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Shell Problems: More Information and Treating

This is my answer to a question someone posted. The turtle was showing 
white rash (fungus?) on the skin and a couple of holes in the shell.
The animal was active and eating well. This person was new to keeping
turtles. Here is my reply:

Let me tell you what I would do, and then you have to decide for yourself
what you want to do.
For the kind of problem you are describing, there are basically two courses
of treatment: antispetics and antibiotics. The first one is always used,
the second one is necessary, if the problem has gone systemic. Only a vet
can tell. Generally, if the problem seems 'local' and improves, no
antibiotics are used. As long as your turtle is active and eating, AND
improving, and the problem doesn't look too horrible, you can do 
without antibiotics. My personal recommendation, based on my experience
with treating sick turtles, but I am not a veterinarian, is as follows:

1) Keep the turtle out of the water as much as possible. This means keeping
   it in a box and giving it a bath or letting it swim twice a day for
   and hour. Make sure it eats and poops when taking the bath.

2) Keep the turtle warm. Reptiles need to be warm for their immune system
   to kick in. Use a heating pad or a lamp to create a temperature
   differential in a box. Do not overheat, otherwise the turtle will
   dehydrate and die.

3) Feed foods high in vitamins. What are you feeding now? Tender Vittel
   cat morsels are high in vitamins and if your turtle likes them, they
   make a good staple food. Feed every 2-3 days; feed veggies the rest
   of the time.

4) After the bath, let the turtle dry off, or wipe it dry with a towel. Make a
   solution of water and Betadine, about the color of dark ice tea. Put
   it in a small container, such that when you put the turtle in, it can
   stick its head up, but the shell is covered. Make sure it cannot climb
   out. Let it sit in there for at least 15 minutes. The turtle won't like it,
   but will get used to it. It will learn to stick its head out and
   not swallow. Betadine will not burn in the eyes too much.
   When done, do not rinse the turtle, but put it back in its box and let the
   stuff dry on it.
   Some discoloration of the skin happens. It is temporary. 

5) Wait. Do this for a week, and see whether there is any change. If the
   turtle gets worse, see a veterinarian immediately. If the turtle gets better,
   continue treatment until the skin is well. Check it very carefully for
   new holes or developing whitish patches right under the surface of the
   shell. If there are such patches, take the turtle to a veterinarian. Such patches may
   need to be opened and exposed, and this should only be done by an 
   experienced person with sterile tools. The turtle may also 
   need some internal medication. Watch her breathing. If it gets harder, 
   or if there is discharge from the nose or mouth, or if they eyes get
   encrusted, it may also have pneumonia. It is a possible complication to
   many turtle problmes and needs to be treated by a veterinarian.

6) Be patient. I could take several months for your turtle to heal completely,
   and you will have to continue some treatment for a while. Once the turtle looks
   good, you can discontinue the Betadine soaks, but you should still keep
   the turtle out of the water overnight. Drying out is one of the most
   important aspects of treatment.

Some last words: Be conservative about vitamin shots. If the
dose is too high, which it sometimes is, since it is very hard to determine the
right dose for turtles, the turtle will die. Rather, feed a vitamin-rich
diet. Some people/veterinarians may recommend a topical antibiotic. If you get one,
make sure it is not greasy but comes off in the water. Otherwise the
betadine soaks will be ineffective, and the grease in the cream will keep
the dry air out which is needed for healing. Silvadene cream is good;
Neosporin is too greasy. Instead of Betadine soaks, you can use a 50%
Nolvosan solution and sponge the turtle off. But Nolvosan is harder to
get, and it really burns in the eyes, and it is trickier to administer,
so I suggest you stick with the Betadine for now.

Yeah, you got yourself quite into something. It happens a lot to new
turtle owners, because petstore animals often are sick, mostly from
stress, poor diet, and less than ideal living quarters.

You may want to find a herp society in your area, too. That way, someone
with experience can take a look at your turtle without you having to 
see a vet; or they can recommend a good veterinarian.

Possible Causes of Holes in Shell

* Abrasions: your turtle might be rubbing itself agains some 
  rocks in the cage. Remove the rocks and it should heal.
* Poor shedding. If your turtle does not shed scutes well, water
  collects under partially shed scutes; a paradise for bacteria.
* Bites by another turtle.
* Husbandry issues, leading to shell rot.