How to Identify and Treat Turtle Prolapse

Prolapse in turtles and tortoises is a common problem. In fact, even experienced keepers encounter it – despite doing everything they can to keep their animals happy and healthy.

Often, the cause of a prolapse is constipation, but there are several other causes, and it’s important to know what they are if we want to prevent it from happening.

Essentially, a prolapse is when either a sex organ from the cloaca or an internal organ from the body cavity can be seen outside of a turtle’s vent. By its very nature this is a dangerous event, unless the animal is breeding – but we’ll get into that later.

First, let’s take a quick look at Chelonian (turtle and tortoise) tail anatomy so that we understand what the vent, cloaca and body cavity are.

Afterwards we’ll look at how to identify prolapse, what causes it, how to prevent it, treat it and when to see a vet.

Chelonian tail anatomy

In addition to its other functions, the cloaca also plays a part in the turtle’s reproductive tract. This can sometimes lead to issues like cloacal prolapse, especially in male turtles.

Often, you hear people use the term cloaca to describe the orifice on the tail of a reptile, but this isn’t correct. The orifice on the underside of your pet’s tail is the vent.

Inside the vent is the cloaca, which is where waste moves to before being expelled.

The cloaca plays an important role in turtle biology by housing the sex organs and absorbing moisture from waste, which in turn helps keep the animal hydrated.

The cloaca is not part of the body cavity, which houses the internal organs. The only organs that the cloaca houses and can safely prolapse (or evert) are the sex organs.

From this recap, we can understand that a turtle sex organ exiting the vent is not always harmful – because they can naturally do this. Internal organs from the body cavity, on the other hand, should never exit the vent.

How to identify a prolapse in turtles

While the most common type is the male sex organ, there are different types of prolapse to be aware of. Cloacal prolapse and urinary bladder prolapses are among the health problems that can be witnessed in turtles. Recognizing the specific prolapsed tissue can help in quicker diagnosis and treatment.

As mentioned the most common kind of prolapse is an everted male sex organ. This will be a large, cylindrical, black tube with a flattened or multi-lobed end.

It looks a heck of a lot like some of the creatures from your favorite sci-fi movies. Trust me, you can’t miss it (though you might wish you had).

If you are unsure about the sex , check this guide for identifying if your turtle is a male or female.

A prolapsed sex organ should always go back in on its own. If it doesn’t within a few minutes, then there is a problem.

The second type of prolapse is of internal organs such as the rectum or large intestine. This is much more serious and not normal in any circumstance.

Prolapsed internal tissues and organs look like a fold or bubble of red material coming out of the vent – often becoming more swollen as the minutes go by.

In some cases, especially in a juvenile tortoise or a male box turtle, you might notice a penile prolapse, where the reproductive organ is visible.

What causes prolapse?

The number one cause of both kinds of prolapse is constipation. Other common causes include:

• Diarrhoea
• Intestinal parasites
• Impaction from eating pebbles or gravel
• Infection
• Injury/trauma
• Bladder stones
• Hyopocalcaemia (low levels of calcium in the blood plasma)

Incorrect temperatures, poor husbandry, and a lack of proper nutrition can also lead to prolapse. Issues such as metabolic bone disease, which affects the turtle’s body, might also be a contributing factor.

How to prevent prolapse

First, let’s not forget that sex organ prolapse for a male turtle or tortoise is completely normal when mating (copulating) or “practicing” (a lot of them will do this with tennis balls, dog toys, rocks, or anything else that is even vaguely turtle-shaped!). All you need to do is leave them to it.

Moreover, when turtles and tortoises are mating you must never attempt to separate them. This has been known to cause injuries leading to prolapse, as well as severe stress. Why people attempt this, I really don’t know. I honestly can’t think of a worse idea!

On the rare occasion that a male’s sex organ stays prolapsed the cause can be trauma, as described above, but is just as often a result of husbandry-related constipation or illness.

Occasionally, it can be due to an infection called Cloacitis. This type of infection can be due to overall poor health or hygiene. To prevent it, pay attention to enclosure hygiene for tortoises and box turtles, and water quality for aquatic turtles.

When it comes to prolapsed internal organs and cloacal tissue, constipation is the number one culprit!

In fact, one of the main jobs you have as a reptile owner is keeping an eye on how often your pet poops (glamorous hobby, huh?). It doesn’t have to be written down, just a mental note when you notice it.

To prevent constipation, you must act as soon as you notice your pet defecating less often. Stop it early on!

For tortoises, add watermelon, some pumpkin and small amounts of mineral oil to their diet for a few days. This often does the trick. Also, make sure clean drinking water is available.

However, in some instances, especially in the case of a sick tortoise, they may not be inclined to consume their food item, which might exacerbate the issue.

Your other go-to constipation remedy for both turtles and tortoises is a lukewarm bath, at roughly 80-90°F (27-32°C) and for a duration of 10 minutes, every day until they relieve themselves.

Make sure the water is only at roughly one-third of the height of their carapace for a tortoise or one half for an aquatic turtle.

If your pet is still having trouble, try adding a few spoons of Epsom salts to the baths – these contain magnesium that will act as a laxative if they drink it.

On occasion, constipation can be caused by impaction from eating pebbles or rocks.

Red Eared Sliders are particularly bad for this because of their voracious appetites and curious nature.

Generally, small pebbles can be passed, but larger ones can cause impaction, in which case the animal will be completely constipated and none of these measures will work – even after several days.

Time to call a vet! To prevent this use large, flat rocks in an enclosure rather then pebbles or gravel. For tortoises, feed them on a clean, flat dish.

On the other side of the scale, diarrhoea can also cause prolapse due to the straining and discomfort that goes with it.

Generally, diarrhoea is more common in tortoises and box turtles. If you spot this, your first step is to review your pet’s diet and make sure they are getting enough fibre.

If so, then the next most common causes of diarrhoea are intestinal parasites (including Coccidia) and viral illnesses. These infections will almost certainly need help from an experienced exotics vet to identify.

I personally recommended that a vet should be consulted whenever diarrhoea occurs for several days and does not improve with a high-fibre diet.

Prevention of diseases like those mentioned in the paragraph above can go a long way to preventing prolapse. To this end, you should have a two-pronged approach: maintaining strict hygiene and using quarantine measures.

Strict hygiene means removing uneaten food and waste from your animal’s enclosure immediately and cleaning their enclosure entirely every couple of months with veterinary disinfectant.

Using quarantine measures means keeping new pets separate for at least a month and making sure that your outdoor pets are unable to encounter their wild cousins.

Bladder stones and hypocalcaemia are more rarely involved in chelonian prolapse, but both can be prevented with good hydration, a balanced diet, and correct vitamin supplementation.

To prevent a prolapse from these conditions, do as much research as you can on your turtle’s natural diet and vitamin requirements.

Keeping the turtle’s enclosure clean, offering fresh water, and ensuring a clean environment reduces the risk of gastrointestinal tract and digestive tract issues.

Prolapse from other causes can be harder to prevent, and sometimes there is little you can do.

On occasion, gravid tortoises and turtles are unable to pass their eggs. This is known as “egg binding” and is often caused by poor health, high levels of stress, or poor diet.

Sometimes, however, it occurs due to a complication that is not the fault of the owner. If you have a female turtle or tortoise that has been breeding, make sure that you supply an excellent diet and plenty of nice, humid spots to lay their eggs.

These steps will make egg binding much less likely, though still possible. Your best bet is to record the last date at which the animal mated or showed a change in behavior and consult your veterinarian if you believe that they have been gravid for longer than average for their species.

How to treat turtle prolapse and when to see a vet

For a condition like this, you can easily find YouTube videos for home treatment – but this is never a good idea! I know the “do it yourself” approach is popular these days, but is it worth risking your pet’s life?

A prolapse that lasts more than a few minutes is an emergency that requires veterinary treatment, and the sooner your animal gets it, the better the outcome will be.

In some instances, emergency treatment of an intestinal prolapse can be critical, especially if the prolapsed intestine or section of the colon has been exposed for a long time. Even if it’s a Sunday night or late evening, do not delay in seeking medical attention.

This is because internal tissue tends to become necrotic (rotten) when prolapsed, and every minute that goes by makes tissue damage and infection more likely.

Now, it is true that sugar water can help to relieve the swelling, and I would recommend a bath in this while waiting for a vet appointment. This can help make the animal more comfortable.

Occasionally, a sugar water bath can even help a minor prolapse resolve itself, but not always. Either way, a vet must be consulted to get to the bottom of things.

If you take a turtle or tortoise with prolapse to a vet they will:

• Administer pain medication and sedate the animal
• Treat tissue with something like sugar powder to reduce swelling
• Clean and remove necrotic tissue
• Replace the organs to their correct position
• (Occasionally) use what’s known as a purse-string suture on the vent to prevent prolapse recurring
• Administer a course of antibiotics

It’s important to know that sometimes, a physical examination may reveal an underlying condition or even a foreign object that has resulted in the prolapse. The result of the turtle or tortoise’s condition can vary based on how long the issue has been present and the severity of the prolapse.

If constipation or egg binding is suspected, then an x-ray will be taken. If, on the other hand, a disease, dietary imbalance, or parasitic infection is suspected then a stool sample or blood test will be needed.

A fecal sample can particularly help determine issues like severe parasite infestation. In severe cases, a turtle might even require a daily dose of topical medication or antibiotic cover.

After treatment, do not be surprised if your vet asks you to leave your pet with them for several days or a week for observation. This is completely normal, and in your friend’s best interests.

The video below shows an expert treating prolapse. Please do not try to do this yourself. The video is just to show you one way treatment is provided.

Wrapping up

Prolapse in Chelonians is a serious problem, but like many other conditions, we can do a lot to prevent it or stop it from coming back.

Sometimes, the condition occurs from an accident, such as an interruption during mating. Other times it occurs due to husbandry issues like poor diet, hydration, hygiene, or water condition.

Proper care, from offering the turtle warm water to ensuring they are not exposed to incorrect temperatures or cool water, can prevent many of these issues. Also, while there might be videos or guides suggesting the use of human medicine or the use of table sugar, always consult with a vet before making any decisions.

Whatever the case, it is regularly treated by vets with a high degree of success. It might look scary, but an animal with a prolapse can make a full recovery in a matter of weeks.

If you suspect your turtle has a prolapse, get treatment from your vet, then use their help and resources like this website to get to the root cause.

As always, comment or get in touch for more information.

More First Aid Guides

• Shell rot prevention and treatment
• What to do if your turtle has a Cracked Shell
• Vitamin A deficiency
• How to clean a turtle shell
• Did my turtle drown?

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