Common Injuries and Illnesses
Module Goals
- Be aware of common injuries and illnesses in wild turtles
- Understand potential complications of these conditions
- Be familiar with basic treatment considerations
If you would like to listen to an audio recording of this module, please click here. (Duration: 9:14)
Introduction
Wild turtles present for a variety of reasons, and often the presenting complaint may not be the only problem or the problem that is most critical. When presented with wild turtles, there are a set of common injuries and illnesses that we see, and often these problems may overlap or have a similar course of action for treatment. The most common injuries we see are due to trauma, generally from being hit by a car or run over by a lawnmower, and other common injuries include soft tissue trauma from dog bites, fishing hooks, and gardening accidents. The common infections we see include conjunctivitis and upper respiratory infections, and wild turtles may also present with other viral infections.
The purpose of this module is to present an overview of the most common conditions seen in turtles – in-depth information about treatment protocols and procedures are provided in later modules.
Traumatic Injuries
Shell Trauma
Turtles frequently suffer shell trauma – such as fractures and abrasions – because their shell is their first line of defense against predators (and vehicles). Fractures can occur on any part of the shell and may or may not include underlying structures.
It is possible to repair many shell fractures. Shell repairs are done using wire and bra hooks or holes drilled into the marginal scutes away from the body. When fractures are stable or well apposed, shell repair may not be needed as the fracture will heal on its own. Shell repairs should not be performed unless the patient is stable enough to be sedated, and there should be no risk of internal bleeding. Patients at risk of coelomitis following shell repair should receive antibiotics. Similarly, any patients with dog or cat bite wounds should be treated with antibiotics.
Once the shell is repaired, the turtle is often kept out of water or only soaked in minimal water and may need parenteral fluids as part of their treatment to ensure they’re hydrated. If an aquatic turtle is unable to be in water, they are unable to eat, so this should be kept in mind when developing a treatment plan. The other major portion of the treatment plan will be pain management (NSAIDs), a systemic antibiotic if indicated, and silver sulfadiazine applied to the cracks along the shell to help promote healing.
Repairs of the plastron and caudal carapace are difficult to heal, especially if a turtle is very active, as the hardware applied during a shell repair may fall off.
Infections can occur, especially if the coelom has been breached by the fracture.
Fly eggs and maggots are commonly found in older shell fractures and must be removed prior to repair. Both can be manually removed as well as treated with pulverized Capstar.
For fractures that are not suitable for repair using wires, bandaging can be used for stabilization or the shell fragment can be removed if it is on the edge of the shell.
Soft Tissue Trauma
Soft tissue trauma can occur in turtles, especially along the legs, head, and tail where the shell may not protect them. Common causes include vehicular trauma, lawn equipment encounters, animal attacks, fishing tackle (in aquatic turtles), or even entrapment of a limb by the shell in box turtles.
Following soft tissue trauma, wounds should be thoroughly cleaned. Sutures can be used to close the wound, but usually delayed first intention healing or second intention healing is preferred as most wounds are dirty and contaminated. Amputation of a severely damaged limb does not greatly impact the mobility of the turtle, but removal of more than one limb is generally an indication for humane euthanasia.
For damage to the vent or tail, the turtle must be monitored to make sure that it is still able to defecate. This may take a while as turtles can go a long time without eating.
Soft tissue trauma to the eyes is common in turtles. Enucleation is indicated when a turtle still has one viable eye – fully blind turtles are not releaseable and should be humanely euthanized.
During the healing process, triple antibiotic ointment is used to prevent infection of the wounds, along with bandaging and flushing. It should be noted that triple antibiotic ointment may be damaging to the eyes, so a neomycin ointment with bacitracin, or a similar product, should instead be used on all facial wounds. Pain management is indicated for all traumatic injuries and fluid therapy may be needed if a turtle is unable to be soaked in water due to its injuries.
As with any wound, infection is the primary complication of concern. Thorough cleaning of the wound is needed, along with proper wound care and avoiding closing wounds that could be infected. Systemic antibiotics may be indicated in turtles with large injuries, especially if they are already infected on presentation.
Dehiscence is another possible complication. Whenever possible, an everting suture pattern is used in reptiles due to their unique skin. However, dehiscence can still occur – use of proper suture tension and wound care is essential.
If you administer systemic antibiotics to a turtle, they should not be released until 4 weeks after their final dose.
Infectious Diseases
Upper Respiratory Infections
Upper respiratory infections are common in box turtles, especially in the spring when they are waking up from brumation. Affected turtles will have swollen eyes, nasal and ocular discharge, and may also be open-mouth breathing or making a clicking noise while they are breathing. All turtles with this presentation should have their oral cavity and eyes checked for white plaques, which indicates a viral infection. Turtles with viral respiratory infections should ideally be kept separate from any other reptiles in your hospital, and staff with reptiles at home should not handle them, or should use adequate biosecurity measures to prevent transmission of diseases to their reptile pets.
As in other animals, treatment of viruses in turtles largely relies on symptomatic and supportive care. Adequate access to water for soaking or fluid therapy if the turtle cannot soak are important to maintain hydration. Anti-inflammatory and antibiotic eye drops can be used for turtles with conjunctivitis – we commonly use diclofenac and ciprofloxacin. Systemic antibiotics are rarely indicated in patients with viral symptoms.
These respiratory infections are thought to be associated with hypovitaminosis A in turtles. Giving an oral or injectable dose of vitamin A may be beneficial.
The most common complication is secondary infections, which can be bacterial or fungal. Pneumonia is not uncommon and can be detected using radiographs, and a transtracheal wash can be used to determine the best antimicrobial drug to use. In very severe cases, humane euthanasia could be indicated – especially in severe fungal pneumonia.
Ranavirus is an emerging disease of wild reptiles and amphibians. If you receive a turtle with swollen eyes and yellow/opaque plaques on the face or in the mouth, please send appropriate samples to a diagnostic laboratory (see additional resources links) or contact the Turtle Rescue Team for more information.
Aural Abscesses
Box turtles are prone to developing aural abscesses, which generally appear as swellings of the tympanic cavity, and can be unilateral or bilateral. These are thought to be associated with hypovitaminosis A and/or organophosphate exposure and are due to a buildup of bacteria and caseous debris in the ear.
These are treated by removal of the compacted caseous plug surgically, followed by treatment with triple antibiotic ointment and flushing the site to patency.
Complications include post-operative infections and recurrence of the abscess. Abscesses can also burst if they are not treated, which is painful for the turtle.
Relevant Videos
Additional Resources
- Ranavirus Fact Sheet from Northeast Wildlife Disease Cooperative
- List of Ranavirus diagnostic laboratories
Key Concepts
- Many of the injuries seen in wild turtles are similar in how they are treated, but always consider the individual needs of the turtle in your care.
- Practice proper wound care to avoid wound infections and reduce the need for systemic antibiotics
- Isolate turtles with viral infections from other reptiles using biosecurity protocols