Urgent Care :: RES with sudden large amounts of bruising?

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Post Posted: Sun Jan 06, 2013 2:25 pm   RES with sudden large amounts of bruising?

My six year old female RES Crush went to the vet recently for a well visit after eating large amounts of styrofoam dock. We wanted to make sure nothing was lodged (it wasn't, we had x-rays and a scope done). We also wanted to ask about what we could build for her that she wouldn't be able to eat, that would last a long time in water and not deteriorate, and be easy to get on and off of. We have since built her a fancy new basking platform that she can't eat, out of Trexx, that is the right size for her and doesn't sink under her weight so she can now completely dry off. This was suggested to us because of two things--- one, the turtle shouldn't be eating styrofoam obviously, and two, she seemed to have developed a few sores from spending too much time in the water.

We built the new platform, and we were advised to dry dock her for a few hours every day to get rid of the sores. They didn't seem to be leaving, so the vet advised that we come back in for a second visit. The vet tried to take a blood sample to see if the sores (which he then started calling bruises) were being caused by a metabolic problem, like the wrong diet. We listed off everything she eats, so he ruled that out as the cause, and when trying to take blood from Crush's tail vein, was unable to do so. We opted not to sedate her for a neck vein draw, reasoning that we might just be jumping the gun. Turtles seem to have slow-moving healing processes so maybe it was just taking a little longer for her to shake off the sores. We would continue to dry dock her until they disappeared.

The next day I came downstairs first thing in the morning and the bruises looked worse. Definitely not sores. They looked like when a person gets a blood blister, only that's impossible for my turtle. There are no sharp edges in her tank, no sharp rocks for her to bang into, and the bruises were occurring tucked into the hip joint around her leg and tucked in around her shoulders, places where her skin would never even touch if she were to bump her shell against something. I will attach pictures of what I'm talking about (as soon as I figure out how!!!).

We took Crush back to the vet for a third time, where the vet decided it's an infection, and prescribed us Amikacin injections, once every three days, for two weeks. He said he wanted to see her if she doesn't improve, but that the injections should help stop the bruising and clear up whatever's going on. That was Dec. 26, lovely day after Christmas present, to be told finally something would help. It's been quite a few doses and her bruises have stayed the same size and darkened, they look like blood, but there's no blood on the surface of the skin. Her skin is either very translucent or there's a lot of blood in there trying to get out. Either way it does not look good. She has an appointment Monday, which is jumping the gun a bit on her two week mark, but I can't wait any longer... I feel she needs to be seen.

My question is, has anyone else encountered abnormal bruising like this that just appears suddenly for no reason? They checked for egg binding, and she is alone in her tank so it wasn't caused by another turtle. We feed her all the right things, she even has calcium bones (cuttle bones) to chew on, plenty of sun, the right amount of heat, etc. The vet even suggested we warm her basking spot up more to encourage the skin to dry out (back when he thought it was just sores) so we did that. But like I said, they just don't seem to be leaving and seem to be slowly getting worse. I can't imagine what she would have internal bleeding from, and I can't imagine what could be bruising her, and in short I just can't seem to even fathom what could be wrong.

We see Dr. Schaper in Branford CT, he isn't a specialized herpetologist but he has been caring for turtles, rehabilitating, re-homing and fixing ailing turtles for close to 40 years on his own time. They are his secret love outside of his practice itself, so we trust him to know what he's talking about. I would prefer not to have to go anywhere else unless she absolutely needs it, and so far I trust his opinion and we'll see what he says when we go back Monday. But it never hurts to have a second opinion from what I've seen, so I am reaching out to all of you.

MANDITORY QUESTIONS:
How big is your turtle? She's 2.5 Lbs, not sure exact length. Last time I checked she was 8" long.
How long have you had it? We've had Crush from egghood, 6 years in December.

What is the water temperature? Ranges 78/80 degrees.
Did you use a thermometer? Yes.
Are you using a water heater? Yes.
How much water is in there? Enough for her to completely submerge.
Are you using a water conditioner? Yes.
Are you using any filtration? Yes.

What is the basking temperature? 85/90 degrees (based on a recent Vet recommendation)
Is there a basking light? Yes.
Is there a basking platform that is easy to climb on? Yes.
What kind is it or what is it made out of? We made one out of Trexx (deck material) because she was eating the styrofoam one. We figure Trexx is mold-resistant, won't chip, and can't be ingested. We checked with her Vet on this before building.
Is there a UVB light? Yes.

What have you been trying to feed it? She eats krill, feeder pellets, strawberries (only one at a time, weeks apart), feeder fish, lettuce (never iceberg), and raspberries when we have them available.
When was the last time your turtle ate? This morning. She eats once a week, small amounts, which her vet said is fine. We check regularly to make sure she's not becoming obese. She can still completely retract into her shell.

How big is the tank/pond/enclosure? Fifty gallons.
Is the tank near a window? Yes.
Is the tank in a room with a lot of activity? Not usually, but she isn't the shy type and doesn't mind people anyway.

Have you read the Basic Care section? Yes.
Have you searched the forums for similar situations? Yes.

Is there any other unusual activity/symptoms? I've done my best to describe that above.
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Post Posted: Sun Jan 06, 2013 3:40 pm   Re: RES with sudden large amounts of bruising?

Automatically first thing that comes to mine when you mention blood blisters is Septicemia. You should talk to your vet about that being it. If it is that which it does sound like there is nothing you can do by yourself it has to be handled by the vet. Also can you post pics? Just to make sure it doesnt look to be like something else though it does sound like septicemia especially eating something he wasnt susposed to can cause it.

Septicemia:

Septicemia is a condition where there is a bacterial presence in the blood. It is essentially blood poisoning, a serious and life-threatening infection that requires immediate emergency care. The immune system responds to the infection with systemic inflammation. This can negatively impact the circulatory system and cause multiple organ dysfunctions. Septicemia affects the entire body and is deadly in any creature that has it. Only qualified immediate medical care can assist this condition.

Previous illness, infection, injury or improper habitat may be an indirect cause of septicemia. It is possible for egg-bound females to develop it and any of those former conditions may have been a contributing factor, especially if they were prolonged. Symptoms that may be present are pinkish or reddish coloring on skin or shell (in or between the scutes, plastron, or carapace - any possible appearance that resembles bleeding into the skin), lesions, sores, lethargy, withdrawn behavior, unresponsiveness, swelling (flesh, eyes, etc.), and lack of urine.

Blood tests may be used to determine if there is blood poisoning and measure the degree of severity. I cannot stress the importance of getting immediate and experienced medical care.
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Post Posted: Sun Jan 06, 2013 5:33 pm   Re: RES with sudden large amounts of bruising?

It's only on her skin, not touching the seams where the shell joins to the skin, and there's nothing between the scutes on her back or belly. I thought that might be it too, but it doesn't seem like it at all. I've researched pictures too, and it definitely isn't as severe-looking as Septicemia. I also figured that since she has been on antibiotic shots every three days for 2 weeks, that if it was Septicemia, the shots would help. She has an appointment tomorrow, don't worry, because I was worried that might be the case.

She ate pieces of styrofoam, only small bits, but she's done this numerous times throughout her life and it never bothered her. We brought her to the vet to make sure that no pieces were left in her system, they did a scope and an x ray, and we built her a brand new basking platform to eliminate that in the future. We keep her tank very clean and as soon as we knew she was sick and started noticing the bruises we have been cleaning it every few days just to continue the cleanliness while she heals. The problem was she isn't healing.

The bruises are also mainly located in the back, in front of her legs. If they were all over I would agree with you on the Septicemia diagnosis but it is just these two mainly and they haven't come up anywhere else. I took pictures, but she was basking and sleeping so I didn't take her out of the tank and move her, since the Vet advised we allow her to bask as much as possible. Also it's not letting me upload them because the file size is too big. Let me try a few things to change the file size and then get back to you.
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Post Posted: Sun Jan 06, 2013 5:40 pm   Re: RES with sudden large amounts of bruising?

Nevermind, must've just been my computer freaking out. Here's a few, the best I could get at the time without bothering her.
Attachments
P1062285 (640x494).jpg
Better picture of Back left leg.
P1062283 (640x479).jpg
Back left leg.
P1062282 (800x584) (640x467).jpg
Back right leg.
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Post Posted: Sun Jan 06, 2013 8:08 pm   Re: RES with sudden large amounts of bruising?

From those pic i see red spots all over her left back leg. Otherside not sure with the lighting if she has light red spots either. Not large spots but small spots all over. They dont have to be large spots. Does she have tiny red spots at all on the front legs or neck at all? Also they can get tiny red spots in the mouth.

From the pics Id stick with septicemia. I hope the vet can help.
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Bruising.jpg
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Post Posted: Sun Jan 06, 2013 10:58 pm   Re: RES with sudden large amounts of bruising?

Me too. We'll see tomorrow when she is examined. I didn't even notice those while I was concentrating on getting the big spot in the picture... Poor girl. I don't see any on the front of her, I took her out and looked at her in brighter lights. It seems like just that back left side is the worst. The right side doesn't have any tiny dots like the ones you circled.

What can they do for septicemia? Are there injections for that? Obviously not for me to give, but for the vet to give to her. I'm a little clueless as to what possible treatments could be.
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Post Posted: Sun Jan 06, 2013 11:54 pm   Re: RES with sudden large amounts of bruising?

I'm not sure what your vet will prescribe, but it'll be some sort of antibiotic - usually something like Fortaz/Ceftzadime, Amikacin or Baytril. A vet can show you how to give injections and there are sometimes oral forms of meds you can use. How is her stool? is it normal? Parasitic infections might also lead to septicemia.

I think catching this early on is very important and she sounds like she's in great hands. Some people have to offer antibiotics for months, so it might take a bit longer to see improvements.
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Post Posted: Mon Jan 07, 2013 3:49 pm   Re: RES with sudden large amounts of bruising?

She is already on Amikacin. Turns out the Amikacin wasn't doing anything because she's severely anemic. It isn't Septicemia, but they can't do anything for her right now until they find a blood donor. There's next to no blood left in her body that would carry medicine to where it's needed, so they can't give her anything to fix her until they give her a transfusion. We saw the vet this morning at 8am, she has been there all day and they are calling everyone they can who has a healthy reptile that would be willing to donate blood. We're hoping she can hold on until then but it is very touch and go. The bruising that we saw on her skin could be all over her organs, there is no way to tell, and without any blood inside her they can't take a blood sample to begin diagnosing and treating. My poor turtle girl.
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Post Posted: Tue Jan 08, 2013 12:58 am   Re: RES with sudden large amounts of bruising?

Sorry to hear it! I don't recall any turtle on this forum having such a severe case of anemia :(
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