How to find a good Veterinarian for your Tortoise (and maybe an excellent one!)

Finding a good veterinarian who is experienced and up-to-date on caring for tortoises (not just turtles) can be very difficult. Since tortoises live for a century or longer, there is a good chance that your tortoise will need to go to the vet at some point, whether for a beak trim, an injury or for an illness, or to be treated for parasites.

Mila, getting a check-up from Dr. Kelly Flaminio

In an ideal world, a tortoise keeper already has a relationship with a reliable and knowledgeable reptile vet before the tortoise has even been purchased or adopted. A check-up and a fecal exam (to check for parasites) should be done within the first two weeks of owning the tortoise. This is especially the case if you bought your tortoise from a pet store. If parasites or other problems are discovered by the vet within the initial 14 days, most larger chain stores will actually refund you the cost for the office visit and the parasite treatment.

We love our reptile vet, Dr. Kelly Flaminio!

Whether you are being proactive, or you already find yourself in over your head with a sick or injured tortoise, it is important to ask a few questions of the vet before trusting him or her with your tortoise's health.

First, how should you go about finding an exotics vet?
A good starting place is a list of vets that has been compiled by tortoise keepers on the tortoise forum HERE. This list is sorted by State, as well as by country. If you live close to a State border, you may want to check for clinics on the other side of the State line.
(Please keep in mind that not all of the vets on this list are guaranteed to be awesome.... they are however at the very least more likely to know how to provide healthcare for a tortoise!)

The TFO list of reptile vets in the USA and in the rest of the world.

Google can be of help, too. Entering "exotics veterinarian" in a map search near you should provide you with several options (Note: If your Google search brings forth a list of places advertising "girls girls girls" you might need to narrow your key words down a little more!). Follow the links to the vet clinics' websites, and see what they say about themselves. Often, Google listings already have ratings associated with the listing. Read the ratings carefully, keeping in mind that there are probably many happy clients who just didn't get around to writing a review.

Google map search for "exotics vet" or "exotics veterinarian"

When you have found a reptile vet who looks promising, give them a call, and politely ask them a few questions:

1. Does this vet clinic have experience with tortoises, specifically? (you can even ask if they have experience with your specific tortoise species, e.g. Russian tortoises)
2. Is this exotics vet familiar with the different care and dietary requirements of a tortoise in comparison to a turtle?
3. How long has this vet been practicing? (sometimes a newer vet will actually have more up-to-date knowledge about tortoises!) 
4. How long has this vet been providing healthcare for tortoises?
5. How many tortoises does this clinic treat each month? 
6. How often does the veterinarian treat reptiles in comparison to dogs and cats?
7. How often does the exotics vet attend continued education events and conferences pertaining to reptiles and tortoise care?
8. Is this vet able to trim your tortoises beak, if necessary? 
9. Does this vet perform surgery on tortoises, should this ever become necessary?
10. Is this vet available in the case of after-hour emergencies? (Not all are - in that case, please also ask for the contact information of an emergency vet who will see a tortoise. It is good to have this information on hand, should it ever become necessary.)
11. Is this vet able to keep a tortoise overnight should treatment require an extended stay?

If you have a VERY large tortoise, such as a full-grown sulcata or even an aldabra tortoise, you may want to also ask if this vet does house visits. In some cases, transporting a vet is easier than transporting a tortoise... 

A few questions should be asked that pertain to the financial aspect of a vet visit:

1. Is the first exam free? (can't hurt to ask - often it is!)
2. How much is the exam fee? (within a town, this can vary greatly from one office to another!)
3. Does this clinic do fecal exams for parasites in-house or externally?
4. Are they willing to run a fecal exam without requiring an office visit? Then if parasites are found, and treatment is necessary, you can still bring your tortoise in for the office visit and to get treatment.
5. Does the veterinarian give a price quote before performing a surgery or another procedure? Will different options be given? Does this vet clinic offer payment options if a high vet fee is incurred?

Armed with the above questions, you should be able to determine whether a vet will be able to help you and your tortoise.

Although currently in perfect health, this tiny baby tortoise
will likely need vet care at some point in her life.

We are lucky to have a wonderful and experienced reptile vet within easy driving distance of our home. Our veterinarian, Dr. Kelly Flaminio at the East Mill Plain VCA, is very knowledgeable, and we have had a very good experience with her care for several of the reptiles we own or foster. 

Because our reptiles have gotten such great care, I thought it might be useful to you to see a few of Dr. Kelly's answers to some of my questions:

Q: "How many reptiles does your veterinary clinic see on average?"
A: "Between 50-100 per month. Usually about 3 per day."

Q: "How long have you been treating tortoises?"
A: "I have been treating tortoises and other reptiles for about 5 years."

Q: "How often do you attend conferences and continued education events?"
A: "Twice a year."

Q: "What are the most frequent reptile cases you see?"
A: "We most frequently see new lizards parents bought for kids. Next, the most frequent cases are amputations and abscesses of various reptiles. Many reptile keepers don't bring their animal in until something bad happens, unfortunately."

Q: "What do you most frequently see tortoise patients for?"
A: "New tortoise pets often come in to be checked and treated for parasites and to have blood work done to ensure they are healthy. Long-term, tortoises most frequently come in for a beak trim. Some tortoises we see suffer from MDB (metabolic bone disease) from improper husbandry. In the Spring we usually see quite a few tortoises with URIs (upper respiratory infections) or pneumonia. Sometimes tortoises that have been found on the loose are relinquished to the clinic, and then we find foster homes for them."

Many of the above questions had already been answered in previous interactions: Dr. Kelly has extensive experience with tortoises, and definitely knows the difference between a box turtle and a tortoise. She is able to perform surgery on tortoises and other reptiles in-house. The clinic is able to keep reptiles overnight if necessary.

During my interview with her, Dr. Kelly also mentioned that local new patients to her clinic are welcome to print off the 'free first exam' coupon from their website. They will honor the coupon for reptiles as well as for dogs and cats.

Whether you have a very large tortoise, or a very small tortoise,
...it's a good idea to know a good reptile vet!

The above questions don't always guarantee that a vet is awesome. Sometimes, it will take several office visits to find a vet that will meet the needs of you and your tortoise. Many veterinarians are VERY GOOD veterinarians, but just haven't specialized on tortoises. Others might be operating off of out-of-date information.

There are a few RED FLAGS that indicate that a reptile vet is NOT a good tortoise vet:

1. You are told to feed your tortoise 'more animal protein.' (this is based on a confusion over tortoises vs. box turtles)
2. You are told to add cat food into your tortoise's diet (this is based on 35-year-old, outdated information that results in terribly deformed tortoises)
3. The vet suggests treatment for parasites with medication other than Safeguard or Panacur (active ingredient fenbendazole). (other worm medications, such as ivermectin, can kill a tortoise!)
4. You are told not to provide water in the enclosure (this is based on outdated, false information)
5. You are told to use sand for substrate
6. The vet claims to be able to tell you how old your tortoise is based on the 'rings' in his shell (tortoises are not trees. The rings are based on seasons of plentiful food and lack of food... which can happen several times throughout a year. The only way to know a tortoise's age is to know it's hatch date or at least hatch year).

Mila frowns on the idea of having her rings counted to tell her age.

CAUTION:
If you live out in the country, it may be necessary to drive several hours to get to a good reptile vet. If the weather is very hot or very cold, be sure to accommodate your tortoise accordingly. A bin with some paper towels or cloth towels works well for a transport container. Never leave your tortoise in the car - you don't want it to die of freezing or heat stroke.
If it is necessary to cross State lines to get to a good reptile vet, please be sure to know the laws pertaining to bringing reptiles across. The last thing you want is for your tortoise to be confiscated, or for you to have to pay a fine.

The pictures have been posted with permission from Dr. Kelly. I have not received any payment or other incentives to write this blog post. It was purely written to help other tortoise keepers find an excellent reptile vet.

How to trim a tortoise's beak - with pictures!

Tortoises kept in captivity frequently get overgrown beaks, which then need to be trimmed. Many tortoise keepers pay a vet to do this. However, did you know that trimming a tortoise's beak is actually safe and easy enough that you can do this at home?

NOTE: If you are not sure whether you can do this, please don't risk your tortoise's health. Have an expert show you how. Paying to treat an infected cut is a lot more expensive than paying to have your tort's beak trimmed, and it would be so sad to injure your pet. 

Mo was one of my rescues. His beak was EVEN longer when we  first got him!

You will need a few supplies:

Toenail clippers (XL), stainless cuticle trimmers, a white pencil, a skewer, a nail file.

I bought the stainless steel cuticle trimmers on eBay for $2 - they are by a well-known German brand, and very well made. It took 2 weeks to ship from China. Make sure it has the clipping feature, so you can get good leverage.
I don't often use the skewer - this is only necessary if you need to trim the bottom beak, which is rarely necessary. I used the skewer to gently pry open the tort's beak (holding the skewer perpendicular to the beak, so Mo ended up having the skewer in his mouth in the way a horse has a bit), which was only necessary once when we first got Mo. Normally the bottom beak will keep itself short by rubbing against the inside of the top beak. 

Today I will trim Mo's beak:

Mo's beak is too long. 

I know this is hard to believe, but Mo's beak has gradually been trimmed 2x since we got him. It was so terribly overgrown that we couldn't see his 'chin'. We didn't want to trim it all at once, because it can make a tort pretty sore, and we didn't want it to interfere with his eating. 

1.) You will want to tightly wrap your tortoise into an old rag or piece of cloth you don't mind throwing away when you are done (paper towels will be shredded by their claws). Getting his beak trimmed is stressful for a tort, and he WILL expel every bit of feces he has in his gut. My female also pees... have a back-up cloth ready, and wear some clothes that need to go in the laundry anyway. 

2.) With the white pencil, draw a line marking up to where you want to trim your tort's beak. You'll have to trim it bit by bit, and you don't want to stop before you are done, or go too far. This will also help keeping it even on both sides. 

I drew a white line starting at the corner of his mouth, parallel to the top of Mo's head.

3.) Some people choose to hold onto their tortoise's head while they trim. I find that this only freaks the tortoise out even more (making them really struggle and squirm), and most Russian tortoises can't (or don't) pull their heads all the way into their shell. I personally choose to 'free-hand' it (just holding the legs out of my way). You'll be able to reach the beak carefully, even when the head is almost pulled completely in. Just be careful not to poke the eyes or nares (nose).

If you DO choose to hold the head, however, THIS is how:

Wait for the head to be far out. Then firmly but gently hold on with thumb and pointer
just behind the jaw bone on each side.

If you do choose to hold onto your tortoise's head, make sure his eyes don't start bulging, or his eye lids don't turn purple. This means you are closing off his wind pipe, and he can't breathe. You can use the middle and ring fingers to hold the right front leg out of the way.
Make sure you are holding your tortoise's head on either side, behind the jaw, rather than top and bottom. This way your tort can easily breathe, AND you have a good grip. Again, I choose to free-hand it and don't hold the tort's head...

4.) Gently but firmly hold your tortoise's shell against your chest, with your left hand, hold the tort's front leg(s) out of the way, and as soon as you can reach it, begin clipping on the right side, always with the tips of the cuticle trimmers facing towards the front of the beak.

Start on one side, using the cuticle trimmers.

Clipping a tortoise's beak will feel a lot like clipping a thick-ish human toenail, but a little more brittle. The sides are thinner (and easier to clip), and the front is the toughest. 

5.) Bit by bit, clip away the beak, approaching the line you drew. Mo needed so much of his beak trimmed, that I had to cut parallel to the line several times before I was done.

Almost done - but as you can see, I still need to trim a little more away, up to the line.

6.) the very front of the beak may be thick enough that you have to use the XL conventional toe-nail clippers. Be careful not to get any of the tortoise's skin flaps caught in the corners of the clippers - that's one reason why I prefer using the cuticle trimmers. 

Much better! I just need to file the edge smooth.

7.) Finally, carefully file the edges smooth with a nail file (not the metal kind). 

8.) Throw away the cloth wrap, then rinse off your tortoise in warm water, to get rid of any feces, and to clean away any little shards of beak material that might be stuck in the skin flaps. 

ALL DONE! 

Your tortoise will probably pout for a day or two - having a beak trim is stressful, but NOT trimming an overgrown beak is more harmful in the long run than any stress caused by the trim. 

Some tortoises only get an overgrown beak in the front (especially in young tortoises who aren't fed properly, too soft food, not enough calcium). This was the case with the little Greek tortoise Boo. Here's a before/after pic of his trim:

Boo's beak was VERY overgrown in the front. It still needs to be trimmed a little more.

To maintain your tortoise's short beak, make sure to feed your tortoise on a flat rock, and offer a cuttlefish bone (available in the bird section of most pet stores). Also, as long as your tortoise is healthy, there is no reason to cut up a tortoise's food. Let your tortoise work a little while he eats! 

Feel free to ask questions in the comment section if you have any!

De-worming the torts

When I brought home Mo and Joe, Mo was terribly infested with worms. It was so bad that I could see large numbers of them wiggling in his droppings.

After talking to the vet and my wonderful reptile rescue friend Mary Esther (I will introduce her to you in a later post!) we decided to treat all of my torts for worms. Joe was living with Mo, so he probably had some. Although I quarantine my rescues from Timmy and Roz, most tortoises do carry a small number of parasites in their gut, so it certainly couldn't hurt to just treat them all, since I had to purchase the medicine in a bigger dosage anyway.

We chose to treat with fenbendazole (the active ingredient in Panacur and Safeguard), which is safe for tortoises (and some other reptiles) in the proper dosage. The dosage is calculated by weight. I am not going to post the dosage here, because it is important that you work with your vet and/or someone experienced in treating tortoises for parasites... an overdose can kill a tort. Plus, make sure that after the treatment (which is usually 2 doses 2 weeks apart), you have a fecal sample examined by a vet to make sure you killed the worms.

The "horse" paste version is best for herbivores such as tortoises. Ask your vet about proper dosage.

I used a small syringe to measure the proper dose of the 10% fenbendazole paste, and rolled it up in a lettuce leaf cigar style. I prepared each of the 4 doses first and put each on a piece of paper labelled with the tort's name (since each tort is a different size, they each need a different dose). Then one by one I had them eat the medicine-cigar out of my hand, to make sure they got the full dose.

Mo and Joe were easy to dose. They are both so friendly and laid back, and like to eat out of my hand. Roz is GREEDY, and while he'll come right to me to eat out of my hand, he's also accidentally bitten me a few times. I held his 'cigar' at the veeeery end, and as usual, he went to town and gobbled it up. Timmy wanted nothing of hers (she doesn't like to eat out of anybody's hand), and Roz kept trying to nab some, so I finally took Roz out of the enclosure and let him run around the floor for a little while. After 2 tries, Timmy finally took her dose. Boo is so new, I haven't dosed him - he still hides whenever anyone comes near, and is also a bit of a picky eater. I'll probably just collect a fecal sample to see if it's even necessary to treat him when I have fecals run for the other torts.

Mo digging

While treating with fenbendazole, it is SUPER important to keep your tortoises well hydrated, both by soaking them every 1-2 days, and by providing a water dish (which you should have in their enclosure anyway). The protein from the dead worms will stress the tortoises' filter organs, so the extra water will help them process the waste. I gave my torts a little more of the "wet" lettuces (like romaine) than usual, to ensure they got some extra water.

Don't be surprised if your tortoises act kind of nauseated for a few days. As long as the dosage was correct, and they are getting enough water, they will be ok. After about 2 days, Mo began pooping out big clumps of dead worms (sorry, TMI). This was good, because it meant the meds were working!

I gave the torts a second dose of fenbendazole 2 weeks later, to be sure that any newly hatched worms were killed, too. This time around, Mo's droppings looked much better, with only the occasional worm.

Now that treatment is complete, I will wait a couple of weeks, and have the vet run a fecal sample for each tort. You may also want to feed some probiotics. I purchase TNT supplement from Carolina Pet supplies, and these include probiotics if you choose that option, which I did. This will help your newly wormless tort to grow healthy digestive flora in his gut.

While (very) small numbers of worms are 'normal' in wild-caught specimen, large numbers of worms can draw nutrients away from the tort, causing vitamin deficiencies. After treating Mo, I noticed a steep increase in activity and alertness. He acts so much more like a tortoise now, and seems healthier overall.

Mo chowing down on some arugula. 

DISCLAIMER: I am in no way affiliated with or being compensated by Panacur or Safeguard. I only mention them because this is the brand of medicine we successfully used. Please talk to your vet before using any medication on your pet, to insure proper dosage. 

Mo and Joe's story

The two Russian tortoise males Mo and Joe's rescue story wasn't nearly as dramatic as little Norbert's - they weren't unloved and neglected, they just weren't being cared for properly.

Mo and Joe basking - this was the first time in years that they had heat and light

They belonged to a 12-year-old boy who had bought them from a friend the year before. The boy got bored of them, so the Mom had to do all the work. When I drove out to pick them up, they were housed next to a large window in a modified train table (quite nice actually, about 3'x4'), filled with cedar shavings (BAD for all reptiles), but without lighting. Their owner also fed exclusively romaine lettuce. This is fine to feed as PART of a Russian tortoise's diet, but should not be the only thing they eat. It has too much water, and is lacking in many of the nutrients a testudo horsfieldii needs.

I had kind of hoped that at least one of them was a female, since I hope to expand little Roz' harem... but either way I was glad to have brought Mo and Joe out of a situation in which they would have likely died of a respiratory infection. Since both are male, I knew that these, too, would be rehabilitated and then adopted out to someone who is familiar with proper tortoise care.

Upon arriving home, I threw away all the cedar shavings, and scrubbed the whole table surface. Then I got a cement paver from a friend for the basking area, and attached a 'gallows' type contraption on one side of the table to hang the heat lamps from. I pilfered a heat lamp from my other torts, and ordered a good basking lamp and a UVB strip light. For now I lined the table with newspaper, and filled a giant turkey-baking-pan with moistened coconut coir. I wanted to keep an eye on both tortoises' feces and urates, to get an idea for their health. They started burrowing in the coir right away.

Mo and Jo burrowing in their coconut coir.
They had been kept in cedar shavings for 2 years.

Next I weighed and measured and examined each of the torts, and gave each of them a nice long soak.

Joe had a beautiful, smooth shell. He was obviously not young - my guess was around 50 or so, judging by his face and shell, and the wear and tear on his plastron (the underside of his shell). He had puffy eyes, an overgrown beak, and very, very long toenails. I hoped that the puffy eyes were just an irritation from the dry cedar shavings, and that with proper humidity they would get better on their own. His shell was 6 inches long, and he weighed 500g.

Joe basking

Mo felt very heavy, and looked truly ancient - his shell was almost completely black, and shiny like glazed pottery. He had a few spots of shell rot, which I treated with diluted betadine tincture later. His nails were very long, and his beak was overgrown, too. His eyes were puffy, just like Joe's. His shell was 6 inches long, and he weighed a whopping 580g. Mo could very well be 80 years old or more. Truly a senior tort.

Mo - very heavy and dense

About a week after getting Mo and Joe, we had their beaks and toenails trimmed. They walked a bit strangely for a couple of days, because they were so used to walking on their enormously long nails... but then they became comfortable again. Eating was also a lot easier without the overgrown beaks...

As soon as their basking area was set up (with a nice hot 95-100 degrees F), they started to spend most of their time basking. Remember, the previous owners just set their table by a window, and didn't add any heat or lighting. I bathed them daily for about a week, just to make sure they were hydrated (they have a water dish in their tort table, too). I also encouraged them to dig in the moist coco coir, and misted them, to help their puffy eyes. Mo's eyes went back to normal within a couple of days, and Joe's eyes stopped looking swollen about 2 weeks later.

The 'quarantine' tort table - newspaper covers most of it, so I can monitor feces... they LOVE burrowing in the coco coir, but for now only get a small portion of it. 

A few days after bringing Mo and Joe home, I noticed that Mo had many tiny worms in his feces. Completely grossed out, I talked to our vet, as well as with my reptile rescue friend Mary Esther. We decided to treat Mo and Joe with fenbendazole - I will write more about this at a later time. The bottom line is that the treatment worked, and Mo soon began pooping out large quantities of dead worms. Joe had a few, but not nearly as many as Mo. A second treatment is recommended, which we did 14 days later.

Both Mo and Joe were very friendly - they like to come over for a visit if someone is near their table, and they LOVE to eat right out of my hands. I put a cuttlebone into their tort table, and they crunched it down to about half its original size... they obviously needed the calcium.

Top view of Mo's carapace. I've treated the shell rot (white spots). 

After several weeks, I decided that Joe was ready to go to a new home. He sometimes picked on Mo, and I had known from the beginning that I wouldn't keep them both long-term. I started putting my feelers out for a potential new tort-Momma, and found someone who already had a nice big tortoise table set-up and all the necessary lights. Her little Russian tortoise had escaped from their yard last year, and she was looking for a new one (lesson learned - she would never again leave her tort in the yard unattended!). I asked lots of nosy questions, and finally was satisfied that she would feed Joe properly, provide proper heat and light, and would love him for the rest of his life. I am still in contact with Joe's new owner, and he has adjusted well and is friendly and curious and is eating like a little piggy.

As of right now, I still have Mo. This sweet old-man-tort has grown on me, and I haven't had the heart to search for a new home for him yet. I also still want to keep an eye on him, to see if he has fully recovered from his worm infestation - the vet will examine a fecal sample in a few weeks to see if new worms hatched in spite of the repeat treatment.

Sweet old man, Mo

Mo will need another beak trim soon, too... we didn't want to trim too much off at once!