Conflicted on Vet Advice: Shell Biopsy

reflectedgray

New Member
10 Year Member!
Location (City and/or State)
Portland, OR
None of us realized how bad MVBs are initially. I used to use and recommend them. We learn as we go.

Sand should never be used for substrate. Its a serious impaction risk as well as a skin and eye irritant. Dirt can be okay doing on its composition. Coco coir is safe, but messy. Fine grade orchid bark works best for adult Russians.

Both of your enclosures are way too small. Each of them should be at least 4 times bigger. Minimum size for an indoor adult Russian tortoise table should be 4x8 feet. This might be a contributor to the beak and shell issue too, as small enclosures seem to go hand in hand with overgrown beaks and carapace growth anomalies.

Spring mix is not a good tortoise food, and Russians are not grass eaters, so the hay really serves no purpose.

I don't say these things to make you feel bad. I say them so you'll know what is wrong and how to fix it.

Give this a read. Diet, heating and lighting, substrate, enclosure size, and much more is explained. Questions are welcome.

Thanks for the advice. The write up was helpful. I can change her substrate out immediately indoor. Its good timing, as I was going to replace it this week. The feed advice I can do as well with a combination of upping my grocery store game and looking into growing some stuff. Unfortunately I cant expand her box by that much right now. I'm in an apartment. I got a tortoise without really knowing how much space they needed and expanded as much as I could once I learned better. The good news is I bought a house! We are closing on it now, so my first priority will be larger enclosures for poor Delilah. I'm lucky that its a big place with lots of indoor and outdoor room so I'm looking forward to Delilah finally getting her palace.
 

queen koopa

Well-Known Member
Location (City and/or State)
Las Vegas Nevada
Thanks for the advice. The write up was helpful. I can change her substrate out immediately indoor. Its good timing, as I was going to replace it this week. The feed advice I can do as well with a combination of upping my grocery store game and looking into growing some stuff. Unfortunately I cant expand her box by that much right now. I'm in an apartment. I got a tortoise without really knowing how much space they needed and expanded as much as I could once I learned better. The good news is I bought a house! We are closing on it now, so my first priority will be larger enclosures for poor Delilah. I'm lucky that its a big place with lots of indoor and outdoor room so I'm looking forward to Delilah finally getting her palace.
Great news on the house! Woo!!
And also... good catch on the not so good vet advice. Many people need to read this post.
 

GMDVM

Member
Location (City and/or State)
Ionia New York
I could not find any case studies of Penicillium caused mycosis infection of tortoise shells The most common cause of shell rot is the fungus Fusarium. So it is likely that the fungus your vet cultured is a contaminant. A biopsy is one way to more definitively diagnose the issue. As your pet’s owner you have every right to decide whether or not this is an appropriate course. Personally I do not think that a biopsy is a must nor would I start systemic antifungals at this point-and I doubt that systemic anti- fungals would even reach a superficial infection. In one study a dilute iodine solution was applied for several weeks which proved helpful. Notable is that all the cases involved the plastron. Your tortoise’s shell does look a little desiccated which may in turn make it more susceptible to issues in the long run I am certain you are giving Delilah wonderful care. So nice of you to have rescued her
 

JMM

Active Member
Location (City and/or State)
Worcester, MA
I posted my last reply before seeing this. Here are the responses:

Substrate: Inside, I use a 50/50 mix of dirt and sand with some coconut fiber to create more depth on the cool side. Outside she's on coconut fiber.

Temperature: INSIDE- Prior to the vet's concerns about heat, I used a mercury vapor bulb. The basking spot was at 90 degrees. It was pretty focused, so the rest of the warm side was more like 80. Cool side was somewhat dictated by the temperature in my house because I don't have AC. In summer sometimes my house got warm (80ish) but that was in the heat of summer at the peak of day. Usually its more like 65 -70. It doesn't get below 60 at night. OUTSIDE- Normal Northern CA weather. She had a shaded side, but my deck gets a lot of sun. If it was warmer than 90 in the sun I brought her inside.

Location: Bay Area of Northern California

Inside / Outside: She's outside a lot. I sometimes leave her out overnight in really good weather but usually I'll bring her back in when it gets dark. In the Spring - Summer she's out most of the time unless its too hot or raining. In Fall she's out in the middle of the day through early afternoon. In winter she's in a lot since its rainy or cold. I still try to put her out for an hour or two when warm enough.

Enclosure: Her inside enclosure is 24 by 48. Her outside enclosure is 60 by 30ish. She seems comfortable with both pens, so I don't think moving back and forth upsets her. She definitely is happier in her outside box.

Diet: Her food base is bagged spring mixes with no spinach (she won't eat any spinach anyway). I supplement that with whatever greens I have on a rotating basis (that are okay for tortoises). She likes arugula, dandelion greens, carrot tops, kale etc. I've been thinking that maybe I should be more diligent about what I add to the spring mix. Its typically one extra thing a week but I could do better and maybe chop them up in advance so she has more weekly variety. I add a calcium supplement with no D3 on top at recommendation of vet. She also has hay, but she typically doesn't eat much of it.

Bulbs: Based on the last response, this might be where i'm falling down. This is the bulb I used: https://www.amazon.com/gp/product/B07Y9MBBFQ/?tag=exoticpetnetw-20. In the past I also used this bulb, but at a lower wattage I think: https://www.amazon.com/gp/product/B00101JIFG/?tag=exoticpetnetw-20. I have a heat emitter to control nighttime temps and raise the general temp of her box in winter.

Do you think those bulbs caused the damage? I didn't realize that mercury vapor bulbs were so damaging.
You obviously care very much for Delilah--she is lucky to have you. Her shell isn't pretty and Yvonne has given you an excellent summation as to why. You've also gotten some great advice as to what to do going forward (more hydration, no MVB, better food, substrate change, etc.). I would urge you to not leave her out overnight. If at all possible, you should find a new vet experienced and trained in tortoise care. If not for a third opinion now, for future needs. Fortunately you are in an area where you have a good chance of finding someone. If you need help finding someone, PM me.
 

Sue Ann

Well-Known Member
Location (City and/or State)
chapin , South Carolina
Hello,

I haven't posted in a very long while, mostly because things have been going well with my tortoise up until recently. The last six months have been rougher though. My tortoise fell off a badly placed rock in her outdoor enclosure years ago, which resulted in a minor spot of damage which morphed into minor / moderate shell rot. I got all of that treated when it happened, and since then it was okay. However, about six months ago I was giving her shell a gentle scrub with a toothbrush, and that revealed what looked to me like new rot.

I treated it myself at home for a couple of weeks using the silver cream / anit-fungals that could be acquired over the counter. Looking back I wish I brought her straight into the vet, since that didn't work. They told me that they would characterize her current shell rot condition as mild to moderate, and that it was still very treatable topically. They put her on prescription rounds of silver cream and anti-fungal every day, and that seemed to really help for a while. I did the full course of treatment for months, then stopped. All was good for a couple of weeks. I kept cleaning her shell as recommended, and during one of those times it seems like her shell was a bit flakey again. I got worried and brought her back to the vet.

That's when things started to escalate. The new vet she saw (the old vet went out on maternity leave) thought her beak and claws were a little long. Not definitively long, but she thought combined with the persistent shell issues it could indicate some kind of deep fungal infection or bone disease. I'm a bit skeptical of this, considering Delilah seems quite healthy and is eating / active. Still, we did shell cultures to be safe. The shell cultures came back negative for all the usual shell rot suspects and showed no bacteria. That's good, but we were still considering whether to move on to x-rays to make sure there wasn't a systemic infection that we successfully treated topically before, but was now coursing through her little body.

However, it took another week to get the full culture results. Once we got those, it showed penicillium. I guess that could just be a random environmental bacteria that just happens and has nothing to do with her overall health. OR, it could be a sign of some deep insidious fungal infection.

Now my vet wants to do both x-rays and a shell biopsy. That will cost about $1200 and she will need to be sedated and take mediation after she comes home. If it shows a fungal infection we will need to put a tube in her esophagus and give her more medication for months. If it was just about the money I would do it, though obviously its a lot of money. My confliction comes more from doubt about if any of this is actually necessary? I'm not doubting my vet's ability, but we haven't actually met due to COVID. It just feels like an awful lot to do to a tortoise that seems healthy besides the shell and was treated successfully (on the surface at least) for a mild to moderate case of shell rot. It feels really invasive, though obviously letting her keep getting sick isn't a good option. The tube in her throat would have to stay in for months, and I don't have a good enough understanding of tortoise pain levels to know how uncomfortable that would be for her. I have limits on how much i'd make an animal suffer to treat them. This all just escalated so fast, and I'm kind of wondering if I'm just diving head first into a sea of crazy because of what could be a random spore?

Does anyone have any thoughts when it comes to systemic shell rot issues, or following vet advice? My first thought is that I need to just do what the vets say, even if it turns out to be nothing, but I just don't feel like I have enough experience to really judge how necessary and prudent this all is. I don't want to think any vet would just rack up vet bills, but has anyone experienced things escalating so fast in an otherwise healthy animal?
I would not trust this new vet. She seems to be racking up bills.Gives me a bad feeling.
 

AgataP

Well-Known Member
Tortoise Club
Location (City and/or State)
Seattle, WA
When my Russian tort was found half melted into an asphalt he has some shell issues - I was a kid back then (8 or so) , vet had no clue about torts but what my mom and did, we took liquid vitamin D and E and rubbed some on the damaged shell- keep in mind there was no lights involved. The shell got smoother specially in one very damaged place. I can’t tell if it was the vit D and E or simply just good nutrients, plus vitamins and safe sleeping place. We kept them outside a lot from May till September- only brought them inside if they didn’t burrow. I am not an expert just sharing some experience with my Russians. Maybe it’s all the snail shells they ate 🤣😂.
 

reflectedgray

New Member
10 Year Member!
Location (City and/or State)
Portland, OR
Mercury vapor bulbs are extremely desiccating. This might have been a contributor to the problem.

The basking area directly below the bulb should be near 100 degrees. 90 is not warm enough and 83 is definitely too cool. Here is how you measure it: Get a digital thermometer from HD, Lowes, or Walmart that records daily highs and lows. Get a small square of 2x4 or something similar in height and place it directly under the basking bulb. Rest the thermometer dead center under the hot bulb and let it cook. After an hour or so, I like it to be right around 95-100. If its too hot, raise the fixture. Too cool, lower the fixture. Or change bulb wattage. Or run the bulb on a rheostat to control the wattage that way.

A CHE isn't going to work. Its for ambient temperature maintenance, not basking. CHEs can be even hotter than regular bulbs and they emit deeper penetrating radiation than typical incandescent bulbs.

There are four elements to heating and lighting:
  1. Basking bulb. I use 65 watt incandescent floods from the hardware store. Some people will need bigger, or smaller wattage bulbs. Let your thermometer be your guide. I run them on a timer for about 12 hours and adjust the height to get the correct basking temp under them. I also like to use a flat rock of some sort directly under the bulb. You need to check the temp with a thermometer directly under the bulb and get it to around 95-100F (36-37C).
  2. Ambient heat maintenance. I use ceramic heating elements or radiant heat panels set on thermostats to maintain ambient above 80 degrees day and night for tropical species. You'd only need day heat for a temperate species like Testudo or DT, as long as your house stays above 60F (15-16C) at night.
  3. Light. I use LEDs for this purpose. Something in the 5000-6500K color range will look the best. Most bulbs at the store are in the 2500K range and they look yellowish. Strip or screw-in bulb types are both fine.
  4. UV. If you can get your tortoise outside for an hour 2 or 3 times a week, you won't need indoor UV. If you want it anyway, get one of the newer HO type fluorescent tubes. Which type will depend on mounting height. 5.0 bulbs make almost no UV. You need a meter to check this: https://www.solarmeter.com/model65.html Here in our climate, you shouldn't need indoor UV.
Hi Tom (and others who care to chime in, of course),

I have a follow up question. I went to the hardware store and picked up a 65 watt flood light. I installed it, and tried lowering it closer to create the right temperature hot spot. It only got to 77 degrees about a foot from her tank? That seems wrong to me. I have some other bulbs with higher wattage that I can use next, but I'm concerned about further damaging her shell from heat.

Could a higher wattage regular incandescent flood lamp desiccate her shell if the hot spot is 90? How much wattage is TOO much wattage for this scenario? For example, if the 90 watt bulb got the temperature right, could that ruin her shell? I know she needs a proper basking spot, but I don't want to accidentally over do it again.

EDIT: After going online, I think I got the wrong type of bulb. I don't think the light is directional enough, because it doesn't create a proper "spot". I'll get a new bulb. The rest of my question still stands though about overdoing the wattage trying to get the temperature right.
 
Last edited:

vladimir

Well-Known Member
Location (City and/or State)
Pennsylvania
EDIT: After going online, I think I got the wrong type of bulb. I don't think the light is directional enough, because it doesn't create a proper "spot". I'll get a new bulb. The rest of my question still stands though about overdoing the wattage trying to get the temperature right.

I could be wrong, but I think you want the broader flood style so that it doesn't create areas of intense heat in the middle. Let's see what others say though.
 

maggie3fan

Well-Known Member
Location (City and/or State)
Crazy Train
I could be wrong, but I think you want the broader flood style so that it doesn't create areas of intense heat in the middle. Let's see what others say though.
Hi Tom (and others who care to chime in, of course),

I have a follow up question. I went to the hardware store and picked up a 65 watt flood light. I installed it, and tried lowering it closer to create the right temperature hot spot. It only got to 77 degrees about a foot from her tank? That seems wrong to me. I have some other bulbs with higher wattage that I can use next, but I'm concerned about further damaging her shell from heat.

Could a higher wattage regular incandescent flood lamp desiccate her shell if the hot spot is 90? How much wattage is TOO much wattage for this scenario? For example, if the 90 watt bulb got the temperature right, could that ruin her shell? I know she needs a proper basking spot, but I don't want to accidentally over do it again.

EDIT: After going online, I think I got the wrong type of bulb. I don't think the light is directional enough, because it doesn't create a proper "spot". I'll get a new bulb. The rest of my question still stands though about overdoing the wattage trying to get the temperature right.
I 'think' Tom recommends a 65 watt incandescent bulb
 

Tom

The Dog Trainer
10 Year Member!
Platinum Tortoise Club
Location (City and/or State)
Southern California
Hi Tom (and others who care to chime in, of course),

I have a follow up question. I went to the hardware store and picked up a 65 watt flood light. I installed it, and tried lowering it closer to create the right temperature hot spot. It only got to 77 degrees about a foot from her tank? That seems wrong to me. I have some other bulbs with higher wattage that I can use next, but I'm concerned about further damaging her shell from heat.

Could a higher wattage regular incandescent flood lamp desiccate her shell if the hot spot is 90? How much wattage is TOO much wattage for this scenario? For example, if the 90 watt bulb got the temperature right, could that ruin her shell? I know she needs a proper basking spot, but I don't want to accidentally over do it again.

EDIT: After going online, I think I got the wrong type of bulb. I don't think the light is directional enough, because it doesn't create a proper "spot". I'll get a new bulb. The rest of my question still stands though about overdoing the wattage trying to get the temperature right.
Post a pic of the bulb you got, and make sure its not a 65 watt "replacement" led bulb. 77 doesn't sound right. How are you measuring the temperature?

Please go into your user profile and add a location for us. Where are you? If you are in CA you will not find an incandescent bulb in a store here.
 

reflectedgray

New Member
10 Year Member!
Location (City and/or State)
Portland, OR
Hello,

I'll grab a picture of the bulb when I get back home. I'm pretty positive I got the wrong thing now. I'm in California (bay area). When I went into home depot they literally had 2 incandescent bulbs that were even somewhat within the wattage range. I think the one I got is actually made for wide angle indoor lighting.

I have a thermometer with a sensor on a wire. I put the node in her hot spot then wait a while for the sensor thermometer to stabilize.

I called around trying to find actual flood light bulbs and none are in stores. California is not joking around about its energy efficiency. I'm going to order one. Do you think these would work? Sorry this is pretty basic stuff. I've always bought reptile specific bulbs so I had no idea I couldn't just go to a hardware store and buy a flood light bulb.

https://www.amazon.com/gp/product/B000KKHU76/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1
 

Markw84

Well-Known Member
5 Year Member
Platinum Tortoise Club
Location (City and/or State)
Sacramento, CA (Central Valley)
Hello,

I'll grab a picture of the bulb when I get back home. I'm pretty positive I got the wrong thing now. I'm in California (bay area). When I went into home depot they literally had 2 incandescent bulbs that were even somewhat within the wattage range. I think the one I got is actually made for wide angle indoor lighting.

I have a thermometer with a sensor on a wire. I put the node in her hot spot then wait a while for the sensor thermometer to stabilize.

I called around trying to find actual flood light bulbs and none are in stores. California is not joking around about its energy efficiency. I'm going to order one. Do you think these would work? Sorry this is pretty basic stuff. I've always bought reptile specific bulbs so I had no idea I couldn't just go to a hardware store and buy a flood light bulb.

https://www.amazon.com/gp/product/B000KKHU76/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1
That is the right bulb. I would order it right away as this seller on Amazon apparently doesn't know they are not supposed to ship to California. Most of them will say not allowed to ship to CA when you try to check out, but his one does allow it currently. They are very hard to find and get in CA!
 

maggie3fan

Well-Known Member
Location (City and/or State)
Crazy Train
Post a pic of the bulb you got, and make sure its not a 65 watt "replacement" led bulb. 77 doesn't sound right. How are you measuring the temperature?

Please go into your user profile and add a location for us. Where are you? If you are in CA you will not find an incandescent bulb in a store here.
BTW Tom, ya can't get them in Oregon the tree hugger state either...IRRITATION :)
 
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