RNS and the use of Clarithromycin

[Mich]

I believe there is a specific health related forum on here but unfortunately I can't find it using the mobile site and the app won't let me log in using my login credentials so I'll post here and maybe a moderator could bump it to the right spot for me.

I took in a young male leopard last spring. Aside from some pyramids on his shell he seemed healthy although he was kept in a mixed species enclosure. After just over 6mon with no issue I put him in with my other leopard tortoise and now about 3mon later he has a runny nose and weezy breathing. After calling every vet in the city to find the one most familiar with exotics I rushed him to the vet (who was not knowledgeable in the LEAST sighhh) and after much back and forth was finally given a prescription for clarithromycin to be administered orally with food at a dose of 1.2ml every other day (for a 5.5lb tortoise). Over the course of 10 day I'm only to give this to him 5x then discontinue but I see others here that have had to use it for far longer before the symptoms cleared up. I'm nearing the end of the prescribed time. Do I keep giving it to him? Do I request a different drug? No swabs or tests were completed, all this "exotic pet vet" did was look on her own vet forum. She also recommended injections which I'd rather not do unless necessary, I'm just wondering if I've given the clarithromycin a fair chance at only 5 doses? I'd hate to stop an antibiotic half way if I should keep going. Unfortunately my regular herp vet is no longer practising and relocated so I'm stuck with vets that have little or no knowledge on the subject.

 

[Tom]

I see what was offered by the vet to treat the symptoms. I don't see what was done to address the cause of the symptoms. They don't get sick for no reason, and treating symptoms without fixing the problem is futile and hard on the animal.

Where does this tortoise live? What is the overnight low? Do you have just two? So they are living as a pair?

I really don't feel qualified to give advice on medicines and dosages, even though I have some experience in the matter. I hate to impose, but perhaps @deadheadvet wouldn't mind sharing his general thoughts on the matter? He is a very knowledgeable and experienced tortoise vet that we are lucky to have here on the forum with us.

 

[Yvonne G]

I hadn't heard of clarithromycin, so can't talk about that. Fortaz is a good antibiotic to use on leopards.

 

[Tom]

I hadn't heard of clarithromycin, so can't talk about that. Fortaz is a good antibiotic to use on leopards.

That is what my vet recommended when we were trying to save Hope. We went through two courses of injectable.

 

[deadheadvet]

Can be used for upper resp. infection every 72 hours. Not sure of the cost, that;s why we haven't used much of it, always a good choice with culture results. If it is the only antibiotic effective based on culture and sensitivity results, I would use it.

 

[Yvonne G]

Since no smears were done, you might be looking at a case of stress, and not R.I. Stress causes a runny nose sometimes too. It could be that since you've put a 'pair' together, you have a dominance/subordinate situation going on. Separate the two until the symptoms go away.

 

[Mich]

The vet was recommending daily injections for 7 days if giving it orally didn't work.

Daytime temps around 90 (bumped up a little bit now in the hopes it may help). I'm in northern Canada so my tortoises need to be housed indoors over the winter. No night heat needed as our house temp goes no lower than 70f. The UV lights were just swapped 2 months ago. I only have the two tortoises, I've had the original about 6yrs now I think. The only thing I've changed recently was the substrate. I usually use cypress mulch but had a hard time finding some during the winter so I tried coco fibre but found it too dusty, tried mixing some plays sand and soil but again it was dusty. I finally found a bag of cypress mulch and swapped the substrate out. A few days later I noticed the runny nose. Maybe the dryness of the winter? The stress of cohabitation since Christmas? Or being housed indoors? Could he have had it prior from being house with mixed species and is now a carrier, I've read it is often reoccurring so maybe it cropped back up? Honestly I don't know

 

[Yvonne G]

Because your tortoise got sick housing him the way you are, I would get a CHE:



and set it up on a thermostat to run at night after the lights are off. I don't feel that ambient house temperatures are warm enough for a tortoise, even though they are at 70F degrees.

 

[Mich]

Can be used for upper resp. infection every 72 hours. Not sure of the cost, that;s why we haven't used much of it, always a good choice with culture results. If it is the only antibiotic effective based on culture and sensitivity results, I would use it.

The cost wasn't much, $26 CAD for a 55ml bottle. Tortoises have been separated again at the sign of first symptoms, perhaps my ambient temp isn't quite enough at night, I have red night bulbs on hand but will go grab the ceramic one immediately. I wish I could recall the name of the injectable drug that was mentioned. Given what I've read (obviously I'm far from being an expert) with their slow metabolisms daily injections sounds like a lot. What I wouldn't give for a knowledgeable vet, I've left messages with vets in the next city (1.5hrs away) to see if perhaps they are more knowledgeable. Problem is they claim to be but then you get there and hear them call your tort a turtle

 

[Tom]

The vet was recommending daily injections for 7 days if giving it orally didn't work.

Daytime temps around 90 (bumped up a little bit now in the hopes it may help). I'm in northern Canada so my tortoises need to be housed indoors over the winter. No night heat needed as our house temp goes no lower than 70f. The UV lights were just swapped 2 months ago. I only have the two tortoises, I've had the original about 6yrs now I think. The only thing I've changed recently was the substrate. I usually use cypress mulch but had a hard time finding some during the winter so I tried coco fibre but found it too dusty, tried mixing some plays sand and soil but again it was dusty. I finally found a bag of cypress mulch and swapped the substrate out. A few days later I noticed the runny nose. Maybe the dryness of the winter? The stress of cohabitation since Christmas? Or being housed indoors? Could he have had it prior from being house with mixed species and is now a carrier, I've read it is often reoccurring so maybe it cropped back up? Honestly I don't know

Just sharing my observations:

1. I think 70 is much too low for a night temp. If the thermostat is showing 70 on the wall, I would bet money that its a few degrees colder on the floor of the tortoise enclosure. In any case, Standard Operating Procedure for a RI is to bump up the temps. I would get the basking spot up to 100, daytime ambient in the low 90's and night time should not drop below 85 until two weeks after the disappearance of symptoms, at which time I'd keep it around 80. During this time of extra heat, it is important to soak a lot to keep them hydrated. I recommend daily, but skipping a day now and then is not the end of the world.
2. If your substrate is dusty, that is an indication that its much too dry. I would dampen it to give them some humidity, but not until the temps are warmed up.
3. The main change that you are not taking into account is that you put them together. This is very stressful for them and stress can hamper the immune system enough to let a RI take hold, especially when other factors are less than perfect, like cold night temps. Tortoises should not be housed in pairs. Any tortoise moved into a new territory is going to be stressed. A territory already occupied by another tortoise? Even more stressed. And this is even if the other tortoise didn't do anything. Just its presence and the potential of conflict is a stressor. If the other tort folioed the new one, sniffed at it, crowded it, slept in the same area, looked at it from across the enclosure, sat on the food, etc…, more stress.

 

[Tom]

What I wouldn't give for a knowledgeable vet, I've left messages with vets in the next city (1.5hrs away) to see if perhaps they are more knowledgeable. Problem is they claim to be but then you get there and hear them call your tort a turtle

This is tough. Where are you? What city? Perhaps another member in your area might have a recommendation. We have lots of Canadian members. Perhaps start a thread in the "Regional Requests" section asking for vet recommendations in your part of Northern Canada.

 

[Mich]

Just sharing my observations:

1. I think 70 is much too low for a night temp. If the thermostat is showing 70 on the wall, I would bet money that its a few degrees colder on the floor of the tortoise enclosure. In any case, Standard Operating Procedure for a RI is to bump up the temps. I would get the basking spot up to 100, daytime ambient in the low 90's and night time should not drop below 85 until two weeks after the disappearance of symptoms, at which time I'd keep it around 80. During this time of extra heat, it is important to soak a lot to keep them hydrated. I recommend daily, but skipping a day now and then is not the end of the world.
2. If your substrate is dusty, that is an indication that its much too dry. I would dampen it to give them some humidity, but not until the temps are warmed up.
3. The main change that you are not taking into account is that you put them together. This is very stressful for them and stress can hamper the immune system enough to let a RI take hold, especially when other factors are less than perfect, like cold night temps. Tortoises should not be housed in pairs. Any tortoise moved into a new territory is going to be stressed. A territory already occupied by another tortoise? Even more stressed. And this is even if the other tortoise didn't do anything. Just its presence and the potential of conflict is a stressor. If the other tort folioed the new one, sniffed at it, crowded it, slept in the same area, looked at it from across the enclosure, sat on the food, etc…, more stress.

 

[deadheadvet]

Clarithromycin: 15mg/kg B.W. ORALLY every 3 days.

 

[Mich]

I agree that substrate was too dry even with misting so I discontinued using it. I did consider the stress of cohabitation being the cause but only afterwards. I guess since it's been a few months, and after the recommended quarantine time before introduction, I thought it was ok although of course I know they can take a long time to display symptoms of illness. Shoot I honestly didn't know housing them together would be a problem so long as I quarantined, when reading so many websites and forums it sounded like common practice and so long as they had appropriate room, weren't over crowded or weren't mixed with any other species (which he initially was but not by me). I will bump up the night temp immediately. I will also continue to soak them, I'm glad you mentioned that because I meant to ask if it was still recommended during illness. Any advice is very much appreciated!!

 

[Mich]

Clarithromycin: 15mg/kg B.W. ORALLY every 3 days.

THANK YOU!!! He was weighed just two days ago at 2.5kg so I have an accurate weight to go by. I admit it's very difficult to administer and his over grown beak makes it hard.

 

[deadheadvet]

You may consider looking at a compounded version of the medication. We routinely get oral meds compounded to have Stevia powder as a natural sweetener and red color dye with strawberry flavor to get tortoises to take the medication more readily.

 

[Tom]

I agree that substrate was too dry even with misting so I discontinued using it. I did consider the stress of cohabitation being the cause but only afterwards. I guess since it's been a few months, and after the recommended quarantine time before introduction, I thought it was ok although of course I know they can take a long time to display symptoms of illness. Shoot I honestly didn't know housing them together would be a problem so long as I quarantined, when reading so many websites and forums it sounded like common practice and so long as they had appropriate room, weren't over crowded or weren't mixed with any other species (which he initially was but not by me). I will bump up the night temp immediately. I will also continue to soak them, I'm glad you mentioned that because I meant to ask if it was still recommended during illness. Any advice is very much appreciated!!

Housing them in groups usually works out okay. There can be some initial stress, but most of the time they work it out and its okay, unless you have two adult males in one enclosure. Even that works sometimes though with this species. Its pairs that are the problem. Its just too personal. One will always be dominant, and therefore the other submissive. When there are multiple tortoises hanging around, the dynamic is different than a one-on-one situation.

To clarify about the substrate. I don't think you had the wrong substrate. I think it was just too dry. If you don't wet the cypress mulch, it will be too dry too. Misting the surface is not effective, as you've already discovered. You have to pour water in the substrate to get it right, but DON'T do this with cool night temps. I usually just dump their water bowls into the substrate daily, as long as there is no poop in them. For some enclosures this is enough to maintain adequate substrate moisture. Others need more or less.

 

[SarahChelonoidis]

Are you in Ontario? There are a few vets in the greater Toronto area that I could recommend who have experience with tortoises.

 

[Mich]

You may consider looking at a compounded version of the medication. We routinely get oral meds compounded to have Stevia powder as a natural sweetener and red color dye with strawberry flavor to get tortoises to take the medication more readily.

I wasn't wetting it enough then, I will wet the substrate more ! Night time temp has now been bumped up too and is in sync with my daytime timers.

So far I've been administering the meds with food as the vet recommended. I mix it with a bit of butternut squash puree and torn up bits of green in a dish. He doesn't like it but over the course of about half an hour I am able to get him to eat it piece by piece. Once he eats that I feed him the rest of his greens. I'm very grateful for the advice and will follow the 72hr/dosage deadheadvet was kind enough to give me! Do I continue until the symptoms resolve (or maybe a few days after)?

 

[Mich]

Are you in Ontario? There are a few vets in the greater Toronto area that I could recommend who have experience with tortoises.

Yes, North Bay Ontario. About 3.5hrs north of TO. Next major city to me is Sudbury (1.5hrs north) or Barrie (2hrs south).