Adverse reaction to Baytril
(Enrofloxacin) in a Leopard Tortoise (Geochelone
Patricia J. S. McLaughlin
My Leopard Tortoise (LT) was taken to the vet for treatment of persistent "runny nose" consisting of opaque, grey mucous discharge. Some wheezing and squeaking sounds were evident, especially when temps got cooler than 75 ºF and his legs would lightly pump in and out with each breath. Nasal symptoms appeared intermittently with periodic bubbles emitting from his nares.
No eye discharge or other visible symptoms were noted. Appetite was suppressed but he ate once a day or grazed on hay, combined with access to water and periodic warm water soakings. Bubbles on his nares appeared most often when straining (defecation) and also upon emerging from his hide box indoors in the mornings. Although the thermostat was set for mid 80's ºF the box at the far end of his habitat generally cooled to the low 70's at night.
LT had been with me for 3 months after being abandoned by a previous owner who kept him in poor husbandry conditions with a Redfoot tortoise. LT hid a lot and would not eat until opuntia cactus was offered. Under a UV Power Sun Lamp, his appetite and activity increased gradually and his weight increased from 640 grams to 660 within 90 days using Oxbow Hay Co's Critter Care supplement sprinkled over his food. He had daily access to 3-4 hours of outdoor Texas sunshine and grasses during the end of August, September and early October before ground temps fell into the 70's range and he had to remain indoors for the winter. He was kept indoors at night even when the weather was warm, for his safety and my peace of mind.
Most noticeable about his outward carapace appearance is a twisted-malformed scute on his left-side and some pyramiding that skews his central carapace ridge, also towards the left-side. As well, his lower jaw/beak is slightly overgrown such that it juts out beyond his upper beak, making eating very difficult, almost impossible actually, without hand-feeding. A food-processor was used to finely chop grasses, hay, cactus, hibiscus leaves, carrots/squash into small enough pieces for eating. His weight and energy gradually began to increase.
After seeing one "reptile" vet who diagnosed the LT with a "simple cold similar to a child's clear runny nose" and "not to worry", LT was taken to another "regular" vet on 11/21/08 who quickly diagnosed the infection. A Baytril injection was given and an allergic reaction described in the following section occurred. On 11/23, I took a nasal mucous culture and results came back after 4-5 days showing a "heavy load of Aeromonas". This strain of Aeromonas tested sensitive to Baytril, Amikacin, Nolvasan, Gentamycin, Carbenicillin, Timentin, Cipro, Ceftazidime. Resistant antibiotics were CHPC, Ditrim, Cefatabs, doxicycline, penicillin, and Naxcel. However, marbofloxacin was not tested.
Allergic Reaction to Baytril
LT received an injection of Baytril on 11/21 at 10:30 AM intramuscularly in the front leg. Within 2 hours it was noticeable that he had gotten worse. His symptoms included swollen nares including the raised nose area above the nares, and swollen eyelids that remained closed and puffed out. He was loosely pulled-in and unresponsive to normal stimuli, and made an occasional loud coughing (almost barking) sound unlike any heard before.
By 12:30 I had returned to the vet. In the time it took to drive back, LT's carapace growth rings had taken on a pale pinkish tinge, specifically in the lighter coloured, previously ivory, brand-new growth rings. The pale pinkish-orangey tone encircled his carapace while my vet explained that this was due to internal tissue swelling. New growth areas on his plastron also took on the same pinkish tinge, but only in the new growth-sections. When he did open his eyes, the white part of his "third-eyelid" had pulled over part of his eyes. This had all occurred within 2 1/2 hours of the injection of Baytril. He was also urinating freely, another sign of internal tissue swelling.
My vet administered .3cc of cortisone and the LT's relief was almost instantaneous. The pinkish tinge paled to ivory and was gone within 3-5 minutes of the injection. His nares began to return to normal sized openings. There was no mucous discharge throughout this event. Instead of any further injections, we opted to mix Amikacin 2:1 with saline and administer drops directly to the nares twice a day while holding the LT upright to allow it to make contact with internal mucous membranes.
It should be noted that A. Highfield's, “The Encyclopedia” was referred to, as well as Richard Fife's pamphlet on LT care. However, neither prepared us for this allergic reaction to Baytril.
Two days after the injection, the LT had regained his previous strength and more. In fact, he was very hungry and energetic, and basked openly under his lights throughout the following day and evening. He drank freely when offered water. The day of his cortisone shot he urinated a strong yellow urine when soaked later that afternoon. He is always thoroughly dried with paper towels after each soaking. I placed a heating pad on low to keep his hidebox at a constant 85-88 ºF, and increased thermostat regulated heat via an infrared lamp day/night at 90-95 degrees. His overall activity remained steady and improved until Day 4 after the Baytril injection. He began to hide again and had to be pulled out of his hidebox to bask and warm up. He drank deeply when his feet were placed in shallow water. By Day 5 we had the culture results back and a heavy Aeromonas infection was identified.
Amikacin drops continue and Amikacin injections will begin 12/1/08 at a rate of 10mg/1kg. There is some fear of kidney damage but with warm water soakings and careful monitoring, this can hopefully be mitigated. This Aeromonas infection needs to be eradicated. The vet will allow me to give injections every 2 days for 10 days and then continue for another 10 days if needed. This will probably be the case since Aeromonas can persist beyond a normal 10-day course of antibiotics, especially in reptiles.
Marbocyl and Zeniquin were recommended by A. Highfield of the Tortoise Trust. However, since marbofloxacin is in the same antibiotic family of fluoroquinolone antibiotics as enrofloxacin (Baytril), we did not want to risk another allergic reaction for the LT. At this writing the LT's nares are not showing any mucous discharge. Amikacin drops appear to be directly influencing his recovery, while tomorrow's Amikacin injections will be a systemic approach to ending the infection. Care will also be taken to continue to strengthen the immune system of the LT. It should be noted that this LT will always be a potential carrier of this bacterial infection, and will never be placed with another tortoise.
Note by Andy Highfield
It is worth noting that other species have displayed similar problems following Baytril (Enrofloxacin) given both by injection and orally.
These include members of the Indotestudo group (I. elongata and I. travencorica), in Angulate tortoises (Chersina angulata), in Gapalagos giant tortoises (Geochelone elephantopus) and also Indian Star tortoises (Geochelone elegans). We do not therefore recommend Baytril should be used with any of these tortoises. Generally, other drugs such as Marbocyl (Marbofloxacin) can be substituted. No adverse reactions to this have been observed, even in tortoises that previously reacted badly to Baytril.
Casares, M. and F. Enders. 1996. Enrofloxacin side effects in a Galapagos tortoise (Geochelone elephantopus nigra). Proc. Am. Assoc. Zoo Vet 1996:446–448.