Urgent Care :: Shell rot worse after vet treatment

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Post Posted: Wed Nov 23, 2016 2:36 am   Shell rot worse after vet treatment

Hi,

I took my RES (not sure of the age, but he has been in my care for 3 years now and was about 3.5" when I took him in) to the vet 3 weeks ago for shell rot. Initially he had slight pitting on his plastron, which was treated with dry docking and iodine. It escalated to 2 soft spots on his carapace near his tail, so I took him for a vet visit. Per the vet, he has been dry docked continuously, with the exception of 15-30 minutes of clean water to eat, dried off, then wiped down with a chlorhexidine solution and silver sulfiladiazine cream is applied. After 2 weeks, the soft spots on the carapace were hardening up, but the super soft spots by his tail (vet debrided those areas down to bone) appear to be getting worse. After a few days of this treatment, the pitting in his plastron (which appeared to be healing pre-vet visit and the oozey discharge never smelled funky and was always clear) began showing redness- almost vein like, as opposed to a general irritation/infection redness- and seemed to be getting worse with treatment. At the 2 week follow up, the vet gave us ceftazidime injections (fecal test showed negative for parasites, so she prescribed the antibiotic to be proactive). It has been a week since the follow up visit and the initial soft areas on his carapace are still hardening back up, but the edge of his plastron directly under his tail is now so soft that it moved/squished and got red when I was gently applying the silver sulfiladiazine cream with gauze. Other than being annoyed and occasionally peeing while I'm giving him his meds, he has not shown any signs of stress. He has been eating every time he gets to swim, urinates (I only see it when he's upset over getting meds) and is very active. He drinks out of a water dish in his kiddie pool/dry dock area. Only concern is that he seems to deficate about once a week. When he does go, it's an all day eventomorrow and we can't keep up with making sure his towels/bedding is clean.

Has anyone experienced shell rot/ infection with this treatment getting worse?

Also, he was found at a friend's work (rafting company) in a sand pail with a female friend (they were named Lost and Found). The friend lost Lost and was unable to provide remotely acceptable care for Found, so we took him in. Initially, the tank was filled with city water (treated with those dechlorination drops), then we moved up the mountain and had to use well water. He seemed healthy at both locations. We moved to our current place this past May, which is also well water, and August was when my catfish got suddenly ill and passed, as well as when I first started to see signs of shell trouble. The landlord stated that she had the water tested last year and everything was in acceptable levels, but I have never seen the actual test results. The pH tests at 6.0 out of the tap and in the tank, but I'm not sure what the actual reading is since the API Master kit stops at 6. The only thing that makes me think water is not the cause is that both Found's tank and my tank with 2 young RES (rescues from the pound, so not much history on them either) both show good ammonia/Nitrite/nitrate levels and temps, and the only issues the babies have are being afaid of people and Agatha's retained scutes, both of which are improving immensly. Could acidic water cause or encourage pitting/ softening in the shell?

Found and I were taking all of this in stride (he is sooooo very tolerant of the dry docking and meds, especially the injections every 3 days, and gets curious and shows off for the vet) until I noticed the newly softened and red area by Found's tail. Now I'm getting quite concerned for my little buddy and feel an even more urgent need to figure out the exact cause of his shell infection.

Any simmilar experiences or advice would be greatly appreciated!
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Post Posted: Wed Nov 23, 2016 12:24 pm   Re: Shell rot worse after vet treatment

Without knowing the whole case history, this sounds like the treatment for a severe case of shell rot. I've always viewed herpetological medicine as not nearly advanced as it is for mammals, so I can only assume that this was a qualified vet. Debriding is a very serious procedure, were there other options provided?

Hard to know if the water is the cause, but it's usually not. If it's safe to drink, it should be safe for Found. It doesn't take much for bacteria or something to take hold on a shell. Being around water provides ample resources for this to happen, and I think basking is pretty significant in shell health.
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Post Posted: Fri Nov 25, 2016 12:06 pm   Re: Shell rot worse after vet treatment

The vet specialized in reptiles and amphibians in school but actively treats mostly mammals, as they don't see many species other than cats and dogs in this area. The closest vet who advertises themselves as specifically an exotics vet is 3 hours away, so this one was the best choice.

Found has an above tank basking area that spans about 2 feet in length (about half the tank) and he has always been an active basker, and I even catch him sleeping up there a few times a week.

The vet felt that 2 areas were severe enough to need debrided, but left the majority of the soft spots intact. The newest soft spot by his tail appears to be healing already. It is hardening up and the redness is dissapating. During the first visit, her plan of action was to see how he progressed with just the antiseptic wash and cream, then if the fecal test came back positive, treat for parasites (she was surprised it came back negative) and if it was negative and wasn't improving quickly by the 2 week follow up, give injectable antibiotics to try to get the bacteria and infection level down. As for other options to the debriding itself, no, she did not give any. She said she felt the 2 areas she did needed it but felt the other areas weren't severe enough to require immediate dibridment. As a next step, she wants to do blood work to eliminate any underlying health issues and make sure the bacteria isn't in his blood. I feel like taking a sample/swab of the debrided area may shed light on the specific bacteria causing his shell rot, so we can tailor the antibiotics to that specific bacteria, but she hasn't brought the idea up yet. I will talk to her about it during the next follow up phone call (we are waiting about a month for the 3rd office visit since turtles heal so slowly)
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Post Posted: Sat Nov 26, 2016 6:02 am   Re: Shell rot worse after vet treatment

I'm surprised blood work wasn't done on the first visit. Culturing what might be on the shell could be an issue as some vets want to take a core sample rather than just a swab. If that is true, you might want to find a friend who knows their stuff and do a swab. Just don't expect the vet to act on that information, do it more so for your curiosity and yes, this is something that I have gone through.
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Post Posted: Wed Nov 30, 2016 1:34 am   Re: Shell rot worse after vet treatment

Thank you for that information. His areas that were squishy are beginning to harden up and it looks like the scutes are beginning to return on the debrided area! I am not sure I would be comfortable with the vet doing anything more invasive than a swab. I was reading up on drawing blood and the general consensus seems to be that around 10% of a turtle's body weight is blood and of that, it is safe to take 4-8%. A 5% sample would be less than 2CC of blood, as he is 7.9 oz. I am still waiting to hear back from the vet about what tests she would be able to do with such a small blood sample. To me, drawing a large enough sample to do anything with from such a small animal is risky. I am not allowing him to be poked at and go through a procedure that seems dangerous if the tests are just nonsense to bleed more $$$ out of me, and not of actual use in figuring out the cause of his infection. I fed him acorn squash today and he was afraid of it at first, and has had very wary responses to other orange items since we started the antibiotics (the syringe caps are orange) so I do not want to stress him more by allowing the vet to remove a chunk of tissue that is finally starting to show signs of healing. If it is going to cause more harm than good, terriorizing him and exposing him to the risks of further infection and the dangers of anesthesia I most definitely will not allow the vet to take a core sample. For the swab, I studied limnology in college and I could do it myself. The issue is that I do not have access to a microscope. I may need to look into purchasing one, especially since it would be an investment for the turtles, ecological research, as well as my graphics/photography company. Again, I appreciate the information and insight!
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Post Posted: Wed Nov 30, 2016 3:25 am   Re: Shell rot worse after vet treatment

When my RES had some blood taken, it was only a small amount, though I don't know how many CCs it was. A white blood cell count can be done or septicemia could be ruled out. I would not be concerned with an experienced vet taking a sample and perhaps you can delay it as he builds up his strength.

I don't know if a core sample would require anesthesia, but I would probably avoid both. I'm not sure what kind of microscope you need or what is involved to culture samples, but I would be very curious of the results.
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