# Yellowfoot xray



## Meganolvt (Dec 9, 2015)

I took Roland to work today to use him for xrays. We are tweaking our technique charts and I needed an exotic animal to work on. Check out his xray. I had no reason to xray him other than for practice. It has to be a pile of rocks I think? He has had no access to pebbles since i've had him (4 months). Could they have been ingested before and are just sitting there? My other thought was kidney stones maybe? Despite being a vet tech, I know very little about tortoise anatomy or gastrointestinal normalities. Can they hold on to things like females do eggs? In a dog or a cat, these would be pebbles in the intestines. In a tortoise, I don't know. He's eating, active, etc. Any thoughts? My vet wasn't in today, we'll see what she thinks tomorrow.


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## mike taylor (Dec 9, 2015)

That's crazy !


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## Yvonne G (Dec 9, 2015)

Yellowfooted tortoises' diet should include food containing seeds. They are used to eating seeds and will eat rocks if they aren't fed seeds.


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## Meganolvt (Dec 9, 2015)

@Yvonne G you mean like fruit with seeds?


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## SarahChelonoidis (Dec 9, 2015)

Whoa, fascinating. My tortoise anatomy is quite weak. What structure are they bound into? I've seen images of material that's made it into the intestines and it's all spread out and doesn't look anything like that.


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## Tom (Dec 9, 2015)

Many tortoises will eat pebbles like that. Its usually associated with a low fiber diet of grocery store greens and lack of mineral content, but not always.

That X-ray almost doesn't look real. The detail and color of the pebbles almost looks like a picture superimposed on your X-ray photo. Also the way they are grouped there seems pretty unusual.


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## Yvonne G (Dec 9, 2015)

Meganolvt said:


> @Yvonne G you mean like fruit with seeds?



Yes. Any kind of fruit whose seeds are small enough to fit down the tortoise's throat would be good - papaya, watermelon, cantaloupe, etc.

I learned this fact because I had a YF tortoise who was egg bound and prolapsed. The x-ray showed many small pebbles through the digestive tract. While the vet was trying to get the prolapse back inside, many pebbles came out. This is when I learned about the importance of seeds in their diet.


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## Meganolvt (Dec 9, 2015)

Tom said:


> Many tortoises will eat pebbles like that. Its usually associated with a low fiber diet of grocery store greens and lack of mineral content, but not always.
> 
> That X-ray almost doesn't look real. The detail and color of the pebbles almost looks like a picture superimposed on your X-ray photo. Also the way they are grouped there seems pretty unusual.


It's real! Crazy huh?


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## SarahChelonoidis (Dec 9, 2015)

I'm very curious to hear what a vet has to say about this.


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## lisa127 (Dec 9, 2015)

Yvonne G said:


> Yes. Any kind of fruit whose seeds are small enough to fit down the tortoise's throat would be good - papaya, watermelon, cantaloupe, etc.
> 
> I learned this fact because I had a YF tortoise who was egg bound and prolapsed. The x-ray showed many small pebbles through the digestive tract. While the vet was trying to get the prolapse back inside, many pebbles came out. This is when I learned about the importance of seeds in their diet.


I'm assuming the same goes for redfoots?


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## deadheadvet (Dec 9, 2015)

Depending on the health status of the animal, they could pass on grass and hay only. No greens. If the tortoise is compromised, could be problematic.
If the tortoise is off food, a feeding tube might need to be placed so fluids and some pureed fiber diet could help move the rocks along. Serial radiographs every week could show any movement of the rocks.


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## motero (Dec 9, 2015)

Can you get a shot from the side, to see how thick the pile of rocks is. Might give you a better idea of how much is really in there.


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## Meganolvt (Dec 9, 2015)

You can really see his crazy shell shape on this one. He wasn't exactly lateral (sideways), a little oblique (he was really fighting me).


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## ZEROPILOT (Dec 10, 2015)

I agree with Tom.
I would have discounted this as photoshopping.
The area of "pebbles" is so pronounced and in such focus.
Please update us as soon as you are able to.
Very interesting.
I've had a few tortoises eat stones. By why would they all collect in an area like that?
It almost has to be something else.


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## Pearly (Dec 10, 2015)

Meganolvt said:


> View attachment 158235
> You can really see his crazy shell shape on this one. He wasn't exactly lateral (sideways), a little oblique (he was really fighting me).


Sorry you are having to deal with this potentially serious issue. This second xray makes me think that the pebbles are getting stuck at this particular part of intestine for some reason (narrowing?). The shell shape also looks like an advanced MBD. I'm glad you took this animal for the practice xray. Who knows, you maybe able to save his life and spare suffering. Thank you for posting. Very good education!


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## deadheadvet (Dec 10, 2015)

Looks like the pebbles are in the stomach or proximal duodenum but without contrast or CT can not be sure. As far as bone density goes, you can not tell from these images since the radiograph was set for whole body and not limbs. The limbs are burned out and can not be visualized well. Very nice Digital radiograph. That is why there is very good detail.


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## ZEROPILOT (Dec 10, 2015)

deadheadvet said:


> Looks like the pebbles are in the stomach or proximal duodenum but without contrast or CT can not be sure. As far as bone density goes, you can not tell from these images since the radiograph was set for whole body and not limbs. The limbs are burned out and can not be visualized well. Very nice Digital radiograph. That is why there is very good detail.


So it is the stomach?
What great timing. This would likely end in the death of the tortoise if not found wouldn't it?


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## Pearly (Dec 10, 2015)

deadheadvet said:


> Looks like the pebbles are in the stomach or proximal duodenum but without contrast or CT can not be sure. As far as bone density goes, you can not tell from these images since the radiograph was set for whole body and not limbs. The limbs are burned out and can not be visualized well. Very nice Digital radiograph. That is why there is very good detail.


This goes to show how ignorant I am in chelonian anatomy and pathophysiology. Thank you for the correction. I guess I made assumption that stomach would look more like pouch kind of a compartment, duodenum didn't cross my mind because the pebble collection looked like it was "contained within" but you are right, without further study it's hard to say for sure. As for MBD I was under the impression that such severe shell deformities are commonly associated with MBD. Again, my bad. I just tend to "fish out" health related threads in my very limited forum time, as to increase my own awareness of potential issues. I'm very glad to have the professionals contributing here. Thank you again


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## deadheadvet (Dec 10, 2015)

I have been dealing with a similar case (maybe) Tortoise ate a bunch of small rocks. What was initially thought was all the stones were in the stomach.
Nope, cranial duodenum on CT. Some started to move along on their own. So depending on the yellow foot's health status, it could be possible to take a conservative approach and see if they will move along on their own, daily soaking could help stimulate the GI tract to move them down. Fiber diet may help push the stones through. Without follow up radiographs, no way to know.


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## ZEROPILOT (Dec 10, 2015)

I'm not sure that a tortoise eating rocks is all that unusual. I've seen it many, many times and said rock always seems to pass. 
What's frightening is to see so many that look to be stuck. If they truly have all been there for at least four months, I wouldn't be too comfortable not attempting something soon. (Like surgery)


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## mike taylor (Dec 10, 2015)

I know alligators and crocodiles eat rocks . Supposably helps break down their food. You think tortoises maybe doing the same ?


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## Yvonne G (Dec 10, 2015)

Let's send and alert to @Will . When this happened to my YF he gave me a big scientific answer that I had a hard time following. Maybe he can dumb it down for us.


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## Kapidolo Farms (Dec 10, 2015)

The explanation is that these tortoises tend to not eat grass so much, but their intestines are still in a tortoise shell, so they make up the difference by eating seedy plant matter. It gives their intestines a substrate to move a bolus of food back and forth. They actually allow (have evolved to exploit) the bacteria in the large intestine to further break down large molecules and then they ( with muscle that wrap around the intestine) push that bolus of food back up to the small intestine (towards the mouth end of the whole gastrointestinal pipe) for greater absorption of nutrients. Soft foods are too squishy and it won't work. So they will eat small pebbles to replace that substrate. 

Madkins007 has the tortoise library and somewhere in that online source are the technical articles that narrate these things from wild tortoises being observed in the wild and in semi captive conditions. Otherwise I agree with @Tom on the appearance of the x-ray, it looks strange.


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## Meganolvt (Dec 10, 2015)

Well, my vet thinks it is bladder stones. I know this is common in torts and I assume he came to me with them. He does have severe MBD, also came like this. I know tortoise bladders are much more caudle than where the stones are (closer to the tail), however there are multiple pictures of torts with huge stones that are really high up, so I suppose it's possible. Since he is eating, pooping, and acting no different then when I adopted him four months ago, we're assuming itt probably isnt in his stomach, duodenum, etc. I know there is no way to tell without a CT or maybe an ultrasound, neither of which we have.
So, since he is doing great, we're going to wait it out and see what happens. We see torts and turtles at my clinic but it is always easy stuff like shell rot, etc. My vet has never actually done a tortoise surgery, and neither have I. We decided that if he shows signs of a problem, we'll go ahead and try surgery. We're doing our homework so we will be ready. 
I am an excellent, very experienced licensed veterinary technician, and she is an awesome doctor, so I have confidence we can do it when the time comes. It sucks to have my guy be the guinea pig, but we both need the experience, so i'm ok with it.
The MBD has caused a misshapen shell, but I have been doing everything right (I think), and it has actually smoothed out a tiny bit since I adopted him. I'm going to keep doing what i'm doing, avoid spinach and other things high in oxolates, and keep a close eye on him. I do plan to re-xray him in a few weeks, so I'll post it then!


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## Meganolvt (Dec 10, 2015)

deadheadvet said:


> Looks like the pebbles are in the stomach or proximal duodenum but without contrast or CT can not be sure. As far as bone density goes, you can not tell from these images since the radiograph was set for whole body and not limbs. The limbs are burned out and can not be visualized well. Very nice Digital radiograph. That is why there is very good detail.


Thanks! I take my radiographs very seriously.


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## Meganolvt (Dec 10, 2015)

@deadheadvet if you disagree and think those are GI rocks, I would very much appreciate your input. I know that what I really need to do is save my pennies and get a CT or something done at a specialty hospital. Do you think ultrasound would work? That is more within the realm of possibility right now.


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## Yvonne G (Dec 10, 2015)

I'm not a vet, but I totally disagree. Bladder stones have rough edges and are basically round. The stones or little rocks inside your tortoise are all different, pointy shapes, like some sort of flower bed top dressing.


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## Meganolvt (Dec 10, 2015)

@Yvonne G, to be honest, 50% of me disagrees too. I have seen lots of little bladder stones like this in dogs, but all I can find in vet books as well as online are tortoises with one huge round stone. To me, it looks like a pile of rocks. I just can't get around the fact that he has had no access to rocks in at least four months. It just doesn't make sense since he poops regularly, eats all the time, etc. I could go either way. Hopefully an xray in a week or so will answer some of these questions. The good news is that apparently they can live with either and not necessarily have a problem, so hopefully Roland will be one of the lucky ones.


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## Tom (Dec 10, 2015)

mike taylor said:


> I know alligators and crocodiles eat rocks . Supposably helps break down their food. You think tortoises maybe doing the same ?



Ha! Maybe this is why healthy tortoises feel so heavy! They are full of rocks.


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## GotTort (Dec 10, 2015)

I'm not a vet but am a human doctor. The stones (or whatever they are) are definitely in the gastrointestinal system and not the bladder. The dark black around and below the stones is air (gas in the bowels). Be interested in what @deadheadvet has to say.


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## SarahChelonoidis (Dec 10, 2015)

The distinctness of the stomach (or other organ) reminds me of this image that was going around of the tortoise that swallowed the pendant: http://www.tbo.com/ap/offbeat2/x-ray-shows-sick-fla-tortoise-swallowed-turtle-pendant-20141028/ What is the other high contrast material in the stomach of the tortoise that swallowed the turtle pendant?


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## SteveW (Dec 10, 2015)

Will said:


> The explanation is that these tortoises tend to not eat grass so much, but their intestines are still in a tortoise shell, so they make up the difference by eating seedy plant matter. It gives their intestines a substrate to move a bolus of food back and forth. They actually allow (have evolved to exploit) the bacteria in the large intestine to further break down large molecules and then they ( with muscle that wrap around the intestine) push that bolus of food back up to the small intestine (towards the mouth end of the whole gastrointestinal pipe) for greater absorption of nutrients. Soft foods are too squishy and it won't work. So they will eat small pebbles to replace that substrate.
> 
> Madkins007 has the tortoise library and somewhere in that online source are the technical articles that narrate these things from wild tortoises being observed in the wild and in semi captive conditions. Otherwise I agree with @Tom on the appearance of the x-ray, it looks strange.



Bolus, eh? Sounds like a bunch of crap to me.


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## SarahChelonoidis (Dec 10, 2015)

SarahChelonoidis said:


> The distinctness of the stomach (or other organ) reminds me of this image that was going around of the tortoise that swallowed the pendant: http://www.tbo.com/ap/offbeat2/x-ray-shows-sick-fla-tortoise-swallowed-turtle-pendant-20141028/ What is the other high contrast material in the stomach of the tortoise that swallowed the turtle pendant?


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## mike taylor (Dec 11, 2015)

Tom said:


> Ha! Maybe this is why healthy tortoises feel so heavy! They are full of rocks.


Are you poking fun at me man ! You lucky I don't have at&t to reach out and touch you ! Ha-ha


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## deadheadvet (Dec 17, 2015)

Those are rocks and are either in the duodenum or stomach. Definitely not in the bladder.


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## Meganolvt (Dec 18, 2015)

Well, here is another xray, taken today, about 1 1/2 weeks later. It actually looks bigger but hasn't moved. I think now that this probably does have to be bladder stones. He's been eating and pooping, it would have had to move with a week and a half of eating if it was in the intestines I think. He is acting the same as always, but I suppose he came to me with them four months ago, so I dont really know what was "normal" for him prior to that. The good news is he seems fine, at least for now.


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## Yvonne G (Dec 18, 2015)

All the X-rays I've seen show a single, round stone like this:








I suppose it's possible to be in the bladder, as this picture shows the bladder goes all the way across the tortoise, side to side:








But I've seen a lot of bladder stones, and none of them look like the little pebbles in your X-ray. Also, as you can see in the picture above, the bladder is one big 'container' going from one side of this tortoise to the other, while your pebbles are contained in some sort of little pocket, which is obviously not the bladder.

The next picture in the series has the bladder out of the body cavity, and shows the large intestine directly under it on the left side, exactly where your little stones are. If you'd like to see the pictures, they're here:

http://www.documentingreality.com/forum/f10/tortoise-autopsy-115627/


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## Meganolvt (Dec 18, 2015)

I don't know @Yvonne G, you may be right. Neither makes sense really. He's had no access to pebbles of any kind, he's been indoors since the end of October. But you never see little bladder stones, only one giant one. I just wish I would have xrayed him right when I got him. It would be nice to know if he came like this or if he ate / developed something since i've had him. I'm still wondering if an ultrasound would help. I don't know if ultrasound would even work on a tortoise.


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## MPRC (Dec 19, 2015)

Meganolvt said:


> He's had no access to pebbles of any kind, he's been indoors since the end of October.



My redfoot just pooped out a big chunk of bark, he hasn't been near bark (or even outside unsupervised) since September. 

I am really intrigued to see how this goes.


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## MPRC (Feb 2, 2016)

Can we get a Roland update? Any new xrays? Any rocks? Any more adorable dopey faced Roland pictures?


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## Meganolvt (Feb 2, 2016)

I javen't xrayed him since the last one I posted. I need to do it again, but first I have to pay my bill (just cleaned my 17 year old dog's teeth). He's doing fine though, no signs at all that he is carrying around a bunch of rocks/uroliths. When I xray him again, I will post it. But for now, here's a pic I took 2 days ago


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## Meganolvt (Mar 18, 2016)

Roland update: took another xray of Roland today. Looks the same! He's still doing fine though, you'd never know it.


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## MPRC (Mar 19, 2016)

Huh, so he looks the same and nothing has even moved. It makes me really want to get my critters x-rayed just to see theirsoft squishy insides. I really miss working at the vets office.


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## Yvonne G (Mar 19, 2016)

Have you tried mineral oil? Don't just put mineral oil in the tortoise's mouth, as he might aspirate it. Take a romaine lettuce leaf and spread a little mineral oil on it then roll it up like a burrito. Hand feed him from one end of the burrito. Or you can put the oil on anything that you know for sure the tortoise will eat.

Mineral oil is non-absorptive, so it just lubricates all the pipes and makes it easier for things to pass through.

I looked at both your x-rays side-by-side, and the rock configuration is different. Eating rocks, or more naturally, food containing seeds, is natural for this species. I would try the mineral oil burrito, and as long as he seems healthy otherwise, eating, etc. then don't worry. But add foods containing seeds to his diet.


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## Meganolvt (Mar 19, 2016)

We still think it is bladder stones, and the fact that they are jumbling but not moving down kind of confirms that. It's just unusual because you normally see one big stone instead of all these little ones, but I don't know his age or upbringing (which was obviously bad judging by his saddle shell). Maybe there's something in upbringing that contributes to multiple stones instead of one, but who would know? Anyone who does things so obviously incorrect probably doesn't take their tort to get xrayed. Hopefully those little stones just stay put and don't go trying to escape. Unfortunately there are special diets for stone dissolution in cats and dogs, but not torts.


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## MPRC (Mar 19, 2016)

Meganolvt said:


> Unfortunately there are special diets for stone dissolution in cats and dogs, but not torts.



Trying to get dogs to eat the Hills Rx Diet for dissolving the stones was the bane of my existence for a bit there. Even then it rarely worked. Since there are many different types of stones I wonder if he has something other than the common types seen in torts.


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## Yvonne G (Mar 19, 2016)

Well, I disagree, but your vet obviously knows best. If you try the mineral oil burrito, it won't hurt anything, and just may prove to your vet that he's wrong.


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## Meganolvt (Mar 19, 2016)

LaDukePhoto said:


> Trying to get dogs to eat the Hills Rx Diet for dissolving the stones was the bane of my existence for a bit there. Even then it rarely worked. Since there are many different types of stones I wonder if he has something other than the common types seen in torts.


I've seen better compliance with Royal Canin SO in dogs.


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## MPRC (Mar 19, 2016)

Meganolvt said:


> I've seen better compliance with Royal Canin SO in dogs.



We used that as well. I seem to remember it costing a lot more when I was working at the clinic so a lot of people tried Hills first. At least the C/D is palatable.


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