Sulcata prolapse

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chairman

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Last night when I went in to check on my 14" 'female' sulcata I discovered that a)she is a he and b) his hemipenes were prolapsed. I examined him and his organ was swollen but otherwise appeared to be undamaged. I immediately soaked him in warm water and he's still soaking now (he's been soaking for about 24 hours now). Since soaking hasn't worked I am planning to put him in the syran-wrap-diaper with honey in an attempt to reduce the swelling. If it reduces then I can attempt to help things back in with mineral oil. If that fails, back to soaking he goes until my vet reopens Wednesday (I called this morning to find they were closed for the holiday).

But until then I'm trying to figure out if there's anything else I can do. I think I have the basics of prolapse care taken care of but would be happy to hear if anyone has anything to add.
 

Yvonne G

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If I'm not mistaken, tortoises don't have hemipenes, just regular penis.

I haven't heard of the honey treatment. You can also try sugar water to help reduce the swelling. You can also gently push it back in. And it isn't just males that prolapse. Sometime if there's a blockage or something like that, a female will prolapse too.

Main thing is not to allow it to dry out.

If you can push it back in, you may have to hold it for a few minutes to be sure it doesn't pop back out.


http://www.anapsid.org/hemipenes.html
 

chairman

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I did add sugar to my original soaking water but didn't add any in the next rounds of refills. I'm using honey because it is a variety of sugar that has antiseptic properties, something I think might be a good idea since I can't get antibiotics until Wednesday.

Despite the swelling, the bit that is poking out looks like what my male hingebacks have flashed at me.

I think that I've read posts that suggest that the sugar could be left in place for a day or two... does that sound right? It would be a shame if I had to have the vet remove the male bit just days after I found out I had a male.
 

Yvonne G

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Yes. You make a paste of the sugar, so don't use too much water. Then you apply it and put something over it to hold it in place. I liked your idea of the plastic wrap diaper. But, really...try to push it back in. This has worked for me quite a few times.


Another important thing is to try to figure out why this happened. Adolescent males will put their penis out to play with it and experiment, but it usually goes back in. If he has prolapsed due to straining, it is important to know if he has stones or if he is constipated. One thing that I have done before with a prolapsed penis it to clean the bath tub real well, rinse it well, then add warm water that comes up to the middle of the tortoise's sides. Position a light over the tub to have a warm spot in there, then leave the tortoise for a long time. A LONG time. he will eventually become tired of being in the water and start to try to get out. This is what you want. This will aid him passing a blockage and may help the penis go back in.
 

chairman

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The sugar is in place. I'm hoping the swelling will have reduced enough that I'll be able to put him away again in the morning.

On the way to putting him to bed for the night we stepped on a scale and he's up to 15 lbs now.

When I had him soaking for the last day I had him set up in a concrete mixing tub, water to the depth suggested, and heat lamps to maintain appropriate temperatures. He did poop but nothing that screamed 'this was the problem'. There was a fresh poop prior to the soaking that was larger than normal... his poop is usually really long and thin, this was shorter and much fatter... it could have been what caused the prolapse. And what caused the big poop was my error, I left him alone for a couple days and he emptied his water dish during that time. Lots of artificial heat, no water, and no me to refill the water... I'm fairly certain I'm to blame but I think the cause has already been passed. The stupidest part is that I already converted a kiddie pool into a nice big water dish for him, one that would have been far more difficult to dump out, I should have installed it already.
 

chairman

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Nothing new to report except that I have a vet appointment scheduled for later today. Tissue still looks good, sugar reduced some swelling, but my tortoise is at the very least going to need to be sedated to get things put back. I tried to gently put it back myself but quickly got my fingers cut and pressure/blood blistered by the back feet during the process.

The more and more I research the problem I can't tell whether it is a prolapsed penis or oviduct. The structure of the shell back there does still indicate female. My biggest identification issue is that I cannot find any good pictures of the back side of the oviductal prolapse. From the front it looks like the female, from the back it looks like the swollen "flower" of the male organ. I am going to have to take some good 360 degree pictures and post them for later reference.

The reference pictures I've found thus far for the female prolapse:
http://www.tortoiseforum.org/thread-20461.html
http://www.britishcheloniagroup.org.uk/testudo/v6/v6n3mcarthur

And a boy with no swelling (couldn't find a swollen picture):
http://www.tortoiseforum.org/thread-3473.html
 

Jacqui

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Mike, I have been following this thread, but had no knowledge to share. I just wanted to wish you good luck at the Vet's. Yes, do try to take some good pictures, so we have pictures to share with others in figuring out what they are seeing.
 

KingInCulver

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pardon my ignorance, i am new to this topic, prolapse - what causes this? at what age/size does this usually occur? what can/should you do to prevent it? is this something more than constipation or compaction?
 

Yvonne G

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Prolapse occurs when the tortoise is straining too much to get "something" out. Egg bound...constipation...stones...a blockage of any sort.
 

chairman

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Unfortunately, the issue has not been resolved yet. My regular vet told me that she thought it looked like a prolapsed oviduct and that the organ, while discolored, seemed to otherwise be healthy enough to save. Sadly, my tortoise would not allow her to administer anesthesia or otherwise put things back in order. I was referred to a specialist that our local zoo uses.

That vet told me that it was a penile prolapse and that the tissue was dead enough that she just wanted to remove it. Talk about a 180. I guess that at this point I don't care what it is, I just hope the vet can fix it (it isn't like either part is vital for anything but breeding). I have a new surgery set for tomorrow morning. For now my tortoise is back at home to soak in warm water until we leave for the vet again.

Pictures of the organ in question:
DSCN6415_zps76080733.jpg

DSCN6417_zps0017b62d.jpg

DSCN6418_zps5d984dce.jpg

DSCN6420_zps450af8b9.jpg

DSCN6411_zps7706c977.jpg
 

Laura

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it does look dead... sorry.. but I dont understand why the vet could not anestethise your tort... did they not have a container big enough? place in a crate and place crate ina large garbage bag.. and turn the gas on...
or do torts not go down that way???
 

Yvonne G

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No, you put the tortoise's head, nose first, inside the cone. But tortoises hold their breath for a very long time. I have one that wouldn't breathe in the sedative too. So he's probably sending the tortoise to a vet that can use an injection to sedate the tortoise. Whole different ball game.
 

chairman

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My vet tried both injectible and gas. Gas didn't work because he wouldn't breath it in and you have to worry about overdosing with that method a bit more than injecting. Injecting didn't work because... she wanted to inject in the soft tissues but my tortoise wouldn't allow access? I'm not sure why going through the front leg wasn't a viable option. I do trust my vet to do what she thinks is best for my animals, though. Tortoises make up a very small portion of her practice (I do live in the 'frozen north') but when I mentioned to her that I had been seeking advice on the issue she was very interested in hearing what a seasoned rehabber like Yvonne had to share. That counts for something to me.

Hopefully the vet I was referred to will take care of everything tomorrow.
 

Laura

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cones dont work for some animals.. that why you use a container to put the whole animal in.. like feral cats or wild.. we leave them in the crate. place a bag around the crate and put the air/gas in and wait... a tort would have to take a breath sooner or later...
 

Yvonne G

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Also, the injection doesn't go into soft tissue, it has to go into a vein.
 

Tim/Robin

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emysemys said:
Also, the injection doesn't go into soft tissue, it has to go into a vein.

That depends on the drug. Ketamine, for example, is most often given as an injection not IV. In contrast, Propofol has to be given intravenously.
 

chairman

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Both vets were/are planning to use a type of Ketamine.

For anyone interested in the cost of this kind of thing, my original vet was going to charge me $260 to correct the issue (regardless of actual procedure necessary); I ended up not even having to pay an office visit because she referred me to the other vet. The new vet is charging $550 for the amputation.
 

Thalatte

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That's not too bad considering he is a specialist. I was expecting closer to $800.
 

chairman

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I couldn't wait for the vet to call for an update so I called myself... tortoise is in recovery and I should be getting a call from the vet to hear about the procedure later.
 

chairman

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I got him home today. Seems just fine. I need to inject him with antibiotics for about 12 days (4 shots, once every 3 days).

When I picked him up the vet quizzed me to make sure I was going to feed him right during recovery. I told her his daily staple is a little mazuri and either a pile of greens or all the graze he can eat (weather depending). Then the vet shared that she had given him a pile of lettuce, fruit, and a tomato earlier that morning... oh well.
 
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