25+ Box Turtle Health Problems and How to Handle Them

Box turtles don’t talk. So when something’s wrong, you’re left guessing. One day they’re active, the next they’re hiding, skipping meals, or acting plain weird.

Most people don’t realize how many things can go wrong. Eye infections. Shell rot. Organ failure. Stuff you won’t even notice unless you’re paying close attention.

And the worst part? A lot of these problems look the same in the beginning—swollen eyes, soft shell, not eating. Miss the early signs, and you could be in real trouble fast.

This post covers the most common box turtle diseases, what they look like, what you can do at home, and when you should call the vet. No fluff. Just straight-up help when your turtle needs it most.

What Are The Common Diseases Of A Box Turtle?

Several diseases may occur to a box turtle. Most of these diseases are not severe. But if you ignore a minor condition at an early stage, it could be life-threatening later. Here I am going to talk about several diseases of a box turtle.

Some diseases of a box turtle are,

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Vitamin A Deficiency Or Hypovitaminosis

Lack of vitamin A affects skin, eyes, and internal organs. It’s often caused by an all-fruit or low-variety diet.

What it looks like:

• Swollen eyelids
• Loss of appetite
• Dry skin or flaking
• Runny nose
• White patches inside the mouth (can turn into mouth rot)

What to do:

• Add high-vitamin A foods: sweet potato, kale, dandelion, squash
• Use a reptile multivitamin twice a week
• Keep water clean—poor hydration makes it worse
• Improve UVB lighting

Call a vet if:

• The turtle’s not eating
• It’s got multiple vitamin A symptoms
• You’re unsure what dosage to give

Respiratory Infection

Box turtles can get sick lungs just like us—usually from cold temps, bad air, or poor diet (especially low vitamin A).

What it looks like:

• Runny nose or bubbles from the nose
• Puffy, closed eyes
• Open-mouth breathing or wheezing
• Lethargy, not moving much
• Hangs out under the heat lamp nonstop
• Stops eating

What to do:

• Move the turtle to a warm, clean, dry tank
• Keep temps steady: 83–85°F overall, 93–95°F basking spot
• Wipe the nose and eyes gently with a clean cloth
• Offer soft, smelly foods (like boiled chicken or tuna) to tempt appetite
• Add a UVB bulb if you’re not already using one

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Call a vet if:

• It’s gasping, coughing, or weak
• Still not eating after 3 days
• Eyes are sealed shut or leaking pus
• You hear clicking or wheezing while it breathes

An Ear Abscess

Box turtles don’t have visible ears like us, but they’ve got middle ears that can get infected. When that happens, pus builds up and forms a hard lump on the side of the head.

What it looks like:

• Swollen lump behind the eye or jaw area
• Looks like a firm bump under the skin
• Turtle may seem off—less active, less hungry
• Can affect one or both sides

What causes it:

• Dirty enclosure
• Vitamin A deficiency
• Untreated respiratory infection that spreads
• Weak immune system

What to do:

Don’t poke it. Don’t squeeze it. This usually needs minor surgery.

A vet will:

• Use anesthesia
• Cut a small opening
• Drain the pus
• Leave it open to heal
• Prescribe antibiotics or shots

After that, you’ll need to:

• Clean the wound daily (as the vet instructs)
• Keep the enclosure dry and clean
• Follow the full antibiotic course, even if it looks better

Can you prevent it?

Mostly, yes.

• Treat colds or respiratory issues early
• Keep the tank clean
• Provide a diet with enough vitamin A (like leafy greens and squash)
• Maintain humidity between 60–80%

Call a vet if:

• You see a lump forming near the turtle’s head
• It’s getting bigger
• The turtle isn’t eating or acting normal

Trying to treat this at home is a bad idea unless you’ve done it before. Most turtles need a vet to drain it safely.

Shell Rot

Infection in the shell from bacteria or fungus—often from injuries or dirty water.

What it looks like:

• Soft, smelly spots
• White, yellow, or gray areas
• Pieces of shell falling off
• Fluid under the scutes
• Exposed tissue

What to do:

• Clean the area daily with diluted betadine
• Let it dry out fully after cleaning
• Keep the turtle dry except for short soaks
• Apply silver sulfadiazine or other vet-recommended cream

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Call a vet if:

• The rot spreads
• You see blood or deep tissue
• The turtle acts sick overall

Shell Peeling

Shedding of the outer shell layer. Can be normal—or a sign of trouble.

What it looks like (normal):

• Thin, clear scutes peeling off
• Happens slowly over time
• No smell, no soft spots

What it looks like (bad):

• Thick scutes peeling off
• Bad smell or fluid underneath
• Soft areas or swelling

What to do:

• Don’t pick or peel it
• Check for soft shell, swelling, or odor
• Keep basking temp and UVB consistent
• Improve diet if peeling seems fast or rough

Cracked Shell

Usually caused by a fall, predator bite, or sharp object.

What to do:

• Clean the wound with diluted betadine
• Keep it dry and warm
• Cover the crack with gauze if it’s open
• Vet visit is a must—cracked shells can lead to blood poisoning

Metabolic Bone Disease

MBD is what happens when your turtle doesn’t get enough calcium—or can’t absorb it. It wrecks their bones, shell, beak, and even internal organs. It’s slow, painful, and very common in poor setups.

What causes it:

• No calcium in the diet
• Wrong calcium to phosphorus ratio (should be 2:1)
• No UVB light, so the turtle can’t absorb vitamin D3
• Poor diet over a long time

What it looks like:

• Soft or misshapen shell
• Wobbly legs, trouble walking
• Legs splayed or dragging
• Curved or overgrown nails
• Beak growing crooked
• Can’t close into the shell
• Swollen joints
• In babies: deformed shell growth, bumpy scutes

What to do:

• See a vet—they may give calcium shots or other supplements
• Upgrade the UVB lighting immediately (no UVB = no calcium absorption)
• Add cuttlebone to the tank
• Dust food with calcium powder (without D3 if you’re using UVB, with D3 if you’re not)
• Fix the diet—add calcium-rich greens like dandelion, kale, turnip greens

Prevention tips:

• Use a proper UVB bulb and change it every 6–12 months
• Feed a balanced diet (not just fruits or cheap pellets)
• Supplement with calcium 2–3 times a week
• Watch for early signs—MBD creeps in slowly, but it’s easier to fix early

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Call a vet if:

• The turtle can’t walk properly
• Its shell feels soft or bends under pressure
• It stops eating and acts weak
• You see deformities forming

Once it gets bad, you can’t reverse the damage completely. But you can stop it from getting worse—and save your turtle a lot of suffering.

Internal Parasite

These are tiny worms or protozoa living inside your turtle’s body. They feed off your turtle’s nutrients and slowly weaken it. Most turtles have some parasites—problem starts when they multiply out of control.

Common types:

• Roundworms (Nematodes)
• Tapeworms (Cestodes)
• Flukes
• Protozoa (like flagellates or coccidia)

How it spreads:

• Eating bugs or plants with parasite eggs
• Dirty enclosure
• Contaminated food or water
• Poor hygiene after handling multiple turtles

What it looks like:

• Weight loss, even with a normal appetite
• Stringy or weird-looking poop
• Diarrhea
• Lethargy
• Bloating
• Vomiting
• Irregular eating habits

What to do:

• Go to a vet. They’ll run a fecal test to confirm the type
• If confirmed, they’ll prescribe deworming meds like fenbendazole or metronidazole
• Clean the entire enclosure—substrate, bowls, decor, everything
• Replace water daily and keep things spotless during recovery

At-home signs to watch for:

If your turtle keeps losing weight, has runny poop, or acts off—parasites should be on your radar.

Can you prevent it?

• Don’t feed wild-caught bugs or plants
• Keep enclosure clean
• Don’t let food sit out for too long
• Do routine vet checks (especially for outdoor or rescued turtles)

Call a vet if:

• There’s blood in the stool
• Turtle is vomiting or not eating
• It’s losing weight fast
• You suspect parasites and haven’t done a fecal check in months

Don’t try to treat parasites with random meds. Wrong dose or wrong drug can mess things up worse.

Scratches and Minor Wounds

Cuts, scrapes, or shallow wounds on the shell or skin. Usually happens from rough tank decor, sharp edges, fights, or accidents.

What it looks like:

• Visible scratch or open cut
• Mild bleeding
• Redness or irritation
• Turtle flinches when touched near the spot

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What to do:

If it’s a small scratch, you can treat it at home.

Here’s the basic care:

• Clean the wound with diluted betadine or chlorhexidine
• Let it air dry for 10–15 minutes
• Apply a thin layer of triple antibiotic ointment (no painkillers in it)
• Repeat once daily until healed
• Keep the turtle dry for a few hours after treatment
• Soak only the bottom half of the turtle if hydration is needed—don’t soak the wound

Cover it?

Only if it’s in a spot that keeps reopening. You can use sterile gauze and surgical tape, but most shallow scratches heal better uncovered.

Watch out for:

• Redness spreading around the wound
• Pus or weird smell
• Turtle acting sluggish or not eating
  These are signs of infection. Don’t wait—go to a vet.

Prevention tips:

• Smooth out sharp edges in the enclosure
• Don’t overcrowd the tank (less chance of fights)
• Supervise any outdoor time
• Keep the enclosure clean to prevent infection

Even small cuts can turn nasty fast if the tank’s dirty or the turtle’s immune system is weak. Clean it right, keep it dry, and you’re good.

Closed/Shut-Eye

Most eye issues come from vitamin A deficiency, bad water, or infection. You’ll often see the same signs repeated: closed eyes, swelling, discharge.

What it looks like:

• Swollen eyelids or eyes shut tight
• Watery or sticky eyes
• Eyes look sunken or bulging
• Can’t see or bumping into things
• White film or pus near the eye

What to do:

• Check your water quality—dirty water is the #1 cause
• Boost vitamin A foods (dandelion greens, sweet potato, carrots)
• Use sterile saline or artificial tears twice a day
• Keep the turtle warm and dry for now
• Clean enclosure thoroughly

Call a vet if:

• The eye is bloody or rotting
• Turtle keeps rubbing its face
• White, cheesy pus appears
• You’ve tried home care for 3–4 days with no change

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Mouth Rot

A nasty mouth infection caused by bacteria, fungus, or both. It usually shows up when your turtle’s immune system is weak—either from stress, poor diet, or another illness like vitamin A deficiency.

What it looks like:

• White, cheesy gunk inside the mouth
• Red, swollen gums or tongue
• Open sores or ulcers
• Turtle won’t eat
• Bad smell from the mouth
• Turtle drools or keeps mouth slightly open

What causes it:

• Dirty tank
• Poor diet (especially vitamin A deficiency)
• Untreated respiratory infections
• General weakness or poor immune health

What to do:

This one’s not a DIY job if it’s bad. You’ll need a vet.

Vet treatment usually includes:

• Oral antibiotics or antifungal meds
• Cleaning and flushing the mouth
• Possibly injectable meds for deeper infections
• Fixing the root problem (diet, lighting, etc.)

At home, here’s what you can do while waiting for a vet:

• Isolate the turtle
• Keep it warm and dry
• Offer soft, easy-to-swallow foods (if it’ll eat)
• Clean the mouth gently with diluted betadine using a Q-tip—don’t force it

Call a vet if:

• You see white pus or sores in the mouth
• The turtle hasn’t eaten in days
• It looks painful or smells bad
• It’s getting worse fast

Prevention tips:

• Keep the enclosure spotless
• Feed a balanced diet with vitamin A
• Watch for early signs—most cases start small
• Don’t ignore poor appetite or small mouth blisters

Mouth rot doesn’t go away on its own. If left untreated, it can spread to the jaw and become life-threatening.

Overgrown Beaks

The beak (basically the mouth) keeps growing, like a fingernail. In the wild, it wears down naturally. In captivity, it can overgrow and cause eating problems.

What it looks like:

• Beak looks long, sharp, or uneven
• Turtle struggles to bite food
• Jaw looks misaligned

What causes it:

• Soft or wrong food
• No rough surfaces to chew on
• Poor UVB or calcium levels
• Sometimes tied to metabolic bone disease (MBD)

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What to do:

• Vet can trim it safely
• Add cuttlebone to the tank for chewing
• Fix the diet—more leafy greens, less soft fruit
• Make sure your UVB setup is on point

Don’t try to trim it yourself unless you seriously know what you’re doing. One slip can cause real damage.

Overgrown Of Nails

Turtle nails that get too long and start curling. It’s common in indoor turtles that don’t walk on rough surfaces.

What it looks like:

• Long, curved claws
• Turtle stumbles or has trouble walking
• Nails get caught on things in the tank

What to do:

• Trim the nails using a reptile nail trimmer or Dremel (if you know how)
• Don’t cut too short—just the tip
• File edges if they’re sharp
• Let the vet or groomer do it if you’re unsure

Prevention:

• Add rocks or rough wood for natural wear
• Let them walk on outdoor surfaces (under supervision)
• Trim every few months if needed

It’s not life-threatening, but bad nails = bad posture = more stress on the turtle.

Organ Disease / Failure

When internal organs like the liver or kidneys stop working properly. By the time you notice symptoms, it’s often too late to fix.

What causes it:

• High-protein diet
• Long-term dehydration
• Parasites
• Vitamin A overdose or deficiency
• Untreated illness dragging on too long

What it looks like:

• Weakness or no movement
• Extreme weight loss
• Swollen body or limbs
• Turtle stops eating
• Pale mouth or eyes
• Weird smell from the body
• Red blotches under the shell

What to do:

• There’s no home treatment—take the turtle to a vet
• Blood tests or imaging may be needed to confirm
• Vet may recommend fluids, meds, or supportive care
• In bad cases, euthanasia might be the kindest option

This is one of those “hope you never need this” sections. Prevention is the only real plan here.

Organ Prolapse

This is when something inside your turtle’s body pushes out through the vent. Usually it’s the intestine, cloaca, or sometimes the penis in males. It’s serious and needs vet care—fast.

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What it looks like:

• Pink or red tissue sticking out of the back end
• Turtle straining or pushing constantly
• Avoids eating
• Might have trouble walking or sitting still
• Looks stressed or uncomfortable

Why it happens:

• Constipation
• Parasites
• Straining from laying eggs
• Cloacal infections
• Poor diet, dehydration, or weakness

What to do:

• Call a vet immediately—don’t try to push it back in yourself
• Keep the turtle on a clean, moist towel
• Keep it warm and quiet
• Don’t let the tissue dry out—use damp paper towels if needed
• Don’t feed it until a vet checks the cause

This is one of those “drop everything and go” situations. The longer it’s out, the worse it gets.

How To Set Up a Hospital Tank for Your Box Turtle

If your turtle is sick, injured, or needs to be kept away from others, a hospital tank makes things way easier. It’s not fancy—it’s just a clean, quiet space for recovery.

What you’ll need:

• A spare tank or plastic tub (20–30 gallons is fine for most box turtles)
• Heat lamp and UVB light
• Clean towel or paper towels for the bottom
• Optional: moist sphagnum moss for humidity
• A shallow water dish (only if needed—not during shell rot or open wounds)
• A hiding spot (use a clean plastic container or hide box)

How to set it up:

• Keep temps steady: 80–85°F ambient, 90–95°F in basking area
• No loose substrate—stick to paper towels or towels for easy cleaning
• Clean daily—no exceptions
• Keep the lighting on for 12–14 hours a day
• Cover part of the tank with a sheet or lid (not airtight) to reduce stress

When to use a hospital tank:

• Your turtle has an infection or open wound
• It’s recovering from surgery
• You’re giving meds and need easy access
• You’re isolating it from others (to prevent disease spread)

You don’t need a brand-new tank. A clean plastic bin with the right lighting and heat will do the job just fine.

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Final Check: Is Your Box Turtle Sick?

Not every problem is obvious at first. Here are some red flags you shouldn’t ignore:

• Not eating for more than 2–3 days
• Swollen, shut, or leaking eyes
• Runny nose or open-mouth breathing
• Sudden change in behavior—lethargic, hiding all day
• Soft, lumpy, or oddly shaped shell
• Wounds that won’t heal
• Red spots or blotches under the shell
• Weird smell from the body or mouth
• Anything sticking out of the vent (organ prolapse)
• Blood in poop, or poop that looks off

If you see any of these and you’re not sure what’s wrong, don’t sit on it. Call a reptile vet.

Catching things early can save your turtle’s life—and save you from a way bigger bill later.