Common Diseases of Box Turtles

By Gregory Rich, DVM; Laurie Hess, DVM; Rick Axelson, DVM

What are some common diseases of pet box turtles?

Common conditions of pet turtles include metabolic bone disease (MBD), vitamin A deficiency, respiratory diseases, abscesses, shell infections, shell fractures, and parasites.

What are the signs of these diseases?

Metabolic bone disease (MBD) is an imbalance of calcium and phosphorus due to an improper diet, lack of adequate ultraviolet (UV) light, or a combination of poor diet and insufficient UV light. Signs of MBD in box turtles usually include either a misshapen shell or deformed bones in 1 or all 4 legs. Turtles affected with MBD will grow slowly and often never grow to full adult size.

Vitamin A deficiency (hypovitaminosis A) occurs when turtles are fed an inappropriate diet. Turtles that are fed iceberg lettuce, an all-meat diet, or a poor-quality commercial diet are most likely to develop hypovitaminosis A. Lack of vitamin A produces changes in the epidermis (outer layer of the skin) and in the mucus-producing glands and membranes lining the mouth, eyes, kidneys, and upper respiratory tract. Symptoms include a lack of appetite, lethargy, swelling of the eyelids (often with a pus-like discharge), swelling of the ear (due to the formation of an ear abscess), kidney failure, and respiratory infections.

In turtles, most respiratory tract infections are caused by either mycoplasma (a type of bacteria) or bacterial infection secondary to a viral infection. The most common viral infection in box turtles is caused by an alphaherpesvirus. Respiratory infections are often secondary to vitamin A deficiency, as well. Turtles with respiratory infections may have excess mucus in their mouths (seen as bubbles in the mouth, nose, and eyes), nasal discharge, lethargy, loss of appetite, wheezing, extension of the neck to breathe, and open-mouth breathing or gasping.

Abscesses are infected, pus-filled swellings within a body tissue, and appear as hard, tumor-like swellings anywhere on the skin or within the pet's body. Reptile pus is usually very thick and dry, with the texture and consistency of cottage cheese. Abscesses often develop in turtles’ ears or oral cavity, and they appear as large swellings on the sides of the head, just behind the eyes or on the roof of the mouth. Abscesses in turtles are often related to vitamin A deficiency. Abscesses in the oral cavity will generally cause a thick nasal discharge and/or mucus to form around the sides of the mouth.

Shell infection (shell rot) is often encountered in turtles, due to bacteria, fungi, or parasites. These infections are often secondary to trauma, burns, or bites. Some of these infections can penetrate deep into the layers of the shell, causing ulcers or pitting of the shell or extension into the bone below. The outer layer of the shell (keratin) protects the living bone underneath; the shell provides extremely important protection for the inner organs, which are located beneath the shell.

Gastrointestinal parasites, such as roundworms, are common in pet turtles. In many cases, parasitic infections do not cause any clinical signs; they are detected on a routine fecal examination. With severe infection, parasites may cause diarrhea or weight loss and may require treatment.

How can I tell if my turtle is sick?

Signs of disease in turtles may be specific for certain diseases, such as nasal discharge in the case of a respiratory infection. More commonly, signs of illness are non-specific, such as a turtle with lack of appetite and lethargy, which can be seen with many diseases. Any turtle who shows a deviation from normal should be evaluated by a veterinarian familiar with reptile diseases.

How are turtle diseases treated?

Vitamin A deficiency is treated with oral or injectable vitamin A. Vitamin A deficiency typically indicates improper nutrition that must be corrected with dietary recommendations made by your veterinarian. Treatment should only be performed under veterinary supervision, as overdose of vitamin A to treat hypovitaminosis A can occur.

Respiratory infections are most often caused by bacteria. Many turtles with respiratory tract infections also have underlying vitamin A deficiency that requires correction. Your veterinarian may recommend X-rays (radiographs), as well as blood tests and cultures to determine the cause of the infection. Respiratory tract infections are usually treated with antibiotics orally, through injection, or possibly as nose drops. Very sick turtles may require hospitalization for intensive care, including injectable fluid therapy, antibiotic injections, and force feeding. Box turtles infected with herpesvirus often do not recover.

Abscesses are treated surgically. Your veterinarian will open the abscess, drain the pus, and flush the affected tissue with a medicated cleansing solution. A culture of the abscess is typically recommended to determine the type of bacteria that is causing the abscess. Topical medication, plus oral or injectable antibiotics, may also be required.

Veterinarians can often repair most basic shell fractures if the fractures are fresh and the patient is in a good nutritional state. Treatment for shell infections can be challenging, but usually involves microscopic analysis and culture to identify what type of organism is causing the problem (virus, bacteria, or fungus), thoroughly cleaning the shell, and treating with appropriate medications.

Gastrointestinal parasites are treated with deworming medications. A microscopic analysis of the stool will identify the type of parasite involved, which will determine which drug is needed.

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