A sick box turtle may not eat and may lose weight, have swollen and/or runny eyes, nasal discharge, swollen ears, lumps or swellings, and/or wounds to the shell. Increased water consumption, diarrhea, and extreme lethargy are other signs of illness. Subtle changes in behavior and the turtle's routine often signal the onset of illness. It is at this stage in the course of an illness that a box turtle should be presented to a veterinarian. A thorough physical exam and a laboratory work-up (blood and/or bacteriology tests) can be performed to diagnose and properly treat the problem.
Conditions Requiring Veterinary Attention
Disease Resulting from Malnutrition and Vitamin Deficiencies
Most diseases afflicting captive box turtles are, at least in part, the result of malnutrition. Box turtles that do not receive all of the nutrients vital to sustain optimum health do not remain healthy, and become ill from a variety of causes.
Hatchlings are the most prone to disease resulting from dietary deficiencies because their nutritional requirements exceed those of adult turtles and because their rate of growth is so rapid. Hatchling turtles often exhibit soft shells, associated with protein and mineral deficiencies, and swollen eyes, which accompany vitamin A deficiency. Adult box turtles, by contrast, are unlikely to exhibit soft shell problems but may show signs of anemia weight loss, mouth rot, internal infection, or abscess with chronic malnutrition
Respiratory disease is common in box turtles. Epidemics may occur in populations of wild box turtles, characterized by runny noses and pneumonia It may be bacterial or viral and can be highly contagious. The Ornate Box Turtle (Terrapene ornata ornata) seems to be especially sensitive to respiratory disease in captivity, and the respiratory signs seem to be particularly devastating in this species.
A common sequel to an upper respiratory infection in a box turtle is abscesses of the ears. A swelling appears on one or both sides of the head, beneath the external ear openings. Cheese-like pus can usually be removed by the veterinarian, and antibiotic therapy by injection is usually rewarding.
Abscesses (Other than Ear)
Bacterial abscesses are common from puncture wounds, bite wounds and other injuries. Injectable antibiotics must be used under these circumstances to Prevent formation of internal abscesses or septicemia (blood poisoning).
A wide variety of bacterial infections can occur. Often, multiple organ systems are involved. Liver and/or kidney disease is common because of the septic nature of turtle diseases and the filtering action of these 2 organs. Chronic hepatitis and chronic kidney disease (the latter resulting in gout from elevations of uric acid in the blood) are routinely seen. Infections of the heart are also common. Blood tests are useful for diagnosis of these and other problems.
Older box turtles are subject to organ failure, most often resulting from chronic infection or other long-standing disease involving one or more organs. Diseases that usually accompany advancing age in other animals also affect elderly box turtles (for example, arteriosclerosis). Blood chemistry analysis is necessary to diagnose these cases.
Bot Fly Infestation
Box turtles are commonly subject to the ravages of migrating "bot fly" larvae. These large parasites are different from the much smaller maggots (larvae of other flies). The adult flies deposit their eggs on the skin and/or mucous membranes and the newly hatched larvae, penetrate into the body and form large, visible lumps where they come to rest, resembling abscesses. These grubs may cause substantial tissue damage and mechanical interference for the turtle. Some turtles die as a result of this infestation.
"Fly strike" and maggot infestations are extremely common, especially among wounded or sick box turtles. These turtles are virtually defenseless and flies can easily take advantage of their weakened condition. Traumatized or diseased box turtles should be kept indoors or within a screened enclosure during their convalescence.
Shell rot occurs when either the upper shell (carapace), lower shell (plastron) or both develop erosions. This condition usually results from injury or chronic infection to a filthy environmental. Malnutrition and are frequent predisposing factors.
Serious injuries to the shell are often inflicted by dogs, lawn mowers and automobiles.
Overgrown Upper Jaw
The upper jaw of some captive box turtles may occasionally overgrow. Abnormal wear patterns resulting from prior injury or a steady diet of soft food may be involved. Periodic trimming of the upper mandible by an experienced veterinarian or technician is necessary in these cases.