Gout turtle

[Lyliteuteu]

Hi everyone,

I’m looking for advice about my Hermann’s tortoise. She has been diagnosed with gout at an advanced stage. Despite everything, she is still moving around, exploring her enclosure and doing her business normally — which gives us hope.

The problem is that she has completely stopped eating on her own. We are currently feeding her through a tube with water and a protein powder. She also has a drip for hydration.

Has anyone experienced this with their tortoise? Did you find any way to stimulate their appetite again? Any food that worked, any supplement, or any trick to encourage them to eat by themselves?

We are doing everything we can for her and would love to hear from people who have been through something similar.

Thank you so much

 

[The_Four_Toed_Edward]

Maybe @zovick can help you?

 

[zovick]

Maybe @zovick can help you?

Sorry, but I have no ideas. I have never heard of a tortoise with gout.

From my knowledge of gout in humans, I do not think gout would have anything to do with the failure to eat.

 

[Tom]

I've never heard of a tortoise with gout either. The problem is that a misdiagnosis means you are not treating the right thing, and it will never get better.

Unfortunately, most vets don't know tortoise care. Misdiagnosis is common. They often attempt to treat symptoms, and give little to know thought about WHY the tortoise got sick in the first place and what to do about that. There is no semester on tortoise care in vet school, and vets learn about tortoise care from the same wrong sources as everyone else.

What symptoms are you seeing? Tell us about your housing, lighting, substrate, temperatures, and feeding routine. Let's see if we can figure out what's wrong.

Tube feeding can often save them, but rotein powder is not what should be fed. Over here we use a powdered product called "Critical Care". There is one for herbivores, like our tortoises, and another for carnivores, like monitor lizards. There are a couple of other newer options too, but they are herbivore powders, not "protein".

 

[Lyliteuteu]

I've never heard of a tortoise with gout either. The problem is that a misdiagnosis means you are not treating the right thing, and it will never get better.

Unfortunately, most vets don't know tortoise care. Misdiagnosis is common. They often attempt to treat symptoms, and give little to know thought about WHY the tortoise got sick in the first place and what to do about that. There is no semester on tortoise care in vet school, and vets learn about tortoise care from the same wrong sources as everyone else.

What symptoms are you seeing? Tell us about your housing, lighting, substrate, temperatures, and feeding routine. Let's see if we can figure out what's wrong.

Tube feeding can often save them, but rotein powder is not what should be fed. Over here we use a powdered product called "Critical Care". There is one for herbivores, like our tortoises, and another for carnivores, like monitor lizards. There are a couple of other newer options too, but they are herbivore powders, not "protein".

Thank you so much for your response.

Let me explain the full situation. We are based in France. Our tortoise is 22 years old and for 19 years she has been doing absolutely great — healthy, active, eating well. Everything changed after she caught worms, which we believe came from a new tortoise we introduced.

She was already weakened by the worms when she went into hibernation. When she came out of hibernation, she was completely static, not eating at all, and seemed to be in pain when urinating.

We took her to the vet who told us her kidneys were likely severely damaged. They wanted to euthanize her, which we refused because we know our tortoise and we know she has fight in her.

We took her to the vet who told us her kidneys were likely severely damaged. They wanted to euthanize her, which we refused because we know our tortoise and we know she his strong

The vet gave us a product called Herba.Care (a powdered herbivore formula) and also wanted to prescribe medication — but since her kidneys were already damaged, we were concerned this medication would put even more strain on them, so we decided against it.

Her current setup: she lives indoors in France, with a UV/heat lamp in one corner. She is mainly fed lamb’s lettuce (mâche) and occasional fruit.

Right now she is still moving (though very limited movement, as if each move is painful), she is urinating and defecating, she is alert and watches us — but she refuses to eat on her own. We are tube feeding her with EmerAid IC Herbivore and providing IV fluids.

Do you have any advice given this full picture? Could this be something other than gout? We are fighting for her !!

 

[COmtnLady]

Could the word "gout" be a mistranslation? Please post the exact phrase.
What did the vet tell you it meant?

She should be eating a variety of different types of green leafy vegetables and weeds, not just lambs lettuce (though it is a good food for her).

She should not have fruit of any kind. It kills off some of the good bacteria needed by her body to digest her food and keep away bad bacteria.


(All of the next suggestions are a gamble. Finding someone who actually knows tortoises is very difficult due to there not being good education and training on keeping and medical care for tortoises in the Veterinary schools. When you DO find one who actually raises tortoises, there is still the problem that each species needs different care than the other kinds of tortoises. The feeding of fruit is a perfect example - only tropical species CAN eat fruit, but it damages the digestion of all the other species. Knowing that, ask for a veterinarian who keeps their own tortoises, one who knows and understands Hermanns specifically is best, but any that has a tortoise of their own would be a better chance than a veterinarian who only cares for cats and dogs.) Please check back here before you allow any different medications, and use an Herbivore powder, not the protein based powder, to mix for her tube-feeding.

Can you find any sort of list or directory of Exotic Veterinarians that you might take her to?
Is there a group of tortoise keepers you could ask for a good trusted vet? Is there a tortoise rescue near you which you could call and ask for recommendations? Does France have a Humane Society, or Society for the Prevention of Cruelty to Animals that might know of tortoise veterinarians? Is there a University that specializes in Veterinary teaching who might be able to recommend a vet that specializes in tortoises?

Not meaning to be disrespectful, but the vets you have taken her to keep telling you the wrong things to do. They had you double-dose your tortoise to get rid of worms (basically poison your tortoise), and keep wanting to put your girl down rather than try to cure her. You need to find a better one!


As Tom asked above:

What symptoms are you seeing? Tell us about your housing, lighting, substrate, temperatures, and feeding routine. Let's see if we can figure out what's wrong.

Tube feeding can often save them, but protein powder is not what should be fed. Over here we use a powdered product called "Critical Care". There is one for herbivores, like our tortoises, and another for carnivores, like monitor lizards. There are a couple of other newer options too, but they are herbivore powders, not "protein".

Please post pictures of her from top, bottom, sides, and ends. Also, post pictures of her enclosure.
Frequently pictures show a stranger a problem that didn't occur to an owner to mention.

How often do you soak her? Do you keep the water warm (30-33C) and change it to clean warm water when it gets dirty, the entire time? As she is not feeling well, long warm soaks (minimum of 30 minutes, though twice that would be better) The water should only be as deep as where the top and bottom shell comes together, so it will cool off rapidly - it is important to keep the water warm at all times. It would be better to keep the feeding tube entrance dry, so make the water even more shallow if needed, but it MUST be kept warm for the entire time.

What temperature is her enclosure? Again, because she is not feeling well, warmer is better. Keep her at least 30-32C.

Post the info Tom asked for here as soon as possible for better suggestions to help her recover.




.

 

[Tom]

Thank you so much for your response.

Let me explain the full situation. We are based in France. Our tortoise is 22 years old and for 19 years she has been doing absolutely great — healthy, active, eating well. Everything changed after she caught worms, which we believe came from a new tortoise we introduced.

She was already weakened by the worms when she went into hibernation. When she came out of hibernation, she was completely static, not eating at all, and seemed to be in pain when urinating.

We took her to the vet who told us her kidneys were likely severely damaged. They wanted to euthanize her, which we refused because we know our tortoise and we know she has fight in her.

We took her to the vet who told us her kidneys were likely severely damaged. They wanted to euthanize her, which we refused because we know our tortoise and we know she his strong

The vet gave us a product called Herba.Care (a powdered herbivore formula) and also wanted to prescribe medication — but since her kidneys were already damaged, we were concerned this medication would put even more strain on them, so we decided against it.

Her current setup: she lives indoors in France, with a UV/heat lamp in one corner. She is mainly fed lamb’s lettuce (mâche) and occasional fruit.

Right now she is still moving (though very limited movement, as if each move is painful), she is urinating and defecating, she is alert and watches us — but she refuses to eat on her own. We are tube feeding her with EmerAid IC Herbivore and providing IV fluids.

Do you have any advice given this full picture? Could this be something other than gout? We are fighting for her !!

-Captive tortoises can carry all sorts of horrible diseases. Many are difficult or impossible to diagnose without a necropsy after death. Worms from another tortoise are likely the least of your concern. One of the many other pathogens is more likely.

-Compromised animals should not be brumated. They need to be kept up and warm and eating. How did you brumate the tortoise? Inside? Outside? What temperature?

-Grocery store greens are not a good diet for a tortoise. If you must use them, they need to be amended with fiber, calcium, and nutrients to compensate for their shortcomings. If this was the main diet, over a period of years, this could also be the problem, or a contributing factor.

-Likewise, sugary grocery store fruits can wreak havoc with the gut flora and fauna, and that may be another contributing factor.

-"One lamp in the corner" is not a good way to go. Mercury vapor bulbs can cause all sorts of problems and should not be used over tortoises. Here is a breakdown of the four heating and lighting essentials:

1. Basking bulb. I use 65 watt incandescent floods from the hardware store. Some people will need bigger, or smaller wattage bulbs. Let your thermometer be your guide. I run them on a timer for about 12 hours and adjust the height to get the correct basking temp under them. I also like to use a flat rock of some sort directly under the bulb. You need to check the temp with a thermometer directly under the bulb and get it to around 95-100F (36-37C).
2. Ambient heat maintenance. I use ceramic heating elements or radiant heat panels set on thermostats to maintain ambient above 80 degrees day and night for tropical species. In most cases you'd only need day heat for a temperate species like Testudo or DT, as long as your house stays above 60F (15-16C) at night. Some people in colder climates or with larger enclosures will need multiple CHEs or RHPs to spread out enough heat.
3. Ambient light. I use LEDs for this purpose. Something in the 5000-6500K color range will look the best. Most bulbs at the store are in the 2500K range and they look yellowish. Strip or screw-in LED bulb types are both fine.
4. UV. If you can get your tortoise outside for an hour 2 or 3 times a week, you won't need indoor UV. In colder climates, get one of the newer HO type fluorescent tubes. Which type will depend on mounting height. 5.0 bulbs make almost no UV. I like the 12% HO bulbs from Arcadia. You need a meter to check this: https://www.solarmeter.com/model65.html A good UV bulb only needs to run for 2-3 hours mid day. You need the basking bulb and the ambient lighting to be on at least 12 hours a day.

-How often were you soaking the tortoise?

All of the above is intended to help you figure out what may have gone wrong. Most of the tortoise care advice from most sources all over the world is terrible. People with the best of intentions are often just given bad advice and sold the wrong products. This is unfortunate, and the tortoises suffer for it. I point all of these things out because if you don't know what is wrong, you can't fix it. For this tortoise to survive and recover, the husbandry issues need to be resolved.

More info here, and questions are welcome:

Info For New People. Please Read This First.

Hello and welcome to tortoiseforum.org! We are all glad you are here! There is no other forum like this anywhere. We have tens of thousands of members from all over the world ranging from kids with their first tortoise to people who have been breeding and keeping high end tortoises since the...

tortoiseforum.org

 

[The_Four_Toed_Edward]

Gout does happen in reptiles and is reported in tortoises as well. I am no expert, but based on my short research I have some questions.

There are two forms of gout.

• Visceral gout forms when gout crystals are deposited on or in internal organs.
• Articular gout forms when uric acid crystals are deposited in joints, usually in elbows, wrists, ankles, and toes

Which one are we talking about? (or both)


Have you discussed with your vet the possible causes? Here are some key factors: "Why gout occurs in reptiles is not entirely clear, but diets too high in protein or containing inappropriate proteins are a predisposing factor. Dehydration and altered kidney function are also key factors. In the case of starvation, an animal will use its own bodily resources, including proteins, for energy, which can lead to gout." https://vcahospitals.com/know-your-pet/reptiles---gout

How was gout diagnosed? Did the vet do a blood test?

 

[Lyliteuteu]

-Captive tortoises can carry all sorts of horrible diseases. Many are difficult or impossible to diagnose without a necropsy after death. Worms from another tortoise are likely the least of your concern. One of the many other pathogens is more likely.

-Compromised animals should not be brumated. They need to be kept up and warm and eating. How did you brumate the tortoise? Inside? Outside? What temperature?

-Grocery store greens are not a good diet for a tortoise. If you must use them, they need to be amended with fiber, calcium, and nutrients to compensate for their shortcomings. If this was the main diet, over a period of years, this could also be the problem, or a contributing factor.

-Likewise, sugary grocery store fruits can wreak havoc with the gut flora and fauna, and that may be another contributing factor.

-"One lamp in the corner" is not a good way to go. Mercury vapor bulbs can cause all sorts of problems and should not be used over tortoises. Here is a breakdown of the four heating and lighting essentials:

1. Basking bulb. I use 65 watt incandescent floods from the hardware store. Some people will need bigger, or smaller wattage bulbs. Let your thermometer be your guide. I run them on a timer for about 12 hours and adjust the height to get the correct basking temp under them. I also like to use a flat rock of some sort directly under the bulb. You need to check the temp with a thermometer directly under the bulb and get it to around 95-100F (36-37C).
2. Ambient heat maintenance. I use ceramic heating elements or radiant heat panels set on thermostats to maintain ambient above 80 degrees day and night for tropical species. In most cases you'd only need day heat for a temperate species like Testudo or DT, as long as your house stays above 60F (15-16C) at night. Some people in colder climates or with larger enclosures will need multiple CHEs or RHPs to spread out enough heat.
3. Ambient light. I use LEDs for this purpose. Something in the 5000-6500K color range will look the best. Most bulbs at the store are in the 2500K range and they look yellowish. Strip or screw-in LED bulb types are both fine.
4. UV. If you can get your tortoise outside for an hour 2 or 3 times a week, you won't need indoor UV. In colder climates, get one of the newer HO type fluorescent tubes. Which type will depend on mounting height. 5.0 bulbs make almost no UV. I like the 12% HO bulbs from Arcadia. You need a meter to check this: https://www.solarmeter.com/model65.html A good UV bulb only needs to run for 2-3 hours mid day. You need the basking bulb and the ambient lighting to be on at least 12 hours a day.

-How often were you soaking the tortoise?

All of the above is intended to help you figure out what may have gone wrong. Most of the tortoise care advice from most sources all over the world is terrible. People with the best of intentions are often just given bad advice and sold the wrong products. This is unfortunate, and the tortoises suffer for it. I point all of these things out because if you don't know what is wrong, you can't fix it. For this tortoise to survive and recover, the husbandry issues need to be resolved.

More info here, and questions are welcome:

Info For New People. Please Read This First.

Hello and welcome to tortoiseforum.org! We are all glad you are here! There is no other forum like this anywhere. We have tens of thousands of members from all over the world ranging from kids with their first tortoise to people who have been breeding and keeping high end tortoises since the...

tortoiseforum.org

Here is the full medical report from the École Nationale Vétérinaire d’Alfort (the top veterinary school in France), so you can see exactly what was diagnosed and treated.

Medical history timeline:

• 12/08/2025: Consultation for diarrhea for 2 weeks, with lethargy and digestive parasites. Treatment with fenbendazole (Panacur) 100mg/kg for both tortoises
• 19/08/2025: Persistent lethargy. Blood work showed hyperphosphatemia (3.1 mg/dL) and elevated uric acids, compatible with early kidney damage. X-ray showed small mineral foreign bodies in digestive tract, likely eggshell fragments. Treated with tramadol and oxytetracycline
• 29/08/2025: Worsening condition with anorexia, severe diarrhea from nematode parasites. Feeding tube placed. Blood work showed hypocalcemia and hyperphosphatemia compatible with kidney failure. Treated with fenbendazole, metronidazole, tramadol and
marbofloxacin
• 15/09/2025: Feeding tube removed. Favorable progress, diarrhea resolved, appetite returned. No ongoing treatment at that point
• Note: tramadol was never actually administered at home, and marbofloxacin was stopped 2 days before end of recommended treatment
• 24/05/2026: Emergency consultation for anorexia and severe lethargy

Hospitalization 28/05/2026 to 01/06/2026:

Clinical exam on admission:

• Alert and aware
• Weight: 1.310 kg
• Body condition score: 3/5
• No dehydration detected
• Temperature: subjectively cold
• 2 slightly hyperhemic patches on left plastron
• Elongated claws
• Respiratory rate: 10 breaths per minute
• Moves with difficulty, mainly using front limbs, marked muscle weakness
• Eyes, mouth, ears: normal
Test results:

• Hematocrit: 31%
• Blood urea: 0.5 g/L (normal 0-0.24) → severe dehydration
• Full body CT scan: polyostotic bone lesions with bilateral asymmetric joint distension and intra-articular mineralization, compatible with generalized articular gout. Mineralized bladder material (uric acid crystals) consistent with visceral gout. Heterogeneous liver enhancement
• Diagnosis: Generalized articular gout

Procedures performed:

• Cystoscopy: removed 200mL of urine with small urinary stones
• Esophagostomy feeding tube placed surgically (15cm tube to stomach)

Follow-up blood work 01/06/2026: Worsening kidney failure, icteric serum
Official diagnosis:
Terminal kidney failure not responding to treatment, in a 19 year and 4 month old female Hermann’s tortoise, in a context of articular and visceral gout with severe deterioration of general condition.

Treatments during hospitalization:

• Continuous IV Ringer Lactate drip 0.5mL/kg/h from 28/05 to 01/06
• Warm water baths 3x per day
• Tube feeding with EmerAid IC Herbivore 13mL 3x per day
• Tramadol (pain relief) every 2 days

Conclusion from the vets:
Despite treatment, no significant improvement. Euthanasia was proposed but declined by the family. Palliative home care was organized. The vets confirmed that home palliative care will unfortunately not allow improvement of Teuteu’s condition.
Current home setup:
She has her own space with a heat/UV lamp, natural substrate (JBL TerraBasis), and a water dish. She also spends time roaming freely on our balcony and in the living room. She is still alert, moving (though with limited painful movements), urinating and defecating, but not eating on her own. We are tube feeding her with EmerAid IC Herbivore and giving her warm baths.

She has been with us and healthy for 19 years. We are doing everything we can to keep her comfortable Important note: we never administered the tramadol at home, and we also decided not to give the other prescribed medication (Allopurinol) as we were concerned it would put additional strain on her already severely damaged kidneys.

 

[COmtnLady]

Thank you for that.

From what that says she is at the point of no great or easy choices, so now it is time to try to balance what affects one thing without doing too much damage to another. With that in mind, you are correct that the Allopurinol will put more of a load on her kidneys - BUT - it is what will help remove the crystals that have accumulated in her joints. So there will need to be a balance between the two.

"Palliative care" means just trying to manage the pain and not do anything to prolong life... make her as comfortable as possible.
If it is to that level, try giving the Allopurinol. It takes forever to see any results. If the drug is too much for her kidneys, she dies a bit sooner (palliative care). If it removes some of the crystals/gout she should feel better and live a bit longer. That would also allow her to move her legs again.

The crystals are caused by the kidneys not filtering out enough of the uric acid for quite some time. Without blood tests there is no way you could have known. It is possible that it was caused by a poor diet, but that is not the only way it happens, and you care too much to not have done your very best. Hope for the best and keep helping her.

The problem probably doesn't have a good outcome, but Tortoises are sturdy. They surprise us all the time, and have been around longer than humans, so don't give up hope for her. (Be realistic though and if it gets to be too much for her, do the kind thing.)

Keep her warm (32-4C) and soak her in warm water every day for at least a half an hour (two or three soaks would be even better for her).



.

 

[Lyliteuteu]

Thank you for that.

From what that says she is at the point of no great or easy choices, so now it is time to try to balance what affects one thing without doing too much damage to another. With that in mind, you are correct that the Allopurinol will put more of a load on her kidneys - BUT - it is what will help remove the crystals that have accumulated in her joints. So there will need to be a balance between the two.

"Palliative care" means just trying to manage the pain and not do anything to prolong life... make her as comfortable as possible.
If it is to that level, try giving the Allopurinol. It takes forever to see any results. If the drug is too much for her kidneys, she dies a bit sooner (palliative care). If it removes some of the crystals/gout she should feel better and live a bit longer. That would also allow her to move her legs again.

The crystals are caused by the kidneys not filtering out enough of the uric acid for quite some time. Without blood tests there is no way you could have known. It is possible that it was caused by a poor diet, but that is not the only way it happens, and you care too much to not have done your very best. Hope for the best and keep helping her.

The problem probably doesn't have a good outcome, but Tortoises are sturdy. They surprise us all the time, and have been around longer than humans, so don't give up hope for her. (Be realistic though and if it gets to be too much for her, do the kind thing.)

Keep her warm (32-4C) and soak her in warm water every day for at least a half an hour (two or three soaks would be even better for her).



.

Thank you so much for your kind words and advice

We wanted to give you an update — she is actually still moving and even climbing around as if nothing is wrong! It really surprises us given how serious her condition is. Because of this we are giving her 3 warm baths per day, and she also has access to her heat lamp and water at all times.

The only thing that worries us is that she completely stopped eating on her own. We are tube feeding her but she shows zero interest in food. We are wondering if the problem might be linked to her stomach or digestive system somehow, rather than just the gout and kidneys — but we are not sure.

In any case, we are taking good care of her and fighting for her every day. Thank you again for your help and support