Fecal flotation to evaluate for helminths and protozoa (e.g., amoeba cysts).
Fecal cytology to rule out fungal infections
Diagnostic imaging (radiographs, CT, ultrasound) as needed.
Fecal bacterial cultures are rarely useful in the diagnosis and treatment of chelonians with diarrhea.
PATHOLOGICAL FINDINGS
Enteritis
Malodorous and liquid intestinal content
Emaciation
APPROPRIATE HEALTH CARE
N/A
NUTRITIONAL SUPPORT
Correct diet to ensure sufficient fiber intake in herbivorous tortoises.
Provide nutritional support to emaciated and/or anorexic animals.
Provide fluid therapy to dehydrated animals.
CLIENT EDUCATION/HUSBANDRY RECOMMENDATIONS
N/A
DRUG(S) OF CHOICE
Metronidazole: 40–100 mg/kg PO repeat 10–14 days or 25 mg/kg PO q24h for 5 days. Effective against motile protozoal organisms.
Emodepside/praziquantel (Profender®, Bayer DVM, Pittsburgh, PA): 1 ml/kg topical on skin. Repeat after 14 days. Effective against nematodes, trematodes and cestodes. Recommended in particular in animals that cannot be dosed orally. Animals should not be soaked for 24 hours after topical administration. Apply to skin around forelimbs and neck.
Fenbendazole: 20 mg/kg PO q24h for 3–5 days. Effective against nematodes and flagellates.
Pyrantel pamoate: 25 mg/kg PO q24h for 5 days, repeat in 3 weeks. Effective against nematodes including pinworms and ascarids.
Keep on newspaper until treatment is completed and recheck fecal samples.
Immediate removal of feces to prevent ingestion, bathing the tortoises, and cleaning of the pericloacal region to remove feces and eggs or cysts are strongly recommended.
Prevention of reinfection is critically important during and following treatment against parasites with a direct lifecycle.
PRECAUTIONS/INTERACTIONS
Fenbendazole has been shown to result in heteropenia and biochemical abnormalities in Testudo hermanni following administration of two courses of 50 mg/kg q24h for 5 days.
Fenbendazole has been shown in other reptiles to cause bone marrow suppression and temporary pancytopenia. Avoid doses > 20 mg/kg.
Do not use ivermectin or other macrocyclic lactones (e.g., selamectin) in chelonians.
PATIENT MONITORING
Return to normal fecal consistency.
Weight gain and maintenance of hydration.
Repeat fecal exams to ensure treatment effectiveness.
EXPECTED COURSE AND PROGNOSIS
If dietary causes are responsible for the diarrhea, then prognosis is good to excellent.
Animals in good body condition with no concurrent morbidities have a good to excellent prognosis.
Animals in poor body condition with signs of systemic illness (dehydration, lethargy, etc.) have a guarded to poor prognosis.
COMMENTS
Diarrhea is a clinical sign associated with an underlying diseases, improper husbandry, or nutrition.
Identification of the underlying cause is necessary to improve outcome and reduce the risk of reoccurrence.
Correction of husbandry is always recommended to in help improve the outcome.
ZOONOTIC POTENTIAL
Salmonella spp. are commonly shed from chelonians with and without diarrhea.
SYNONYMS
N/A
ABBREVIATIONS
CT = computed tomography
PO = per os
Suggested Reading
1 Funk RS. Diarrhea. In: Mader DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier Saunders; 2006:772–773.
2 Greiner EC, Mader DR. Parasitology. In: Mader DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier Saunders; 2006:343–364.
Author Christoph Mans, Dr. med. vet., DACZM
Dystocia
DEFINITION/OVERVIEW
Dystocia is difficulty laying eggs.
ETIOLOGY/PATHOPHYSIOLOGY
The
