Esmeralda needs surgery

[ascott]

Thanks for your input, @ascott and I understand what you’re saying. If I decided on what I feel I wouldn’t have the surgery, as I’m emotionally invested; this is my pet, I love her, and I’m worried. However, I’m a rational person, and I work in logic and evidence and I have been presented with evidence of the diagnosis (x Ray, ultrasound and blood work) so it seems unreasoned for me to doubt this.




She’s been digging nests since April, the only outward symptom I have observed, and my initial reason for the vet visit. He said the follicular development in the ovaries are most likely making her think she’s gravid, when she’s not.

Thank you for your well wishes, it’s much appreciated.

Well, logic tells me that there are no eggs bound in the xray, according to what you outline. You say this is a tortoise that has just started this behavior (last few months) and would mean somewhat the equal to the boys and the fun they find when they find the joy they acquire from their penis...something that is driving a behavior does not mean there is something wrong.

 

[Tom]

Hi Tom, thanks for your input. I’m aware that digging test holes was common, but I was under the impression that nest digging meant that eggs were likely to happen soon, if not imminent. Is that not the case? It’s just that she’s been been doing this since April, and the X-Ray last week showed no eggs.

This is a hormone driven behavior. Like what @ascott mentioned about the males flashing their penises. Her digging holes doesn't mean there are eggs coming. Its just means she's digging test holes because her hormone driven instincts tell her too.

As long as she is not forming eggs and then refusing to lay them, I would not do surgery to remove her sex organs. Other than a precautionary x ray from time to time, I see no reason to do anything at all except feed and enjoy your tortoise.

 

[Yourlocalpoet]

Thanks, @ascott and @Tom. I agree that something that drives behaviour does not necessary mean something is wrong, but I can’t ignore the advice of a professional so easily. Can I ask, excluding the male showing behaviour comparison, what makes you sure this is nothing to worry about? Experience of this? Literature?

What is concerning the vet are the size and amount of follicles on the ovaries, a slightly low white blood cell count, increased blood calcium and other indicators that she is creating yolk.

I value everyone’s input, and want to make an informed decision, but I need to be able to justify it. I also want to speak to the vet again before I do anything - in addition to disputes you have already made, is there anything else I should ask/challenge?

Thanks again.

 

[TammyJ]

If you have actually already made up your mind to let the vet do the operation, then all the best to you and your tortoise, I hope it all works out well.
If it was me, I would only consider surgery as an emergency and a last resort, especially if it is only one particular vet that I have consulted, and not got a second opinion from another good herp vet.
You know that the people on this site are terrific, seeing as you have been here 5 years.

 

[Yourlocalpoet]

If you have actually already made up your mind to let the vet do the operation, then all the best to you and your tortoise, I hope it all works out well.
If it was me, I would only consider surgery as an emergency and a last resort, especially if it is only one particular vet that I have consulted, and not got a second opinion from another good herp vet.
You know that the people on this site are terrific, seeing as you have been here 5 years.

I haven’t made a decision yet; I want to get as much info, opinions and suggestions as I can first. Absolutely, some people on the forum are greatly experienced with chelonia and give great information - my own knowledge of reproductive diseases is limited though. Been here for 9 years actually!

 

[mark1]

has progesterone been tried ……. not sure of the size of your tortoise , but they can do a laparoscopic ovariectomy in small animals , dogs and cats ,they may not be there yet , but you'd think it'd be possible for a skilled reptile surgeon ?

 

[Yourlocalpoet]

has progesterone been tried ……. not sure of the size of your tortoise , but they can do a laparoscopic ovariectomy in small animals , dogs and cats ,they may not be there yet , but you'd think it'd be possible for a skilled reptile surgeon ?

I believe surgery can be performed with incisions through the front of the hind leg, but depends on the species and size? I want to say I read somewhere this is probably only accessible in large tortoises.

Es isn’t that big - 8kg and about 14 inches SCL.

 

[ascott]

Hi Yvonne, thank you for that. I pretty much just asked Tom the same, but what’s the time frame between digging and laying roughly like? I thought nesting implied imminent laying. She’s been digging for 4 months almost now, and there are no eggs inside her as of an X -Ray last week. She’s just done another one this afternoon - dug up a 4 year old lavender bush and roots in the process!

So I went back and am reading all of your posts....if a tortoise has eggs and holding them for four months...there would be outward signs of distress....low or less eating, lethargy no desire to do much activity, etc. Just because you have the opinion of one vet does not make that vet correct, and what I mean by correct is---the vet does not "know" this to be the absolute diagnosis...only a guess based on a few items....that is a lot riding on the opinion of one person. I mean, it sounds as though (and I say, sounds as though) you have already jumped on the vets bleacher and therefore are having a hard time to take in other information/suggestions with that same open mind....therefore, as I did before, I wish you the best and I wish your tort the best. If it were me however, I would go back and forth in discussions with Tom and Yvonne and the many others here who that females doing "normal" behavior in the entire process of being a female tortoise (of a variety of species) and what that can mean vs what one vet is saying....Tom and Yvonne and a number of others here are an unmatched library of knowledge....I hope that you can open your mind and take that in. I also would strongly suggest you get another opinion....just because the vet was referred by a friend does not make the vets words all right.

 

[Yourlocalpoet]

So I went back and am reading all of your posts....if a tortoise has eggs and holding them for four months...there would be outward signs of distress....low or less eating, lethargy no desire to do much activity, etc. Just because you have the opinion of one vet does not make that vet correct, and what I mean by correct is---the vet does not "know" this to be the absolute diagnosis...only a guess based on a few items....that is a lot riding on the opinion of one person. I mean, it sounds as though (and I say, sounds as though) you have already jumped on the vets bleacher and therefore are having a hard time to take in other information/suggestions with that same open mind....therefore, as I did before, I wish you the best and I wish your tort the best. If it were me however, I would go back and forth in discussions with Tom and Yvonne and the many others here who that females doing "normal" behavior in the entire process of being a female tortoise (of a variety of species) and what that can mean vs what one vet is saying....Tom and Yvonne and a number of others here are an unmatched library of knowledge....I hope that you can open your mind and take that in. I also would strongly suggest you get another opinion....just because the vet was referred by a friend does not make the vets words all right.

I don’t understand this forum sometimes.

As I have said on every comment, I appreciate all responses and everyone taking time to read the thread and offer opinions, but honestly, as much as I value your response, I find it a bit patronising and confusing.

I am on the vet’s bleacher because I’m not going to dismiss their diagnosis outright? Or because I didn’t immediately accept the opinion of yourself and Tom, Yvonne without asking further questions to learn and clarify?

I have admitted I am not an expert here, I have tried to separate my personal bias from this animal and be objective, I am trying to challenge my vet to understand the diagnosis, I am curious to your disagreement with my vet’s diagnosis, I am asking questions and actively trying to find evidence against this; how much more open minded can I be?

If I wasn’t interested in people challenging what I’m presenting, I wouldn’t be here. I would’ve smiled and nodded and handed her over for surgery a week ago.

I have taken your advice and sought a second veterinarian’s opinion, and in the meantime I am still very much interested in what questions I should be asking them, people’s opinions and any experiences that are similar to my situation.

 

[ascott]

I don’t understand this forum sometimes.

As I have said on every comment, I appreciate all responses and everyone taking time to read the thread and offer opinions, but honestly, as much as I value your response, I find it a bit patronising and confusing.

I am on the vet’s bleacher because I’m not going to dismiss their diagnosis outright? Or because I didn’t immediately accept the opinion of yourself and Tom, Yvonne without asking further questions to learn and clarify?

I have admitted I am not an expert here, I have tried to separate my personal bias from this animal and be objective, I am trying to challenge my vet to understand the diagnosis, I am curious to your disagreement with my vet’s diagnosis, I am asking questions and actively trying to find evidence against this; how much more open minded can I be?

If I wasn’t interested in people challenging what I’m presenting, I wouldn’t be here. I would’ve smiled and nodded and handed her over for surgery a week ago.

I have taken your advice and sought a second veterinarian’s opinion, and in the meantime I am still very much interested in what questions I should be asking them, people’s opinions and any experiences that are similar to my situation.

Okay, so now you seem open to others . Sometimes I can come off a bid rash, but that is sometimes by design. I mean I completely understand that you do not know perfectly what to do because you are not an "expert". Hey, I have never labelled anyone an expert...to do so would designate that person responsible for all knowing and that just is not ever possible (exactly why a vet also is not the all knowing).

I just would like for you to know that there are many here that have learned the hard way, and the tort at the mercy of a human, learned even the harder way with their life. I find that a lot of times we tend to think that a vet knows everything and they simply do not. If you had come here with the vets words of Maybe, Perhaps and this is what I think...then that would be more plausible. Plausible in that the vet should not automatically recommend a procedure based on a series of guesses....not a diagnosis. You have the information from the vet (and that should be strongly taken) and then you have the information here from many folks that also have personal first hand experience. I only mention Tom and Yvonne because well hell, Yvonne is seasoned both in the old and also partakes of the New Ways and Tom has a great interest in the New Ways (and that is not a dig, that is a positive comment intended from me). They both have had many females in their care and have observed, promoted and shared success and downfalls with their females....understand that a living creature can suffer death as anything else living can and as much as we all would love to save and help everything to live ....death is also part of life and while we may all do all that we can to support living forever, it is a hard thing to achieve.

No one here wants harm to come to the tortoise in your care...but we also know that a simple statement from one vet does not make us feel warm and fuzzy when we know that a vet can also be very quick to "label" what is wrong and want to do surgery or want to do injections...and while both of those things may be necessary, they may not always be.

So, if it were me...I would tell the second vet you are going to visit some of the behaviors of the tortoise (without giving any information that the first vet gave you) and then see what they come up with. Also know, I am not a big fan of stressing a tortoise out going to the vet...the car ride, the probing and handling...this is a very nomadic creature....and stress can bring out weakness in the health of a tortoise. So I would try a variety of things in my own control before I ever subjected a tortoise to the stress of a vet visit. Again, my way of thinking and not meaning to impose it onto you.

I do not want you to feel like me nor anyone here thinks taking the advice of a vet is the wrong thing. I personally just know that the vet is not always the best answer my dear.

I would like to bring in @Yvonne G and @Tom to offer up some detailed help that they may take if in your situation. I know Tom said no big issue in a prior post and Yvonne said she would not have thought there was a problem with with what you describe....perhaps they can offer up a little more insight as to why?

 

[TammyJ]

Okay, so now you seem open to others . Sometimes I can come off a bid rash, but that is sometimes by design. I mean I completely understand that you do not know perfectly what to do because you are not an "expert". Hey, I have never labelled anyone an expert...to do so would designate that person responsible for all knowing and that just is not ever possible (exactly why a vet also is not the all knowing).

I just would like for you to know that there are many here that have learned the hard way, and the tort at the mercy of a human, learned even the harder way with their life. I find that a lot of times we tend to think that a vet knows everything and they simply do not. If you had come here with the vets words of Maybe, Perhaps and this is what I think...then that would be more plausible. Plausible in that the vet should not automatically recommend a procedure based on a series of guesses....not a diagnosis. You have the information from the vet (and that should be strongly taken) and then you have the information here from many folks that also have personal first hand experience. I only mention Tom and Yvonne because well hell, Yvonne is seasoned both in the old and also partakes of the New Ways and Tom has a great interest in the New Ways (and that is not a dig, that is a positive comment intended from me). They both have had many females in their care and have observed, promoted and shared success and downfalls with their females....understand that a living creature can suffer death as anything else living can and as much as we all would love to save and help everything to live ....death is also part of life and while we may all do all that we can to support living forever, it is a hard thing to achieve.

No one here wants harm to come to the tortoise in your care...but we also know that a simple statement from one vet does not make us feel warm and fuzzy when we know that a vet can also be very quick to "label" what is wrong and want to do surgery or want to do injections...and while both of those things may be necessary, they may not always be.

So, if it were me...I would tell the second vet you are going to visit some of the behaviors of the tortoise (without giving any information that the first vet gave you) and then see what they come up with. Also know, I am not a big fan of stressing a tortoise out going to the vet...the car ride, the probing and handling...this is a very nomadic creature....and stress can bring out weakness in the health of a tortoise. So I would try a variety of things in my own control before I ever subjected a tortoise to the stress of a vet visit. Again, my way of thinking and not meaning to impose it onto you.

I do not want you to feel like me nor anyone here thinks taking the advice of a vet is the wrong thing. I personally just know that the vet is not always the best answer my dear.

I would like to bring in @Yvonne G and @Tom to offer up some detailed help that they may take if in your situation. I know Tom said no big issue in a prior post and Yvonne said she would not have thought there was a problem with with what you describe....perhaps they can offer up a little more insight as to why?

Thank you for continuing to try and help, Ascot. I have decided not to interfere any more as I don't want to sound patronising. I hope the tortoise will be OK.

 

[Yourlocalpoet]

She had the surgery yesterday, and is recovering well so far.



The vet was spot on - she had follicular stasis as suspected due to the consistent gravid behaviour with no egg laying and the blood tests, notably the poor white blood cell count.

This is what was removed from her.



Look at size and the colour of some of those follicles. Pretty nasty stuff. I actually cannot believe she seemed so bright and coped so well with the amount of those on her ovaries. This has clearly been an issue since at least last summer with no outward symptoms until this year and it may have damaged her liver. Time will tell.

@TammyJ, I am candid and honest; I wasn’t trying to be offhand, so I’ll preface this last statement by saying explicitly that I am NOT trying to antagonise anyone with what I’m about to say, but I think it’s important to acknowledge that had I taken the advice from this forum and assumed this was just exploratory or normal behaviour and left her alone as advised, this would not have ended well for my tortoise.

No, this isn’t always the case; I have witnessed fantastic advice over the years here which have probably saved the lives of many animals, and I’ve learned a lot about tortoises. Yes, the people on this forum are fantastic, greatly experienced, helpful and wonderfully knowledgable, but I feel there is a lesson to be learned here; we are still only hobbyists on an Internet forum, and no matter how knowledgeable we are, we must always challenge and enquire and make judicious use of all information given to us, and this includes information from qualified reptile veterinarians.

Thank you again to anyone who gave advice or well wishes regarding this - I sincerely appreciate it. Essie isn’t out of the woods yet as she has to recover but hopefully this thread might help someone else who’s tortoise ever has this disease.

Some articles for reference on Follicular Stasis for anyone interested.

http://www.britishcheloniagroup.org.uk/vetscorner/stasis

https://www.vettimes.co.uk/article/reproductive-diseases-in-reptiles/?format=pdf

https://www.vetstream.com/treat/exotis/reptile/diseases/pre-post-ovulatory-stasis

 

[EllieMay]

She had the surgery yesterday, and is recovering well so far.

View attachment 277574

The vet was spot on - she had follicular stasis as suspected due to the consistent gravid behaviour with no egg laying and the blood tests, notably the poor white blood cell count.

This is what was removed from her.

View attachment 277573

Look at size and the colour of some of those follicles. Pretty nasty stuff. I actually cannot believe she seemed so bright and coped so well with the amount of those on her ovaries. This has clearly been an issue since at least last summer with no outward symptoms until this year and it may have damaged her liver. Time will tell.

@TammyJ, I am candid and honest; I wasn’t trying to be offhand, so I’ll preface this last statement by saying explicitly that I am NOT trying to antagonise anyone with what I’m about to say, but I think it’s important to acknowledge that had I taken the advice from this forum and assumed this was just exploratory or normal behaviour and left her alone as advised, this would not have ended well for my tortoise.

No, this isn’t always the case; I have witnessed fantastic advice over the years here which have probably saved the lives of many animals, and I’ve learned a lot about tortoises. Yes, the people on this forum are fantastic, greatly experienced, helpful and wonderfully knowledgable, but I feel there is a lesson to be learned here; we are still only hobbyists on an Internet forum, and no matter how knowledgeable we are, we must always challenge and enquire and make judicious use of all information given to us, and this includes information from qualified reptile veterinarians.

Thank you again to anyone who gave advice or well wishes regarding this - I sincerely appreciate it. Essie isn’t out of the woods yet as she has to recover but hopefully this thread might help someone else who’s tortoise ever has this disease.

Some articles for reference on Follicular Stasis for anyone interested.

http://www.britishcheloniagroup.org.uk/vetscorner/stasis

https://www.vettimes.co.uk/article/reproductive-diseases-in-reptiles/?format=pdf

https://www.vetstream.com/treat/exotis/reptile/diseases/pre-post-ovulatory-stasis

Well said! Best wishes for a speedy recovery. Looking forward to updates!

 

[wellington]

Glad everything is turning out good.
I only wish that a pic of the xray would have been posted and the blood values would have been shared in your first statement about this problem. Giving all details from the beginning helps to give a much better informed response. Also that you now state it's been going on since last summer, all info held back from your original post.
If you can, I'd still would like to see the xray. With as much as was taken from her and the size some of them look, it had to show on the xray like a big mass of a bunch of balls.
A lesson to be learned from anyone reading this. Give all info upfront and as detailed as possible along with any pics to get the best informed advise.

 

[Blackdog1714]

WOW! Awesome for you and your Tortie. Personally I wouldn't hire your Vet to touch up any plaster walls, but it will hold! Being a pet parent is the worst, they are so stoic and can't tell us where it hurts! Here is to a full recovery!

 

[katieandiggy]

So glad she is on the mend.
I know my vet has carried out that operation before and for very similar symptoms to what you mentioned, the recovery was a long process but they got there in the end.
Please keep us updated, I would love to hear about her recovery.

 

[Yourlocalpoet]

Glad everything is turning out good.
I only wish that a pic of the xray would have been posted and the blood values would have been shared in your first statement about this problem. Giving all details from the beginning helps to give a much better informed response. Also that you now state it's been going on since last summer, all info held back from your original post.
If you can, I'd still would like to see the xray. With as much as was taken from her and the size some of them look, it had to show on the xray like a big mass of a bunch of balls.
A lesson to be learned from anyone reading this. Give all info upfront and as detailed as possible along with any pics to get the best informed advise.

Thanks @wellington. I don’t think I did hold anything back? I gave all the information I was given about the blood work: low white blood cells, increased calcium and yolk formation - (see post #23)

There was nothing on the X Ray, I saw it but don’t have a copy, but the follicles were visible via ultrasound.

I didn’t know it was going on last year, the vet has just surmised this from the amount of follicles removed; she wasn’t digging or doing anything out of the ordinary last year.

 

[Yourlocalpoet]

WOW! Awesome for you and your Tortie. Personally I wouldn't hire your Vet to touch up any plaster walls, but it will hold! Being a pet parent is the worst, they are so stoic and can't tell us where it hurts! Here is to a full recovery!

Thank you, that’s very kind. Originally they wanted to use resin, but the vet said she had A LOT of muscle, and because she was so vascular, there was a lot of blood post op so they didn’t think the resin would cut it. Fibreglass seems to be okay, no seepage.

 

[TammyJ]

I wish her a quick and complete recovery from the surgery. And a long and good life from now on.

 

[Yvonne G]

I may be wrong, but I'm thinking I remember reading that tortoises are born with all the follicles they're ever going to have throughout their life. So seeing that many follicles in that container doesn't scare me. It looks normal to me.