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Secondary nutritional hyperparathyroidism is a common disorder for chelonians, particularly those that are herbivorous like most tortoises and it is the most common cause of Metabolic Bone Disease in both turtles and tortoises. This disease prevents the proper absorption of calcium and can cause serious deformity as it can cause softening and abnormal growth of the bones and shells of these animals. This type of hyperparathyroidism is most often caused by an inadequate diet.
Hyperparathyroidism is a deficiency in the metabolism of calcium absorption that can lead to softened bones and abnormal shell growth for turtles and tortoises.
This disease can be particularly damaging to turtles and tortoises who have a larger or heavy shell naturally. Even softened, the heavy shell puts a great deal of stress on the weakened bones in the spine and legs
Primary hyperparathyroidism - This is due to dysfunction within the parathyroid gland itself, and is most often caused by either a tumor or glandular hyperplasia
Dietary - Calcium deficiencies in the diet can trigger this disorder, or an overabundance of phosphorus which binds to the calcium, preventing its absorption
Lighting - Lack of ultraviolet lighting can inhibit the ability to make vitamin D, and therefore the capacity to process calcium from the diet
Low temperature - Lowered temperatures can interfere with the digestion system of all reptiles, reducing the amount of calcium that is absorbed from the diet
Most of the time the diagnostic visit will begin with a physical exam, which will include evaluating and recording the patient’s weight, mobility, and its overall appearance. The examining veterinarian will also go over information about the patient’s current living environment, including humidity levels, heat, feeding schedule, and access to fresh water to ensure that the problem isn’t environmentally driven.
A fecal analysis will help to determine if there are any internal parasites present, and blood tests such as a biochemical profile and complete blood count (CBC) will assist in determining if any infections are existing or if there are any imbalances in the sugars or enzymes in the blood. The blood tests will reveal lowered blood levels of calcium for animals that have any form of hyperparathyroidism and urine samples will show that the level of phosphorus is substantially increased. X-ray imaging may also be used to better visualize any internal damage to the bones.
Treatment for acute cases of hyperparathyroidism will likely start with administering fluid therapy in order to combat dehydration, usually followed by injected calcium. In stubborn cases, Calcitriol, a man-made version of vitamin D, will be injected as well. Turtles and tortoises who are suffering from this disorder are often very weak and may require feeding from a syringe to regain some of their strength. As broken bones are fairly common for reptiles with hyperparathyroidism, these will need to be addressed before further treatments may occur.
These damaged bones will generally require splinting or setting, and occasionally even surgery, and anti-inflammatories will be prescribed to reduce pain and swelling. Bones that have been softened by this disease do not, however, respond well to the addition of pins or plates to heal the bone. The best treatment plan for this condition usually includes determining either the nutritional or environmental origin of the disease and correcting the circumstances that are leading to the disorder.
The prognosis for secondary nutritional hyperparathyroidism will depend on how long the disorder has been going on, the overall softness of the bone, and the speed in which the dietary adjustments are made. Warped shells can be very uncomfortable for turtles and tortoises, and broken bones can make it very difficult and painful to move. The addition of regularly scheduled visits to assess the overall health and wellness of your pet will help to prevent this disorder from occurring. It is also essential to make sure that adequate UV light is offered and the animal is properly hydrated.
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