable to pass her eggs. Dystocia is a reasonably common problem in reptiles, caused by a variety of factors, and can be life-threatening. Egg binding is often associated with poor husbandry, including improper environment, incorrect lighting and temperature, inadequate nesting sites, improper diet (malnutrition), and dehydration. Other contributing factors include the age and condition of the animal, injuries or physical obstruction from deformed or oversized eggs, physical abnormalities of the reproductive tract or pelvis, infections, constipation, and abscesses or masses.
A healthy box turtle that is gravid (carrying eggs) may not eat for several days or weeks, but she will still be bright, active, and alert. A gravid box turtle with dystocia is anorexic and rapidly becomes sick, progressing to severe lethargy, and may become unresponsive. A veterinarian familiar with reptiles must examine this turtle immediately. The veterinarian will diagnose dystocia through a physical examination, blood tests, and X-rays. Medical and/or surgical procedures may be needed to help these animals.
