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I rescued a female Ornate Box Turtle a little over a week ago from a country road next to a crop field. At first, I just stopped to move her off the road, but then I saw a huge gouge in her shell packed full of mud and seeds, and she was really ill-tempered, so I took her home to investigate the injury. I soaked the mud out of the wound, and it is literally the worst gash I've seen in a living turtle. It is a good 3/4 inch across, and about 3 1/2 inches long, placed vertically just to the right side of her spine. The injury is almost 1/2 inch deep consistently, and it destroyed all the bony layers of her shell. A fraction of an inch deeper, and it would have opened into the body cavity. I don't want to release her back into the wild right now, because even the slightest trauma would split the wound open entirely, so I set her up in a very nice home, am keeping her warm, and she has settled in so quickly it's amazing! The first day, I fed her nightcrawlers which she devoured. Each day after that, I have been giving her berries on a plate, and her favorite food is crickets....which she takes off of my feeding tweezers with no hesitation! In fact, she comes literally running when she sees me holding the tongs, and she can also race around and catch crickets by herself for some good exercise. She spends a good portion of her daytime soaking in her warm water dish, relaxing, and her temperament has improved since I cleaned the wound of debris. Now, I am keeping it filled with antibiotic cream, and cleaning the wound/replacing the cream every two days. She really gets relaxed when I replace the cream, it must feel soothing! I see improvement in the condition of the wound already, and her overall health now seems excellent. She is a great turtle!

Since she came from the freshly tilled field, and because of the nature of the wound, I think she was injured by some sort of farm machinery. Luckily, she is not otherwise injured, but I am going to keep her until her shell wound gets a lot stronger, it just feels too risky to release her right now. Has anyone else seen an injury like this? Do they tend to heal well? I've been rescuing/keeping/releasing box turtles locally for quite awhile now, but I've never seen an injury like this before, so any advice/input would be appreciated. I will post a picture as soon as possible. Thanks in advance!

I used to get a lot of Eastern box turtles with injuries from lawn mowers. Often, the tops of the turtles' shells would be sheared off. It sounds like you're doing great! I really admire the success that you're having. With a split, you may not experience what I have with lawnmowers. There is such a large gap that is taken off with the lawnmower, it is impossible for the shells to "bridge". Often, you end up with the top of the shell healing into no more than "skin". Since the top of a turtle's shell is so exposed, the conventional wisdom suggests applying some sort of non-toxic epoxy that will harden and add protection. It's never as good as the real thing, but it allows release of the turtle to the wild. Keep an eye on your turtle's healing...you may need to do the same. Great job!

Of course, I'll suggest getting veterinary advice... more important if you're thinking about using an epoxy covering. IF used improperly, you could end up killing the turtle. If used correctly, it still usually needs removal as the turtle grows. A released turtle will either loose this covering, or have it seriously affect long term shell growth.
Using fiberglass, and/or epoxy coverings used to be the prefered method in vet. med and is still used widely today... however it is slowly losing favor to treating these types of wounds in an open fashion.

For this turtle in particular, if not taking to the vet, I would add hydro therapy to your regimen. The benefits of hydro on open wound healing (2nd intention) are immeasurable. In case you're unfamiliar with it, it involves flushing luke warm water over the wound in a constant flow for 10-15 minutes several times a day. Aim for 3, 4 is better. Afterwards, lightly pad the wound dry then apply a thin film of your cream.

What hydro ther. does is flush out any particulate debris that has built up, gets rid of old, used up medications, flushes bacteria and necrotic tissue, and invigorates the healing process.

Good luck

Ian

>>Using fiberglass, and/or epoxy coverings used to be the prefered method in vet. med and is still used widely today... however it is slowly losing favor to treating these types of wounds in an open fashion.

Not only is this so but I'd worry about infection too.
Mader's book states that with open wounds infection sets in quickly and generally with a shell repair antibiotics need to be prescribed as well.
Infection will kill them before the open shell will.

It's great that you want to help this turtle. With devastating wounds like you're describing for this one, it'll probably take about 2 years for it to heal. They can't be hibernated when they're healing so you have to keep them indoors & awake during winter. It's rewarding to do this though, so I'm certainly not trying to talk you out of doing this.
Good luck with your injured turtle!
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PHRatz

Thanks for the suggestions! It's great to hear that hydrotherapy is recommended by more than one person, because I have actually been doing it twice a day, to flush everything out of the wound, drying it with tissue(she particularly hates this step), and replacing the cream. I will continue those treatments! As for vet advice, I was told that since the wound is so wide across, but doesn't quite penetrate into the body cavity and doesn't appear to be infected, the best course of action is to keep the turtle in a safe location and to treat it topically. Thanks for the opinions, I will continue doing what I'm doing and hope for the best.

I haven't seen a lawnmower injury since I moved to the South, about 5 years ago. Ian, have you been able to heal this specific type of injury without the long-term use of epoxy? I'm sure I'll run across this sometime in the near future, and I'd like to know the latest. I've called a few fairly knowledgeable people and nobody seems to know. The only new thing I've heard is using Adaptix to speed the healing process, but the turtle is typically still left with a gaping area of no more than weak granulation or scar tissue on the top of the shell. Obviously I'm referring to full grown adults, where long term epoxy is feasable. Please feel free to contact me via email.

Honestly, I have no first hand experience treating major shell trauma because no turtles are native to where I live. All I"ve learned are through discussions on the veterinary information network (about as up to date as you can get) and through veterinary text books (most recent one out is Mader Dec 2005)

Yes though, success has been seen in adult turtles with this type of injury. If epoxy is still seen as the best route, or because protection is necessary during healing, (the epoxy does delay union I believe), then it is only applied at a much later time to make sure healing has progressed well, and infection will not be trapped withen (impossible to completely eliminate this risk).

Ian

From personal experience with acrylic, I can say covering wounds like this probably does delay union but in some cases wiring can't be used, I think it all depends on how they're broken.
You know my Chip has been put back together with acrylic, but my Shell E was put back together with stainless steel suture. SS worked wonders for her but her break was in only one area, and it wasn't anywhere near as horrible as Chip's.
He was so broken I don't see how anything but acrylic would've worked for him.

Our tortoise was shot with a gun, her bullet holes were covered in acrylic a couple of years or so ago and it's steadily worn off as time passes. Some of the wounds where it wore off are now completely healed. Last month some of it wore off and exposed a bullet hole, the wound looked better than it did 2 years ago but the vet still decided to go ahead & cover those unhealed areas again.
I can see that yes she has been healing under there so when the vet said "I need to do this over" I said ok.
I said ok because she buys all the latest books, goes to 2-3 reptile veterinary conferences every year, keeps up with all the latest, so I decided I need to trust her on this because she's never failed me.
Even though epoxy & such is falling out of favor now, it's apparently still useful.
I'm not saying any of this to sway opinions.
This is just a little testimonial on my own experiences with broken shells.
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PHRatz

When there is shattered shell, but most of the pieces are still there, it is amazing what some screws, wire, and careful placement can do. It's really amazing. In those instances, epoxy is no doubt more harm than good. The problem comes with large areas of missing shell. That area is well below structural standards for a box turtle in the wild, even after full healing(which is the only time I've ever personally used the epoxy). If I start finding out that epoxy is harmful or ineffective in the long run, I will dismiss is as a viable option. My goal was always to return the animals to the wild, but maybe this case warrants placement in a home.

Ian, I appreciate your input. You obviously are either a Vet yourself or work in the field in some capacity. It's always good to hear about the latest news regarding treatment protocols. It's SO hard to find a Vet that will work on wildlife, let alone an exotic Vet to work on our pets. More often than not, wildlife rehabbers know more than Vets about wildlife...and that's a darn shame. Most of us do this in our spare time, and don't have the opportunity to research the latest and greatest. I wanted to ask you about water therapy...do you use sterile saline, chlorhexidine solution, or just tap water?

Ratz, I've been wanting to ask your opinion on Baytril. The specialty exotic Vets around me have given us strong warning to refrain from using this Ab in chelonians. It sounds like your Vet is very informed. If you remember, can you ask his/her opinion on this. I know that we can sometimes get carried away with changing protocols when there's even a whiff of negative research.

To pass along info I've received from the vet I've been taking mine to lately: if Baytril is called for, the first dose is given via injection, the remaining doses are given orally. Which is a challenge, of course!

>>To pass along info I've received from the vet I've been taking mine to lately: if Baytril is called for, the first dose is given via injection, the remaining doses are given orally. Which is a challenge, of course!

I read a Reptiles mag once, this was I dunno 3-4 years ago. I was reading Dr. Mader's column and what Steph said here is exactly what he had to say about Baytril.
Baytril is used so much for so many animals not just reptiles that my ears perk up when I hear or read something about it so I tend to remember it.
Dr. Mader said the injection is meant to get the benefits into them quickly then it's better for them to go orally after that first initial injection and that this is originally what the intentions for Baytril are... I am not 100 percent sure on this part but I believe he said that is the manufacturer's recommendation.

Ken,
I've already had this discussion with my vet last fall when Janie the box turtle sat outside in the cold then fell ill with a respiratory infection.
She went with a sulfa drug first and said at the time Baytril is over used and if another will work it's best to go with another.

My vet views Baytril's use in reptiles the way I view it's use for rats. I have 11 years or so of experience with keeping pet rats, they are extremely prone to bouts of pneumonia so for them Baytril is the big gun.
You use other antitbiotics first for minor respiratory illnesses because as they age they'll only have more problems anyway so you use the big gun only if nothing else works.
That's because they tend to have chronic pneumonia, which is very much like the chronic pneumonia in American gopher tortoises. It's a Mycoplasma species that causes chronic illness in rats, it's a different Mycoplasma species that causes chronic illness in the gopher torts but you can't kill Mycoplasma you can only attempt to control it, and so you don't want them to build up a tolerance to Baytril.

When Janie the box turtle did not improve on the sulfa drug I already had a full bottle of chloramphenicol that the vet had specially ordered for my rats and it was compounded into a strawberry flavor.
The vet worked out a dose for Janie to use that, she loved the flavor as much as the rats did so I used it & it worked fabulously which made me very happy. So now Janie has never had Baytril, if we need that big gun one day it'll work better for her then.
Based on all my rat pneumonia experience I was really happy when my vet told me that Baytril isn't always her first choice & why it's not. So it looks like she agrees with your vet on this.
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PHRatz

"she buys all the latest books, goes to 2-3 reptile veterinary conferences every year, keeps up with all the latest, so I decided I need to trust her "

This is the perfect vet-client relationships. The vet couldn't ask for a better client, and the client couldn't ask for a better vet. The animals are who wins hands down

Ian

>>This is the perfect vet-client relationships. The vet couldn't ask for a better client, and the client couldn't ask for a better vet. The animals are who wins hands down

I don't know if I am the best client although 2-3 months ago the office manager there told me that I am one of only a handful of their clients who actually cares enough for my critters to do everything I am supposed to be doing for them & then follow up on their medical care. The prices I am charged are so much lower than the prices I paid with the previous vet who's not a reptile vet that I always forget to ask what anything will cost. Whatever is needed for any pet I just always say do it. So far I've never been charged an unreasonable price for anything I've had done there so I've been happy that way too.

My vet though is the best vet I have ever found in my entire life.
She's young, she loves animals- reptiles especially. She thinks the way I do; that is when they're broken/sick/in need and can be helped then we do it, period. She has a happy life of her own. I think her personal happiness and her youth both have a lot to do with her enthusiasm.
I've never been happier with a vet than I have been with her.
I feel so lucky!
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PHRatz