Disease Resulting from Malnourishment and Vitamin Deficiencies: Most diseases afflicting captive box turtles are, at least in part, the result of malnutrition. Box turtles that do not receive all of the nutrients vital to sustain optimum health do not remain healthy, and become ill from a variety of causes. Hatchlings are the most prone to disease resulting from dietary deficiencies because their nutritional requirements exceed those of adult turtles and because their rate of growth is so rapid. Hatchling turtles often exhibit soft shells, associated with protein and mineral deficiencies, and swollen eyes; which accompany vitamin A deficiency. Adult box turtles, by contrast, are unlikely to exhibit soft shell problems but may show signs of anemia, weight loss, mouth rot, internal infection, or abscessation with chronic malnourishment.
Respiratory Disease is common in box turtles. Epidemics may occur in populations of wild box turtles, characterized by runny noses and pneumonia. It may be bacterial or viral and can be highly contagious. The Ornate Box Turtle (Terrapene ornata ornata) seems to be especially sensitive to respiratory disease in captivity, and the respiratory signs seem to be particularly devastating in this species.
Ear Abscesses: A common sequel to an upper respiratory infection in a box turtle is abscessation of the ears. A swelling appears on one or both sides of the head, beneath the external ear openings. Cheese-like pus can usually be removed by the veterinarian, and antibiotic therapy by injection is usually rewarding.
Abscesses (Other than Ear): Bacterial abscesses are common from puncture wounds, bite wounds and other injuries. Injectable antibiotics must be used under these circumstances to prevent formation of internal abscesses or septicemia (wide-spread infection).
Shell Disorders: Shell rot occurs when either the upper shell (carapace), lower shell (plastron) or both develop erosions. [his condition usually results from injury or chronic exposure to a filthy environmental. Malnutrition and infection are frequent predisposing factor. Serious injuries to the shell are often inflicted by logs, lawn mowers and automobiles.
Overgrown Upper Jaw: The upper jaw of some captive box turtles may occasionally overgrow. Abnormal wear patterns resulting from prior injury or a steady diet of soft food may e involved. Periodic trimming of the upper mandible by an experienced veterinarian or technician is necessary in these cases.
Foreign Body Ingestion: The intestinal impactions occasionally seen in desert tortoises are rarely a problem in box turtles. However, eating snail shells occasionally causes intestinal tract damage in box turtles. Certain individuals seem to be plagued by this problem and should not be fed whole snails. Most box turtles can safely eat snails and snail shells.
Eye Disorders: Various disorders involving the eyes of box turtles are noted from time to time. These include cataracts, corneal ulcers, puncture wounds and other traumatic injuries, infections, maggot infestation, conjunctivas and dry eye (keratitis sicca).