Treatment of Shell Necrosis in Orlitia borneensis
World Small Animal Veterinary Association World Congress Proceedings, 2015
Z. Knotek, DVM, PhD, DECZM (Herpetology)
Avian and Exotic Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic

Professor Zdenek Knotek (Sid) graduated from Veterinary University Brno in 1982 (with honours). He is head of the Avian and Exotic Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic. Sid is a founding member and diplomate of the European College of Zoological Medicine, member of ARAV, past-president of EAZWV, president of CAZWV. Sid had teaching activities in Budapest, Copenhagen, Kosice, Ljubljana, Utrecht, Vienna, Warsaw, Purdue (USA), Denpasar (Indonesia). As a founder of reptile medicine specialty he headed the Unit for Birds and Reptiles at Vetmeduni Vienna (2010–2013). Sid supervises courses: Summer School for Exotic Medicine and Surgery (since 2004) and ESAVS courses - Exotic Pets Medicine and Surgery I, II, III (since 2005). His current focus involves medicine and surgery in reptiles, small mammals and birds.

Chronic diseases of turtles and tortoises due to inadequate catching conditions, trauma during transport, and inadequate nutrition are a phenomenon commonly encountered in veterinary practice.1-4 Imported turtles and tortoises often suffer from heavy parasitic invasions, which may cause serious condition in animals with compromised immune status.5-7 Serious disorders of the internal environment are associated with alterations of blood count as well as biochemical parameters of blood serum or plasma.8 The Bornean river turtle (or Malaysian giant turtle) Orlitia borneensis (Gray 1873) is a large semiaquatic turtle living in the rivers and lakes of Malaysia, Sumatra and Borneo. Hundreds of these turtles were confiscated and the animals were placed in many zoos. All the turtles rescued were in poor condition, weak, with traumatic lesions on legs and the shell. Fish-hooks were found in the oesophagus and stomach in majority of the turtles examined.

In a group of nine patients (1 male, 8 females) we observed chronic ulcerative shell necrosis. Clinical signs consisted of necrotic ulcerations of the shell and skin, general weakness and anorexia. Gram-negative bacteria as well as yeast elements were identified cytologically at the sites of deep shell lesions. The treatment protocol was based on administration of rehydration fluid (20–230 ml/kg BW, ICC), deworming with mebendazole (25 mg/kg BW, PO, 2x in 14 days) and praziquantel (20 mg/kg BW, PO, 2x in 14 days) antibiotic treatment (enrofloxacin 5–10 mg/kg BW, SC) and tube feeding. Surgical intervention - aggressive debridement of the necrotic tissue from the plastron and carapace was followed by washing the turtles with a solution of enilconazole or povidone iodine. The turtles were placed in a basin with salted water for 6 hours and then kept out of water on the clean floor. During the first month of treatment antibiotics were injected daily (from 14 to 30 days, according to the condition of plastron and carapace). The water regime was changed continually from salted to fresh water bath. Residual parts of necrotic tissue were taken out surgically. Small wounds were washed by povidone iodine solution. After 8 months of this "hospital regime" the health status of turtles was revised.

Blood samples were collected first at the start of treatment of the patients and then after 8 months. At the start of the treatment values for PCV, RBC counts and haemoglobin concentration in Orlitia borneensis turtles (0,15 ± 0,1 l/l; 0,26 ± 0,1 T/l; 19,1 ± 8,3 g/l) were very low, lower than ranges for healthy chelonians. We revealed basophilia, eosinophilia, heterophilia and azurophilia. The banana-shaped or sausage-shaped intraerythrocytic gamonts of Haemogregarina sp. were present in stained blood smears of all patients. After eight months of the treatment the number of leukocytes decreased significantly (p < 0.01). The number of basophils, eosinophils, heterophils and azurophils returned to the normal ranges. Animals with extensive shell defects from the confiscated contingent of turtles Orlitia borneensis were proved to suffer from hyperproteinemia and hyperuremia. The significant decline in hematocrit, number of erythrocytes, and haemoglobin concentration were accompanied by basophilia, eosinophilia, heterophilia, and azurophilia. These alterations can be regarded as typical of patients with ongoing infection suffering from undernutrition and chronic stress.4,9-10 The fact that in eight out of nine tested turtles, blood parasites were repeatedly detected in peripheral blood raises the question to which extent their presence could have been reflected in the above-mentioned alterations of the blood count. Gametocytes of Haemogregarina sp. were present in peripheral blood of 8 patients. Plasma concentrations for total protein (21,1 ± 8,9 and 22,3 ± 17,4 g/l) were lower than the normal ranges for chelonians (45,1 ± 6,8 g/l), concentrations for BUN (14,3 ± 3,9 and 28,8 ± 5,8 mmol/l) were higher than the normal ranges for chelonians (6,8 ± 1,3 g/l). After eight months of the treatment, plasma levels of uric acid and ALT decreased significantly (p < 0.05).

The intensive therapy of turtles Orlitia borneensis was aimed at suppressing mixed shell infection and improving the alimentary status of reptiles. The adjustment of some of the blood count parameters to the physiological range and a significant improvement of the shell status in all animal patients suggest that the comprehensive intensive therapy was successful. On the other hand, the persisting hyperproteinemia, hyperuricemia, low hematocrit and low proportion of erythrocytes in peripheral blood suggest that the patients continue to require close attention and good care.


This project was partially supported by the Grant of the Faculty of Veterinary Medicine, VFU Brno (Specificky vyzkum, FVL 2014). The study was performed together with colleagues Zora Knotkova DVM, PhD; Stanislav Mazanek DVM, Ph.D and Martin Hovorka, DVM, PhD.


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10. Knotek Z, Knotkova Z, Mazanek S, Pejrilova S, Hauptman K. Haemogram and plasma biochemistry in a group of Orlitia borneensis terrapins with ulcerative shell disease. In: Proceedings from the 41th International Symposium of European Association of Zoo and Wildlife Veterinarians; May 28 to June 1, 2003: 185–189; Rome, Italy.


Speaker Information
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Z. Knotek
Avian and Exotic Animal Clinic
Faculty of Veterinary Medicine
University of Veterinary and Pharmaceutical Sciences Brno
Brno, Czech Republic

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