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     Manouria
                                             Healt & medical
Constipation: Soak the tortoise in a bath of tepid water for 30 minutes, with the water level just covering the plastron. If this does not work, consult your veterinarian for advice. This condition is almost invariably the result of poor dietary management. Increase fibre intake substantially. Laxatives commonly used are liquid parafin and lactulose. Dandelion root added to feed will often work here too.
Diarrhoea: Add alfalfa (rabbit pellets are compressed alfalfa) to diet as a temporary measure (they are rather high in protein for routine use) and change to a less hydrated food. Overfeeding of fruit is a common cause. Use drugs only if an infection is present, consult your veterinarian. Any foul smelling diarrhoea should be reported to your vet without delay. A fecal sample should be checked for evidence of worms or flagellate organisms.
Vomiting: is a serious sign, consult your vet without delay. Can also indicate a very severe worm infestation.
Abscesses: These are quite common in tortoises, especially in the ears. Take your tortoise to your vet at the first sign of any abnormal swelling. Abscesses can also follow minor bites or other injuries, such as a thorn penetration. Abscesses in tortoises will not respond merely to antibiotic treatment; they must be physically drained and all necrotic material removed surgically and the wound left to drain without stitching. Good post-operative follow-up is vital.
Pneumonia:The most common causes of respiratory disease are: unhygienic and damp conditions, overcrowding, inadequate temperatures and exposure to "carriers".
Symptoms: Acute - gaping, stretching neck and respiratory difficulty, often mucous in nostrils and mouth, leg weakness and poor retraction, dehydration, depression, open mouth breathing. Some tortoises run about blindly. Urgent veterinary help is needed if the tortoise is to survive. Begin injected antibiotics at once. Even a few hours delay can prove fatal.
Symptoms: Chronic - persistent low level discharge from nose, weakness, poor head and limb retraction. Probably the most common disease found in tortoises. The tortoise should be treated by a competent veterinarian immediately.
Eye infections: Infections usually respond to treatment with either Genoptic (gentamycin) eye drops or terracortril eye suspension. Mild cases respond to Neomycin or Chloramphenicol eye ointment. Where you see severely swollen eyelids there is usually a primary bacterial infection in which case a course of antibiotics will be essential. Some eye problems are simply an indication of vitamn A deficiency. Supply vitamin A and use a mild eye ointment, if the condition does not respond fairly quickly get veterinary help.
Impacted colon: Occasionally encountered, usually through incorrect diet or accidental ingestion of foreign material, and can develop into septicaemia if untreated. Severe worm burdens can also cause gut impaction. Distension of the gut affects lung capacity and inhibits respiration leading to rapid death. Gut impaction should be suspected if the animal does not pass droppings, is lethargic and having difficulty breathing. Soaking the tortoise in a bath of tepid water will encourage defecation. Severe cases need veterinary treatment immediately. An x-ray and even surgery may prove necessary.
Septicaemia: Signs include vomiting, lethargy, distinct reddish flush or tinge on the plastron or under carapace shields (except in angulates). Haemorrhages of tongue and oral mucous membranes occur, jaundice, and the animal drinks excessively. This is sometimes caused by egg retention/rupture, or gut impaction. Obtain veterinary help immediately.
Egg retention: Signs include reluctance to walk, lethargy and general signs of septicaemia. Here prevention is better than cure - provide good nutrition with plenty of calcium, the correct laying environment for the species, and keep levels of stress to a minimum. X-rays can be taken to confirm diagnosis and your vet can then determine the best treatment. Laying can be induced using a combination of injected calcium and oxytocin.
Renal dysfunction: Signs include oedema (water retention), pale mucous membranes, lethargy, reluctance/inability to urinate, weight increase due to fluid retention. Often seen following long term anorexia, dehydration and bacterial infection. Get veterinary help immediately. In early stages, regular warm baths and physiotherapy of back legs can help release any blockage. Always ensure that your tortoise has access to clean, fresh water. Diabetes: Symptoms include lethargy, anorexia, weakness. Your vet can do a blood test to ascertain whether diabetes exists.
Shell rot: This is often caused by injuries and sometimes ticks. Treatment includes the removal of any loose shields and thorough cleaning daily with a solution of Nolvasan or Betadine. Exposure to air will aid cure. Where this treatment fails, flamazine can be applied once daily after thorough cleaning. Advanced cases may need simultaneous administration of an injectable antibiotic from your veterinarian.
Skin infections: Treat early! Clean with betadine or chlorhexidine (Nolvasan) twice daily and apply betadine ointment as necessary. Consult your veterinarian.
Septic arthritis and articular gout: Usually seen together. There will be swelling of limbs/joints, stiffness and pain on locomotion. This is usually caused by a diet too high in protein, which in turn elevates blood urea to dangerous levels. Consult a veterinarian immediately.
Anorexia: Observe closely for other symptoms. May indicate a severe parasite infection, a metabolic problem such as renal or liver dysfunction, or even a broken jaw or ear abscess which causes pain on eating. Requires further investigation by your veterinarian.
Stomatitis: If caught early, swab mouth twice daily with diluted Nolvasan or povidone-iodine (Betadine liquid). Severe infections need urgent veterinary treatment. Regular beak maintenance is important to prevent stomatitis. Some forms are caused by a herpes-group virus. Mixed colonies are much more at risk than small same-species groups maintained in isolation. Treatment is prolonged and often the prognosis is poor.
Sterile gut syndrome: Can be caused by antibiotic therapy (usually Tetracycline or flagyl). Symptoms are intense diarrhoea, often with undigested food being passed. Often follows a severe flagellate infection. It is an indication that beneficial bacteria in the intestinal system have for some reason been eliminated or reduced. Remedies include feeding Benebac with food, live natural yoghurt or screened droppings from a healthy tortoise of the same species. Consult your vet about treatment if you are unsure about this.
Parasites: For any external parasites you can dip the tortoise in Alugan or diluted tritix (Amitraz) 1-2ml/litre. Ticks can be removed manually - coat with alcohol or vaseline, turn on its back to loosen its grip and pull off. Apply a little betadine to the spot where the tick was attached.
Symptoms of worms: diarrhoea, anorexia, sometimes vomiting, Some tortoises splutter small volumes of liquid from the mouth. If left untreated, infection with worms can cause serious perforation of the intestine or intestinal blockage.
Treatment and prevention: Avoid overcrowding. Worm eggs can survive on the ground for long periods and can infect other tortoises feeding in the area. It is recommended that routine worming with Panacur or Oxfen be carried out twice yearly, once in the spring and once in the autumn. Recommended dose of panacur is 25-50mg/kg, dose again after two weeks and have a fecal done two weeks later to check that you have in fact eliminated the infection. Infestations of hookworm are better treated at weekly intervals with the lower dosage rate until a fecal tests clear. All companions should be treated at the same time.

Worming should be achieved by oral means only - use of a stomach tube is generally recommended. In all cases, where a bodyweight is cited for dosing purposes, this should be understood to include the tortoise's shell - this is also living tissue and must be included in all drug dosage calculations. If you are fortunate enough to be able to obtain Panacur paste then this is ideal for de-worming as the dose is small and can be offered on a titbit of favourite food.
To deworm hatchling hingebacks: inject the correct dose of dewormer into an earthworm and feed this to the tortoise. This saves them the stress of tube- feeding
  

Some important vitamins :

VITAMIN-A :Important to the condition of the skin and mucous membranes, eye (especially retinal) condition, biochemical and reproductive functions. Plants contain carotene which is converted to true vitamin-A in the body.

VITAMIN-B COMPLEX :The B-complex vitamins are water soluble and excesses are excreted in the urine. Vitamin B1, thiamine, is a regulator in the carbohydrate metabolism; Vitamin B2, riboflavin, is a co-enzyme in energy release and interacts with vitamin B6 and vitamin B12; Vitamin B3, niacin, is also crucial to the energy metabolism and is often obtained by converting the amino-acid tryptophan - this process requires the presence of thiamine, riboflavin and pyridoxine; Vitamin B6, pyridoxine, is involved in energy conversion from glycogen and in the synthesis of haemoglobin and antibodies; Vitamin B12 interacts with folic acid to govern the production of red blood cells. A deficiency causes pernicious anaemia and neurological symptoms. This vitamin is only produced within the gastro-intestinal tract when various micro- organisms act upon trace level cobalt. Deficiencies can occur following malabsorbtion syndrome or as a consequence of severe parasite infestations. The B-complex is just that. A matrix of interacting and inter-dependant compounds.

VITAMIN-D : vitamin-D is a fat soluble vitamin which is essential to the absorption and utilisation of calcium and phosphorous, as such, it plays a major role in bone formation. It can be obtained either naturally, by the action of ultra-violet light on sterols in the skin, or orally by supplementation - virtually all specialist calcium/mineral supplements intended for reptile use contain vitamin D in sufficient quantity.

VITAMIN-C :Vitamin-C has many functions, but as it is present in almost all fruits and green vegetables, deficiencies are extremely unlikely in tortoises.

VITAMIN-E :Many plants contain vitamin-E which is an antioxidant and works in conjunction with vitamins A and C.

VITAMIN-K :A fat-soluble coagulation vitamin. This vitamin is synthesised in the gut by bacterial action and is also found in plant foods. It is especially abundant in green, leafy plants.

MINERALS :Minerals are quite different from vitamins and are both chemical regulators and construction materials - Calcium forms a major part of a tortoise's body, more than any other mineral. Calcium deficiency is also extremely common as a growing tortoise requires substantial quantities of this mineral in order to build its skeleton.
The building of healthy bone tissue is the result of many vitamins and minerals acting in cooperation with each other.
It is essential to note that calcium is poorly absorbed by the body whereas phosphorus is readily absorbed - if a diet is heavy in phosphorus in relation to calcium, the excess phosphorus will prevent the uptake of calcium to the bone. It is very easy to feed a diet too concentrated in phosphorus because it is available in nearly every foodstuff whereas calcium is relatively rare. We must knowingly choose calcium bearing foods when designing diets for captive animals.
Calcium and phosphorus together account for three-fourths of the mineral elements in the body, and five other elements account for most of the rest. It is important to note that their actions are interrelated; no one mineral can function without affecting the others.
The major function of calcium is to act in cooperation with phosphorus to build and maintain bones. Calcium is essential for healthy blood and also helps to regulate heartbeat. In addition, calcium assists in the process of blood clotting and helps prevent the accumulation of too much acid or too much alkali in the blood. It also plays a part in muscle growth, muscle contraction and nerve transmission. Calcium aids in the body's utilization of iron, helps activate several enzymes (catalysts important in metabolism), and helps regulate the passage of nutrients in and out of cell walls.
graphicCalcium absorption is very inefficient. Two factors effect absorption directly; the availability of calcium in the diet and the current body need. Unabsorbed calcium is excreted.
graphicCertain substances interfere with the absorption of calcium. When excessive amounts of fat combine with calcium, an insoluble compound is formed which cannot be absorbed. Other substances that can disrupt this process include oxalates and phytic acid.

Phosphorus :Phosphorus is the second most abundant mineral in the body. It functions along with calcium. A balance of calcium and phosphorus is needed for these minerals to be effectively used by the body. phosphorus plays an important part in almost every chemical reaction within the body. It is important in the utilization of carbohydrates, fats and protein for growth, maintenance, and repair of cells and for the production of energy. It aids in the transference of heredity traits from parents to offspring. It is also necessary for proper skeletal growth, kidney function and transference of nerve impulses.
If phosphorus content is high, additional calcium must be taken to maintain proper balance. Phosphorus is available in a wide variety of foods and further supplementation is not necessary.

Miscellaneous trace elements :Calcium, chlorine, phosphorus, potassium, magnesium, sodium, and sulfur are present in relatively high amounts in the body tissues. Other minerals are present in the most minute quantities but are essential for proper body functioning. Iron, copper, and fluorine are present in sufficient quantities from deep green leafy plants. Iodine is needed to maintain a positive calcium balance, so a multi-mineral mixture containing iodine should be provided in addition to supplementation of raw calcium.

GENERAL GUIDELINES:Try to ensure that all diets are as varied as possible - in this way, a wide cross-section of trace elements will be made available.
Do not dose with 'pure' vitamins unless under veterinary direction - some pure vitamins (such as vitamins A & D are highly toxic if taken in excess). These should only be used as part of a treatment program to correct a properly diagnosed specific deficiency.