# ?Liver failure (green urine)



## RGB (Feb 25, 2014)

I have a 3 -4yr old 13", 11lb Leopard Tortoise that has begun to progressively pee dark green for about 2 mos. I first noticed it after feeding it some peas, corn, and beans (first time I ever let it eat anything other than weeds/grasses/greens/mazuri....the staple if it's diet is mazuri.... Probably unrelated, but might as well share this detail) I can't seem to find much info online about possible causes... If I decide to go and try a vet in my area, it is helpful if I can go with great ideas because this specialized area of animal care is not easy to find. I have basically found that the urine looks like bile and I believe represents possible liver failure.
I've treated with flagyl for possible hexamitiasis. No improvement. The tortoise still eats and drinks well. It walks upright and appears very healthy other than the dark green urine. 
I suspect this isn't going to end well for my tortoise . There does not appear to many treatable causes of green urine that I can find... 
Any thoughts??


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## Yvonne G (Feb 25, 2014)

Oh, wow...that really is green. I know that eating a lot of dandelion greens causes the urine to look almost red, but I've never seen or heard of green.

Here's hoping its just something he's eating and not a health problem.


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## wellington (Feb 25, 2014)

So sorry I can't help you. I do hope, like Yvonne said, it is just something he has eaten. Good luck and your leopard is adorable. Keep us updated.


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## TortieLuver (Feb 25, 2014)

Wow I have never seen that green urine before either, but I can say that liver failure causes much different symptoms, very inactive/lethargic, not wanting to eat, and even trouble being mobile. Perhaps someone else can shed some light on the color issue. I agree with tortoises, what they excrete has a lot to do with what they eat. I have never seen that with peas either...what do you mean by beans? Green beans?


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## RussianTortxo (Feb 25, 2014)

I didn't think that Tortoises could eat corn. Us humans have a hard time passing corn so I would imagine a turtle trying to process corn would be just as difficult if not more.


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## RGB (Feb 25, 2014)

Green beans...
This was just one meal.
And was probably 3 months ago

The urine is now just like bile. Very very dark green.


The corn passed through easily.
It's hard to provide variety in frozen months in Canada so I thought some mixed vegetables would be a rare addition to her diet. Like I said, just tried the once. Mostly eats mazuri


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## RussianTortxo (Feb 25, 2014)

Have you seen this forum? 
http://www.reptileforums.co.uk/foru...23117-my-leopard-tortoise-still-having-2.html


This leopard tort owner described the same dark green urine that your tortoise seems to be experiencing. 

This tortoise was seen by a vet and had blood work and tests done but everything came back normal yet was still having "potty issues". After have reading this, maybe you can try some of the same things this owner did to see if it helps.


*read this


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## sibi (Feb 25, 2014)

I don't know what's causing the urine to be green, even dark green, but I doubt it is bile fluids. I would think that any bile fluid would change in the intestinal tract; not the bladder. Is it possible that your tort is actually excreting greenish water diarrhea? That would make more sense. Why not get your tort to discharge this green fluid without a soaking, and have a fluid analysis done. That would tell you more. Hope your tort gets well.


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## ascott (Feb 25, 2014)

> _The discoloration is a harmless side effect from a variety of food items. Asparagus sometimes adds a greenish tinge that's also perfectly harmless.
> 
> Green urine can also be a sign of a urinary tract infection or a bacterial infection that has gotten into the blood (bacteremia)._


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## RGB (Feb 26, 2014)

RussianTortxo said:


> Have you seen this forum?
> http://www.reptileforums.co.uk/foru...23117-my-leopard-tortoise-still-having-2.html
> 
> 
> ...






Great read!
I have been trying flagyl but at a lower dose (50mg/kg) than referenced in that thread (125mg/kg). I have also directly observed the urine for parasites and could not find any. I am going to attempt getting a urine culture done. A urine dipstick was useless as the urine was so green that the color changes needed to be observed on the stick were masked by the intense green staining. My tortoise continues to have normal bowel movements with no difficulty,no parasites on microscopic examination of the stool either.

It might be worth changing diet from mazuri and see what happens as well.

I will try a higher dose of flagyl. The potential reward appears to be worth the risk.


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## RGB (Feb 26, 2014)

Urine sample...
It has been much darker!
The green color is quite variable.


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## Jacqui (Feb 26, 2014)

That sample is pure or from a soaking and diluted?


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## T33's Torts (Feb 26, 2014)

Jacqui, I'm assuming its diluted. It'd be very awkward to get a urine sample from a tortoise.


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## Saleama (Feb 26, 2014)

If I carry my torts around long enough they always pee on my hand. I was scrubbing Taco's (my first Sulcata) belly with a soft toothbrush once and he peed in my face so I know collecting a sample is not that hard, it is just a bit time consuming. On topic, I have a baby leopard that peed real thick and tinted slightly green but only the one time that I observed and it was after feeding them some soft grass and cactus pads. Not at all sure if the two are related but thought any input might be useful. One never knows what can be discovered with the smallest of clues.


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## Yvonne G (Feb 26, 2014)

Somewhere in this article it says, "...Symptoms include Strong smelling urine, Dark green urine sometimes flecked with blood, ..." but I didn't have time this a.m. to read the article again and mark the place for you.

http://www.tortoisetrust.org/articles/parasites.html


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## Laura (Feb 26, 2014)

bile is yellow.. and would be a fecal issue... 
so this is either diarrhea or green urine.. from something... 
acting normal?


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## ascott (Feb 26, 2014)

I personally would not be offering any meds as a result of the green pee...after all, you did say you fed the tort Peas...this is going to offer some fun green in the pee....also, mazuri would not do the color--would not imagine why????

I bet you are reacting a bit and may want to observe for awhile, especially since you say all else is good and normal with the tort....increasing the meds will only lead to an actual issue....please just wait and watch....

That is a healthy looking green, like a result of food item consumption....please do take a breath and be observant for any other signs;

Lack of interest, lethargy, stinky rancid poo, lack of appetite, no poo, no pee...these are actual things to spark concern....simply having beautiful green pee after eating green Peas....would not concern me....also, you said you offered corn and beans? What type of beans? Corn should be smashed up a bit before offered as a seasoning to a food pile offering....


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## RGB (Feb 26, 2014)

Yvonne... Yes I saw that article which is main reason I began flagyl:
From the article u referenced....
"Hexamita: Is highly contagious and identified from a urine sample. Symptoms include Strong smelling urine, Dark green urine sometimes flecked with blood, excessive thirst, anorexia and fluid retention, weight loss".

Even though my hermann breeding group is quarantined from my leopard, I'm afraid of hexamita spreading if that were the case.


Urine was easy to get- just annoy her over a clean bucket! She will fill it! 
So the urine was not dilute.

I should have taken in a sample before treating... Currently the urune results are:
No parasites
No bilirubin or blood
Everything seems normal except color
Culture for bacteria set up

Also, the peas were eaten at least 2 months ago...


Thanks for all the info!
I'll keep everyone posted, it's very helpful to learn from each other.
Bob


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## ascott (Feb 26, 2014)

How much calcium do you offer this tort? Do you offer supplemental calcium in addition to food offerings?


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## RGB (Feb 27, 2014)

Calcium carbonate 1-2 times a week (powder sprinkled on good). 

Diet is predominately mazuri, often eaten dry. I rarely give alfalfa based pellet foot, and usually give it a salad once a week which is mostly romaine. This is its winter diet. Summer is grass and weeds, she is outside most days.

I soak her every 4-6 days, and she always has a large bowel movement that looks the same as always. No diarrhea, not dark.


Edit: Oops, calcium sprinkled on FOOD (not good).


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## bouaboua (Feb 27, 2014)

This is a great thread. Lots to learn. Thanks 

You got to love this forum........Looking forward to next update.


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## RGB (Feb 27, 2014)

Urine cultures (post flagyl): Negative for pathogenic bacteria

So now we wait and see what happens.


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## sibi (Feb 27, 2014)

Wait for what? Did they do an analysis on the urine other than check for parasites/works? That green urine has to test for something? 



RGB said:


> Urine cultures (post flagyl): Negative for pathogenic bacteria
> 
> So now we wait and see what happens.


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## ascott (Feb 27, 2014)

Elevated levels of calcium can give off green color in urine....if you are offering mazuri as regular part of diet and then during the warmer months the tort is outdoors grazing is there a reason you are supplementing additional calcium??


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## RGB (Feb 27, 2014)

Sibi- wait and see if the tort gets "ill" or the green urine subsides. Nothing else to get tested in the urine.

Ascott- not sure what makes you state that calcium would make green urine. I have never read that. I have been providing some calcium supplementation as a rapidly growing leopard would seem to have a high demand... Maybe it's unnecessary. But I'm not sure how it would contribute to the green pee.

Thanks
Bob


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## ascott (Feb 27, 2014)

Hypercalcemia (too much calcium in the blood) can cause green or greenish blue urine.....


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## RGB (Feb 28, 2014)

So here is my latest research:

It appears that Heme in Red Bood cells typically gets broken down into bilirubin by animals/humans. Excess bilirubin causes jaundice which is yellow and causes yellow blood and brighter yellow urine. 
However in birds/reptiles, heme from RBCs gets converted into biliverdin that relies on the liver to excrete it in the bile. So anything that causes excess biliverdin to be produced (excessive blood breakdown-hemolysis) or reduction of biliverdin excreted in bile (either obstruction of bile secretion /blockage post hepatic, or liver failure preventing the excretion of the biliverdin in bile) will result in accumulation of biliverdin in the blood and therefore excreted in the urine (biliverdinuria). The most common cause of Biliverdinuria is liver failure. Biliverdin is green and creates bright green urine. It would not be detected in urine with dipsticks that detect bilirubin. 

This is what I believe my tortoise has: biliverdinuria. Most likely from liver failure just based upon probabilities. I could investigate further, although I am unsure of any therapy that would alter the outcome. I will continue to give it the best supportive care; nutrition and hydration; and see if it can improve/recover. She is strong and eating well, so that is good for prognosis at this point. I will continue to research the potential causes, investigations and treatments to see if there is more worthwhile to do other than wait and see how she does.

I'll keep u posted!
Bob


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## TortsNTurtles (Mar 1, 2014)

Thank you for sharing your research. Keep us posted. Sorry to hear the possible bad news and I hope you come across information that may help.


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## RGB (Oct 9, 2014)

Update:
The tortoise has been doing great. Other than continuing to have green urine (see pic), she has had no other symptoms.... At times she urinates normally, at times quite green. She continues to grow appropriately and is very healthy and strong.

I would think that a serious illness such as hemolytic anemia or liver failure would have had other problems (or death ) by now!! It's been many months since this was first identified.

I'm totally stumped. 

Just thought i would pass along the update...


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## Tyanna (Oct 9, 2014)

It would be really interesting to figure out the cause of this.


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## tortadise (Oct 9, 2014)

For renal quandaries a blood panel would be best. However in my experience renal failure would be unlikely in an animal 3-4 years old unless in an extreme neglected scenario. However that doesn't dissolve the possibility. Nature can allow it to happen. But I would get a blood panel done, and do a local swab for PCR analysis through university of Florida, I can forward you there lab information if you'd like. I had a chilensis pass from renal failure, did not take it long. Once the liver goes it passes off to the kidneys. Urination typically doesn't take place anymore. They will swell typically around the neck or hind legs. Very intriguing indeed. Hope all comes through well.


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## AmRoKo (Oct 9, 2014)

In my experience with humans and animals, any that have liver failure smell like rot and people/animals with kidney failure smell sickeningly sweet.


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## Amanda81 (Oct 9, 2014)

Perhaps you could eliminate one thing for say a month, see if the green urine clears up. Like stop the calcium supplement for a month, mazuri is a complete diet so she should be fine. Then if she still has green urine after that month, just eliminate something else, like in the summer stop feeding mazuri for a month, see what happens. You might discover the issue that way. Just a suggestion.


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## ascott (Oct 10, 2014)

RGB said:


> Update:
> The tortoise has been doing great. Other than continuing to have green urine (see pic), she has had no other symptoms.... At times she urinates normally, at times quite green. She continues to grow appropriately and is very healthy and strong.
> 
> I would think that a serious illness such as hemolytic anemia or liver failure would have had other problems (or death ) by now!! It's been many months since this was first identified.
> ...




I bet is simply some part of the tortoise diet....and that is not a sickly green color by the way....beautiful tort.


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## RGB (Oct 11, 2014)

In the past it has been thick dark green like bile... Now it is just green coloured but otherwise normal "water" like urine.


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## les27 (Apr 10, 2016)

RGB said:


> I have a 3 -4yr old 13", 11lb Leopard Tortoise that has begun to progressively pee dark green for about 2 mos. I first noticed it after feeding it some peas, corn, and beans (first time I ever let it eat anything other than weeds/grasses/greens/mazuri....the staple if it's diet is mazuri.... Probably unrelated, but might as well share this detail) I can't seem to find much info online about possible causes... If I decide to go and try a vet in my area, it is helpful if I can go with great ideas because this specialized area of animal care is not easy to find. I have basically found that the urine looks like bile and I believe represents possible liver failure.
> I've treated with flagyl for possible hexamitiasis. No improvement. The tortoise still eats and drinks well. It walks upright and appears very healthy other than the dark green urine.
> I suspect this isn't going to end well for my tortoise . There does not appear to many treatable causes of green urine that I can find...
> Any thoughts??
> View attachment 71759


Hi 
Very sorry to hear the leopard with green wee my 9 year old leopard had the same problem treated by vet with furtum & flagyl with no effect who passes away today .
How is your tortoise doing?


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## dmmj (Apr 10, 2016)

in 30 years I've never seen green urine. And that is green. be interesting to see what this is.


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## Randi (Apr 10, 2016)

@deadheadvet
Sorry to bother you as I'm sure you're very busy. Do you have any experience with this? Thank you.


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## Kori5 (Apr 11, 2016)

@OurZeus beloved tortoise was peeing green. It had liver failure. You can contact @thewoodenleg on instagram. His tortoise has liver problems and the treatment is milk thistle through tube. The tortoise is getting better . I wish you luck. Ups. Now I see it's an old thread .


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## deadheadvet (Apr 11, 2016)

We would be concerned for either intrahepatic disease or cellular rupture causing the change in color. Diet sounds good so less likely to be the culprit. Trying to get a dose for S-adenosyl for a tortoise, has been used in sea turtles in the past but don't know how much.


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## Mantissa3 (Jun 21, 2016)

RGB said:


> In the past it has been thick dark green like bile... Now it is just green coloured but otherwise normal "water" like urine.



How is your tortie doing please. Mine has always had periods of dark green slimey urine as you have pictured, but no testing ever came back positive for any health issues over the past two or three years.


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## jockma (Jun 21, 2016)

I swear I've seen another thread about another tortoise with this same exact issue. Perfect health but unexplained green pee. Maybe it wasn't this forum?


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## Mantissa3 (Jun 26, 2016)

Hi:

I've been reading your post about your Leo having dark green mucous-ey urine, and I posted a question, but no response yet.

I've had a dwarfed redfoot who was SERIOUSLY ill when we rescued him... He still has bouts of this same, exact dark green slimey urine. I've had it tested at 4 different vets, and all the stuff comes back normal.

I can't find a trigger, but I'll tell you what helps- and it was an accidental "find" because he went in for a "cold" with inflamed nictitating membranes at the same time the green pee started last year.... Usually it is only the green urine, or only the swelling of the nictitating membranes, never both together.

The swelling membranes is thought to occur due to bacterial infections of the tear ducts. So I found a wonderful, very smart vet that gave me 20mg/kg of Ceftazadime, alternating front legs Sub-Q, injection ever 3rd day for 7 doses.

This not only clears up the mild bacteria infection in his eyes- about the 3rd dose clears up the dark green, mucous-ey pee too. Then she told me she suspects it is a urinary tract infection because of his consistent clearing due to the Tazicef.

Just wanted to mention this to you, as we now give the Ceftazadime (Tazicef is the name brand) each time we see the nictitating membrane swelling OR when he starts getting the mucous-ey green pee.

Hope this helps,
Karen


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## RGB (Jul 24, 2016)

Still getting occasional bouts of green pee... Sometimes when severe, it is mucousy. But otherwise she is growing normally and seems healthy!


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## Mantissa3 (Dec 31, 2016)

Laura said:


> bile is yellow.. and would be a fecal issue...
> so this is either diarrhea or green urine.. from something...
> acting normal?




Bile for tortoises and turtles is not yellow- it is called biliverdin and has a normal green pigment for chelonians and pond turtles...


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## Mantissa3 (Dec 31, 2016)

RGB said:


> Still getting occasional bouts of green pee... Sometimes when severe, it is mucousy. But otherwise she is growing normally and seems healthy!



I just had another bout of the mucous-ey green pee with my little redfoot, so I contacted a research vet and started reading more veterinary medical articles.

There seems to be consensus that this green mucous-ey urine in tortoises is called "biliverdinuria" and indicates a large amount of bile retention- then they expel the excess bile (from the liver) into the cloaca, which then vents with the urine stream...

I just read a great article that says Green Urine (Biliverdinuria) in tortoises is suggestive of hepatopathy, cholestasiss, could be due to viral/bacterial infections of liver or kidneys, or bile duct obstruction (then when bile builds up to abnormal level, can vent at once, creating the various density of green color in the urine.)

For Cholestasis, diets rich in carbs and proteins are indicated, along with oral administration of soluble Vitamin A, D, E, and K - and my little one LOVES high protein diets - such as fish and shrimp and eggs, while my other tortoises just sniff and walk away... 

If the green urine is due to hepatic lipidosis, then the treatment is very different and can actually be negatively affected by drugs that treat the green urine due to viral and bacterial infections and parasites (so flagyl and oral Baytril are out, and Ceftazadime is best- which I've seen in my baby).

I'm uploading a couple of papers here in case you recognize one symptom over another and want to try a week's worth of diet or Flagyl or Ceftazadime. They are saying the only real diagnostic tool for shelled reptiles is liver biopsy, which is way too risky for me to permit in my little redfoot, so I'm going with treatment for a short period and watching the symptoms to see whether the treatments/diet changes/supplaments are making any difference.

One of the best things I read within these papers I'm uploading is that if the green urine is due to hepatic lipidosis, then it is not a disease, rather a metabolic condition that can be corrected with the diet rich in proteins and carbs, and the oral administration of soluble Vitamins A, D, E, and K...

Hope this helps- and please let me know if anybody has further information on vets and labs that can do this type of differential diagnosis and treatment plans for biliverdinuria?


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