Metabolic Bone Disease: Another Rubber Tortoise!

WARNING: THE VIDEO AT THE END OF THIS ARTICLE IS DISTRESSING AND FEATURES A DEAD ANIMAL IN A POOR PHYSICAL STATE. PLEASE WATCH AT YOUR DISCRETION.

Virtually every week I am presented with a pet reptile which has an advanced disease relating to poor owner preparation or knowledge on how to keep these specialist animals. Today I had a tortoise patient booked in as a health check, but knew instantly on taking it out of it’s container that I would be humanely putting it to sleep as it had been suffering for a long time from metabolic bone disease (MBD) relating to poor husbandry and nutrition. I am angry, frustrated and weary of having to destroy animals that can be kept very successfully in captivity with a little bit of preparation, initial outlay of financial investment, research and common sense. I am astounded that I am having the same conversations over and over again with reptile owners who really don;t know how to keep the animals in their care, but have taken someone else’s word for it without doing extensive research of their own. I will explain what led to this animal’s demise, and how it could have been prevented. I hope this post gets shared widely as the owner has kindly agreed I can share the story so that other owners may be educated and welfare improves for at least some animals as a result. I have to commend the owner of this tortoise for at least bringing the tortoise to the vet. I’m sure many don’t and their animal dies slowly at home. My role as a vet is to educate owners and safeguard animal welfare, often having to be quite diplomatic in the face of pretty distressing cases of animal suffering. I recognise the tone of this post comes across as an angry rant, but I need to drum home an important message in the hopes I help some new keepers revise the care they are providing to their pet reptile and correct any issues before they cause such suffering as I saw today. Firstly, before I get to the details of this case let me explain a little about metabolic bone disease (MBD).

MBD is a condition whereby an animal lacking in calcium, ultraviolet (UV) light exposure or both eventually becomes so deficient that it starts to absorb calcium from it’s skeleton and in the case of turtles and tortoises, it’s shell, in order to maintain normal metabolic function. Calcium is required for a variety of bodily functions including skeletal growth, neurological activity, muscle contractions and hormonal control for example. Reptiles in captivity are particularly vulnerable to MBD as they are reliant on their owners to provide them with artificial UV lighting, replication of a varied and natural diet, as well as appropriate calcium and other vitamin/mineral supplementation. The absorption of UVB light from natural sunlight allows reptiles to synthesise Vitamin D3 in their skin, and vitamin D3 allows them then to absorb calcium from their diet in the gut. This delicate balance between sunlight, vitamin D and dietary calcium sources is reliant on environmental temperatures, and is hindered if reptiles are kept in conditions which are colder than their preferred optimal temperature zone (POTZ). So you can appreciate that there is a fine balance between several interlinked factors that could contribute to the development of MBD when we take reptiles into captivity and take control of their immediate environment. Temperature, lighting and diet are the three factors that lead to the development of MBD. Get any one of those factors incorrect and you are setting your animal up for ill health. For further reading on this topic I can highly recommend reading the following book from leading reptile lighting specialists Arcadia: (www.arcadia-reptile.com/mbd-book-reviews/).

The basis of keeping any reptile as a pet is very simple. I will share this basic ‘secret’ now. It is not rocket science. It is very simple and achievable. Although it is often inconvenient or more expensive than some people are prepared to pay. And it is not often achieved by taking shortcuts or following some pet shop’s or online forum’s advice. The simple rule of reptile keeping is this:

REPLICATE THEIR NATURAL CONDITIONS IN THE WILD!

Sounds easy, right? Well it is. But unfortunately there are a multitude of sources of information giving conflicting advice, a bewildering array of equipment and housing options commercially available, and an unfortunate trend in the reptile hobby of keeping animals in conditions which allow them to survive with minimal effort or expense. The aim of keeping reptiles as pets should be to provide them everything they need to allow them to thrive and flourish in as near natural conditions as possible, not just to survive with the minimum provisions they need. It is not up to the pet shop staff to give you the right equipment. It is not up to the guy on some forum who told you how to keep your pet alive. It is up to YOU to research the conditions your animal comes from in the wild, and how best to replicate them in captivity. There is no one perfect list or care sheet that does this work for you. Different keepers do things different ways. What you need to research is what temperature, humidity, diet and light your animal needs and then ensure you are providing that by monitoring the conditions in your particular set up. Just because someone does it their specific way and has had success, doesn’t mean you will achieve the same in your particular setup by following their lead. There are many variables that might affect your animal’s long term health.

I have lost count of the amount of times I ask someone the question: “What temperature is your vivarium?” and am met with the reply “I don’t know, it’s warm”. A thermometer so you can record and monitor the temperature, and a thermostat to control the temperature are two vital pieces of equipment for providing the correct environment. A thermometer costs very little, a thermostat significantly more. But without them how do you know you are providing the animal with the correct range of temperatures it needs to survive? YOU DON’T! So you could be providing sub optimal temperatures sometimes or overheating your animal at others, resulting in biological stress and impaired immunity or overall health. If you have no thermostatic control of your vivarium, then the temperatures will fluctuate depending on conditions outside the vivarium in the room for example. Hence why advice telling you a specific wattage of bulb is suitable for a certain species is far too vague, as it doesn’t take into account how cold or warm the room in which the vivarium is housed tends to be. Rather, good advice should tell you the correct temperature  range for your species, and it is up to you to find the correct bulb or other heating to achieve that temperature range that allows natural thermoregulation. UV lighting needs to be the correct intensity for the species of reptile being kept, needs to give enough exposure to UV rays by it’s spread and location in the enclosure and needs to be replaced frequently to maintain high enough levels in the enclosure. These bulbs also cost money. Diet needs to be researched. Convenient options often lead to long term problems. It takes time and significant effort, as well as significant expense, to provide a varied and natural diet. If you are not willing to invest this time, research, effort and expense into keeping a pet reptile, DO NOT BUY ONE!

The reptile hobby as it stands is under increasing pressure from animal rights and welfare lobbyists arguing that these animals should not be kept in captivity at all due to the significant welfare problems they experience and the relatively high (often over exaggerated) mortality rates. I know many wonderful, knowledgeable and extremely capable reptile keepers as friends and as clients who provide amazing care to the animals they look after. However, there is a massive welfare problem with captive reptiles which cannot be ignored. I see it in my line of work very frequently that beginner or inexperienced keepers are making very costly husbandry or nutrition mistakes which are costing the lives of a huge number of animals up and down the country every day. As a hobby, we are defensive when criticised by animal rights groups, but to ignore that there are huge welfare problems in the hobby is actually doing ourselves a disservice.

Anyway, back to the tortoise I had to euthanise today. It was only a year and a half old and had been purchased from someone online. It had been kept in a vivarium with a single combined UV and heat lamp as the sole heat source. The owner didn’t know what temperatures were being provided. There was no thermostat. The pet shop staff told the owner that bulb was suitable for tortoises. The bulb had not been changed for well over a year. The tortoise was fed commercial tortoise pellets from a large plastic tub as it’s staple diet. It also ate lettuce and cucumber. No calcium, multivitamin or mineral supplements were provided. The owner noticed it’s shell was ‘looking weird’ around Christmas time. Today is the last day of March. It was brought in today because it had stopped eating. It had also stopped moving very much. It’s shell was very flat and very soft. TORTOISES SHOULD NOT HAVE SOFT SHELLS! IF THEY DO, YOU’VE BEEN DOING IT WRONG! Why are we still seeing cases where reptile owner’s are doing it so wrong?

Here’s my take on the above husbandry failings. You should research tortoise or any pet’s care long before you buy one. You should have read all available information, and asked as many questions as you can of experienced keepers until you are an expert on their care. Clear up any confusion you have before you purchase an animal. Don’t just listen to one point of view. Explore the theory, and examine the logic behind the varied advice you are given. Steer clear of prescriptive advice that tells you ‘X species needs Y type of bulb’. REPTILE HUSBANDRY IS NOT THAT SIMPLE!

Mediterranean tortoises do best in large open topped well ventilated enclosures such as ‘tortoise tables’. Vivaria can lead to problems with temperature and humidity for Mediterranean tortoises. A single combination UV and heat bulb may work for some keepers who have mastered the pretty simple task of knowing and controlling the temperature correctly using a thermometer and thermostat, selecting the correct wattage bulb for their set up and providing a nutritious, appropriate captive diet with correct supplementation. It does not work for everyone, and I would argue that pet shops should not be selling these bulbs for beginners to keeping tortoises as these are the owners who are likely to get other factors such as diet wrong too. A preferable option is to provide a heat lamp and a separate UVB fluorescent tube which covers the entire length of the enclosure. That way the tortoise will receive UV light throughout the entire enclosure, even when it is not basking directly under the heat lamp. Tortoises do not bask in the one spot for long periods, they roam. By choosing a combination bulb your tortoise may not receive the optimal level of UVB exposure over time and therefore if your temperatures and diet are also somewhat deficient your tortoise will not thrive. It may even develop metabolic bone disease. Remember the intricate relationship between temperature, lighting and dietary balance? Take any one of those factors out or skimp on their provision and you are setting yourself up for a case of entirely avoidable MBD, among other potential health problems. If you do not know the temperature you are keeping your reptile at, buy a thermometer and find out. Pretty simple concept. If the temperature fluctuates widely in your specific set up due to external factors then buy a thermostat and make sure it is controlled. Yes, that costs money. If you can’t afford one, maybe you can’t afford a reptile. If you can’t afford one for your newest reptile, maybe you have too many reptiles. NOT KNOWING WHAT TEMPERATURE YOU KEEP YOUR PET REPTILE AT IS A COMPLETE NEGLIGENCE AS A PET OWNER.

UV lighting needs to be changed on a regular basis. The bulbs give out light for long periods, but the output of the UV spectrum of light declines with time, generally over the course of 6-12 months depending on the manufacturer and quality of the bulb. Document when you buy new bulbs and when they need to be replaced. Young, actively growing reptiles in particular with high calcium demands cannot do well with a sub optimal level of UV light, even for short periods without suffering.  Commercial pelleted foods are not a staple diet, they are a supplement to a healthy diet. Their nutritional content declines with time. They may be convenient for the owner as they sit in a tub ready to be poured into a feeding bowl, but tortoises need a variety of fresh greens, weeds, grasses, flowers and small amount of vegetables to thrive. Dry pelleted food is not a substitute for a fresh diet. Diets also need to be supplemented with calcium, and other vitamins and minerals that may be lacking in the limited diet we invariably provide in captivity. Lettuce, cucumber and tomato is an extremely poor diet as it has a high water content but very few valuable nutrients. As an aside which is unrelated to this case, I hear from time time time about the act of feeding tortoises dog and cat food. NEVER FEED ANIMAL PROTEIN TO HERBIVOROUS MEDITERRANEAN TORTOISES. (Jam sandwiches or chips are also off the list. I’m not joking!).

If you notice your tortoise or other reptile pet acting or looking strange, then BRING IT TO THE VET! Don’t wait until it can’t move or no longer eats. Don’t wait until you’ve read a few articles and self diagnosed it, then tried to treat it at home. Don’t ask other hobbyists on five separate internet forums until you hear get the answer you want or whatever other DIY home treatment option you might try first. IF YOU CANNOT AFFORD VETERINARY FEES, YOU CANNOT AFFORD THE PET! Reptiles hide illness very well to avoid predation int he wild. If you think they are sick, they are probably sick. Seek a qualified and experienced reptile vet at the earliest opportunity and work with them. Don’t lie to them or withhold important information that could aid their diagnosis (this happens a lot too, though not in this case). A deformed or misshapen shell in tortoises and turtles is always indicative of a problem. If the shell is softening this problem is advanced.

This tortoise today had a softened, flattened shell like a rubber ball. This did not happen overnight. The owner noticed at Christmas that something was wrong. But only brought it in to my clinic when it had stopped eating and stopped moving. The tortoise was so deficient in calcium over a long period of time due to poor heating, poor lighting and poor diet that it had absorbed it’s shell and skeleton of calcium, thus softening the bones to the point they could no longer support it’s body weight. It was undoubtedly in immense pain. It was having to pull it’s forelimbs back and forth to try to keep breathing as it’s collapsed rubbery shell was compressing it’s lungs and causing respiratory distress. It was undoubtedly in multi-systemic organ failure at the tender age of 18 months. It had the potential to outlive it’s owner, it’s owners children and potentially grandchildren if a little more research and effort had gone into it’s care. Sadly, it was beyond help, and I have to take comfort in the fact I could relieve it’s suffering and put it out of it’s misery humanely. I am however, still angry, jaded, frustrated and tired of seeing this problem crop up over and over again whilst trying to maintain an upbeat, positive demeanour that will help educate the owner rather than turn them against the idea of veterinary care.

Below is the video of the tortoise which may be distressing to some people. Please view at your discretion. Please also note that I took this video AFTER the tortoise had died, so it is no longer suffering. It is explicit to show the extreme changes that can occur with MBD as a direct result of poor husbandry and nutrition. If it makes one person improve the care of their pet tortoise it will be worth posting, so please feel free to share this article.

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17 thoughts on “Metabolic Bone Disease: Another Rubber Tortoise!

  1. Very distressing to see the poor wee mite. I totally agree with all of your advice and of every sentiment that you have expressed. I have two Hermanns at home and made sure that we did the research Before getting them. Also visited the Royal Dick Vet in Edinburgh (earned a gold star for husbandry and yes I could tell you the temps) the very same day one of them didn’t “look right”. 3 hour trip each way and costly, but that’s my problem not our Torts! We chose to have them so we must look after them!! I agree that if you can’t afford a vet then don’t get a pet. Unfortunately a lot of people swear by the wrong advice given by pet shop owners who (a lot of them) are only out to make a sale. And as for the Forums on the internet…well don’t get me started on that! People express their ‘love’ for their tortoises but don’t do the research and rely on amateurs for advice. I have the utmost respect for what you have to deal with on a daily basis and I applaud you for speaking out loud.

  2. That was amazing. I’ve never seen that before. I have seen pyramids on shells and softing between the pyramids. But not rubber shell. I will share this in hopes of saving and educating the few that will read it.

  3. Hi there, We opened a reptile and aquatic shop 12 months ago and work closely with our local specialist reptile vet Siuna Reid of TVHC. We put all our own set ups together for people to purchase and they come with UVB, calcium powder and a stat control as standard on all our kits. We also give one of Siuna’s Reptiles R Cool books away with every kit……just wanted to let you know that some of us are fighting the MBD battle with you!! Our shop is http://www.fangsandfins.co.uk if you want to take a look. We also run a local reptile club to try to get keepers to actually talk to each other rather than forums on the internet which can be a mine field (and get unpleasant from time to time). Anyway, keep up the good work and maybe together we can start to change the reptile keepers world from ‘tradition’ to evidence based practice!
    Best wishes,
    Claire Forster

  4. We’ll be highlighting this blog in our daily news brief today (goes live at 11AM UTC – https://theturtleroom.com/blog/2015/04/02/world-turtle-news-04022015/). We’ve got a full team of staff with a wide array of expertise in turtle and tortoise species. Please feel free to have people visit our site or facebook page to contact us for information on care and setup. Our website also includes an ever-growing Species Profiles section where natural history and care information can be found.

    Thanks for fighting the good fight!

    Steve Enders, theTurtleRoom

  5. Pingback: World Turtle News, 04/02/2015 - theTurtleRoomtheTurtleRoom

  6. I’ve took on 2 tortoises last week and I very much suspect they both have MBD due to conditions I was told they were kept in previously (no soft shell) but other things make me suspect , I can only hope the vet will tell me I’m imagining things but sadly I think they will confirm my fears.
    There really is no need for it & when you calculate the things that do need regularly replacing ie UV & basking bulbs the cost per week over the year is absolute peanuts not even the price of a chocolate bar & most things are a one off cost and built to last for years !

  7. I didn’t see the video, but I was very upset about the state of that animal. I am distressed by people who base the care of an animal just on hearsay and the advice of some pet store clark. I wander how it happens and they don’t find even accidentally information about their animal. You are all day long in the Internet like most people today, you are constantly in Facebook and search about your favorite sports team, how on earth it doesn’t happen that you just type the name of your animal in a search engine a day you are bored? Then from that point I hope they will start researching.
    I like to search about my animals and not only them, and try to base their care on the findings of scientific research, so I might be a little biased.

    I don’t believe that those animal rights organizations have to do anything with animal welfare. Their highest goal is to end every interaction of humans with animals, which is deamed as exploitative. Reptiles happen, as newer in the pet trade and also frequentling causing fear to the public, to be much more easily targeted than other animals. But welfare problems exist for most animals, and much more in the so called domestic ones. To be clear, I will give an example. I have a pet rabbit, which is a much more specialized mammal than most think. It needs proper nutrition with lots of fiber, clean water, a safe and clean environment, time for excercise out of the cage, time for interaction with humans, especially if it lives alone, small toys to chew and play, tending of the fur, especially in long-haired breeds, calm approach, picking up only if necessary etc. Even by caring well for my rabbit, I needed to visit the vet twice, and in the one case it needed medication. Now we have lots of rabbits suffering. Rabbits condemned to live in hutches outdoors or in a garage for the whole of their lives, rabbits in cages for the whole of their lives, rabbits given inappropriate foods frequently, like sugary or fatty foods, rabbits in environments with noisy children constantly chasing them and wanting to pick them up, rabbits picked up wrongly, for example by the ears, or to often, rabbits not going to the vet, because they are just a cheap rabbit! And rabbits that are turned loose in the wild. Not to mention uncontrolled breeding. Now these so called animal welfare organizations don’t call for banning of ownership of pet rabbits as a solution most of the time, but why do they advise against reptiles? Because reptiles are what they are, reptiles. Still many people are not comfortable with the idea of such animals living in close proximity to them. And I believe the only reason these organizations don’t call for bans for domestic animals is because then they would lose the base of their income, namely dog and cat owners. They do it by a more incidious way though. By encouraging excessive neutering of domestic animals and urging people to get them from shelters. With no breeding, their numbers will decline, and finally they will become extinct.
    I believe educating people when purchasing an animal, whatever animal, will have a great impact on reducing, though not eliminating, cases of animal neglect or cruelty.

    Ps. Some reptiles can be kept with minimal effort. Nocturnal, sedentary, rodent-eating snakes come to mind, also leopard geckos and geckos of similar ecology. I don’t see the move towards simpler keeping as necessarily bad. I think hobbyists, having now figured out the basic elements of the natural habitat that must be reproduced in order to keep a reptile healthy, start doing away with the others. In the early days of the hobby, the whole habitat was replicated for species, even soil, type of wood and stones and plants, and people hoped the species would breed. Now only the relevant variables are kept, while the others aren’t necessary, and species breed much more reliably. For example the needed temperature zone, humidity and basic layout to express natural behaiviors of a species will be retained, but other, irrelevant features of the environment are not necessary, like the exact natural substrate for non-burrowing species, branches for burrowing species, or fancy natural reconstructions for sedentary species. At least the above apply to small to medium-sized squamates, tortoises might be too specialized for simple keeping.
    Making keeping of animals simpler is a step towards domestication. Again I will use the rabbit as an example. In the Roman Empire and later in the Middle Ages, basically wild rabbits were kept in enclosed parts of land, the so called domestic warrens. Later in the Middle Ages, monks started keeping rabbits in cages and cultivating various domestic breeds. The more controlled keeping seems not to have impacted the species to the least as of today.

  8. Pingback: Metabolic Bone Disease: Another Rubber Tortoise! – Perfect Pets

  9. I have Indian Star Tortoise ( Land tortoise ) which UVB Light and what Specification is more appropriate. Also is there a need for a separate Heat Lamp ?? Your suggestions please.

    • I don’t give prescriptive advice on equipment without discussing and preferably seeing individual set ups. Do some research and find a reputable shop if you can to recommend a specific lighting and heating combo. Did you read the article?

      “A single combination UV and heat bulb may work for some keepers who have mastered the pretty simple task of knowing and controlling the temperature correctly using a thermometer and thermostat, selecting the correct wattage bulb for their set up and providing a nutritious, appropriate captive diet with correct supplementation. It does not work for everyone, and I would argue that pet shops should not be selling these bulbs for beginners to keeping tortoises as these are the owners who are likely to get other factors such as diet wrong too. A preferable option is to provide a heat lamp and a separate UVB fluorescent tube which covers the entire length of the enclosure. That way the tortoise will receive UV light throughout the entire enclosure, even when it is not basking directly under the heat lamp. Tortoises do not bask in the one spot for long periods, they roam. By choosing a combination bulb your tortoise may not receive the optimal level of UVB exposure over time and therefore if your temperatures and diet are also somewhat deficient your tortoise will not thrive. It may even develop metabolic bone disease. Remember the intricate relationship between temperature, lighting and dietary balance? Take any one of those factors out or skimp on their provision and you are setting yourself up for a case of entirely avoidable MBD, among other potential health problems.”

      • I’d recommend looking at the Tortoise Trust website or joining Billy’s Tortoises Facebook page for advice and support. Many pet shops don’t have a clue, but will still sell you the wrong equipment to make a few quid.

  10. Hello!
    Few days ago, I adopted a 10 year old male tortoise from a woman who couldn’t take care of him anymore. Even though she loved the tortoise – she was really sad when she gave him away – she wasn’t educated about how to provide appropriate UV lightning for the little guy.
    They bought him when he was 3 years old, so the poor guy has been living without UV light for years. His condition isn’t as drastic as the poor tortoise in the video – but his shell is a little bit softer on the sides, and seems flat when compared to our another tortoise who we found in the wild.
    I am relatively new in keeping tortoises – we have that one big guy from the wild, who we have kept in our garden, where he has lived just like in the nature, eating wild plants and roaming around (right now he is in his hibernation, so we put him in a box with dry grass, in a cold room). I also have two babies, a few months old, and I have bought an UV lamp and a basking lamp for them – they live indoors, in a wooden enclosure, and seem to be developing pretty well.
    My question is – what can we do to help the poor guy? Except for providing an UV lamp for him. What kind of food should we give him? Maybe some artificial calcium, like some kind of a medicine? I really want to help him recover and be happy and healthy like all the other ones.

    • Could take him to a vet for a checkup and some good advice. Warmth and UV light is a must, and a great diet, supplemented with calcium daily. A combined vitamin & mineral supplement once weekly as a general rule would be good too. Without knowing more and examining your tortoise I can’t give specific advice.

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