Severe caudal infection in T. hermanni. Please help!

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Severe caudal infection in T. hermanni. Please help!

Postby RichardMTCP » Fri Nov 03, 2017 10:27 pm

Another infection enquiry from me, again involving wild T. hermanni from Montenegro.

We have a small number of adult Hermann's rescued from development sites and awaiting relocation to a reserve in the spring. Two of the females appear to have, to varying degrees, tissue infection in the caudal cavity. In one female, most of the visually affected area is in the soft tissue between the tail and the underside of the supracaudal. Additionally, there appears to be an aperture or puncture through this tissue where it meets the shell that possibly contains additional necrotic material beneath. Could this be a conduit into the body cavity? I ask this as there seem to be debris and maggots flushing out that are don't seem to be from the more visible external infected area. There are also raw patches on both hind legs (see photos) as well as a strong smell of infection. The tortoise is also noticeably light for its size.

The second female appears healthy and heavy and there are no obvious signs of infection. However there is a faint smell of corruption and there are fly eggs around the base of the tail.

In the absence of competent vets (or actually more or less any vets!) I have flushed the infected area of both individuals with 0.05% Chlorhexidine (in the form of antiseptic mouthwash ... I hope the flouride and menthol won't have a harmful effect!).

The wounds in both animals were initially flyblown and, in the case of the more seriously infected individual, contained a number of maggots. After several Chlorhexidine flushes there still appear to be one of two maggots remaining. I have on hand 0.1% gentamicin cream which I intend to apply as soon as the wound is fully clean (still some debris, discolored antiseptic and the odd maggot coming out).

At this point I'm guessing that the infection was a result of injuries sustained during reproduction. These rescue tortoises (4m / 2f) were housed in a 12x6 metre enclosure with semi-natural habitat. The enclosure was divided into two for most of the season with males and females separated, but there were times in the year when both sexes co-habited and matings were regular.

I should add that both animals are active, feeding and defecating, and that the more seriously affected individual has been brought into indoor accommodation with a view to overwintering.

Unfortunately there is no opportunity here in Montenegro for adequate veterinary treatment, and a limited availabilty of appropriate drugs (although I return to the UK every so often so it is possible to stock up on necessary supplies) so I am rather dependent on the experience and advice of the good folk of forums such as this!

Any advice regarding the cause / nature of the infection, as well as what I should be doing that I'm not, would be hugely appreciated.

Please note attached photos.

Thank you very much in advance.
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Re: Severe caudal infection in T. hermanni. Please help!

Postby Tracy33 » Sat Nov 04, 2017 5:22 pm

That looks very nasty Richard , again , I hope someone will come on here soon .
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Re: Severe caudal infection in T. hermanni. Please help!

Postby RichardMTCP » Sat Nov 04, 2017 7:26 pm

Thank you Tracy. Here's hoping!

Just a brief update:
Both tortoises are now in an indoor hospital enclosure with basking lights, UVB strip lights and a clean paper-towel substrate. I've changed from the chlorhexidine (which I feel is possibly too dilute at 0.05%?) to 1% povidone iodine (Betadine) which I'm flushing into the cavity twice per day. I'm also trying to apply gentamicin cream in the evening, but having problems getting it to adhere to the affected areas in the sicker animal as the wounds are too wet. The infected areas still appear very raw but are at least now free from maggots and visible necrotic tissue (although the smell is very much still there!).

The sicker animal appears dehydrated with sunken eyes so I'm trying to get fluids into both tortoises via long morning soaks in warm water (not huge amounts of success today, although yesterday was more successful ... is there a generic electrolyte solution I could look out for to aid in rehydration?). Neither have eaten today but that's possibly due to having recently be taken from outdoors where it is now quite cool and almost hibernation time.

I'll keep up with the updates (probably to the point of everyone's exhaustion!!) and in the meantime I would of course be really grateful for any advice. On a related note, does anyone know of any reptile vet who is happy to field enquiries such as this online? I know that the Tortoise Protection Group has / had a "liaison vet", Kevin Eatwell, but his contact links seem to be out of date.

Many thanks.

Richard
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Re: Severe caudal infection in T. hermanni. Please help!

Postby RichardMTCP » Sun Nov 05, 2017 11:16 am

Sadly the tortoise with the more advanced infection / virus died this morning, so all efforts are now on the other female who seems at a far earlier stage of infection.

The remaining tortoise was given an electrolyte bath this morning where she drank heavily and then defecated, although with some effort, presumably as a result of dehydration and / or pain from the infection. I will continue the twice-daily dilute povidone iodine flushes until advised otherwise.

Still frantically trying to identify what this is. I'm trying to find facilities for processing (human) blood samples that are willing / capable of identifying pathogens in a tortoise sample.

As always, any commentary from people in the know on this forum would be desperately appreciated.
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Re: Severe caudal infection in T. hermanni. Please help!

Postby tortydat » Sun Nov 05, 2017 11:40 am

Sorry to hear your news Richard and really don't know what to suggest other than what you are doing or maybe a salt bath but that would presumably hurt the tortoise. You can get something on the internet called F10 Wound Spray which is very good but not sure it would be effective in your case as you don't know what's causing the wounds. You could maybe look t up and see what the compounds are. I hope you have more success with easing the suffering of this tortoise. Mary
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Re: Severe caudal infection in T. hermanni. Please help!

Postby Sue Doxat » Sun Nov 05, 2017 5:59 pm

So sorry I can't help but hope some body here will know of a solution quickly, not sure how you can get an urgent response from an expert.
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Re: Severe caudal infection in T. hermanni. Please help!

Postby Tracy33 » Sun Nov 05, 2017 7:10 pm

I wonder if Richard could PM Andy ?
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Re: Severe caudal infection in T. hermanni. Please help!

Postby RichardMTCP » Sun Nov 05, 2017 11:32 pm

Thank you all for your kind words and advice.

I've come to the conclusion that, whatever this is, the only way to go is antibiotics if the surviving animal is not to end up like the first, so I'm going to risk the local vet! I know that sounds like a crazy thing to say but, without wanting to sound nasty or condescending, the few vets we have here in Montenegro are not what we're used to in the west in terms of training, competence, care or even professional interest in many cases. There is minimal interest in animals and their welfare here, and none at all in reptiles, and sadly the veterinary establishment reflects that.

But anyway, without the necessary experience, access to specific medication or any alternative avenues I guess it's the vet or the highway ... so I've printed out lists of suitable antibiotics, dosages, etc. and will go into battle tomorrow! Hopefully both me and the tortoise will return from the vet in one piece!
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Re: Severe caudal infection in T. hermanni. Please help!

Postby Tracy33 » Mon Nov 06, 2017 4:23 pm

Oh good luck Richard with that . So sorry for your first tortoise , but it sounds like you are doing all you can , so please let us know how you get on tomorrow . Tracy .
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Re: Severe caudal infection in T. hermanni. Please help!

Postby RichardMTCP » Mon Nov 06, 2017 8:51 pm

Thank you so much Tracy.

A brief update from today ...

The tortoise went to the local vet this evening who diagnosed probable septicemia and is planning to swab the animal tomorrow morning and conduct a necropsy on the dead individual. She prescribed Mediflox (enrofloksacin) in oral form via drinking water at effectively 0.12ml per day for 5 days (does that seem right?). I was surprised that she didn't give the antibiotic by injection as it seems like an urgent case.

Whilst the vet was inspecting the tortoise, it passed some very brown urine / fluid followed immediately by a stool. This was the first time I've noticed urine this colour. Earlier today she had been drinking heavily and then immediately passing huge amounts of completely clear urine, before drinking heavily and urinating immediately again. Does this ring any alarm bells with anyone?

So, with any luck at least the swab analysis and / or necropsy will come up with something. I'm starting to hope this isn't contagious but will treat it as such until I'm 100% certain.

As a side note, someone in the know, but unfortunately overseas and unable to get his hands on the tortoise, has suggested this may have started out as a fungal infection. However the degree of smell alone, compared to the relatively tiny extent of apparent external infection makes me, in my complete ignorance, feel that it's something more internal, especially given the dark urine just now.

Thank you so much for the comments and advice so far. Please don't stop!
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