# enema help



## noallawshe (Oct 8, 2015)

i need to give my Sulcata Tortoise and enema and can't seem to be able to get his tail out of the way. also what would be the best enema recipe. he seems to be constipated for some reason.

he eats timothy hay, romaine, grazes in the back yard and occ fruits and veggies

i work as an emergency veterinary nurse, but don't have experience in tortoise medicine


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## G-stars (Oct 8, 2015)

Try cactus pads. They are a natural laxative. Or aloe plants. Soaking the tortoise helps too.


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## Yvonne G (Oct 8, 2015)

Is the tortoise still eating? Mash up some moistened tortoise chow or something similar then mix in a teaspoon or so of mineral oil. Roll this up in a leaf of romaine lettuce so it looks like a cigar. hand feed the cigar to the tortoise, pointy end first. Mineral oil is non absorptive and will coat whatever is in the GI tract, helping it to move. You can put a dropperful of mineral oil up the cloaca too, but I wouldn't go so far as to try an enema.


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## Tom (Oct 8, 2015)

I would not give an enema. If they clamp down their cloaca, you could seriously injure them. I had a leopard female that my vet wanted me to give cloacal fluids to. It work two times and the third time she was on "lock-down". No entry permitted.

Long, warm, shallow soaks in a tall sided opaque container will usually get things moving. How often do you soak this guy? What sort of water source does he have?

The hay and grazing sounds great. Romaine, fruits and veggie, not so much. Check this out:
http://www.tortoiseforum.org/threads/for-those-who-have-a-young-sulcata.76744/


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## Yvonne G (Oct 8, 2015)

Two more tricks to get a tortoise to poop:

Take him for a car ride.

Put him into the human bath tub (large area for walking around) with warm water up to the middle of his sides. Leave him in there to scramble around trying to get out for a half hour or more. All the moving and scrambling in the water usually makes them poop.


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## noallawshe (Oct 8, 2015)

he last ate 5 days ago some timothy hay, he has not had a BM for about 10-14 days that i have seen and only urinated once. He is still very strong but does not move around very much since this has started. i have been soaking him daily for the last week. 

the radiologist recommend the enemas and car rides


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## ZEROPILOT (Oct 9, 2015)

Cactus. Cucumber.
My only experience with enemas and tortoises required that the tortoise be sedated first.


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## Aunt Caffy (Oct 9, 2015)

noallawshe said:


> he last ate 5 days ago some timothy hay, he has not had a BM for about 10-14 days that i have seen and only urinated once. He is still very strong but does not move around very much since this has started. i have been soaking him daily for the last week.
> 
> the radiologist recommend the enemas and car rides


Mine poops like crazy on car rides, which is why I carry multiple lint-free cloths on which to place him in his little carrier.

The mineral oil works well, too. I got mine on Amazon where it was called butchers block oil. I've also gotten it at Bed, Bath, & Beyond and hear you can get it in the pharmacy area at stores. I always keep it around for emergency pooping needs for my animals.


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## ZEROPILOT (Oct 9, 2015)

Is it just me, or does any tortoise or turtle start crapping when placed in a box?


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## Jodie (Oct 9, 2015)

The mineral oil burrito has worked every time for me. When my female wasn't eating she would still eat romaine fed by hand. Really long soaks helped her a lot too.


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## ZEROPILOT (Oct 9, 2015)

My vet gave me some liquid drops for Bertha before the enema and I never could use it because you're supposed to put in on food and she wasn't eating.
I still have it. Two bottles with eyedroppers. If you'd like, I will mail it to you. Free.
I'm just going to throw it away............
I'm at work now and I don't recall the name. It's on my old Bertha thread, but I'd have to dig for ages to find that post.
P.M. if interested.


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## Aunt Caffy (Oct 9, 2015)

Jodie said:


> The mineral oil burrito has worked every time for me. When my female wasn't eating she would still eat romaine fed by hand. Really long soaks helped her a lot too.


For Rowan, it had to be mineral oil on chicken, the only thing he can't resist.


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## noallawshe (Oct 9, 2015)

At this point he has been on 4 car rides of at least 18miles each and has been soaked daily for the past 7 days. He refuses every piece of food i put in front of him. 

Why should i not attemt an enema like the radiologist recommend?


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## noallawshe (Oct 9, 2015)

This is all he does now.


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## ZEROPILOT (Oct 9, 2015)

I think that the consensus is that without sedation it could easily injure your tortoise.
It wasn't very expensive when my vet did it.
This is one time that it might be wise to spend a buck.
I also resist.


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## ascott (Oct 9, 2015)

noallawshe said:


> This is all he does now.



Is that sand his substrate? How long has that tortoise been on the sand?


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## deadheadvet (Oct 9, 2015)

The biggest issue with an enema is, how do you know you are in the correct location. The cloaca is the opening to the common gutter where rectum and urethra meet. You could end up passing a tube right into the bladder. Push some lubricated mixture into the bladder? Could be big mistake. We would thread a catheter up with a metal stylet and than take an xray and be sure we are in the right location.


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## Yvonne G (Oct 9, 2015)

That's a picture of a very sick tortoise. However, I'm not good at reading X-Rays, and I don't see any masses on the X-Ray. But after seeing the latest pictures, I'm with Ascott. Looks like he may be blocked up with sand. But seems to me we would be able to see that on the X-Ray.???


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## leigti (Oct 9, 2015)

If it was my tortoise I would take him to a vet that knows tortoises. And until then I would soak him often.


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## noallawshe (Oct 9, 2015)

There is no sand impaction and he is getting an esophgostomy tube placed tonight for oral hydration from the tortoise vet.


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## Tom (Oct 9, 2015)

Lets back track a bit...

Are you using a cfl type coil bulb for UV? This looks like a tortoise with burned eyes to me.

What are your four temperatures? Warm side, cool side, basking area, and overnight low? What equipment are you using to achieve these temps?

Maybe we can look at this from the perspective of "How did we get here?" It is just not common for older sulcatas like this to get sick.

Has he ever lived with other species? Was he ever living as one half of a pair?

If he is not sand impacted now, he soon will be. I would strongly suggest a different substrate.


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## Tom (Oct 9, 2015)

Also, I wanted to let you know that Deadhead vet who posted above is an actual practicing reptile and tortoise veterinarian, and a good one at that. All of us have experience with caring for sulcatas, but he is the only medical professional that has commented so far. I just wanted you to have that info so you can weigh the advice given thus far.


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## noallawshe (Oct 9, 2015)

Tube placed


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## noallawshe (Oct 9, 2015)

No lights, i live in Florida and he's outside. His eyes are closed in photos.he does not eat sand, this is his porch / overnight box.


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## Tom (Oct 9, 2015)

noallawshe said:


> No lights, i live in Florida and he's outside. His eyes are closed in photos.he does not eat sand, this is his porch / overnight box.



Is there a heat source in his overnight box?


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## noallawshe (Oct 9, 2015)

Tom said:


> Is there a heat source in his overnight box?


Only if it drops below 60 at night


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## noallawshe (Oct 9, 2015)

He has been thriving untill recently. I believe he ate recently mowed yard clippings ghat bound him up.


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## Tom (Oct 9, 2015)

Mine eat yard clippings all summer long. Just fed out a whole trash bag worth today, in fact. That should not bind him up.

I think anything below 75 in your level of humidity is risky. Even though they can survive temps in the low 60s, its not "good" for them. I would not let a sick one drop below 85 day or night. Smaller ones, like yours are particularly sensitive to low temps. I think you need to set your night heat on a thermostat and keep this guy warmer.

Here are some examples:
http://www.tortoiseforum.org/threads/another-night-box-thread.88966/
http://www.tortoiseforum.org/threads/my-best-night-box-design-yet.66867/
http://www.tortoiseforum.org/threads/double-door-night-box.129054/#post-1205002

Cold night temps in a humid climate might be the cause of your issue.

I read what you said about the sand, but they don't have to intentionally ingest large mouthfuls of the stuff for it to be a problem. Over time it sticks to their food in very small amounts and it builds up in their gut. I once necropsied a baby that I got form a breeder that was failing to thrive and we found the entire intestinal tract lined with broken down perlite, which is the incubation media the breeder had used. Sand could be lining your guys GI tract and causing this issue while not showing up as a solid mass on x-ray.

This is all speculation. I'm just guessing based on my past experience with cases I've seen at my vet friends places and from what I know of my years of keeping this species in a variety of ways.


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## noallawshe (Oct 9, 2015)

I find it strange that nothing has changed over that past 5 years and now it would be his environment. The only thing different was he was put in the yard immediately after the wet grass was cut


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## noallawshe (Oct 9, 2015)

But anything is possible.


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## Yvonne G (Oct 9, 2015)

Grass starts to ferment/mold quite quickly when cut and allowed to lay in piles. Maybe he got ahold of some mold??????


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## Tom (Oct 9, 2015)

noallawshe said:


> I find it strange that nothing has changed over that past 5 years and now it would be his environment. The only thing different was he was put in the yard immediately after the wet grass was cut



Is it possible there was some toxic weed of some sort in there? When they graze themselves, mine will eat around any weed they don't like. When the grass and weeds are all mulched up together, they eat it all up by the mouthful with no regard for what it is. I frequently mix my grass clippings with other weeds and leaves and they would eat oleander if I put it in that mix. (Of course I never would…) Maybe something toxic got into the mix some how? Leaves from a nearby tree or bush maybe?


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## Tom (Oct 9, 2015)

I'm no radiology expert, but I went back and looked at those X-rays again and I do see a lot go grainy-ness in the GI tract.

@deadheadvet , May I ask for your expertise here again? What do you see in the x-rays? Is sand build up a possibility, or would that be much more obvious?


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## noallawshe (Oct 9, 2015)

Tom said:


> I'm no radiology expert, but I went back and looked at those X-rays again and I do see a lot go grainy-ness in the GI tract.
> 
> @deadheadvet , May I ask for your expertise here again? What do you see in the x-rays? Is sand build up a possibility, or would that be much more obvious?



Radiology report:
s is your consultation report regarding Case #

Exotic Radiographs

HISTORY: Exotic Radiographs Only
has not eaten in 5 day, lethargic. no nasal discharge, no bm in over 1 week may have urinated last Saturday.
normally eat romain, timothy hay, grazes in back yard, occ fruit and vegtables

______________________________________________________________________
WHOLE BODY, OCTOBER 8, 2015, 8 views

FINDINGS: Submitted in this study are dorsoventral and lateral radiographs of a male tortoise of unknown species. Positioning and technique are fair.

The skeletal structures in this study are normal in appearance and bone mineralization is appropriate. Body condition appears good based on coelomic mass and the musculature of the limbs.

There is a large amount of formed fecal material and gas within the gastrointestinal tract. There are no apparent gastrointestinal obstructions or foreign bodies. The other coelomic structures are unremarkable in appearance.

CONCLUSIONS: Constipation of unknown etiology. Occasionally when smaller tortoises are fed uncut hay the long strands can cause obstructive conditions and cause problems, though there are many other potential causes of constipation in tortoise including both primary nutritional and gastrointestinal disease as well as secondary to systemic disease or problems that cause stress, pain, etc.

RECOMMENDATIONS: Aggressive laxative and enema therapy to clear the GI tract is recommended. Rides in the car or other stimuli that creates vibration can help the tortoise to evacuate its bowel as well.


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## ascott (Oct 9, 2015)

noallawshe said:


> Radiology report:
> s is your consultation report regarding Case #
> 
> Exotic Radiographs
> ...



So, without offending you on purpose....the conclusion is like a long list of what it could be and not a diagnosis at all....xrays are but one way to try to determine what is going on and I know that they are not a sure fire pic to offer exact diagnosis...but I would strongly suggest that this tort be placed in a controlled environment so that your temps can be one hundred percent controlled, there be absolutely no sand within that space and begin long long warm water soaks that last for at least 30-45 minutes a couple of times a day....sand is a funny thing (not like haha funny), it can settle in the digestive track in a bad way...it can slowly build up on itself and then it is hard to get moving out of the system....when was the last time you picked up the tort and really felt its weight....does the tortoise feel heavy and solid like a bunch of bricks or is the weight a little fluffy light in relation to his overall size?


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## ascott (Oct 9, 2015)

noallawshe said:


> This is all he does now.
> 
> View attachment 151669
> View attachment 151670




Also, when I look at these two pics, this tort appears to have a bit of loose skin around the leg areas for being a younger tort and that loose skin should be full of plumb muscle...again, just my observation..


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## kathyth (Oct 10, 2015)

If he has an exotic vet that feels he needs an enema, I would have the vet do it under sedation. I would not treat my own tortoises with an enema. I'm don't know exactly how.
Your tortoise does look sick.
I hope that somehow he gets better!


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## noallawshe (Oct 10, 2015)

ascott said:


> So, without offending you on purpose....the conclusion is like a long list of what it could be and not a diagnosis at all....xrays are but one way to try to determine what is going on and I know that they are not a sure fire pic to offer exact diagnosis...but I would strongly suggest that this tort be placed in a controlled environment so that your temps can be one hundred percent controlled, there be absolutely no sand within that space and begin long long warm water soaks that last for at least 30-45 minutes a couple of times a day....sand is a funny thing (not like haha funny), it can settle in the digestive track in a bad way...it can slowly build up on itself and then it is hard to get moving out of the system....when was the last time you picked up the tort and really felt its weight....does the tortoise feel heavy and solid like a bunch of bricks or is the weight a little fluffy light in relation to his overall size?




He has been receiving long warm soaks daily for the past 10ish days. I pick him up every day and i thought he would weigh more than he does, 5.8lbs.


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## noallawshe (Oct 10, 2015)

kathyth said:


> If he has an exotic vet that feels he needs an enema, I would have the vet do it under sedation. I would not treat my own tortoises with an enema. I'm don't know exactly how.
> Your tortoise does look sick.
> I hope that somehow he gets better!
> View attachment 151771


I sm currently in contact with an tortoise vet and i have been a veterinary nurse for 25yrs.


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## Tom (Oct 10, 2015)

noallawshe said:


> He has been receiving long warm soaks daily for the past 10ish days. I pick him up every day and i thought he would weigh more than he does, 5.8lbs.



Pics can be deceiving. What is his length? When I measure this, I put a tape measure or yard stick against a wall, then put the tortoises front right up against the same with with their head tucked in, and then I look straight down past the back of the carapace at my tape measure.

Knowing the length will allow me to compare weight to similar sized ones in my group and this might offer a clue.


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## ascott (Oct 10, 2015)

noallawshe said:


> He has been receiving long warm soaks daily for the past 10ish days. I pick him up every day and i thought he would weigh more than he does, 5.8lbs.




With me, it is the moment of pick up that says a lot. Here I do not go out and play with the torts a lot during the day...I go in their space and offer any food supplements that I may have for them, I swish out their water bowls every couple of days (every day in the summer heat) and refill, I do stuff in their yards and also walk by them a few times each day....but the one thing that I do just about each day is the pick up..just a non invasive little lift up and right back down...if the tort makes me think, ah yeah...you feel heavy then he is all good, if there is even a moment where the thought of not heavy happens, I will offer up some wet type foods and offer up a drop into their water dish and gently run the hose over their shell and they usually will kinda just stay there while I walk away....then next lift check usually all heavy lifting (well, in relation to their size that is)...

I would imagine that tortoise has ingested some of that sand and that is never a good thing....eating some dirt or nibbling on a small rock and such is not the same as being housed on sand...sand gets stuck to everything eventually...I have had a California Desert Tortoise fully sand impacted, the prior person who hosted him finally gave me full access and control of what went on with the tort and I remember when I picked him up the first time, I thought something is completely wrong here...to look at the tort and to feel the tort did not match, he was only full of sand, and likely very little water intake because he had stopped moving, stopped basking, stopped participating in life..


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## noallawshe (Oct 11, 2015)

Sadly the tortoise died. The radiologist did not feel there was any sand. His decline was rapid and sudden. Thanks for everyones input.


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## Aunt Caffy (Oct 11, 2015)

noallawshe said:


> Sadly the tortoise died. The radiologist did not feel there was any sand. His decline was rapid and sudden. Thanks for everyones input.


I'm very sorry to hear that.


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## Alaskamike (Oct 11, 2015)

I am sorry for your loss. I too have a youngish Sulcata. 

Reading through this thread was informative. Things can go wrong - sometimes we do all we can and cannot make it right. 

I hope you do not give up on keeping tortoises. You obviously care allot and did all you could.


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## ascott (Oct 11, 2015)

noallawshe said:


> Sadly the tortoise died. The radiologist did not feel there was any sand. His decline was rapid and sudden. Thanks for everyones input.




Ah man, that sucks...I am so sorry to hear this....RIP


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## 4jean (Oct 11, 2015)

I am so so sorry for your loss.


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## Yvonne G (Oct 11, 2015)

Aw, darn it. Can you have a necropsy done?


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## deadheadvet (Oct 12, 2015)

Very sorry. I looked at the radiograph as well and didn't think there was an obvious obstruction present. I agree with Tom that another possible cause of this tortoise's decline has to be considered. Parasitic, toxin, viral. If you have no other animals than a necropsy would be academic. If you have others it would be a good idea if not already done. Unfortunately everything costs. Not to be about dollars and cents but a Sulcata is a 60$ tortoise. I have much more valuable tortoises in my collection. If something like this would have happened, I would spend every dollar to understand the cause so I don't have it happen again. I have routinely run fecals on my group, tested for Intranuclear Coccidia, Adenovirus, Mycoplasma.


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