Mazuri Tortoise LS Diet 5E5L eliminate problem of bladder stone in African spurred tortoises.

Introduction

Tortoises are one of the most popular exotic pets in Thailand. Especially, the Sulcata tortoise or African spurred
tortoise. The common disease of African spurred tortoise in Thailand is always from mismanagement like Urolith.
Urolith in African spurred tortoise is a very common yet serious problem.

Physiology

The normal waste product for protein metabolism is ammonia. Tortoises convert this ammonia to uric acid which is
less toxic to the bladder wall and lets them hold water in their bladder for long periods of time. African spurred
tortoise is a desert species. So, water conservation is a large part of their physiology as they have adapted to their
arid environment. They can recycle water from their bladder into their system when they do not have access to
drinking water.

If the uric acid builds up in high enough levels, a situation that might happen when the tortoise is not drinking and
staying well hydrated, the uric acids combines with electrolytes like sodium, calcium, and potassium, to form
urates. In a well hydrated tortoise, these urates are secreted normally when urinating. In a dehydrated tortoise,
that is recycling its urine the urates are not secreted, and can slowly build up into a urolith. The urolith is called
cystic calculi or bladder stone when located in bladder.

African spurred tortoises are herbivores. In the wild, they feed on high fiber and very low protein diets such as dry
fibrous grasses and hays, succulent plants as much of its water, fruits and blossoms occasionally.

Removed urolith from tortoises

Causes of urolith in tortoises

In captivity, Urolith can be caused by a number of factors. The two most common are accumulation of uric acid
from improper diet and no access to water source which lead to dehydration in tortoise.
Dehydration plays a significant factor in this disease. Tortoises need to drink water. Fresh water should be available
all day and also periodic soaking is recommended.

Diet is also a factor in this disease. For all tortoises, the overwhelming majority of their diet is from plants. If the
diet is too high in protein, there might be excess urate production, leading to an increased chance of a urolith being
formed. Your tortoise’s diet should consist of a high percentage of grass and a lesser amount of green, leafy
vegetables.

Many plants & vegetables contain significant levels of a compound called oxalic acid. Some studies indicate that
this compound may affect calcium absorption. It binds minerals more, especially calcium which must be eliminated
through the kidneys. In large amounts or in small quantities with improper hydration can contribute to the
formation of urolith in tortoises.

Thailand is located in the tropical area. So, we have various fresh vegetables available all year round as a low cost
option of African spurred tortoise diet. With traditional practice, most owners commonly feed vegetables to their
tortoises in captivity by not aware of high level of oxalic acid in vegetables which can contribute formation of
urolith in their tortoises even with well management of hydration.

The comparison table below shows different levels of oxalic acid content in top 5 vegetables commonly fed to
captive African spurred tortoises in Thailand VS recommended safe grasses, hays & plants for captive African
spurred tortoises.

Vegetables commonly feed to captive African spurred tortoises in Thailand

Item Serving Size Protein Content (%) Oxalic Acid (in mg) Ca/P (in mg)
Water Spinach 100g 2.6 57.5 77/39
Chinese Flowering 20.2 (Leaf)
100g 1.7 102/46
Cabbage (Choy Sum) 74.0 (Petiole)
Indian Mulberry leaves 100g 3.8 387.6 350/86
Carrot 100g 0.93 500 33/35
Tomato 100g 0.88 50 10/24

Recommended safe grasses, hays & plants for captive African spurred tortoises
Item Serving Size Protein Content (%) Oxalic Acid (in mg) Ca/P (in mg)
Opuntia Cactus 100g 1.32 Low, < 10 164/16
Timothy Hay DM 89% 6.3 Low, < 10 330/210
Orchard Hay DM 89% 8 Low, < 10 390/270
Hibiscus Flower 100g 0.96 Low, < 10 215/37
Grape Leaf 100g 5.6 Low, < 10 363/91
DM = Dry Matter Basis
Case study

There are 4 case studies below from Nana Animal Hospital to demonstrate the effect of high-oxalate vegetable to urolith in African spurred tortoises.

Case study A) Tortoise has been fed variously of vegetables and fruits, especially Water Spinach and fruits which tortoises prefer.
After found urolith, veterinarian suggested to reduce vegetable in diet and mix with Mazuri 5E5L in proper ration. But, The owner
does not control diet and has indulgent husbandry behavior. Mazuri 5E5L has been used as supplement occasionally as inconsistent
ration. At eighth month after first check, urolith size has been increased form 2x2.5 cm to be 3x3.5 cm.

Date Weight Shell Clinical Urolith Treatment X-Ray Image

(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
28 Jul 16 307 4 -Lose 2 x 2.5 -Medication
First appetite -Rehydrate
diagnosis -Loose -Change to
Stool balance diet
(Mixed
vegetable &
5E5L)

16 Aug 16 317 4 -Good 2 x 2.5 -Stop

Follow up appetite medication
-Eating -Rehydrate
well -Change to
balance diet
(Mixed
vegetable &
5E5L)
 Date Weight Shell Clinical Urolith Treatment X-Ray Image Date
(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
30 Aug 16 345 4.5 -Good 2 x 2.5 -Rehydrate
Follow up appetite -Change to
-Eating balance diet
well (Mixed
-Secrete vegetable &
small 5E5L)
amount
urates

30 Oct 16 525 5 -Good 2 x 2.5 -Rehydrate

Follow up appetite -Change to
-Eating balance diet
well (Mixed
vegetable &
5E5L)

24 Mar 17 1235 6.5 -Good 3.5 x 5 -Vet request to

Follow up appetite stop Water
-Eating Spinach &
well veggies.
Case study B) Tortoise has been fed various vegetables and fruits, especially Water Spinach and fruits which tortoises prefer.
The owner does not control diet and has indulgent husbandry behavior. Mazuri 5E5L has been used as supplement occasionally as
inconsistent ration (Same owner with Case study A). At eight month after first check, there are 2 urolith size 3x2.5 cm and 4x4.5 cm
have been formed in this tortoise.

Date Weight Shell Clinical Urolith Treatment X-Ray Image

(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
28 Jul 16 298 4 -Lose none -Medication
First appetite -Rehydrate
diagnosis -Loose -Change to
Stool balance diet
(Mixed
vegetable &
5E5L)

16 Aug 16 308 4 -Good none -Stop Tx

Follow up appetite -Rehydrate
-Eat well -Change to
balance diet
(Mixed
vegetable &
5E5L)
 Date Weight Shell Clinical Urolith Treatment X-Ray Image
(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
30 Aug 16 573 4.5 -Good none -Rehydrate
Follow up appetite -Change to
-Eat well balance diet
(Mixed
vegetable &
5E5L)

30 Oct 16 573 5.5 -Good none -Rehydrate

Follow up appetite -Change to
-Eat well balance diet
(Mixed
vegetable &
5E5L)

24 Mar 17 1419 7 -Good 3 x 2.5 -Vet request

Follow up appetite & to stop Water
-Eat well 4 x 4.5 Spinach.
Case study C) Tortoise has been fed mainly Water Spinach, Chinese Flowering Cabbage and Nappa cabbage.
The diet was changed to Mazuri 5E5L after the tortoise has been admitted to hospital. Urolith size slightly reduce form 3x3.5 cm to be
3x3 cm.

Date Weight Shell Clinical Urolith Treatment X-Ray Image

(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
8 Feb 17 262 4 -Closed 3 x 3.5 -Medication
First eyes & -Rehydrate
diagnosis Inflammati -Stop
on vegetable &
-Upper change to
respiratory 5E5L.
tract
infection

18 Mar 17 272 4 -Very 3 x 3.5 -Start admit

Follow up inactive -Medication
-Gas in -Give normal
gastrointes saline solution
tinal tract -Rehydrate
-Feed only
5E5L

.
 Date Weight Shell Clinical Urolith Treatment X-Ray Image
(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
29 Mar 17 280 4 -Good 3x3 -Medication
Follow up appetite -Rehydrate
-Eat well -Feed only
5E5L.
-Expect to
have surgery.

Case study D) Tortoise has been fed 100% of 5E5L Mazuri Tortoise LS Diet since hatching in April 2016.
X-ray images show clear gastrointestinal tract & bladder without urolith.

Date Weight Shell Clinical Urolith Treatment X-Ray Image

(g.) size sign size Lateral / Dosolventral View
(Inch) (cm.)
18 Dec 16 614 6 none none none
First check
20 Apr 17 1013 7.5 none none none
Second
check

Conclusion

Although, this study does not include blood test, urine test and needs long term study, many case studies above indicate that Mazuri Tortoise LS Diet
5E5L can eliminate the problem of urolith in African spurred tortoises. Current owners and veterinarians who currently use Mazuri 5E5L know this
benefit.
To continue feeding tortoises high oxalate-containing vegetables can contribute formation of urolith even with well management of hydration.
Therefore, commonly used vegetables fed to African spurred tortoises in Thailand are not suitable to be used in high ratio without supplement with
pellet or mix with low oxalate plants, grasses or hays which are close to wild type diets.

Supported information by: Kamonpun Buranapim, DVM. (Nana Animal Hospital)

Nithidol Buranapim, DVM/PhD. (Nana Animal Hospital)
Suthichai Srikumchum (Tortoises owner)
Pichet Purnrak (Data collection & composition)

Reference data sources: USDA Food Composition Databases

Bureau of Nutrition
Hansen, Johnson, and Van Devender, Herpetologica 32:247, 1976.
www.moonvalleyreptiles.com
How to Treat Cystic Calculi in African Spurred Tortoise (Sulcata) and Shell Repair Technique, Chaowaphan
Yinharnmingmongkol 47 : S133, 2017.
Bladder Stones, Long Beach Animal Hospital.