Fecal Smear Identification

TheWaveCarver

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Hey everyone,

My Cherryhead has been having some runny *ahem* stools lately so I decided to do some Fecal Smears and stain with Methylene Blue.

I found tons of the below... im not sure what they are. Images were taken at 400x magnification.

20210120_193114.jpg 20210120_194140.jpg 20210120_195925.jpg 20210120_193111.jpg 20210120_201140.jpg
 

TheWaveCarver

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Other details:

  • Estimating that the subjects in the microscope images are about 100um in length.
  • BH2 BHTU microscope was used for images. Held my cellphone camera up to the eyepiece as I do not own the trinocular tube variant.
  • Tortoise is indoor 90% of the the time.
  • Purchased from a breeder 3 years ago. This tortoise has not been in close proximity to other tortoises since then.
  • During the summers I will let him eat grass and wonder around a park under my supervision.
  • Diet consists of 90% Escarole, Endive, Mazuri Tortoise Food. Other 10% is Pumpkin, Carrots, Banana, and occasional RepCal Vitamin and Calcium supp (once every 2 weeks).

Note: Ive read here that grocery store Escarole and Endive can cause runny stools. I make sure to wash it thoroughly. And Ive also read that stress (I moved around items in his enclosure recently) can cause runny stools.

When I give him a soak - the first stool is pretty solid with the second and third being very runny.
 

TheWaveCarver

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Based on my limited research of googling and after running the pictures by my SO who is a Biology major in college.... my best guess at the moment is that it is some intestinal protozoa.
 
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zovick

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@GMDVM
@zovick

Any idea what these are?
I am no parasitologist, but I would say that the long tapered ones could be pinworms which are not a worrisome problem and do not need to be treated, and the rounded organisms could be amoeba, which are a problem and should be treated. Amoebiasis is sometimes deadly if it gets out of hand. It is usually treated with Flagyl (metronidazole)

Why not take a stool sample to a vet for analysis and then get the recommended medication for what organisms are found (other than pinworms which are not a problem unless the infestation is much heavier than what is indicated in these photos).
 

TheWaveCarver

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I am no parasitologist, but I would say that the long tapered ones could be pinworms which are not a worrisome problem and do not need to be treated, and the rounded organisms could be amoeba, which are a problem and should be treated. Amoebiasis is sometimes deadly if it gets out of hand. It is usually treated with Flagyl (metronidazole)

Why not take a stool sample to a vet for analysis and then get the recommended medication for what organisms are found (other than pinworms which are not a problem unless the infestation is much heavier than what is indicated in these photos).
I think thats the right call. Im near Binghamton, NY so there's not many reptile specific vets. Ill take a look around on google and see who I can find. I would like the peace of mind.
 

zovick

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I think thats the right call. Im near Binghamton, NY so there's not many reptile specific vets. Ill take a look around on google and see who I can find. I would like the peace of mind.
I don't think you need a reptile vet to ID the organisms in a stool sample. Most vets can probably ID pinworms and amoebae. It is prescribing the medication(s) needed for treatment that might require a reptile vet's expertise.

I would find out what your tortoise may have first, then decide whether you need a reptile vet or not. Just submit a stool sample without taking the tortoise to the vet. If you don't take the tortoise along with the stool sample, there is little chance the vet could do the tortoise any harm.
 

TheWaveCarver

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I don't think you need a reptile vet to ID the organisms in a stool sample. Most vets can probably ID pinworms and amoebae. It is prescribing the medication(s) needed for treatment that might require a reptile vet's expertise.

I would find out what your tortoise may have first, then decide whether you need a reptile vet or not. Just submit a stool sample without taking the tortoise to the vet. If you don't take the tortoise along with the stool sample, there is little chance the vet could do the tortoise any harm.
Appointment made! I'll report back once he's been seen.
 

zovick

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Appointment made! I'll report back once he's been seen.
So you are taking the tortoise to the vet rather than just taking in a stool sample as I suggested above? Don't allow any type of vitamin injections if they are suggested, and I would also steer clear of any antibiotics other than ceftazidime (Fortaz) which shouldn't be needed unless there is some type of respiratory infection.

When is the appointment?
 

TheWaveCarver

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So you are taking the tortoise to the vet rather than just taking in a stool sample as I suggested above? Don't allow any type of vitamin injections if they are suggested, and I would also steer clear of any antibiotics other than ceftazidime (Fortaz) which shouldn't be needed unless there is some type of respiratory infection.

When is the appointment?
I called a few different clinics and I found one that would do tortoise fecal examination. Unfortunately, they only agreed to do it after a checkup.

I will stress on the forms and to the doctor that I want no injections or adminstered medication until we discuss. Due to the covid situation I will be unable to be present with the tortoise during the checkup... which definitely has me a bit uncomfortable.

Im trusting that the vet will honor my wishes and not inject a tortoise secretly or adminster medication secretly.
 

Markw84

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So you are taking the tortoise to the vet rather than just taking in a stool sample as I suggested above? Don't allow any type of vitamin injections if they are suggested, and I would also steer clear of any antibiotics other than ceftazidime (Fortaz) which shouldn't be needed unless there is some type of respiratory infection.

When is the appointment?
As a note... Whenever I have changed vets, every one required me to bring in the tortoise for a first visit before they would do a fecal for me. ONce they had seen a representative tortoise, in my case, they would then even do "herd testing" on the tortoise and others in my group without having to see them all. They have all maintained that they could not report test results or prescribe without seeing and establishing a "patient" relationship.

So I let them look over the tortoise and do nothing and give nothing to the tortoise. Once the "relationship" is established most vets are very reasonable in doing regular fecals on my whole group without seeing the tortoise(s).
 

TheWaveCarver

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As a note... Whenever I have changed vets, every one required me to bring in the tortoise for a first visit before they would do a fecal for me. ONce they had seen a representative tortoise, in my case, they would then even do "herd testing" on the tortoise and others in my group without having to see them all. They have all maintained that they could not report test results or prescribe without seeing and establishing a "patient" relationship.

So I let them look over the tortoise and do nothing and give nothing to the tortoise. Once the "relationship" is established most vets are very reasonable in doing regular fecals on my whole group without seeing the tortoise(s).
The vet confirmed the presence of Round Worm in his stool. We're going to de-worm him. I'll update with more information later.
 

zovick

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The vet confirmed the presence of Round Worm in his stool. We're going to de-worm him. I'll update with more information later.
Did he see any of those rounded organisms that were in your photos? To me, if they are amoebae, they are of more concern than the couple of worms that were present. Maybe you could email your stain pix to the vet and ask him what those are just to be on the safe side.
 

TheWaveCarver

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Did he see any of those rounded organisms that were in your photos? To me, if they are amoebae, they are of more concern than the couple of worms that were present. Maybe you could email your stain pix to the vet and ask him what those are just to be on the safe side.
Sorry for the late response, I got caught up in some other stuff today. So I talked with the vet out in the parking lot. She explained that they had 2 techs/vets examine the stool sample independently and then notes were compared. The stool sample ended up being fresh since he went to the bathroom on their examination table - so they were able to get that fresh sample right into the centrifuge. That's where the round worm eggs were seen. She advised de-worming with 0.8ml of Fenbendazole 2 times:
  1. First 0.8 ml Fenbendazole today
  2. Second 0.8 ml two weeks from today
  3. Third 0.8 ml four weeks from today if runny stool diarrhea returns (Hopefully this wont be necessary)
  4. 1 week into treatment, completely change out the substrate.
My tortoise weighs 825 grams currently. So thats all the information regarding the round worm. With regards to the pictures... she did review the pictures prior to the appointment as I had them sent over. I specifically brought up whether its possible he has an Amoeba parasitic infection. Her response was that they did not see any Amoebas and were looking for them - they think the photos may just be clusters of dried poo from the slides I prepared - I'm willing to believe this since Im not a vet. She also mentioned he would be in much worse shape if he had an Amoeba infection. My tortoise is still actively eating and moving around - just has loose stools and/or diarrhea.

Also worth mentioning... I brought up outsourcing the stool sample to a lab. She explained that it is an option but it would cost upwards of $400 and she really stressed that Amoebas were not present and that if symptoms did continue after treatment we could re-visit outsourcing to a lab. She went over Esteban's setup with me and was up-to-date on tortoise care in terms of humidity, UVB, space requirement and temperatures - so that was very re-assuring to hear since it aligns with much on this forum. She mentioned that in addition to an Escarole / Endive staple diet I should try including Clover Hay since it's a bit drier/fibrous.

Overall, Im feeling pretty good about everything and have greatly appreciated everyones help on this forum. Please comment with anything you feel is bad advice or should have been discussed further.
 

zovick

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Sorry for the late response, I got caught up in some other stuff today. So I talked with the vet out in the parking lot. She explained that they had 2 techs/vets examine the stool sample independently and then notes were compared. The stool sample ended up being fresh since he went to the bathroom on their examination table - so they were able to get that fresh sample right into the centrifuge. That's where the round worm eggs were seen. She advised de-worming with 0.8ml of Fenbendazole 2 times:
  1. First 0.8 ml Fenbendazole today
  2. Second 0.8 ml two weeks from today
  3. Third 0.8 ml four weeks from today if runny stool diarrhea returns (Hopefully this wont be necessary)
  4. 1 week into treatment, completely change out the substrate.
My tortoise weighs 825 grams currently. So thats all the information regarding the round worm. With regards to the pictures... she did review the pictures prior to the appointment as I had them sent over. I specifically brought up whether its possible he has an Amoeba parasitic infection. Her response was that they did not see any Amoebas and were looking for them - they think the photos may just be clusters of dried poo from the slides I prepared - I'm willing to believe this since Im not a vet. She also mentioned he would be in much worse shape if he had an Amoeba infection. My tortoise is still actively eating and moving around - just has loose stools and/or diarrhea.

Also worth mentioning... I brought up outsourcing the stool sample to a lab. She explained that it is an option but it would cost upwards of $400 and she really stressed that Amoebas were not present and that if symptoms did continue after treatment we could re-visit outsourcing to a lab. She went over Esteban's setup with me and was up-to-date on tortoise care in terms of humidity, UVB, space requirement and temperatures - so that was very re-assuring to hear since it aligns with much on this forum. She mentioned that in addition to an Escarole / Endive staple diet I should try including Clover Hay since it's a bit drier/fibrous.

Overall, Im feeling pretty good about everything and have greatly appreciated everyones help on this forum. Please comment with anything you feel is bad advice or should have been discussed further.
It all sounds good to me. It is great that no amoebae were noted. Good luck with the worming treatments.
 
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