Box Turtle Health Check List

Adapted from "The Box Turtle Manual"
by Philippe de Vosjoli & Roger Klingenberg, D.V.M.

Symptoms Common Cause Treatment
Red, swollen, bubbly eyes. Bacterial conjunctivitis, often complicated by a vitamin A deficiency, and could be a sign of a respiratory infection Apply a small amount of a triple antibiotic opthalmic ointment to the eyes 3 times a day for 7 to 10 days. If conditions are mild it will resolve quickly. If eyes do not respond, vitamin A deficiency could be the problem as well as a respiratory infection.
White, opaque caps on the eyes. Bacterial conjunctivitis with caseated puss. Apply triple antibiotic opthalmic ointment to the eyes 3 times a day. Once the eye can be opened gently pry loose the puss and lift out with a q-tip. Do not force. Continue to apply the ointment for several days until resolved.
Sticky eyes, won't open, thick secretions. Vitamin A deficiency. Administer daily 20 - 30 minutes soaks to allow the turtle to hydrate the eyes. Use artificial tears or opthalmic antibiotic ointment 3 times a day for 2 to 4 weeks. With mild cases a few drops of cod liver oil added to the food twice a week should clear it up. Otherwise a vitamin A injection administered by a vet will be required.
Bubbles and nasal discharge. Respiratory infection, and often a vitamin A deficiency. Increase heat to stimulate their natural immune system. If nasal discharge is clear in appearance, it could be a vitamin A deficiency. Try to rule out a vitamin A deficiency. If the discharge is opaque or colored in some way, it is most likely a bacterial infection of the respiratory system, although both conditions can accur together. If the turtle is eating and kept warm and dry, sometimes these will cure themselves. If not resolved in 10 days, or conditions are worstening, a visit to the vet is needed for a round of antibiotic injections.
Mild distortions of the mouth with hemmorrhagic spots, vicious secretions and excessive salivation. Infectious stomatitus (Mouth Rot). Increase heat. gently remove loose tissue and clean with Nolvasan®, Betadine®, or peroxide. In all cases but the most mild ones, a vet visit is needed for antibiotic injections.
Beak overgrowth. Eating small prepared meals with little requirement for chewing or biting of the food offered. Also seen with calcium deficiencies that lead to abnormal skull developement. In mild cases, gently grind down the beak with a nail file until it is shaped so that eating will not be impared any longer. In advanced cases, a vet will be needed to do the trimming of the beak and often surrounding tissue overgrowth. Avoid excessive trimming where as the blood line may be hit, as in over trimming a dog's nails.
Puffing out of the throat, extending the neck, gaping mouth making gasping noises. Respiratory infection. See above treatment for respiratory infection.
Swelling just in back of the jaw, causing the head to be miss-shaped. Bacterial infection of the middle ear. Usually requires lancing over the tympanic membrane and removing the caseated puss trapped inside. The area must be carefully scraped out, and flushed with Betadine® or Nolvasan®, and then packed with an antibiotic ointment. The area should be flushed out daily and repacked for 7 - 10 days. then if the area is not healing well, or the turtle is not eating well, see a vet for a round of antibiotic injections. See THIS PAGE if you intend on trying to treat this yourself.
Lumps visible under the skin. Biting fly larvae (Botfly larvae). See Myasis treatment below.
Mild peeling of the skin. Oversoaking. Remove drinking dish and replace with a small enough one as to eliminate the turtle soaking on it's own. Limit daily soaking times.
Severe peeling of the skin with exposure of red, moist tissue. Hypervitiminosis (Excessive vitamin A). Keep the turtle on newspaper and apply triple antibiotic ointment to the raw areas. Limit food items with high levels of vitamin A.
Open wound with small white maggots within. May also appear as lumps under the skin. A small hole with a black crusty discharge is an indication of Botfly larvae. Myasis (infestation of a wound with maggots). This could be prevented by bringing in wounded turtles from an outside pen. Maggots must be plucked out with tweezers and the hole needs to be flushed with Betadine® or peroxide. You could also kill the maggots first by filling the cavity with petrolium jelly which drowns them. All loose tissue and debris should be removed from the entire area. Once maggots are all gone, pack with a triple antibiotic ointment daily. If wounds are massive in size or numbers, see a vet for a round of antibiotic injections.
Shell seems roughened, possibly soft in spots and discolored. Infected shell (shell rot) - usually bacteria and fungus. Gently remove any loose or peeling material. Increase the heat. Apply Betadine® ointment or solution daily for 2 - 3 weeks. Keep the turtle on paper substrate and change the paper often. See a vet if not responding well.
Cracked or broken shell. Caused by some sort of trauma (accident). If shell is stable, clean with Nolvasan® or Betadine®, then apply triple antibiotic ointment. If very unstable, apply gauze over the ointment and tape in place. Contact a vet who is able to do shell repairs with fiberglass patches, or bone cement. The most dramatic fractures can be repaired if cleaned well, and the inner tissues are protected from infection.
Malformed and soft shell with an overgrown beak. Metabolic bone disease. If the shell is not too soft, a corrected diet and the providing of a proper UVB light can correct this problem. If severely soft and deformed, a vet will need to evaluate the situation.
Blood seen on the underside shell (plastron) - sometimes seen under the scutes. Bacteremia (septicemia). Increase heat. A vet will be needed for a round of antibacterial injections.
Loose stool with mucus with or without blood. Bacterial gastroenteritis (intestinal parasites). A fecal exam will be needed to determin the presence of parasites. If no parasites are found, a fecal culture may be indicated. many kinds of bacteria could be the cause, including Salmanella species. A round of antibacterial injections will be needed from a vet.
Tubular mass sticking out of the cloaca (anus). Prolapsed organ - intestine, bladder, penis or uterus. Organ must be identified. Keep moist by gently wrapping in damp gauze. Get to a vet a.s.a.p. !
Male turtle with large reddish purple mass protruding from the cloaca (anus). Prolapsed penis. Male turtles will often fan their penis while soaking. Simply picking them up, carefully not touching the penis, will usually cause them to retract it. If this doen't work and the penis is not dried out, gently lubricate with vaseline or K. Y. jelly. Try replacing it by gently pushing it back into the cloaca with a cotton swab. Don't force it at all! If in doubt call a vet.
Female turtle with legs sticking out backwards. Has a recent history of pacing, prolonged soaking and digging. Egg bound. Rehydrate if she seems week and dehydrated. make an area in your enclosure suitable for egg laying. If she doesn't lay her eggs within a few hours of being placed in a warm quiet area with good egg laying substrate, see a vet for treatment. Look for signs of a vitamin A deficiency.
Overgrown nails. Lack of normal digging and wear in captivity. Extend the limb so that the nails or easily visible. Clip excessive nail tips without coming within 1/8 of an inch to the pink blood line. If you clip it accidentally, stop the bleeding by eith applying pressure, or by applying a coagulant like silver nitrate or KwikStop®.
Swollen feet or forelimbs. Abscesses, cellulitis or trauma. If an abscess or cellulitis (spreading infection) is suspected, then a vet will be needed. If the swelling is do to trauma, then it will improve with treatment of the trauma.
Rotted, eroded or distorted toes. Fungus, sometimes caused by burns. Increase heat. Place the turtle on paper substrate. Gently remove any loose tissue. Apply Betadine® ointment or solution daily for 2 - 3 weeks. If not responding well, see a vet.
Decline in appetite, sluggish movement, appears to be depressed. The season is Fall. Hibernation induced anorexia. If the turtle is in good health, prepare it for hibernation. If the turtle is not well, proper heating and a 14 hour light schedule will be needed to induce the turtle to eat throughout the winter months.