Health Issues & Medications for Tortoises

While not “cuddly,” tortoises are increasing in popularity as companion animals. Russian, Desert, Leopard, and Sulcata Tortoises are common reptile species kept as companions. All tortoises are endangered due to habitat loss for reptiles and illegal pet trade, and many pets are actually wild animals “rescued” by good Samaritans after being injured by cars or dogs. Wild-caught animals tend to be more stressed and thus more susceptible to disease than their captivity-bred counterparts, and will more than likely require a veterinary intervention at some point in their captive lives. They are also highly likely to carry salmonella, which make them poor pet choices for households with infants, young children, and immunocompromised family members. When a tortoise with a runny nose presents in your veterinary practice, will you know what unique metabolic and biologic factors need to be considered when choosing a pharmaceutical treatment?

 

 

VW, a Sulcata Tortoise

VW, a Sulcata Tortoise

 

 

Illness in companion desert tortoises often results from infection, stress due to improper physical environment, or malnutrition. Some common symptoms of upper respiratory infection may include a combination of mucopurulent nasal discharge, puffy eyelids or recessed eyes, labored breathing, loose stool, anorexia or change in weight, listlessness, or a softening of the shell.1 Tortoises will often move their head and forelimbs into their shell to facilitate breathing. A chronically ill tortoise may even develop white scar tissue around the nares. Sick tortoises often refuse to eat and become emaciated.

 

 

Injectable or oral are the preferred routes for medication administration. For oral administration, medication can be injected into fruit, but in-water placement is not recommended due to the unpredictable nature of chelonian drinking2. The antibiotic of choice depends on the pathogen, and the dosage and delivery form will depend on the species, size and temperament of the animal. GI transit times vary among different species (as long as 21 days in large tortoises!), as does drug metabolism and excretion. For appropriate dosing, a specialty chelonian reference or exotic veterinary specialist should be consulted.

 

 

Monument Pharmacy is able to compound several medications by prescription into highly concentrated, palatable oral suspensions or small capsules. Tortoise-friendly flavors for suspensions include strawberry, banana, grape, cherry, orange, peanut butter, strawberry, watermelon, and tutti-frutti. It is important to keep in mind that African tortoises in particular (i.e., Sulcata) are very sensitive to sugar in the diet as it can disrupt the natural flora; it is recommended to use artificially sweetened flavors when needed. The following list3,5 of ORAL compounded medications for tortoises available by prescription from Monument Pharmacy.

 

 

• Acyclovir: flavored water- or oil-based suspension, frequently requested for early stage herpesvirus
• Cisapride: flavored water- or oil-based suspension, frequently requested for GI motility modification
• Clarithromycin: flavored oil-based suspension, frequently requested for mycoplasma infection
• Clindamycin: flavored oil-based suspension, frequently requested for respiratory infection
• Chloramphenicol: flavored oil-based suspension or ophthalmic ointment
• Doxycycline: flavored oil-based suspension, frequently requested for mycoplasma6 and respiratory infections
• Enrofloxacin (species-dependent dosing!4,5): flavored water- or oil-based suspension, frequently requested for upper respiratory infection
• Fluconazole: flavored oil-based suspension, frequently requested for GI mycoses
• Griseofulvin: flavored oil-based suspension, frequently requested for GI mycoses
• Levothyroxine: flavored oil-based suspension, frequently requested for hypothyroidism
• Ketoconazole: flavored oil-based suspension, frequently requested for GI mycoses
• Metoclopramide: flavored oil-based suspension, frequently requested for stimulation of gastric emptying
• Tylosin: flavored oil-based suspension, frequently requested for upper respiratory infection

 

 

Also, the following commercially-manufactured injectable medications are available by prescription on a special order basis. Please call for product availability and pricing.

 

 

• Amikacin
• Ampicillin
• Ceftiofur
• Enrofloxacin

 

 

As a clinical note, ivermectin can be fatal in tortoises and metronidazole can cause vestibular syndrome and sterile gut syndrome5. Aminoglycosides such as tobramycin can be used with caution, but concurrent fluid therapy is highly recommended due to nephrotoxicity. The use of these agents should be avoided. All antibiotics will have considerably longer half lives than in mammals due to slow renal elimination.

 

For prescribers and their patients, quality means accuracy, consistency, professionalism and service. At Monument Pharmacy, our licensed pharmacists and certified technicians prepare all of our compounded prescription medications with the utmost attention to detail regarding purity, potency, and consistency. All ingredients are sourced from FDA-licensed suppliers and compounded prescriptions are prepared according to exacting federal and State of Colorado standards.

 

 

Most prescription orders for compounded medications received prior to 3pm Mountain time Monday-Friday (holidays excepted) can be shipped out the same business day. When you call, you will always reach one of our friendly customer care specialists in person, right here in Monument, Colorado. We have competitive pricing and will beat others’ compounding prices by 10%. As an added value, we are able to ship many prescriptions via USPS first-class mail at no charge! Our goal is for your service to be second to none; in fact, your satisfaction is guaranteed! You can count on us to exceed your expectations. Feel free to contact Monument Pharmacy for details at 1-800-595-7565.

 

 

REFERENCES

 

 

1. Jacobson, Elliot, DVM. The Desert Tortoise and Upper Respiratory Tract Disease.
2. Chitty, J, Raftery, A. Essentials of Tortoise Medicine and Surgery. West Sussex UK: Wiley Blackwell, 2013.
3. Kahn, Cynthia, et al. The Merck Veterinary Manual (10th Edition). Whitehouse Station, NJ: Merck & Co, Inc., 2010
4. Mitchell, Mark. “Therapeutic Review: Enrofloxacin.” Journal of Exotic Pet Medicine, Vol 15, No 1 (January), 2006: pp 66-69
5. Plumb, Donald C. Plumb’s Veterinary Drug Handbook, 10th Ed. Stockholm, WI: Pharmavet, Inc., 2008
6. Eghianruwa, Kingsley. Essential Drug Data for Rational Therapy in Veterinary Practice. Bloomington, IN: AuthorHouse, 2014.

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