Hermann's Tortoise Surgery Recovery

[Zazu]

Hi everyone,

Apologies for skipping the introduction forum and coming straight here. However, my wife and I are quite concerned with our juvenile Hermann's tortoise Zazu, and we'd be truly appreciative if you could kindly help us.

Five years ago, we rescued a 2 years old female Hermann who was in a pretty difficult condition. Over the past 5 years, she fully recovered and was living a happy life. We became particularly attached to her because of our journey together and she became an important part of the family.

About 3 weeks ago, she started displaying mating behaviour for the first time. Despite her many attempts borrow the soil to lay eggs (unfertilised as there are no males in her enclosure) she wasn't succeeding and so we decided to take her to our local exotics vet for an x-ray. Unfortunately, the x-ray revealed that she had three excessively large eggs and she wouldn't be able to pass them through due to their shape. As such, the vet recommended the eggs to be removed via surgery through an incision on her plastron (plastronotomy?), at which point she'd also be spayed.

Fortunately, the surgery went well and over the next 72 hours she seemed to be recovering pretty well. The plastron was sealed using fibreglass and, even though there were some discharges through it (allegedly tissue fluid), the amount of discharged fluid was going down every day. She's been drinking a good amount of water every day (mixed with the prescribed antibiotics). She also started getting more active, stretching, yawning, urinating, and even shy attempts of eating her food.

However, our vet showed concern that Zazu was still not eating much nearly 96 hours after the surgery and he recommended a one-off tube feeding of critical care food and a round of painkillers to help her start re-activating her digestive system. Things started taking a turn for the worse after this.

About five hours after being fed the critical care, she regurgitated it. To help her alleviate the discomfort, we offered her some water and she drank a decent amount. Immediately after this, she started having very runny diarrhea and defecated three times in about 2-3 hours. The main concern, however, is that the liquid discharge through the fibreglass in her plastron now also contains blood.

Zazu is now staying at an indoors enclosure with a padded flooring (kitchen roll) and no objects she could have banged against in order to somehow re-open her wound. We wonder whether this could have been caused by the inner pressure she exerted at the time of regurgitating and / or defecating. Over the past few days, we've been offering her water from a bowl but today we also started soaking her in warm water (our vet said it should be safe to do after 24 hours but we waited 72 hours just to make sure). We don't think this is necessarily the cause but wanted to bring it up just in case.

Please see a picture of Zazu's plastron from this morning (the paper strips got stuck to her on day 1 while the fibreglass glue was still not fully dry and easily go away with water). Also attached a picture showing the blood discharge (size of a coin) and the diarrhea.

Any advice would be extremely helpful. We are UK based so access to reptile or animal meds in general is difficult. For now, we've bought Tamodine, which we'll use to clean the plastron, although we understand its effect might be limited due to the fibreglass covering. Our vet doesn't re-open until tomorrow morning but we are really concerned about our little one.

Thank you very much for all your help in advance. We sincerely appreciate it.

 

[wellington]

Medications can make them not want to eat. I would not force/tube feed again. At least not for a while as it can do more damage then good if not done properly. They can go quite a long time without food. Keep her hydrated which is important.
I would give her time, lots of rest, be sure all temps are correct and offer food daily and keep up the soaks. I would not let the vet do anything knew for a while and let what has been done work and heal.
@Yvonne G

 

[Zazu]

Hi @wellington,

Thank you very much for your message, we sincerely appreciate it.

I'll try to provide a daily update to hopefully help other people in the future as well. Zazu seems to be doing a bit better today. In the morning, she woke up naturally, basked for about 30 minutes and walked around the enclosure. She drank some of her water with the antibiotics and vitamins and we also cleaned her plastron with Tamodine. The exude was back to the normal 'transparent' colour and lesser in amount. After that she went back to sleep.

In the afternoon, she woke up and left her 'house' by herself for the first time since the operation. We offered her some romaine lettuce and she had a good 10-12 bites (we tried different foods but this is the only one she was interested in). After that, she basked for about 1:15 hours. We offered her water once again but she didn't want to drink this time. We'll try to avoid the soaks in warm water for another 24 hours in case the plastron needs to "re-seal". She was then walking up and down, with some intermittent stops to rest, for another 45 minutes and then went to sleep for the day.

The vitamins we are offering her in the water are Vetark Nutrobal. Our vet has also advised that if she doesn't eat we can try Vetark critical care formula (CCF). The antibiotics is Enrocare (1.9ml with 250ml of water) and the painkiller is Virbac Meloxicam (0.1ml mixed with her food). Lastly, our vet also gave us EmerAid critical care, which tried to feed her with a syringe at the beginning and he advised is preferable over Vetrak's CCF. Zazu is 0.8 kg.

We're keeping her indoors at the moment and clean her enclosure every day to prevent infection. For lighting we use the Arcadia D3 Reptile Lamp (12% UBV) and for basking a 160w Mega-Ray mercury-vapor lamp. The room also gets plenty of natural light in the morning. The room is kept at 25-27 degrees celsius (77-80.6 F) consistently.

Attached a picture of Zazu's plastron this morning (the paper got stuck on the first day while the fibreglass glue was still slightly wet and easily goes away with water). I've also attached a picture of our beautiful girl before the operation. The remaining pictures are the critical care and her medicines.

Thank you very much for your help and advise.

 

[wellington]

Stop using the mercury vapor bulb, they are too intense and really don't work great for uvb anyway. Get an incandescent vapor bulb to replace it. Arcadia sells them if you can get those.
She sounds like she is doing good. She likely will sleep more than normal being on meds and won't want to eat as much.
But drinking, eating and basking, coming out on her own to roam a bit all sounds good.
I wouldn't try to force feed anything. If it's done wrong, you can kill her. I also would stick to the meds she is on and not add a bunch of different things. Tortoises do everything slow, so give her time and let the meds she is on do their thing.
For now feed her whatever she will eat, you can switch to better stuff when she is fully recovered.
Keep her on paper towels or regular towels until fully healed, no substrate for now
Keep us posted, sounds like you both are doing pretty darn good, keep it up.

 

[Zazu]

Hi @wellington ,

Thank you for your reply. I'll definitely check out the incandescent vapor bulbs from Arcadia as a replacement for the mercury-vapor bulbs. We keep her on paper towels, which we replace every time she urinates, definitely no substrate any time soon

Zazu made some good progress today. We decided to give her a warm soak this morning as the discharge from the plastron looked clear, runny, and was odourless. She enjoyed the soak and drank plenty of water with the antibiotics. We then cleaned the wound with Tamodine as always. She then basked for nearly two hours, urinated, had a few shy bites of pak choi and went to sleep.

She took a 2-3 hour nap and woke up to bask for another two hours. After she woke up, Zazu had 1.5 leafs of romain lettuce, which is the most amount she's had since the surgery and pretty much matches pre-surgery food levels. She then walked around the enclosure, urinated again, and went to sleep under the basking light once again before going to sleep for the day.

The main concern remains the discharge from the plastron. Tomorrow will be 7 days since the surgery, and even though the discharge has gone down it's still present.

Hopefully she won't regurgitate the food she ate today and we'll see the plastron discharge stop soon.

Attached daily picture of plastron and Zazu relaxing in her enclosure.

Thank you very much!

 

[wellington]

I would give it a couple more days for the discharge to complete stop seeing there was that set back.
If there is no more set backs and it hasn't stopped in 2-3 days, I would call the vet and see if that would still be normal/okay.

 

[Zazu]

Hi @wellington,

The discharge went down quite a bit over night so hopefully this is sign that the plastron is closing up. Zazu did okay today although she ate a bit less than she did yesterday. She had two soaks so that she keeps taking in those antibiotics and urinated twice. She's been basking for a few hours throughout the day as well.

The bit that has us slightly concerned is that we've noticed a slightly more reddish area on the plastron under the fibreglass. I've attached a couple of pictures from this afternoon one with natural light and one with increased brightness. Do you think these could be indicative of infection? I've also sent them to our vet and I'm awaiting a reply.

Other than this, I got the Arcadia incandescent vapor bulb ordered and will replace it as soon as it arrives.

Thank you very much for all your help, we really appreciate it.

 

[wellington]

Hi @wellington,

The discharge went down quite a bit over night so hopefully this is sign that the plastron is closing up. Zazu did okay today although she ate a bit less than she did yesterday. She had two soaks so that she keeps taking in those antibiotics and urinated twice. She's been basking for a few hours throughout the day as well.

The bit that has us slightly concerned is that we've noticed a slightly more reddish area on the plastron under the fibreglass. I've attached a couple of pictures from this afternoon one with natural light and one with increased brightness. Do you think these could be indicative of infection? I've also sent them to our vet and I'm awaiting a reply.

Other than this, I got the Arcadia incandescent vapor bulb ordered and will replace it as soon as it arrives.

Thank you very much for all your help, we really appreciate it.

Boy, I don't know. See what the vet says. I wouldn't expect that to happen. Hopefully it's all good.

 

[Zazu]

Thanks @wellington, the vet replied saying that it doesn't look like an infection to him. We'll continue monitoring the area over the next few days to see how it evolves and keep this thread updated as always

 

[wellington]

Oh that's good news. I hope it stays that way.

 

[zolasmum]

I'm so glad Zazu seems to be making progress. Our Hermann's tortoise is called Zola (he's nearly 24)
Very best wishes to Zazu from Devon
Angie

 

[Zazu]

Hi @wellington, @zolasmum,

Thank you very much for your messages. Nice to meet you and Zola !

Zazu has been very stable over the past two days. She keeps basking, soaking in warm water, drinking her antibiotics, and eating a little. The discharge through the plastron remains very low and we are hopeful that it will stop entirely in just a few days.

The redness in her plastron hasn't spread or changed in colour so we assume it was part of the discharge and it will naturally go away with time. She has another two days of antibiotics to go and that should be it.

Just before the surgery, Zazu's urate turned out with in a yellow colour and with a mucous consistency. At the time, we took a sample to the vet who suggested it was likely caused by dehydration. My wife and I were worried that it could be from a cracked egg but the three eggs that were removed during the surgery were whole and the womb was clean. The first couple of times Zazu urinated after the surgery there was some more yellow urate but we assumed it was residual. However, earlier today her urine contained a small amount of the yellow urate once again.

We've tried to look it up online but didn't come across anything similar. Next time it happens, we'll take another sample and send it to the lab for analysis (the vet was closed by the time she urinated today). Has anyone come across anything similar in the past? I've attached two pictures from the urate before the surgery (larger amount on the carpet) and one from earlier today (on kitchen towel). Could it be worms or anything else parasitic?

Thank you very much for all your help in advance!

 

[zolasmum]

Zola will be keeping his toes crossed that the yellow stuff isn't a further problem for Zazu - please update when you know more.
All best wishes from Zola and me
Angie

 

[wellington]

@Yvonne G

 

[Zazu]

Hello everyone,

Zazu has continued to improve since the last update. Her appetite is back to pre-surgery levels and she's much more active and aware. She finished her antibiotics and continues to take warm 5 minutes soaks twice a day, during which she drinks plenty of water. Today we took her to the vet for a check and her plastron seems to be sealing relatively well. The yellow urates continue to happen which the vet suspects is likely caused by fatty liver. Spaying her should help alleviate the fatty liver symptoms and we'll watch her diet and hydration very closely going forward. She's also been recommended to 'exercise' but we won't be putting her in the outdoors enclosure until another 6-8 weeks to prevent the plastron wound from infecting. Her tongue and mouth retain a pink colour so there is no other evident signs of jaundice. Today's urate had a more normal consistency. Even though it remained yellow, it wasn't gritty and had a more 'tooth paste' like consistency.

The vet has also advised that we can sprinkle a pinch of psyllium husks on her food to help her defecate. She only started eating properly a few days ago but she still hasn't passed the food.

I'll continue to update this thread as she recovers.

Thank you very much!

 

[Zazu]

Hello everyone,

Apologies for the lack of updates but it's been an intense week. Zazu keeps improving, if it weren't because of the scar on her plastron and the yellow urate, you could almost say that she's 100%. Her appetite is back, the discharge through the plastron is gone, and she's as active as she was before the surgery.

A couple of days ago, we got her a slightly bigger enclosure (80x28x106 cm) as the one we set up after the surgery became too small for how active she was (the Boston Fern in the picture is plastic but she has no way to reach it, we added it for enrichment). We've also increased the duration of her soaks to 10 minutes twice a day to help her stay hydrated. We're also feeding her twice a day (romaine lettuce, lambs lettuce, cucumber, green kale, pak choi, courgette) but even between meals she tries to eat the kitchen roll in her enclosure (which luckily she fails to do). It's been cold here in the UK so the marigolds, dandelions, clovers, hibiscus, etc. aren't ready yet. Because of her appetite being back to normal, we've stopped offering her the Vetark critical care formula (CCF) but we continue to add the Vetark Nutrobal to one of her soaks to help her get that extra calcium and vitamins.

We are getting slightly worried that she still hasn't had any bowl movements (with the exception of 2 weeks ago when she had diarrhea after the vet tube-fed her). She's been eating normally for the past 8-10 days but she still hasn't passed her food. We worry that if we continue to feed her we'll only exacerbate the problem. We sprinkled a pinch of psyllium husks for a couple of days but it was forming a paste in Zazu's mouth that she was very uncomfortable with, so we stopped doing that.

We worry that she's now at the edge and if she doesn't poop anytime soon it could be a worrying sign. We've read about mineral oil, pumpkin, and aloe vera as recommended home remedies so we might try that starting soon. Room temperature is about 80F and basking temperature around 90F. Any advice would be highly appreciated.

Thank you very much!

 

[_The_Beast_]

Aloe vera can help with pooping, as can longer soaks. Are you able to do longer soaks at this point or is there a need to keep them short because of the healing process? If you can, do long soaks (30 min+ or even an hour). This will get more water in through the cloacae and potentially promote leg movement through her trying to get out of the bath, which will also help stimulate poop 💩

 

[The_Four_Toed_Edward]

Aloe vera can help with pooping, as can longer soaks. Are you able to do longer soaks at this point or is there a need to keep them short because of the healing process? If you can, do long soaks (30 min+ or even an hour). This will get more water in through the cloacae and potentially promote leg movement through her trying to get out of the bath, which will also help stimulate poop 💩

Yes, and foods high in water are also dilurants like cucumber and courgette. But I have heard that it sometimes might take 8 days for the food to pass, maybe 10 isn't that far of a stretch (especially as he is healing)? The locomotive caused by longer soaks should also help with digestion.

 

[zolasmum]

Hello everyone,

Apologies for the lack of updates but it's been an intense week. Zazu keeps improving, if it weren't because of the scar on her plastron and the yellow urate, you could almost say that she's 100%. Her appetite is back, the discharge through the plastron is gone, and she's as active as she was before the surgery.

A couple of days ago, we got her a slightly bigger enclosure (80x28x106 cm) as the one we set up after the surgery became too small for how active she was (the Boston Fern in the picture is plastic but she has no way to reach it, we added it for enrichment). We've also increased the duration of her soaks to 10 minutes twice a day to help her stay hydrated. We're also feeding her twice a day (romaine lettuce, lambs lettuce, cucumber, green kale, pak choi, courgette) but even between meals she tries to eat the kitchen roll in her enclosure (which luckily she fails to do). It's been cold here in the UK so the marigolds, dandelions, clovers, hibiscus, etc. aren't ready yet. Because of her appetite being back to normal, we've stopped offering her the Vetark critical care formula (CCF) but we continue to add the Vetark Nutrobal to one of her soaks to help her get that extra calcium and vitamins.

We are getting slightly worried that she still hasn't had any bowl movements (with the exception of 2 weeks ago when she had diarrhea after the vet tube-fed her). She's been eating normally for the past 8-10 days but she still hasn't passed her food. We worry that if we continue to feed her we'll only exacerbate the problem. We sprinkled a pinch of psyllium husks for a couple of days but it was forming a paste in Zazu's mouth that she was very uncomfortable with, so we stopped doing that.

We worry that she's now at the edge and if she doesn't poop anytime soon it could be a worrying sign. We've read about mineral oil, pumpkin, and aloe vera as recommended home remedies so we might try that starting soon. Room temperature is about 80F and basking temperature around 90F. Any advice would be highly appreciated.

Thank you very much!

Tortoises are grazing animals, and eat whenever they feel like it or have the opportunity - I suggest you have food available for Zazu at all times, rather than just "mealtimes" and remove whatever is left at the end of her day - this might also discourage her from trying to eat the kitchen towel paper. You could put a drop of mineral oil or vaseline on her cloaca to soften the area up, and give much longer soaks - 30 mins or more - keeping the water warm all the time. Good luck.
Angie

 

[Zazu]

Thank you very much for your replies!

We increased Zazu's soaks to. 20 minutes twice a day over the weekend and she seemed to tolerate those well. As a result, today we increased them to 25 minutes. The reason why these haven't been longer is because of the recent plastronotomy surgery. She's been using the soaks to drink plenty of water and urinate but she still hasn't pooped. Water temperature is lukewarm. Today we also tried placing her 'bathtub' under the basking light. Water is enough to cover her cloaca and the lower parts of the carapace.

We tried feeding her Aloe Vera but she didn't show much interest. Tomorrow we'll try feeding her canned pumpkin to see whether this does the trick.

She's still doing pretty well, showing a lot of interest in food and being active. No signs of lethargy or lack of appetite whatsoever. In their outdoor enclosures they have plenty of food (weeds) and graze regularly but because of the suspected 'fatty liver' issues we want to make sure she doesn't overeat (which she has a tendency to do). Also, we believe Zazu's vision is severely impaired (she was in a very precarious situation when we rescued her) so we often have to hand-feed her anyways.

I guess the only thing worth mentioning at this stage is that she doesn't seem to show any interest in pooping, it's not like she's trying but not succeeding and giving up. The vet also mentioned she was likely rather dehydrated following the surgery and having had three large, misshaped eggs.

Hopefully I'll be able to share some good news soon 🤞