Concerning looking urates

[Zula]

Hello!!
I am looking for advice regarding my tortoise. She is an eight year old horsefield tortoise. Three months ago she went off her food. For three weeks I encouraged her to eat and I bathed her twice a day with reptoboost. When that didn't make any difference I knew something was wrong and I took her to the vet. We discovered that she had follicles that were squashing her liver and stomach. The vet decided that the best thing was to wait and put her on antibiotic injections as a precaution. A month later at our next check up it was confirmed that she was in follicular stasis. The next day she had surgery to remove the follicles. The surgery was a success but the vet discovered that her liver was looking angry. She had a feeding tube placed for food and medication, including liver support. Last week the tube flipped and the vet decided to remove it. She was doing okay and eating not too bad. She is not gaining a lot of weight but just about maintaining her weight. Before the tube was removed, a week ago, I noticed that her urates were not looking right. They were orangish, lumpy, and just horrible. I discussed this with the vet and she wasn't very concerned. She suggested stopping the strong painkillers and starting shallow baths to help her clear her system. An x-ray was done to make sure there was no excess debris in the bladder but everything looked okay. Today her demeanor changed and she wasn't keen on food. I gave her a wee bath and she passed urates that are looking very concerning. I am taking her to the vet on Tuesday and dropping off a sample of the urates tomorrow. I am worried and panicking. I would appreciate if someone could advise me on what this could mean. Is she developing liver disease, or is it an infection? Or is she just clearing her system and I am being dramatic? What is going on?
Also, the urates did have a green yuck around it, that mostly dissolved in water. The main chunk was grey/green and once I opened it up there was reddish stuff that was a bit gritty. Thank you!!

 

[The_Four_Toed_Edward]

Maybe @Yvonne G or @zovick can help you! Sorry to hear you are going through this.

Was the bladder also xrayed?

 

[Littleredfootbigredheart]

Sorry you’re going through this! Hopefully the folks tagged above will be able to help you here!

In the meantime I don’t suppose you’d mind sharing some more information on how they are kept? It’ll help the folks advising you!

What are your temps like? Ie basking spot(directly under the bulb) over all day temps& night temps?
What kind of lighting&heating are you using specifically? Packaging pics are good if you have any
Do you use indoor uv? If so what kind?
How’s your humidity reading? What do you use for substrate?
What sized set up does she have?

A photo of your full set up would be good, along with one of your tort

 

[Zula]

Maybe @Yvonne G or @zovick can help you! Sorry to hear you are going through this.

Was the bladder also xrayed?

Yes, they did a full, x-ray. Everything looked normal. No excess gass in the intestines or stomach and no deposits visible in the bladder at this point. The vet called me back after I dropped off the sample and tomorrow they will sedate her and take bloods.

 

[Zula]

Sorry you’re going through this! Hopefully the folks tagged above will be able to help you here!

In the meantime I don’t suppose you’d mind sharing some more information on how they are kept? It’ll help the folks advising you!

What are your temps like? Ie basking spot(directly under the bulb) over all day temps& night temps?
What kind of lighting&heating are you using specifically? Packaging pics are good if you have any
Do you use indoor uv? If so what kind?
How’s your humidity reading? What do you use for substrate?
What sized set up does she have?

A photo of your full set up would be good, along with one of your tort

Hello,
I am out at the moment so won't be able to take pictures but will do my best to describe her setup. She has a tortoise table that I hand-built for her. It fits right into my flat that way I was able to maximize the amount of space she has. She does have a second floor which she sometimes uses as a bedroom. The table is built from solid wood and plywood that has been properly sealed. It is well ventilated and insulated to keep the heat in. She has a 100w UVB and UVA mercury lamp, I know not everyone is a fan of them but I think they work for us and her enclosure. The basking spot is around 35 celsius and the colder area is about 20 celsius. At night, during summer the temperature doesn't drop any lower then 19/20 celsius and for winter I have a ceramic heater that is connected to a dimming thermostat. Humidity is usually between 40-50% The substrate I use is very fine organic peat-free top solid and coco coir. That is the only thing that works as she loves to eat things that are not meant to be eaten, like sticks and rocks. I don't think it's a mineral or calcium deficiency as she does get multivitamins and calcium powder and her diet is not too bad. I grow some weeds and flowers for her and she gets a bit of salad, lambs lettuce, chicory, rocket, watercress, and other bits and bobs. I think she is just a silly little tortoise with silly ideas. Obviously, at the moment there is no dirt in her house as I had to keep her neck and shell dry and clean to ensure everything heals well. The table is about 1.20 m squared. It's large but not huge. Eventually, when I have more space I will upgrade it or even move her outdoors, part-time but we are not there yet. I do think she is quite happy in her house or at least I really really hope she is. She is a very spoiled and dearly loved tortoise. She is my buddy and my everything.
I hope that makes sense! Thank you for your message! Any advice on how I can improve is appreciated! Thank you
I have attached a photo of Terra and her follicles if anyone is interested.
I

 

[zovick]

Maybe @Yvonne G or @zovick can help you! Sorry to hear you are going through this.

Was the bladder also xrayed?

Sorry, but I don't have any idea as to what may be causing this or what can be done about it.

 

[Littleredfootbigredheart]

Hello,
I am out at the moment so won't be able to take pictures but will do my best to describe her setup. She has a tortoise table that I hand-built for her. It fits right into my flat that way I was able to maximize the amount of space she has. She does have a second floor which she sometimes uses as a bedroom. The table is built from solid wood and plywood that has been properly sealed. It is well ventilated and insulated to keep the heat in. She has a 100w UVB and UVA mercury lamp, I know not everyone is a fan of them but I think they work for us and her enclosure. The basking spot is around 35 celsius and the colder area is about 20 celsius. At night, during summer the temperature doesn't drop any lower then 19/20 celsius and for winter I have a ceramic heater that is connected to a dimming thermostat. Humidity is usually between 40-50% The substrate I use is very fine organic peat-free top solid and coco coir. That is the only thing that works as she loves to eat things that are not meant to be eaten, like sticks and rocks. I don't think it's a mineral or calcium deficiency as she does get multivitamins and calcium powder and her diet is not too bad. I grow some weeds and flowers for her and she gets a bit of salad, lambs lettuce, chicory, rocket, watercress, and other bits and bobs. I think she is just a silly little tortoise with silly ideas. Obviously, at the moment there is no dirt in her house as I had to keep her neck and shell dry and clean to ensure everything heals well. The table is about 1.20 m squared. It's large but not huge. Eventually, when I have more space I will upgrade it or even move her outdoors, part-time but we are not there yet. I do think she is quite happy in her house or at least I really really hope she is. She is a very spoiled and dearly loved tortoise. She is my buddy and my everything.
I hope that makes sense! Thank you for your message! Any advice on how I can improve is appreciated! Thank you
I have attached a photo of Terra and her follicles if anyone is interested.
View attachment 378813IView attachment 378812

Thank you for your response! There are a few things I’d change, not that they’re all necessarily contributing to her current condition, but I think they’d help avoiding potential further problems.
First up I would definitely suggest switching the mercury vapour lamp, there’s multiple reasons they aren’t the best choice, they don’t produce uv over a large enough area, having both uv and heating combined makes it more difficult to get the right basking temp, whilst making sure you aren’t creating a uv hot spot which can be damaging to your tortoises eyes, with the compact bulbs like this, uv is concentrated into a very small area, which is why t5 tube fluorescent bulbs are what’s recommended to use for uv and a floodlight as the basking bulb.
Basking temp isn’t too bad, but I would raise over all ambient temperature during the day, 20c is more of a nightime low than a day temperature, you want the middle more in the 28 range, and the cool side closer to 24, to do this, have your ceramic bulb running along side the basking bulb 24/7, the thermostat it’s on will control the temperature for you, no need to only use during winter.
As she’s passing questionable urates, I’d aim to have humidity more in the 50-60 range to keep her well hydrated. Definitely keep up with the soaks too.
Substrate wise, I’d stick with just the coco coir, the trouble with top soils is, unless you’ve composted it yourself, there’s no way of knowing exactly what kind of plants have gone into it, could be something toxic, many contain small sand/stone bits too which are an issue, especially if yours eats things they shouldn’t.

Hopefully you might find this thread useful to have a look through, I go over equipment, correct levels, appropriately maintaining humidity, there’s a good link for the diet side of things and I included lots of visual examples of stuff

Housing adult Russian and Hermans indoors

Hello there! In this thread I’m going to include some information an example of an appropriate indoor set up for an older Herman/russian. As much as it’s encouraged to have tortoises in a safe outdoor enclosure, I understand being from the uk myself, that some climates make it difficult to...

tortoiseforum.org

This one can also be handy to go over to avoid the wrong types of equipment and materials moving forward

Common keeping errors

Hello everyone! I’d been a long time lurker on this site long before joining just under a year ago now, over that time I’ve seen these husbandry issues come up time and time again, sometimes with dire consequences☹️ I thought this thread might serve as a good visual guide for these common...

tortoiseforum.org

Hope this helps! And hopefully other folks can help with the specific issues she’s having currently

 

[Zula]

Thank you for your response! There are a few things I’d change, not that they’re all necessarily contributing to her current condition, but I think they’d help avoiding potential further problems.
First up I would definitely suggest switching the mercury vapour lamp, there’s multiple reasons they aren’t the best choice, they don’t produce uv over a large enough area, having both uv and heating combined makes it more difficult to get the right basking temp, whilst making sure you aren’t creating a uv hot spot which can be damaging to your tortoises eyes, with the compact bulbs like this, uv is concentrated into a very small area, which is why t5 tube fluorescent bulbs are what’s recommended to use for uv and a floodlight as the basking bulb.
Basking temp isn’t too bad, but I would raise over all ambient temperature during the day, 20c is more of a nightime low than a day temperature, you want the middle more in the 28 range, and the cool side closer to 24, to do this, have your ceramic bulb running along side the basking bulb 24/7, the thermostat it’s on will control the temperature for you, no need to only use during winter.
As she’s passing questionable urates, I’d aim to have humidity more in the 50-60 range to keep her well hydrated. Definitely keep up with the soaks too.
Substrate wise, I’d stick with just the coco coir, the trouble with top soils is, unless you’ve composted it yourself, there’s no way of knowing exactly what kind of plants have gone into it, could be something toxic, many contain small sand/stone bits too which are an issue, especially if yours eats things they shouldn’t.

Hopefully you might find this thread useful to have a look through, I go over equipment, correct levels, appropriately maintaining humidity, there’s a good link for the diet side of things and I included lots of visual examples of stuff

Housing adult Russian and Hermans indoors

Hello there! In this thread I’m going to include some information an example of an appropriate indoor set up for an older Herman/russian. As much as it’s encouraged to have tortoises in a safe outdoor enclosure, I understand being from the uk myself, that some climates make it difficult to...

tortoiseforum.org

This one can also be handy to go over to avoid the wrong types of equipment and materials moving forward

Common keeping errors

Hello everyone! I’d been a long time lurker on this site long before joining just under a year ago now, over that time I’ve seen these husbandry issues come up time and time again, sometimes with dire consequences☹️ I thought this thread might serve as a good visual guide for these common...

tortoiseforum.org

Hope this helps! And hopefully other folks can help with the specific issues she’s having currently

Thank you. I have been looking into changing the light set up but I wasn't sure where to go with it but now I know that I should definitely continue research and upgrade her lighting set up.
Temperature wise I would say middle is around 26 and the cold area is at the lowest 20 during day. I have just bought a laser thermometer to be able to check exactly what the temperature is. I will keep an eye and make sure that it is in the correct range!! The humidity is usually a little higher. I forgot to say that she has a large bathing spot which brings it up but at the moment that is away as she is only allowed very shallow baths due to her neck and shell. I do sometimes hang her damp towels over her house so that sometimes brings the humidity up, probably not advisable. I would totally agree that the soil situation is far from ideal. I have been trying to find the right and safe one for a long time. I do buy a specific one from a small garden center and it does say that it is animal safe I also go through the soil with my hands to remove, stones, stick and anything else. What else could I use? Other then top soil I mean?
Thank you so much for taking the time to write all of your advice and guidance. That is much appreciated!!

 

[Littleredfootbigredheart]

Thank you. I have been looking into changing the light set up but I wasn't sure where to go with it but now I know that I should definitely continue research and upgrade her lighting set up.
Temperature wise I would say middle is around 26 and the cold area is at the lowest 20 during day. I have just bought a laser thermometer to be able to check exactly what the temperature is. I will keep an eye and make sure that it is in the correct range!! The humidity is usually a little higher. I forgot to say that she has a large bathing spot which brings it up but at the moment that is away as she is only allowed very shallow baths due to her neck and shell. I do sometimes hang her damp towels over her house so that sometimes brings the humidity up, probably not advisable. I would totally agree that the soil situation is far from ideal. I have been trying to find the right and safe one for a long time. I do buy a specific one from a small garden center and it does say that it is animal safe I also go through the soil with my hands to remove, stones, stick and anything else. What else could I use? Other then top soil I mean?
Thank you so much for taking the time to write all of your advice and guidance. That is much appreciated!!

No problem at allsounds like you’re taking the right steps, the temperature guns are definitely a good buy! They come in so handy!
Instead of towels, I’d use foil to eliminate any kind of fire hazard incase the towel is to dry out, but yeah good point about the bathing area for the time being, I understand wanting to keep her shell and neck drier with the tube in place
For the substrate, if you prefer the ‘dirt’ route, I’d stick with just the coco coir instead of mixing the soil in, however you can also add a layer of orchid bark or forest floor on top to help keep the coir layer nice and damp, the bark can help lock the moisture in the under layers, which will maintain your humidity longer, make sure your coir is firmly packed down by hand as leaving loose can have it dry quicker and potentially get a bit dusty which you don’t want

 

[The_Four_Toed_Edward]

Keep us updated with what the vet has to say!

 

[Zula]

Keep us updated with what the vet has to say!

Hello,

So my baby spent the night at the vets and today they took bloods under sedation and placed the feeding tube back in. The initial results show that her kidneys are okay, thank goodness, but her liver markers are up... We knew that her liver was not happy just by how it was looking during surgery but we were hoping and thinking that she was recovering. We won't know how bad things are until the more in-depth tests come back. I am so happy and relieved that her kidneys are okay but at the same time, I am upset and very worried about what is going to happen next.
Also, I knew that they took the tube out too early, she wasn't eating great and just about managing to maintain her weight, but she was so happy and comfortable without it... Her weight is the same as when she came out of hibernation after 16 weeks of not eating so she does need a bit of help. I just wish all this wasn't happening, I want her to be back to her usually strong healthy self.
Anyway, the plan is to start a liver medication on top of a liver supplement and continue tube feeds. Our first plan, because we thought she was doing so well, was to give her time and hope for the best but because that plan face planted the ground the vet is going to put in place a proper care plan so hopefully this time I will get a bit more support through her recovery.
Now I am away to pick her up, finally!! Let's hope I can manage to keep myself together and not fall apart at the vet's office.

 

[zovick]

Hello,

So my baby spent the night at the vets and today they took bloods under sedation and placed the feeding tube back in. The initial results show that her kidneys are okay, thank goodness, but her liver markers are up... We knew that her liver was not happy just by how it was looking during surgery but we were hoping and thinking that she was recovering. We won't know how bad things are until the more in-depth tests come back. I am so happy and relieved that her kidneys are okay but at the same time, I am upset and very worried about what is going to happen next.
Also, I knew that they took the tube out too early, she wasn't eating great and just about managing to maintain her weight, but she was so happy and comfortable without it... Her weight is the same as when she came out of hibernation after 16 weeks of not eating so she does need a bit of help. I just wish all this wasn't happening, I want her to be back to her usually strong healthy self.
Anyway, the plan is to start a liver medication on top of a liver supplement and continue tube feeds. Our first plan, because we thought she was doing so well, was to give her time and hope for the best but because that plan face planted the ground the vet is going to put in place a proper care plan so hopefully this time I will get a bit more support through her recovery.
Now I am away to pick her up, finally!! Let's hope I can manage to keep myself together and not fall apart at the vet's office.

Good luck! Hopefully all will go well for you.

 

[Maggie3fan]

She was hibernated while going thru this? I am no expert, but she sounds too cold for my taste, she should be closer to 29c in the day time and cool off some at night. Because she is in a sick/recovery mode I would keep those temperatures up higher than if she was not sick. Please tell me how the vet retrieved those follicles, also you are worried about urates but talk 'follicles'. Please as I am confused follicles mean what? thanks

 

[Maggie3fan]

also, exercise is important to stimulate appetite and pooping...Is there a wound kinda surgery?

 

[Zula]

Hello,
Sorry, it gets confusing because it's a long story. She hibernates usually from December to February/March depending on how she is doing. I keep a record of her weight so now during her unwell period I can see that her weight is the same as at the beginning of the year when she woke up.
Follicles are underdeveloped eggs. Tortoise can either produces an egg and then lay the egg, this is usually quite a quick process or they produce follicles. These are usually small and hollow and the tortoise is usually able to reabsorb them over some time. I think I am not a professional. My tortoise produced follicles that became large, solid throughout, and effectively stuck. When we did an ultrasound to check the follicles we did notice that her liver was squashed and during surgery, the vet noted that her liver looked quite unhappy. But even before the surgery, I noticed that her urates were becoming yellow-ish. This can be a sign of the liver not coping and bile collecting. She recovered well from surgery but her urates were still not looking good. She was on a supplement, milk thistle to help her liver but because she continued to produce worrying urates we had to do more investigations and tests to find out how badly the liver is damaged from the follicles squashing it. I hope that makes more sense!!!

 

[Zula]

She was hibernated while going thru this? I am no expert, but she sounds too cold for my taste, she should be closer to 29c in the day time and cool off some at night. Because she is in a sick/recovery mode I would keep those temperatures up higher than if she was not sick. Please tell me how the vet retrieved those follicles, also you are worried about urates but talk 'follicles'. Please as I am confused follicles mean what? thanks

Ah I forgot the surgery is done by cutting out a "window" in the plastron. Then the follicles are retrieved and removed. They also spayed her at the same time to prevent this from happening again. Then the piece of the shell goes back on and the window is patched up, I am not sure with what. I think glue, fiberglass, and some kind of waterproof substance.

 

[Maggie3fan]

I am asking because my 100+ lb Sulcata had the same general type of surgery to remove a large bladder stone, the Vet who supposedly had exotic surgery experience, made a large cut virtually removing the whole plastron killing him...
Surgery is moving along I see...Bob's urates were an off white with rocky pieces.And he passed large amounts Can you soak her with that plastron surgery? Is there a way you can start like a walking physical therapy? She needs to exercise...also I wouldn't put her on substrate until it's for sure healed

 

[The_Four_Toed_Edward]

They also spayed her at the same time to prevent this from happening again.

@Tom @zovick do you think spaying here was the right call?

 

[zovick]

@Tom @zovick do you think spaying here was the right call?

Yes, it seems to me as though it was a good decision.

 

[The_Four_Toed_Edward]

Just wanted to make sure as it is so rare with tortoises