Our tortoise was diagnosed with shell rot just over 2 weeks ago when we brought him in promptly after noticing a mark on the underside of his shell. Our vet is licensed to do exotics and treats birds, reptiles, etc, although I do not know in what frequency given that we aren't in a major city area. When he was first diagnosed, the vet asked us about his enclosure and we admitted we hadn't done a good job keeping his substrate moist lately, but that he was still being soaked weekly for 20-30 minutes. She concluded it was likely dry conditions that caused the shell rot and we left the office feeling guilty and concerned. We had another appointment scheduled promptly for his shell to have the debris removed to expose the shell rot (she removed about 1/3 of the outer shell portions on his belly) so it could be treated. We were sent home with very specific instructions to soak him 5-10 min in regular water, then 5-10 minutes in water with a squirt of chlorhexidine scrub, then rinse him, let him dry. Apply silver sulfadiazine cream to wounds, bandage and return to a cage with brown paper on one side to make for easy, frequent changing to keep as clean an environment as possible, and the other side with moist, but not wet sphagnum moss. (We were told to use this rather than coconut coir because the coconut coir may work its way into bandaging if he digs.) He was also to have daily injections of Cefazolin .1 ml. All was going well for 2 weeks, and he was eating and moving around great. On day 15 he was suddenly lethargic and had bloody urine. Not really blood in urine, more like straight blood for urine. Dark red, when his diet consists of broad, leafy greens that are acceptable for his species. Made a call to the vet, got him back in again, and after a fecal (he finally defecated while in the office after having not gone 24 hours without eating/pooping) test she said there were a few protozoans and one hookworm egg, but not high quantities of either. We stopped the injections for antibiotics and were sent home with a dewormer to use for 3-5 days but a warning that if this doesn't help, he's likely gone "septic" where his shell rot ailment had taken over his system and there's likely no hope. She said we could order a blood test to determine for sure the cause, but it's expensive and doesn't feel like it would necessarily help with treatment. She said our only options if treatment for worms doesn't work would be to order the expensive tests & then he would probably need full hospitalization, including being sedated with a feeding tube and IV, and there's no promise that would save his life. I really started to question my vet's expertise in the area of reptiles when she told me that if he pulls through we will have to work on "fixing his diet" I showed her the list of foods we rotate (mostly organic: spring mix, endive, kale, turnip greens... etc, in the summer he gets dandelions, clover & plantain). She has told me in the past we should feed him carrots and cooked, cooled sweet potato & we told her we feel a diet closer to what he could've gotten in the wild is more appropriate. He thrived on this diet for the first year + we had him, and has only had health concerns lately.) She asked me what protein source he has in his diet.. umm, what? Also, I wasn't thrilled that the first appointment she drilled us about his cage conditions and after she worked on his shell she then told us it could likely have been a bacteria or parasite. I get the sense that she is just researching to figure out what to do and has maybe never treated shell rot before. She is gently leaning us toward looking at putting him to sleep, which we may have to consider if he seems to be suffering and doesn't improve. We don't have thousands of dollars for this little guy, but we do have hundreds, should I seek a second opinion?
She had chided me about his temps going from 69 at night to 95 in the basking during the day telling me that was too big of a swing in temperature change..... but that's within the realm of norms for him and he's been healthy that way for over a year The dewormer is Panacur liquid.
