Internal Infections: A wide variety of bacterial infections can occur. Often, multiple organ systems are involved. Liver and/or kidney disease is common because of the septic nature of turtle diseases and the filtering action of these 2 organs. Chronic hepatitis and chronic kidney disease (the latter resulting in gout from elevations of uric acid in the blood) are routinely seen. Infections of the heart are also common. Blood tests are useful for diagnosis of these and other problems.
Organ Failure: Older box turtles are subject to organ failure, most often resulting from chronic infection or other long-standing disease involving one or more organs. Diseases that usually accompany advancing age in other animals also affect elderly box turtles (for example, arteriosclerosis). Blood chemistry analysis is necessary to diagnose these cases.