Reptile Case Study: Greek Spur-Thighed Tortoise

Following on from this history taking, there are certainly a few concerns with the husbandry for this patient, and it would be deemed as not appropriate. There is a large difference in climates between the UK and Greece, where this tortoise originates, and given her age it is likely she has been wild caught from Greece and transported over to the UK. Greek spur-thighed tortoises require supplemental heating and UV lighting to better mimic their natural environments. Depending on which source of information you use, temperatures vary slightly but as a general rule they should have a basking spot of around 32 degrees celsius, and an ambient temperature that does not dip below 18 degrees celsius. Lots of older tortoises are used to roaming the garden and tortoises prefer as much space as possible, so outdoor enclosures can be made with access to greenhouses or glass houses to ensure maximum warmth. However, if you are seeing a tortoise that has this kind of set up it is important to ensure that supplemental heat is provided, as even on slightly overcast days greenhouses are not always warm.

In addition, ultraviolet light in the UK is far less than what would be delivered further south in Greece, especially in winter, so supplemental UVB lighting is recommended. Greek spur-thighed tortoises are basking species, which means they absorb ultraviolet rays from above, along with heat. The type and strength of the light will depend on many factors, including distance from the basking spot, size of the tortoise and the environment that it is used in, so it's best to follow manufacturer guidelines when recommending specific light sources.

A diet of garden weeds and plants is often very good for tortoises, however fruits like strawberries and bananas should be avoided, and tomato should be provided sparingly. Some types of lettuce can be used when the garden does not have much to provide in the way of food, and lots of variety should be offered. Calcium supplementation on food is also recommended, provided as a powdered supplement.

This tortoise also has an inappropriate hibernation strategy. The winters int he UK are far longer and colder than those in Greece, and as a result tortoises hibernate far longer than they naturally should in the UK. In addition, hibernating outside or without adequate protection exposes sleeping tortoises to sub-zero temperatures, predation, and also waking up too early if the winter is mild. A Greek spur-thighed tortoise should hibernate for no more than 10-12 weeks, so tortoises in the UK should be woken up before spring is well and truly here, and provided with supplemental heating and lighting until it is warm enough for them to venture outside.

Following on from your physical examination, hydration in tortoises can be assessed by looking for sunken eyes, delayed skin tenting and an increase of thick mucous within the mouth. To visually sex Greek spur-thighed tortoises, females have short, rounded tails with a cloaca closer to their bodies, and makes have long pointed tails with the cloaca close to the tip of the tail. 

In this case, I would be recommending the following tests to the client: faecal parasitology, haematology, biochemistry and Mycoplasma spp. PCR

Our case continues:

The owner agrees to some diagnostic testing.
Where would you take a blood sample from in a tortoise?

Your sample is sent for haematology and biochemistry, along with respiratory pathogen PCR testing, and the results are as follows.
Please interpret these results and give possible causes of any abnormalities seen:

Total protein              28          g/L              (24-61)
Albumin                    21          g/L                 (8-26)
Globulin                   27          g/L                                    (11-40)
Albumin Globulin  ratio    0.8
Sodium                     135         mmol/l                       (116-143)
Potassium                  5.0         mmol/l                     (3.5-7.7)
Total calcium              5.20        mmol/L               (1.2-5.1)
Ionised Calcium            1.86        mmol/l           (1.2-2.2)
Phosphate                  0.9         mmol/L                   (0.2-1.8)
Urea                       4.8         mmol/L                            (0-14)
Uric acid                  626         umol/L                        (0-309)
AST                        536         U/L                                       (0-359)
Bile acids                 1.7         umol/L                         (0-60)
CK                         91          U/L                                          (0-736)
Beta hydroxy butyrate      1.31        mmol/L   (0-1.9)

RED BLOOD CELLS            0.66        x10^12/L                 (0.4-11)
Hb                         7.6         g/dl                       (4.1-13.5)
HCT                        19.0        %                       (11-40)
MCV                        439.4       fl                      (193-350)
MCH                        115.2       pg                  (54.8-125.8)
MCHC                       26.2        g/dl              (21.6-43.3)
Reticulocyte count         ~           X10^9/L

WHITE BLOOD CELLS          8.5         x10^9/L                  (4.1-14)
Heterophils                5.19        x10^9/L                                   (0.8-4.7)
Lymphocytes                1.53        x10^9/L                              (1.4-8.5)
Monocytes                  0.26        x10^9/L                                  (0-1.3)
Eosinophils                0.26        x10^9/L                                   (0-2.4)
Basophils                  0.60        x10^9/L                                     (0-0.2)
Azurophils                 0.68        x10^9/L                                    (0-1)

Picornavirus               Negative
Reptile/Koi herpes PCR     Negative
Mycoplasma PCR           Positive

Faecal parasitology showed a large population of parasite eggs (image 1) and several large, motile organisms (image 2). Please identify these parasites and describe if these are pathological or not.

Please interpret the path results as a whole and formulate a problem list for this animal.
Discuss how you would explain these results to the tortoise's owner, and recommend a treatment plan for this patient
Are there any further diagnostic tests you would like to perform?

The owner asks you where the tortoise would have become infected with mycoplasma - what do you say?

Image 2: