Urgent Care :: chubby turtle with gout

[dansvatek]

Hi
I have a 19 year old red-eared slider (I'm 31, got him when I was 12) Now that he's in his golden years, he's not as spry as he used to be and has sadly developed gout I've been giving him 3.8 cc's of allopurinol each day, as instructed by my vet.

What worries me though is something I've noticed which my vet didn't think was a big deal. Bubbles (my turtle) has become obese and I don't think I feed him enough to warrant it. The skin between his shell and his legs is quite swollen. I don't mean to question my vet's assessment, but I just want to be sure she hasn't overlooked anything since the swelling is kind of freaking me out.

Here's what I feed him: 1 gram of mashed sweet potato each day, which is the only way he'll take the allopurinol (along with two or three trout-chow pellets). Sometimes I give him a few shreds of carrots, which he devours. Ocasionally he'll eat lettuce.

The swelling seems abnormal to me considering that, apart from the sweet potato, I've reduced his diet to just a couple of pellets a day (the gout necessitates reduced proteins).

Okay, thanks if anyone has any thoughts on this!

Dan

[megcornell]

Swelling is not normal, but at older ages some RES do have "looser" skin that sags around their limbs. So, if you could post a picture that would be helpful.

[SpotsMama]

I'm fuzzy on how much one gram of sweet potato is. Is this a very tiny amount? One thought would be that the sweet potato is high in calories and making your turtle fat.

I'd be concerned about balance in the diet and the potential for vitamin deficiencies. Maybe some sort of imbalance is causing your turtle to retain water or gain weight. One thing you could do is switch from the trout chow to one of the well respected pellets specifically formulated for turtles - Reptomin or Mazuri. You might also consider a vitamin/mineral supplement BUT check with your vet first because of your turtle's other condition. Here's a link that lists some respected vitamin supplements for turtles:

http://www.redearslider.com/supplements.html

[industrial_girl_2000]

This might be a silly question, but how did the vet determine that your turtle had gout? Just curious. I have an older turtle too (I've had her for almost 18 yrs & she was already big when I got her so I guess her to be about 20 yrs old) and she is just as active as the day I got her. No signs of slowing down.

I would be worried about the obesity. Carrots & sweet potatos are really high in carbs. Maybe remove the carrots from his diet for the time being. What kind of pellet are you feeding him? I feed my RES Reptomin & it has been her pellet for the entire time I have had her. Also, there are other veggies you can feed your turt to help vary the diet.

Can you post a picture of him & his set up? I would like to see the swelling around the legs you are talking about. I'm wondering if the reason he is having a hard time getting around is because he is just obese (rather than gout). Not trying to contradict what your vet said, but it's just something to think about. My turtle has a lot of saggy skin around her hind legs too but it never stops her from running around all over the place & rearranging her tank on a daily basis.

[dansvatek]

Thanks for all your comments.

I do feed him reptomin, alternating between that and trout chow. I try to vary his diet but he's turning his nose up at reptomin these days. He'll eat it if I feed it to him by hand, moving it around in the water like a fish, so I'll do that to make sure he's getting his vitamins.

The vet took blood tests and xrays, about 6 months ago and concluded he had gout. The allopurinol worked really well for a while to give him mobility back, but now he's gotten fat like this. I wasn't aware carrots and sweet potato were such high-calorie foods for turtles. The sweet potato is one of the only ways I can "hide" the allopurinol so he'll eat it (he never gets tired of sweet potato). But I AM probably feeding him too much (about half a teaspoon?) each day. I'll try to figure out other ways to make the medicine appealing to him.

I guess I'm just worried that it might not be fat-- that his body is filling up with some kind fluid, because he got like this over the course of a couple of months. I hope he's just overweight-- I'm definitely going to start controlling his diet more. Here's some pictures of his baggy legs, and his set up, with a Homer Simpson quality ramp I cobbled together, (but it works). I just got a mercury vapor bulb which is blinding, and he seems to be responding well to it (previously had an incandesent bulb for heat and a seperate UVB bulb)



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[dansvatek]

Here's some more pictures of his front legs which also have some swelling, and a better picture of the tank.

[iac637]

he just looks overweight to me lots of turtles get the fat bags as they get older

[Sarah89]

Thanks for all your comments.

The allopurinol worked really well for a while to give him mobility back, but now he's gotten fat like this.

Maybe it's the medication causing the exsessive weight gain? Or the gout itself? I know in people, who have gout in their legs and feet, the limbs swell.

[SpotsMama]

I looked up allopurinol and weight gain or water retention weren't on the list of side effects - for people.

Also, weight gain and water retention weren't on the list of symptoms of gout - for people. Not to say it doesn't happen in some cases.

I'm suspicious of the sweet potato. Could you cut back on the amount but still keep using it to get the allopurinol in him? And replace the sweet potato with good pellets to help make sure he's getting all the nuitriants he needs.

It's always surprising to me how much turtles love sweet potatos. Mine does too. They didn't evolve to eat sweet potatos but then we didn't evolve to eat chocolate cake.

[marisa]

Since you are questioning your vet's assessment, rather than asking here, I think your turtle would benefit from a second opinion from another qualified herp vet. From the pics, I do think that paunch/swelling is abnormal given amount of food you say you're giving him. About the swelling---does it move at all, meaning, if you hold him and tilt him downward, does it move as fluid would move from one spot to another? How long has it been since your vet saw your turtle---if it's been a little while, would the swelling be more noticeable to your vet now?

I'm assuming your vet concluded it was gout at least in part because of the level of urea in the blood and x-rays of the joints(?). Does your turtle have trouble moving around and getting on the basking area? From what I know, swelling (usually of a joint) is often associated with gout...

You're right about lowering the amount of dietary protein---gout (and arthritis, which often accompanies it) is often associated with excessive protein intake. I don't know the protein content of Trout Chow, but Reptomin is rather high, as is Mazuri. If the protein content of the Trout Chow is lower and he'll eat it, then I'd give him that. Some other decent pellets are lower in protein as well (look for RepCal pellets, for example); you could alternate them with the other pellets. I can't really say anything about the sweet potato except that 1 gram is about 0.035 ounces, which doesn't sound like a lot to me. If the medication is helping him and that's the only way he'll take it, then I'd give it to him in the sweet potato (have you tried squash as well?). Will he eat other plant matter as well?

I don't want to worry you, but very simply, gout is a metabolic disorder that allows uric acid/urate to accumulate in the blood and tissues. Uric acid that is deposited in the kidneys may produce renal failure. One sign of renal failure is excessive fluid retention...

I would really seek out another opinion, especially since from what you say the "swelling" is not improving and alarm bells seem to be going off in you. At the very least, I'd try to get the vet who's seen your turtle to take a closer look at the swelling. Good luck.

[industrial_girl_2000]

I agree with Marisa, a 2nd opinion from another qualified herp vet is in order.

One thing about allipurinol: it can be bad for kidneys, and problems with kidneys can cause water retention.

The swelling around the arms & legs is what concerns me. The older turts will naturally get a little saggy as they age, especially the females after they give birth to multiple clutches of eggs over the course of a lifetime. But they will only sag around the rear legs, not the front legs as you showed in your picture.

Hopefully you can find out what is going on with your boy. He looks great otherwise! Keep us posted!