Last, but not least important section of RES pet turtle care is health, which is heavily influenced by their habitat and their diet, many of the ailments that strike turtles could have been prevented with changes to one or both. Turtle health can be complicated and one set of symptoms does not guarantee that the internet (myself included) was right.

I am well aware of the additional costs a sick turtle can cost .... but just because the turtle was cheap to free does not mean it should be denied medical attention when it needs it or dumped in the local river for it.

Delaying treatment will only likely cost you more money by giving the condition time to progress intoa more difficult to treat ailment. Over the counter and internet concoctions can easily worsen the situation. If you are not sure whether you need to bring your turtle to the vet or not, call them and ask. This article is purely informational and does not in any way replace medical advice or the need to either consult with your vet or go see them.

There are a few 'ailments' that are surprisingly common in online pet forums that are actually quite natural and no need for alarm or a vet visit.

  • Shedding skin and scutes

  • loss of appetite in the fall/winter seasons

  • fanning

  • minor bites, cuts and bruises and broken nails

Some of the other ailments that (for most turtle owners) will likely require a vet visit are:

  • fungus

  • shell rot

  • swollen eyes

  • shell or body injuries

  • respiratory infection

Any signs of respiratory infection your turtle MUST see a vet. I don't care if your turtle owning friend told you to place the turtle under warm light and shared his VD antibiotics with you ... you need to take the turtle to a vet ASAP, respiratory infections are deadly in turtles and best (for turtle and wallet) if caught early.

Below you will find information and pictures on all the possible ailments that could afflict your turtle, but first let's get the ones that are natural and not an indication of sickness.

Shedding Skin and Scutes (Shell)

Shedding is normal and natural for most reptiles and this includes the red eared slider. Excessive shedding is indicative of something wrong with diet or habitat – poor water quality, too high protein diet, toowarm. You do not need to pick it off or help them in any way (other than maintaining housing and diet that is).

When the skin sheds it is clearly noticeable in water more so than on land. In water they look like floating wispy white translucent strips or pieces attached to the turtle. Turtle shedding their skin is nothing like a snake or even lizards, it's more akin to a human sunburn in the way it peels off in small pieces.Shedding Scutes.Credit: ATP

When the shell sheds you will likely first notice it when the scutes appear to be lighter than normal and almost golden in colour (for my guys it is, their shells are a dark brown). This is the air seeping in between the layers, lifting it. The scute can come off in one piece or a couple of pieces, what it shouldn't do is peel off in little pieces like the skin.

Again look at your housing and more likely, your turtles diet for correction. You do not need to help the scutes along, leave them alone and let them come off on their own, it does not bother the turtle at all – but your pulling at his shell may very well bother him greatly.

Nails Broken or Long

Long slightly curved nails are indicative of a male turtle – do not file or trim or cut them. Its utterly unnecessary and risks infection and causing the turtle pain. Males are quite proud of their nails and they are used in attracting a mate by 'vibrating' their claws down the sides of their face like some dance move.

If it is ripped right out or broken beneath the skin and you have never treated a turtle, go to the vet. For those who have will know to dry dock the turtle and if discomfort continues for a few days go see the vet. If the nail broke half way or well above the skin, just keep an eye on it for any sign of infection.

Bites, Bruises, Cuts, Scratches and Burns

Very minor injuries that do not involve the tearing of flesh, a bite that broke the skin, is bleeding or bleeding that doesn't stop/slow, require no medical help. But you should investigate for the source of the injury – which is commonly a tank mate, unprotected heater or something else in the tank – and either remove it or fix it. If it is tanks mates fighting – it usually means your tank is too small and they are fighting over space or food.


Huh? Fanning is basically your turtle flashing you with his ahhh, manly parts. That surprsingly large brown blob thing that just fell out his butt hole (cloaca) and was sucked back up as quickly as it came is called fanning. If it doesn't go back in, then it is called a prolapse and needs vet attention. My vet laughed for hours when I rushed Benedict (my oldest) in to see him for 'fanning'. A two hundred dollar lesson, I got a discount.

Algae on Shell

More commonly seen on wild and outdoor pet turtles, but can happen to pet turtles as well. While it is not a reason to freak out or run to the vet, it is cause to look at your habitat and see why your pet turtle is not drying off completely.

End of reasons to not be too concerned. Everything listed below is reason to be concerned.

Shell and Skin Problems

The shell of a Red Ear Slider should be hard and relatively smooth. The carapace should be dark green and the plastron should be bright yellow. Recently hatched RES will have a slightly soft carapace that is a lighter green shade.

The majority of the issues explained here are related to improper housing and diet. Shell issues are more commonly related to water quality issues – lack of filtration; habitat issues - incorrect basking area, no UVB light, too small tank or aggressive tank mate; diet - lack of calcium, excessive protein.

This means that they are (for the most part) preventable. Sometimes you do all you are suppose to and the turtle still catches a respiratory infection or developes shell issues, but this is rare. Some of these conditions such as Metabolic Bone Disease or severe shell trauma can take months to years to heal correctly and may need intensive home care, medicines or special requirements during the treatment.

It would have been easier and cheaper to just ensure proper habitat and diet.

Metabolic Bone Disease (MBD)AKA Soft Shell SyndromeMBD in RESCredit: tortoiseforums

My youngest turtle, Dips, arrived with all the signs of early MBD. At age four years he was no bigger than a half year old turtle. His shell edges curved upwards like a wave near his tail and his shell had tell tale spots on it. The vet provided a treatment plan and some emergency medication like a calcium shot and sent me home to continue his care.

Metabolic bone disease is also known as soft shell syndrome and it is one of the two more serious issues that affect turtles (many reptiles actually). With the rare exception of chemical processes within the turtle going haywire, this problem is completely avoidable with proper housing and diet. If caught early enough is treatable too – Dips only has a small wave on the one side of his shell. But it can turn into a permanent disability if ignored for too long.

It happens because there are deficiencies – either severe or small ones building up over time – of calcium and or vitamin D3. Remember D3 is needed for calcium absorption so if your are not providing enough of it the calcium that you are adequately providing for can not be used (absorbed). If you have good calcium and D3 but use spinach, the spinach is blocking calcium absorption – thus why it should never be eaten as part of a regular diet.

Calcium is what gives your turtle's shell its tough strength. It is an essential mineral and when there is not enough of it (hypocalcaemia), the body resorts to taking it from bone structure (if not replaced the continual taking of it from the bones weakens them). Younger turtles grow quickly and because of this growth spurt of theirs they need a goodly amount of calcium as hatchlings, egg bearing females also require more. Turtles fresh out of the egg have softer shells for the first few months of life.

Left to continue the shell will develop spots that are incredibly soft (like a sponge) and may have exposed tissue, the shell becomes a hot bed for infections and fungus, white discolouration and shell rot will take hold. Your turtle will likely be lethargic, not eating and weak.

The article covering nutrition goes over the complicated relationship of calcium, phosphorus and vitamin D3. All you really need remember is phosphorus is easily obtained in fresh foods, D3 with proper light and/or supplements, it is the calcium you have to watch out for. It's not justifiable to not provide these, they are relatively cheap and easily obtained.

Septicemic Cutaneous Ulcerative Disease (SCUD) AKA Shell Rot

This is commonly called shell rot. It more often than not stems from some sort of injury, even a small not easily noticeable one – it does'nt have to be traumatic injury, a scratch, burn or abrasion is all that is needed. This condition is like a gateway drug, it leads to so many issues if not caught and dealt with early.

The minor injury (or a large one) gets infected. It is left not noticed or untreated and a lesion will form and you my find fungal, bacterial infections happening or worse, septicemia (bacteria in the blood). The infected areas will become discoloured, localized shell softening, a strong odor and blood or pus may also be seen.

You need to see a vet as that diseased shell tissue needs to be removed completely and the shell repaired, antibiotics are needed and this type of injury can take a very long time to heal. Habitat conditions are often the cause of original infection and you should look closely at your filtration and water quality. This is why some turtles are dry docked for a few days when suffering a small injury, to prevent infection.

Deformed Shells:

Shells become deformed for a number of reasons – birth defects, issues during incubation (heat or light), a physical injury, a lack of UVB light as hatchlings, nutritional deficiencies and being kept in too small a tank for too long.

Audrey - Deformed ShellCredit: RESQShell deformations can be improved wtih proper care and nutrition but the turtle will likely have the deformity for life. But as Audrey of RESQ rescue shows, they still can have a life and even become instrumental in education. 

Dips shell is deformed due to his MBD condition at a young age, I prevented further damage and deformity and smoothed out what he had but I caught it early enough to do so and it took years to fix.

Cracked Shells

For any type of crack I contact the vet always. Minor or major. Often the minor ones I am told will heal on their own with a little antibiotic to prevent or lower the risk of infection. But major cracks, holes and missing scutes you will have to take your pet turtle in.

For those of you reading this whose turtle just cracked their shell from falling or an animal attack, go to the vet immediately, vets can do some pretty fantastic things now-a-days in regards to a turtles shell with shell patches and glue and such. Many turtles who were run over by cars can survive with the right treatment. Even prosthetics are do-able!.

So breath deep and get your pet fixed. Cracked and outright broken shells are not death sentences if treated for quickly.

Red or Pink Coloring on Shell or Skin

 This is an indication of septicemia (blood poisoning) particularly if your turtle has had some kind of minor or major injury recently. The red and pink colouration can be seen between or on the scutes of the shell, the plastron and carapace as well as the turtles skin. It can also be a symptom of improper housing (too cold or drafty).


It is important to be sure that you have a fungus infected turtle or a bacterial infected turtle as the treatments are somewhat different and thus why you will likely need to see a vet.

Fungus InfectionCredit: ATP

Fungus resembles white cotton with coats or patches over the skin and sometimes shell. It's colours can be anywhere from white to brownish to even a greyish tint. Like shedding it is seen better under water where it looks 'wispy and floating'. Fungus on the shell tends to look more pasty than wispy.

The condition is usually attributed to bad housing – lack or inadequate filtration and or no basking spot – depending on the degree of infection it is an easily treated condition but if you ignore it or miss the signs you run the risk of septicemia gaining a foot hold, which is much worse than fungal infection

Discolored Spots

Spots are a symptom, not a disease in and of itself. It indicates fungus, bacterial infection, mineral deposits or shell rot. A little detective work on your behalf will narrow it down.

If you have good water quality, adequate basking and filtration, it is more likely mineral deposits or even a shedding scute. If the spots are decidedly on one scute, they are shedding. If it is all over the shell it is likely mineral deposits.

If the spots start in one area and slowly work their way outwards, you likely have fungus or bacterial issues, possibly beginnings of shell rot. Some of these conditions can be contagious so if you have more than one turtle, you will have to separate them during treatment. See a vet if you suspect fungus, bacterial infection or shell rot.

Eyes, Ears and Mouth Diseases

A turtles eyes should be bright and clear. Anything other than that is often the first sign of a not-so-well turtle. Head should be smooth and not bumpy, no runny liquids escaping their ear and their mouth, if you get to peek inside the mouth it should be pink in colour.

Eyes Closed or Swollen

Swollen and/or closed eyes are more a symptom than a disease in and of itself. Swollen Turtle EyesCredit: ATPDehydration, bacterial infections, trauma, poor nutrition and water conditions, ear abscesses, deficient in vitamin A are all viable causes, as is respiratory infection (deadly) and metabolic bone disease (debilitating).

Use common sense here. If you just changed the turtles water and their eyes look squinty, red and they are rubbing them – it's quite likely chlorine or chloromines in the water. If there is gooey stuff (like humans eyes after waking) and/or they don't open their eyes after being out of water for a bit, then you need to go to a vet – it could be diet related or conjunctivitis. If the infection is left long enough, your turtles eyes will need to be lanced and no, not by you – don't pass out on me. Either way, your little pet is going to need antibiotics.

Bleeding Mouth, Gums

This in and of itself is next to impossible to diagnose at home since most turtles are highly reluctant to open their mouths for you and you really can't force it.

Blood appearing around the mouth area or its gums can indicate a vitamin K deficiency, stomatitis (see below) and injury likely due to trying to eat something it shouldn't have. All treatable conditions, but a vet visit is required to get the diagnosis and treatment plan.

Mouth Rot / Stomatitis

Visual signs include respiratory changes, ulceration around the mouth area including throat and tongue, perhaps some coughing and evidence of mucus or a yellowy white substance around its mouth with blood present is mouth rot or stomatitis. Can be bacterial or viral and either way it's highly contagious among turtles.

Untreated mouth rot is fatal.

Ear Abscess

A surprisingly common condition that is also quite likely the easiest to diagnose, the treatment though requires a vet – that lancing procedure again.

Symptom of Ear Abscess or InfectionsCredit: RESQ

Ear abscesses are ear infections that cause not only swollen eyes and swimming issues, they also cause the turtle to form lumps on one or both sides of the head. And yes, the bumps get lanced – by a vet. 

These form for a variety of reasons an previous battle with a respiratory ailment but more commonly dirty habitat conditions – not enough filtration usually.

Major Illness and Trauma

Any of the conditions listed here will require immediate vet visit and delaying will only make things worse, possibly even delay recovery permanently. The diseases and injuries listed below tend to take a considerable amount of time to heal and require a little extra care at home for a time.



Turtles can drown, but they can survive without oxygen for quite a while, particularly in cool water before the harm becomes irreversible. It is very likely the turtle is just waiting on someone to help it breath again.

Do NOT turn it onto it's back (or upside down) that will force the oxygen remaining to escape and do not put it back into the tank.

Valerie Haecky, an author of aquariums and turtles,provides instructions on resusitating a turtle:

  • Extend the turtles neck completely.

  • Lift the turtle so that it's bum up and head down, open the mouth slightly and water will drip (or lightly run out), this is the water in the lungs escaping.

  • If that doesn't revive him or show signs of life, lay the turtle belly down with neck extended and face it, grasping his front legs and pull them straight towards you – gently.

  • Keeping the legs straight, push them back into the turtle as far as it will go, keep this up till all water is removed.

Whether you have life from the above steps or not, rush to the vet ASAP, as the turtle will need antibiotics and possibly more resusitation (if not conscious from your attempts). Just because your attempts did not work, does not mean he is fully dead yet.


Trauma includes a great many things such as a fall, animal attack or car accident. The turtle can suffer from broken bones and shells, shock, bleeding and risks infections from such wounds. Even severe damage can be healed today. 

TraumaCredit: RESQ

When Dips, my youngest fell out of his tank whilst attempting to balance on the edge of it, my heart sunk at the sickening sound it made when his shell hit the floor. I saw no cracks, no bleeding and he only seemed dazed from his adventure. I still headed off to the vet to ensure nothing was broken internally and externally.


This condition has been mentioned a few times in this article, but it refers to bacteria in the blood and in essence is blood poisoning, which makes it a life-threatening infection that will be fatal if untreated or caught too late. This condition affects the whole body due to the immune system reacting to the infection by causig systemic inflammation, which can mess with the circulatory system and cause multiple organ failure.

The symptoms include reddish to pinkish colouration on skin and/or shell, lethargic, sores, withdrawn behaviour or unusual behaviour, general unresponsiveness, lesions and eye swelling.

Blood tests are needed to diagnose and to decide on treatment. I really can't stress hard enough that your pet turtle with these symptoms needs to see a vet ASAP.


I referred to this earlier in the article as fanning when the turtles manly bits pop out and go back in as quickly as they popped out. When it does not go back in, then you have a prolapse. A prolapse essentially means that something is hanging out of the turtle that shouldn't be – usually penile or intestinal.

If housed with other turtles they need to be removed right away and set in a bucket or tub of water (keep the exposed organ wet) and high tail it to the vets. If you leave the turtle in with other turtles they may bite and scratch at the protruding body part causing more damage.

Prolapse in a TurtleCredit: TurtleTimes

The intestinal prolapses are often cased by a number of things such as eating gravel (impaction), constipation, parasites or old age (weak muscles). Penile prolapse is usually weak muscles but other causes are suspected as well. Neither will heal on it's own, and normally requires surgery.

Respiratory Infections

The Black Plague of reptiles. I'm not kidding, this is a common illness and one of the deadlier ones as well for captive turtles. It is contagious and will spread to your other turtles. Most of the reasons for your turtle acquiring a respiratory infection relate back to habitat, - too cool/cold waters, not hot enough basking or lack of basking spot, exposed to drafts.

Delaying treatment will likely cause your turtle to develop pneumonia and extending treatment to months rather than weeks. Immediate medical attention is required with respiratory infections. As well as immediate correction of the cause.

Some of the symptoms you will see in your turtle are coughing, open mouth, difficulties breathing, sneezing, wheezing, yawning, loss of appetite, mucus from nose or mouth, lethargy and bubbling from the nose and mouth when out of water. If your turtle lists (swims oddly or on a tilt) it is indicative of water on the lungs. Any of these symptoms require immediate vet assistance.

Reproductive Issues

While I don't believe in breeding RES for any reason and do not support it, I also do not support needless suffering of a pet or animal. Many reproductive issues are related to egg laying of which I have no experience with – Ella laid one in the tank and her brother Sam promptly ate it (the mess it made in the tank was ridiculous). That's my experience. Apparently that's normal and the egg was likely not even fertilized – yep the girls can lay eggs even when no male is present.

The conditions listed below are somewhat related and cross over each other, but each are serious and require a veterinarian or medical assistance.

Egg Binding:

This is when the female can not get the eggs out of her. Sometimes an egg broke (nutrition issue) on the way out and stopped up the process. Too many eggs are also a cause as is the turtle being ill with some other ailment. Regardless why they are not coming out, you need to see a vet for xrays and extraction. And no I have no idea how the vet extracts the eggs and not sure I care for the imagery.

Eggs in Water

Almost always habitat related – no nesting box. If the female is laying eggs in the water, the eggs are no longer viable after a few minutes and should be discarded. If no nest is provided she will hold on to her remaining eggs and risk egg binding or more eggs in water. Holding the eggs back can cause infection, disease and organ damage, untreated it is often fatal.

What to watch out for .. since females can lay eggs without a male around ... lethargy, pacing, digging excessively, kicking of hind legs, prolapsing and pacing.

Importance of Preventive Medicine

Earlier in this series I referred to nutrition, housing and health as a trifecta of sorts, and hopefully you see just how much of a difference proper nutrition and housing can make on a turtles health. The extra money spent on housing and diet, save you big vet bills down the road. 

Large volumes of clean filtered water, a basking area with heat and uvb lights. regulated water temperatures, and a varied diet with a focus on minerals and vitamins sounds like a lot to do ... but in the long run it really is worth it and to be frank, all part and parcel of owning a turtle.