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WCV Vets Monitor Box Turtle Shell Regeneration
LOCATION OF RESCUE: Albemarle County, Virginia
INJURY: Extensive shell damage
ADMISSION DATE: September 10, 2011
OUTCOME: Euthanized February 1, 2012
 On September 10, 2011, an Eastern Box Turtle was rescued while trying to cross a road in Albemarle County. Rescuers brought the severely injured turtle, which was likely hit by a car, to the Wildlife Center.
Upon examination, Dr. Adam Naylor found that the turtle was missing a large piece of its carapace [the top, domed shell] above its right front leg. Another section of the turtle’s carapace was fractured, as well as both of its bridges – the parts of the shell that connect the carapace and plastron [bottom shell].
The turtle was bright, alert, and reactive, but faced a serious threat from infection due to damage to its coelomic membrane [the sac surrounding the internal organs just below the skin] that left some of its internal organs exposed. The veterinary team was particularly concerned with the turtle’s bridge fractures. Since the turtle’s bridges had essentially collapsed, its internal organs were compressed and the turtle was also having trouble extending its back legs.
Despite the severity of the turtle’s injuries, Dr. Adam felt that there was still a chance of recovery – though it would take quite a long time for #11-2349 to fully heal. While the fractured pieces of the turtle’s shell should heal within a couple of months, the missing piece of shell will require a much longer recovery period.
After cleaning the turtle’s injuries, metal bars were attached around the fractures to stabilize the shell during healing. In order to compensate for the fractured bridges, Dr. Adam inserted small syringes to act as spacers. The wound below the missing piece of carapace was cleaned and bandaged, and #11-2349 was given antibiotics and pain medicine.
 Dr. Adam uses syringes as spaces while attaching the bars.  Week 2 - The coelomic membrane is regrowing, protecting the turtle's lungs and other organs. Within two days of arrival, the vet staff noticed a visible improvement in the appearance of the wound; a new layer of membrane had grown to cover the previously exposed organs. The staff is closely monitoring #11-2349’s bars and bandages, and is taking weekly photographs of its injuries to document the regeneration process.
October 13 update
In the two weeks since our last update, Box Turtle 11-2349’s wound has continued to heal, but Dr. Adam reports he has recently been fighting off an infection. The coelomic membrane continues to get thicker, drier, and whiter, but a week ago the turtle’s attitude changed from being bright, alert, and responsive to being quiet and lethargic and he stopped eating on his own. Center vets fitted him with a feeding tube and started him on antibiotics, and his attitude has begun to improve. His condition and the results of regular blood work are being closely monitored, as he will be at risk for infection for some time to come. He and 14 other Eastern Box Turtles will be over-wintering at the Wildlife Center because it is now too late in the season to release them in time to hibernate.
 Week 3  Week 4 October 31 update
Box Turtle #2349’s healing is progressing nicely, and Center vets report his attitude has been more bright and alert in recent days. Weekly photos continue to be taken of the turtle’s injuries each Saturday, and today we have included Week 5 and Week 6. The darker yellow patches are scabs which are slowly revealing the new skin growing in underneath.
 Week 5  Week 6 December 1 update
Over the last month, the vet staff have noticed that some areas of the new membrane are calcifying into new shell. The white spots in the photos below are where Diagnostic Intern Katherine White reports there is new bone forming. Another piece of good news is that patient #11-2349 got his bars removed (see photo from Week 10)! Though his injuries make him more susceptible to infection, he has managed to stay off the vets’ “Concerns List” and his attitude has been bright.
 Week 7  Week 8  Week 9  Week 10 December 21 update
Patient 11-2349 continues to heal. One of the scutes over the left forelimb has fallen off, showing the bone underneath. This piece of bone had been held on with bars, and will eventually fall off as the shell regenerates.
 Week 11  Week 12  Week 13 January10 update
Since our last update, #11-2349’s condition has slowly worsened. The turtle has become anorexic and has not consumed food on his own for a number of weeks, and although members of the Center’s rehabilitation staff have been tube-feeding him, they are increasingly worried about his unwillingness to eat.
On January 4, 2012, Dr. Miranda Sadar used the Center’s new rigid endoscope to carefully inspect the inside of the turtle after he was anesthetized. During her inspection, Dr. Miranda noticed that the turtle’s liver was pale and unhealthy in appearance. Dr. Miranda extracted a small tissue sample from the Eastern Box Turtle’s liver and sent it to an offsite laboratory for a series of tests that we are expecting results from soon. Hopefully the test results will provide us with more details on what might be ailing the turtle.
February 1 update
Over the past few weeks, Box Turtle #11-2349’s overall condition has not improved. Liver biopsy results came back indicating that the turtle had reduced liver function — something that could be caused by a number of things, but mostly likely is a result of the turtle not eating well.
While the turtle’s appetite has increased again over the past couple of weeks, the greater concern has been that the turtle is not able to move his hind limbs very well. The veterinary team suspect that this is due to the way the turtle’s fractured shell has healed. When the turtle was first admitted in September 2011, Dr. Adam was particularly concerned about the turtle’s bridge fractures – the collapsed nature of the fractures were difficult to stabilize. Dr. Adam provided small syringe spacers around the fractured bridges so that as the turtle healed, there would be enough room for it to pull its legs in and out of its shell.
It appears that despite the spacers, there is still not enough room for the turtle’s hind limbs to retract. To attempt to fix this issue, the veterinary team would need to re-break both sides of the turtle’s shell – a very traumatic and painful procedure. Given that the turtle is not in the best of health to begin with, and its body has been under a lot of strain the past few months, the team does not feel that he would be a good candidate for a complicated and traumatic surgery –particularly one that may not even be successful. After considering all options, the team made the difficult decision to humanely euthanize the turtle.
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