the anorexic tortoise - BSAVA

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Parameter Comments Skin tenting Hard to assess and a very insensitive measure. Mucous membranes Dry sticky membranes more sensitive than skin tenting. Haemoconcentration In theory, raised albumin and haematocrit should accompany dehydration. However, most of these tortoises will have varying degrees of hypoalbuminaemia and anaemia (due to underlying disease/debility/ anorexia) that such an interpretation is confounded. Uric acid Will rise in dehydration. However, will also rise in renal disease. Urea These species use the urinary bladder as a water store. Accessing this allows smaller molecules, including urea, to enter the bloodstream – i.e. urea is a measure of degree of access to stores. The higher the level of urea, the greater the dehydration. It is unaffected by renal disease (except in severe disease) so is an extremely important indicator of hydration. Table 3: Assessment of dehydration in the tortoise BOX 1: Markers of reproductive function in female tortoises The following parameters may all rise in the reproductively active female: ■■ Protein – total/albumin/globulin ■■ Total calcium ■■ Phosphate – Calcium:phosphate ratio usually remains in normal range ■■ AST/ALKP/CK ■■ Cholesterol/triglyceride NB: This “pattern” is not a marker for reproductive disease or follicular stasis unless such levels remain high and the tortoise is not recovering. Rather, it indicates a need to assess the reproductive system via radiography/ultrasonography. Follicular stasis is diagnosed by a persistent: ■■ Reproductive blood picture ■■ Ovarian follicles – these show no evidence of atresia nor progression to egg Test Comments Indication Faecal analysis May be hard to obtain! Worth bathing daily to twice daily to stimulate defecation. Fresh (
Apart from the very mildest cases, it is highly unlikely this can be provided at home, so almost all cases will require hospitalisation. As husbandry problems started at home, out-patient therapy is unlikely to be successful. Hospitalisation is usually 5–14 days for the average case. Therefore a practice treating these species will need specific facilities. This may vary from a heat lamp in a kennel for the occasional case, to vivaria or tortoise trays where there is a greater caseload (Figure 5). Again, important biological parameters, especially temperature should be measured and maintained at correct levels in hospital (Figure 6). Half measures will not suffice and result in more unsuccessful cases and frustrated owners. It is vital that owner education is a part of the treatment plan. This is especially important for older tortoises as owners do not see why there is a problem now with their husbandry when there had been no issues over the previous thirty-odd years! However, reluctance to change husbandry will simply result in relapsing cases. A frequent finding with inadequate home temperatures is that the tortoise will do well for 48 hours following discharge and then stop eating: some research suggests reptiles can maintain internal temperatures for up to 2 days! 16 | companion How to approach the anorexic tortoise A B Figure 7: Daily bathing is vital. It also helps Figure 5: Hospitalisation units. Vivaria are a typical means of housing all reptiles. They have, erroneously, gained a reputation as a cause of respiratory disease in tortoises due to high humidity. However, this can be controlled as well as temperature. Trays are excellent means of hospitalising tortoises but rely on a high background room temperature as it is this that sets crucial minimum temperatures. The author’s unit uses combined ultra-violet and heat sources as basking points Figure 6: Digital maximum–minimum thermometers are easily available and these units with two probes are inexpensive. This photo shows minimum values that should be achieved in the hospitalised setting. If using vivaria, they should be insulated to achieve these temperatures. If using trays, room temperature needs controlling to these levels While hospitalised, all cases will require basic supportive care. Rehydration All tortoises should be bathed daily in plain warm water or in a glucose/electrolyte mix (e.g. Reptoboost (Vetark, Winchester UK)). For mildly dehydrated animals this may be sufficient to restore fluid balance. Bathing will also help to stimulate urination/ defecation (Figure 7). stimulate defecation/urination (see tortoise on left). Biosecurity is vital – all equipment should be labelled (in this case bath numbers match tray numbers) so no fomite transfer occurs between in-patients For more severe cases, fluids may be given: ■■ Oral fluids – Hypotonic fluids (including plain water!) may be given by gavage tube. Around 20ml/kg in single or divided doses (Figure 8). ■■ Intra- or epi-coelomic (Figure 9) – Up to 30 ml/kg once daily of isotonic fluid. ■■ Intra-osseous – Needles may be placed into the femur or humerus, or Figure 8: Gavage tubing a tortoise. The neck is held straight and the tube gently inserted down the oesophagus
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the anorexic tortoise - BSAVA

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