How do I debride and treat shell rot in aquatic and semi-aquatic turtles?

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Shell rot (ulcerative shell disease) is managed through surgical debridement under general anesthesia, followed by topical antimicrobial therapy and environmental modification. The two established approaches differ in their restorative strategy: open wound management with antimicrobial pastes versus surgical filling with silver amalgam. Debridement is the cornerstone of treatment. Lesions should be debrided and flushed copiously with dilute iodine solution.1 For more extensive ulcerations, surgical curettage using a burr mounted on a micro-grinder under general anesthesia achieves thorough removal of necrotic tissue.2 Two restorative protocols are described. In the open wound approach, debrided lesions are treated topically with a compounded enrofloxacin-nystatin-triamcinolone paste applied every 4 days.1 In the silver amalgam approach, a calcium hydroxide paste is applied to the debrided lesion first, followed by complete filling of the defect with rapidly hardening silver amalgam.2 Amalgam fillings are expelled spontaneously at various periods after placement, and no signs of mercury toxicity or tissue reaction to the prosthesis were observed in treated animals.2 Systemic antibiotic therapy is indicated alongside topical treatment. Ceftazidime at 20 mg/kg IM q72h for 30 days is an established empirical protocol for aquatic turtles with shell rot.1 Post-treatment housing requires environmental modification. Animals treated with the open wound approach should be housed with salinity increased to 2 to 3 ppm for the duration of treatment.1 Animals treated with silver amalgam should be hospitalized in dry containers initially, then transitioned to tanks with controlled temperature within 24 hours.2 Prognosis is guarded in severe cases. Animals with lesions extending from the scute surface to the underlying dermal bone and associated azurophilia (documented at 2.43 × 10³ azurophils/µL against a reference range of 0.298 to 0.458 × 10³ azurophils/µL) showed no improvement