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entamoeba STAR TORTOISE mediciation

P

platynota

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I purchased an Indian Star female this summer that was claimed to be very healthy (via Kingsnake classifieds). She came to me emaciated and looked dehydrated.

I've tried to give her Metronidazole and Panacur in two different treatments over this time. She gained weight (60 grams) and fat, but continues with diarrhea. I took her back to the vet yesterday, and a different vet looked at her. He identified what appears to be Entamoeba invadens (although not certain of the speices). Incidentally, the photo of the entamoeba in his book was from a Star tortoise specimen.

Using a "mini-jimmi" and a 14 gauge metal Avian feeding tube--olive tip--and myself, the doc, and another, we got a full dose of Metrodinazole down her. She'll get another dose tomorrow and Friday.

According to his book, he could only find that Metrodinazole and increasing temperature within her terrarium are the treatments to kill the Entamoeba. He however questioned whether an anti-protozoan medication used for horses and cats/dogs called Marquis (or Ponazuril) could help her...but we don't know if this med has been ever used in chelonians.

GI ulcerations and I believe liver damage will most likely pursue (if not already) if we can't get this taken care of. The good thing is she eats and is very active. I was told that the reptiles will go through a "hibernation" like state when the entamoeba take their worst effects.

Does anyone know if Marquis/ Ponazuril is safe in tortoises??? Does anyone have any experience with this or recommendations? Write me here or [email protected]

Thanks a lot!

Aaron
 
I am late replying here but in case you didn't get your answer, Ponazuril is the "new wave" drug to treat coccidia in reptiles but not quite as effective, if at all, on Entamoeba. Metronidazole continues to be the drug of choice for treatment but it is still a tough disease to control.
 
Hey Ivan, thank you for the reply. I actually have another vet visit tomorrow. The female's been getting Metronidazole (has to be forced by mouth), and in the last fecal culture, Entamoeba couldn't be seen. I've also increased her terrarium's temperature as I've read that is also important during the treatment, and I change newspaper, sterilize the enclosure, and wash her off each time she passes bowels. However, she's still continuing to have diarrhea... I believe trichomonas are present,too, but since she's so difficult to get the meds down her, we decided to work on the entamoeba first.

Do you have any recommendations? Are you a bioscientist or vet, by chance? This is in Geochelone elegans. The only positive is she eats very well, gains weight, and no blood has been present. Hopefully, no ulcerations or liver damage have incurred.
 
Glad to hear she is still eating good because, like you said, it is a positive. You can always try to mix the medication with some fruit and see if she eats it voluntarily and it might save you the trouble of forcing the meds down. I would suggest doing a fecal culture by an independent lab, that way you will have not only the expert advice of your vet but also the results/advice of a lab that will be doing their own cultures and exams on the feces.
At the clinic we do direct fecal smears as well as fecal flotations but sometimes the fecal samples we send for cultures, when needed, reveal organisms we didn't quite see during our screenings.

Trichomonas should also respond to Metronidazole, so either there is something else causing the diarrhea or the dose might need to be adjusted. Not sure as there are many variables and of course, I am not the one treating the tortoise.

Another thing to consider is to back off from the treatment completely for a week or so and just feed her as much as she wants and supplement the food with powdered pro-biotics. Maybe the treatment worked really good but also wiped out the beneficial bacteria leading to a healthy animal with a sterile gut, which will give a sterile diarrhea. Herbivorous reptiles do need a good number of beneficial bacteria to aid in proper digestion so the diarrhea you are seeing could actually be secondary to the long-term treatment. But the follow-up exam might tell you more about this.

Oh yes, and to answer your last question, I am a veterinarian.
 
Ah, great advice about the pro-biotics and sending the fecal sample to a second lab! Quite a few types of pro-biotics can be found for humans at the organic market, etc. I actually buy one for myself that contains about 13 bacterium species. Any specific species that come to mind that'd benefit the herbivore's digestion the most?

This tortoise actually only approves Romain, red leaf, and a few other lettuces; also she gobbles carrots, green beans, corn, and peas (which I try to monitor the protein content, although I've read stars will eat actual beans in the fields in India without problem...but that's of course in the wild.). I have clover and grasses in the freezer I picked this summer. I'm going to get her some of that too. She's the stubbornest tortoise I've ever encountered. haha She'll take Panacur but will withhold from food if a trace of Metronidazole is present--day after day, no matter the food item.

We did a Metronidazole treatment (3 days in a row), then waited 2 weeks. Continued it again after that by the same process, and now it's been about 3 weeks.

I'll give you an update after tomorrow. Much, much thanks also about the Ponazuril.
 
If the tortoise is such a good eater, ask your Vet if he/she can have the neds made by a compunding pharmacy and then add flavor to them. Metronidazole is a bitter drug no matter what but sometimes you can disguise the taste a little better if it comes banana flavored or watermelon flavored for example. Many drugs designed for oral use in reptiles can be accepted better if they are flavored, but of copurse there is always the reptile that will refuse any meds no matter what.

I can't tell you 100% sure which probiotics will be the ones to use but at least I have yet to hear of any that are bad for reptiles. You can use yours mixed with the food or you can even check out a product called Nutri-Bac to see if it is any different than what you are using.

The protocol used with Metronidazole was correct and I am quite happy to hear no Entamoeba was seen as this is one tough disease to treat.
 
Okay I brought her back and she was clear of entamoeba and trichomonas! in fact, her gut bacteria was low altogether, and they gave me the same recommendations to try probiotics. we weren't really sure which would be best for an herbivore, so we had the idea to inoculate her with one of my healthy male star's feces in her food. The vet read in a tortoise book a bit later that exact recommendation. So I did that tonight, and we'll see if her bowels solidify over the next week or so. I'm hoping this will be it!!!

Have you ever tried this and do you know specifically what species of probiotics I should go for in a star tortoise? The vet thought that one time with the feces on the food should do it.

Although she has loose stools, after the last round of the medication, that following week her bowels and habits did change. For instance, before she would eat her feces if we didn't get there immediately. That stopped completely. Also, she'd no longer have diarrhea after rinsing her off from her soak (as she always did before while holding her). In addition, her bowels, although between partially solidified to diarrhea mess, they seemed somehow "less intense" than before. So it stands to reason that probiotics are the answer for this. All we can do is try and see what works. If not, I'm bringing her back and will as well send her feces into an independent lab like you advised. :thumbsup:

Many thanks again!
 
Hey I just realized you had replied on the 5th!! I'm going to check into this!!! Especially if this ever comes up any more. I never dealt with this before. I've always kept reptiles, but never had I caught or bought any that had been in such horrible health. Whatever happened to her prior to my receiving her must've been awful; of course, just long-term exposure with entamoeba could have done it alone I suppose. I personally believe I was fed a lot of BS and she was a smuggled animal. She was absolutely emaciated, bones bones bones. Now she's up to 706 grams I believe from 570! Makes a huge difference in her appearance.



alfon76 said:
If the tortoise is such a good eater, ask your Vet if he/she can have the neds made by a compunding pharmacy and then add flavor to them. Metronidazole is a bitter drug no matter what but sometimes you can disguise the taste a little better if it comes banana flavored or watermelon flavored for example. Many drugs designed for oral use in reptiles can be accepted better if they are flavored, but of copurse there is always the reptile that will refuse any meds no matter what.

I can't tell you 100% sure which probiotics will be the ones to use but at least I have yet to hear of any that are bad for reptiles. You can use yours mixed with the food or you can even check out a product called Nutri-Bac to see if it is any different than what you are using.

The protocol used with Metronidazole was correct and I am quite happy to hear no Entamoeba was seen as this is one tough disease to treat.
Click to expand...
 
That's good news for sure. I am not aware of any pro-biotics out there specific to species, any species of reptile for that matter. The method of mixing a healthy animal's feces with food is actually quiet common and a good idea as it would be the best way to get a "specific" type of microoganism in the tortoise. But in general I would imagine any pro-biotic will do as the ones that can survive will become established and the ones not needed will die off.

My advise would be to test the male's fecal anyway to make sure all is ok with him before mixing his feces with the food. Also, I would still do a fecal culture if you can afford it mainly because it will help you confirm the fact the tortoise is clean right now. Thus having a baseline record/level where to go from if the problem ever comes back again.

Good luck with her and hopefully she will continue her recovery.
 
I'm a lvmt and work with reptiles every day. Entomoeba is really hard to get rid of so don't expect it to "clear" even if the fecals are "negative". No fecal test can be absolutely negative. They can still be lurking, just not shedding. I also would not assume it was imported just because it has parasites. Believe it or not, many CB animals are still carrying them and chelonians are notrious for carrying things, especially amoebas. That doesn't mean there's a problem or that they'll ever get sick, but entomoeba specifically can be serious if that's one they are carrying. We are usually very aggressive about it because we had some sailfin dragons wiped out last year and suspected a couple of snakes based on the histopath report so almost every snake who has bloody stool gets metronidazole for 5 days, at least 2 treatments but depends on how effective it was. And guess where the source came from? Some turtles that were in a "multi species" exhibit....
I find baby food (veg. or fruit) good to mix with metronidazole and fenbendazole (panacur) and mine get fecals at least 2x a year. It's always a good idea to check routinely.
I haven't studied up on star tort diets, but you may want to try some other kinds of greens high in vitamins like dandelion, collards, I would stay AWAY from the corn, and maybe even some of the other veggies you're feeding. Corn has a negative Ca:p (calcium to phosphorous) ratio and in my mind isn't even worth feeding it. I pick it out of my mixed veg.
Sorry to ramble! I'm just totally in the entomoeba rut at work right now so I feel your pain. As far as that newer drug, we haven't tried it yet so I may mention that to my docs, but coccidian organisms and amoebas are not always treated with the same meds. Sometimes it is more specific.
Good luck and stay on top of it!
 
Hey have you guys tried giving him some fluids too? That's another thing we do a lot with emaciated and parasitized reptiles.
 
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