X-Ray vs CT Scan w/GI Block + Possible Foreign Object

[ReptileMommax3]

My tortoise started straining to poop back in November. I got them checked, and an X-Ray showed a 'mineral mass' in their GI tract. We started at-home therapy and IV fluids. Long story short, they showed improvement with their follow-up, we did more of the same, and the next X-Ray looked even better. They are pooping normally again, their appetite is great, and they seem happy. The mystery object they ate came through in a bath. But there is still a 'haze' on the film, and the vet said she cannot tell if there is still a slight block, or something in their bladder. She is concerned if there is still something in there, it could become quite serious. She wants to do a CT scan to see better, but there's more risk to that. If they can't see enough, they have to re-run it with contrast, which of course means expensive. I have a good history with this office; I never feel pressured into unnecessary testing or drugs, they are very friendly there, my kids love them, they break down the bill thoroughly, etc. I don't think she is pushing something my kid doesn't need, but at the same time...define 'need'. Is a little haze normal? They seem fine from the outside, the X-Rays have improved, and their fecal test shows a well-balanced digestive system. So my question is: Better safe than sorry and do the CT scan? Or would you wait, stick with X-Rays for now, and trust their body to do what it needs to do?

P.S. I'm sleep deprived and stressed, so if I missed any important details or this is a little convoluted, that's why. Hopefully, I painted a clear picture.

 

[Littleredfootbigredheart]

Let me tag these guys for you!

@Tom @zovick

 

[The_Four_Toed_Edward]

If possible, could you post a photo of the xray so our more experienced members can take a look at the haze?

 

[ReptileMommax3]

If possible, could you post a photo of the xray so our more experienced members can take a look at the haze?

I don't have a copy. Should I have gotten one? I can email the office to ask for it.

 

[zovick]

Let me tag these guys for you!

@Tom @zovick

Can't tell much from a verbal description of an X-ray.

If it were my personal tortoise and it was acting fine, I would stop worrying and just wait and see what happened down the road.

 

[Tom]

My tortoise started straining to poop back in November. I got them checked, and an X-Ray showed a 'mineral mass' in their GI tract. We started at-home therapy and IV fluids. Long story short, they showed improvement with their follow-up, we did more of the same, and the next X-Ray looked even better. They are pooping normally again, their appetite is great, and they seem happy. The mystery object they ate came through in a bath. But there is still a 'haze' on the film, and the vet said she cannot tell if there is still a slight block, or something in their bladder. She is concerned if there is still something in there, it could become quite serious. She wants to do a CT scan to see better, but there's more risk to that. If they can't see enough, they have to re-run it with contrast, which of course means expensive. I have a good history with this office; I never feel pressured into unnecessary testing or drugs, they are very friendly there, my kids love them, they break down the bill thoroughly, etc. I don't think she is pushing something my kid doesn't need, but at the same time...define 'need'. Is a little haze normal? They seem fine from the outside, the X-Rays have improved, and their fecal test shows a well-balanced digestive system. So my question is: Better safe than sorry and do the CT scan? Or would you wait, stick with X-Rays for now, and trust their body to do what it needs to do?

P.S. I'm sleep deprived and stressed, so if I missed any important details or this is a little convoluted, that's why. Hopefully, I painted a clear picture.

I agree with Zovick. Further, I'd examine what the blockage the passed was made of. Was it sand? Was it urates? Some sort of fiber? That answer alone would give a good indication of which way to go.

A couple of other things: If you aren't feeding opuntia pads a couple of time per week or more, I would start. They are great tortoise food. High in calcium, high in fiber, and high in moisture content. Even better, they are slimy and really work to lubricate the GI tract, which will help pass anything that might be stuck in there.

Second thing: Soak. Soak daily in warm water for at least 45 minutes to an hour. Keep the water warm the whole time. It can be done fully or partially in the sun if you monitor it VERY carefully. I like to put the tub somewhere where the shade will cover it as time passes, and then every few minutes drag ig back more into the sun. This way, if you forget it or get distracted by life happening on a hot day, the tortoise will end up in full shade and not full sun. Soaking keeps them hydrated, and it keeps the GI tract healthy and moving.

Also examine what you are feeding. What are you feeding? The diet should be mostly grasses and weeds. High fiber stuff. This fiber also helps keep things moving in the GI tract. You can use hay and hay pellets if grass is not an option, but there are lots of good plants to feed in AZ at some times of the year.

 

[Tom]

I thought of another important point: Why did this happen, and what is being done about that? A normal, properly fed and housed tortoise doesn't get blocked up like this. Vets treat symptoms, but it is better to discover and correct the causes. If the cause is corrected, the symptoms will often go away with no expensive vet help.

Here are common causes to examine and eliminate: Dehydration, incorrect diet, incorrect temperatures, incorrect substrate, incorrect housing, incorrect feeding practices. Let's look at all of these and try to solve your problem and prevent reoccurrence.

Questions:
1. Where and how is the tortoise housed? Do you have a burrow for summer? Insulated and heated night box for winter? They can't function if not kept at the correct temps, and many people don't keep them at the correct temps for the species.
2. What are you feeding the tortoise?
3. Where and how are you feeding the tortoise? On the ground, on a tray, on a bed of grass hay, on a lawn?
4. What water sources are available, and how often are you soaking the tortoise?
5. What is the tortoise walking on daily? What substrate? Is the enclosure sandy? Dirt? Grassy?

With answers to these questions, we should be able to figure out what went wrong, fix it, and prevent it from happening again.

 

[ReptileMommax3]

I agree with Zovick. Further, I'd examine what the blockage the passed was made of. Was it sand? Was it urates? Some sort of fiber? That answer alone would give a good indication of which way to go.

A couple of other things: If you aren't feeding opuntia pads a couple of time per week or more, I would start. They are great tortoise food. High in calcium, high in fiber, and high in moisture content. Even better, they are slimy and really work to lubricate the GI tract, which will help pass anything that might be stuck in there.

Second thing: Soak. Soak daily in warm water for at least 45 minutes to an hour. Keep the water warm the whole time. It can be done fully or partially in the sun if you monitor it VERY carefully. I like to put the tub somewhere where the shade will cover it as time passes, and then every few minutes drag ig back more into the sun. This way, if you forget it or get distracted by life happening on a hot day, the tortoise will end up in full shade and not full sun. Soaking keeps them hydrated, and it keeps the GI tract healthy and moving.

Also examine what you are feeding. What are you feeding? The diet should be mostly grasses and weeds. High fiber stuff. This fiber also helps keep things moving in the GI tract. You can use hay and hay pellets if grass is not an option, but there are lots of good plants to feed in AZ at some times of the year.

They managed to get ahold of a sleeping bag. I didn't know they'd swallowed pieces until they couldn't poop. I've talked to my housemates to make sure this doesn't happen again, and the sleeping bag has been disposed of. We were doing daily soaks until the X-rays started looking better, and now we are doing them once a week to ensure they stay hydrated. Have never heard opuntia before, but will look into it.

 

[ReptileMommax3]

I thought of another important point: Why did this happen, and what is being done about that? A normal, properly fed and housed tortoise doesn't get blocked up like this. Vets treat symptoms, but it is better to discover and correct the causes. If the cause is corrected, the symptoms will often go away with no expensive vet help.

Here are common causes to examine and eliminate: Dehydration, incorrect diet, incorrect temperatures, incorrect substrate, incorrect housing, incorrect feeding practices. Let's look at all of these and try to solve your problem and prevent reoccurrence.

Questions:
1. Where and how is the tortoise housed? Do you have a burrow for summer? Insulated and heated night box for winter? They can't function if not kept at the correct temps, and many people don't keep them at the correct temps for the species.
2. What are you feeding the tortoise?
3. Where and how are you feeding the tortoise? On the ground, on a tray, on a bed of grass hay, on a lawn?
4. What water sources are available, and how often are you soaking the tortoise?
5. What is the tortoise walking on daily? What substrate? Is the enclosure sandy? Dirt? Grassy?

With answers to these questions, we should be able to figure out what went wrong, fix it, and prevent it from happening again.

The why is they ate a sleeping bag. With the IV fluids and daily soaks and vibration therapy, they passed the pieces they ate. I glossed over what the vet recommended, but taking them in definitely wasn't a waste. They no longer have access to said sleeping bag.

There is no other cause, but if it helps to reassure, I know correct husbandry. They have ample shade and housing for all seasons, a high fiber diet with low sugars, their food sits in the grass, in shade, with a bed of hay for them to eat, and they have a shallow pool for soaking and drinking. My yard is grass and rock. And no, they don't try to eat the rock. The vet asked me that, too. This was all because they accidentally got access to a sleeping bag. I have talked to my housemates to make sure this never happens again. As to why the X-ray is still hazy...that I don't know. They passed the nylon pieces they ate and are pooping again normally, so beats me.

 

[ReptileMommax3]

Okay, they sent me a copy of the images. They mean little to me - I haven't seen many!