Box Turtle Prolapse

Prolapse in turtles is common with most box turtle owners experiencing it at one point or another, even if you are doing everything you can to ensure your pet is healthy and happy.

The most common cause of prolapse is constipation, though there are numerous other causes. Prolapse is when a sex organ or internal organ is outside the vent of your turtle. This is very dangerous unless your turtles are breeding.


Male Sex Organs

The male box turtle’s sex organ will often be displayed outside the body during breeding. It is a cylindrical tube that is flattened, black in color. You cannot miss it.

The sex organ should go back on its own, but when it doesn’t go back within minutes, then there is a problem that needs veterinary examination and treatment, such as an injury.

Internal Organs

Internal organs, such as the large intestine or rectum, will look like a bubble or fold of red material that is coming from the vent. This red material often swells quickly.

This is very serious and needs urgent veterinary treatment.


Whether your box turtle has a sex organ or internal organ prolapse, the most common cause is constipation.


Dehydration and small living areas are often the cause of constipation, which can result in prolapse.

Ensure you provide optimum humidity levels with regular misting and give your turtle a warm water bath at least three times a week.

Increase its enclosure size to get your turtle moving more to encourage it to excrete its last meal.


Diarrhea is another common cause of prolapse in box turtles. Your pet may have diarrhea due to a poor quality diet, such as eating too much fruit or iceberg lettuce, for example.


Internal parasites are something very difficult to prevent in box turtles, but you can manage them.

Parasites are often noticeable in poop, so ensure you examine your box turtle poop regularly to provide efficient and effective treatment.

When your box turtle experiences a parasite infestation, it can cause diarrhea and other digestive issues, including prolapse.


Impaction is a very serious condition and could be the cause of your box turtle’s prolapse. Impaction occurs when your pet eats a foreign object, such as a small pebble or some sand, which causes a blockage.

Impaction can be fatal if veterinary assessment and treatment are not secured.


Bacterial and fungal infections are relatively common in captive box turtles, often as a result of their living conditions. Severe infections can result in organ prolapse.


Sex organ prolapse is often a result of injury. If your male box turtle doesn’t return his sexual organs within a few minutes, then injury may be the case and veterinary treatment may be required.

Bladder Stones

Bladder stones are minerals from your box turtle’s diet form crystals, leading to stones in the bladder.

This is often caused by poor nutrition and not having access to clean drinking water, which results in dehydration. You may also notice blood in your pet’s poop.

Metabolic Bone Disease

Metabolic bone disease can be fatal to box turtles, if not treated quickly.

Often you will notice the shell growing irregularly, which is a sign of metabolic bone disease or malnutrition. If ignored, it can cause serious health issues, including prolapse.

Egg Binding

Egg binding occurs in female box turtles when they cannot lay their eggs, often linked to poor habitat conditions, incorrect temperatures, and lighting, not having nesting sites, and poor diet, along with dehydration.

This condition can be life-threatening if not treated.

Egg binding is a cause of organ prolapse in female box turtles and needs veterinary examination and treatment to ensure your pet gets back on the road to recovery as quickly as possible.


Any prolapse, whether it’s the intestine, urinary bladder, penis, uterus, or cloaca, lasting more than minutes, should be considered an emergency and immediate veterinary treatment should be secured.

The sooner the prolapse cause is identified and treated, the better chance your pet has of a full recovery.

When any of your box turtle’s internal tissues become prolapsed, they start to rot, which means time is of the essence to reduce the risk of infection and long-term tissue damage.

Sugar Water Bath

Many box turtle owners use a sugar water bath to help relieve swelling, while they wait for their veterinarian appointment.

A sugar water bath can relieve the symptoms and make your pet more comfortable. It’s not uncommon for a sugar bath to help relieve minor prolapses on their own.

Even if the prolapse rectifies with the bath, it’s best to keep your vet appointment to identify the cause and prevent the risk of this happening again in the future.

Veterinary Treatment

When you get your prolapsed box turtle to the vet, the vet will immediately give your pet pain medication and sedate the turtle, often using sugar powder to reduce swelling, while they clean and remove the damaged tissues.

The vet then carefully puts the organs back where they belong inside your pet, often using a stitch on the vent to reduce the risk of another prolapse.

Antibiotics are often prescribed, often along with a few day’s hospital stay at the vet for observation.


There are a number of things you can do to try and reduce the risk of organ and sex organ prolapse in your box turtle; these include:

Clean Habitat

Many prolapses are due to poor hygiene, which is easy to rectify and even easier to maintain to prevent the risk of prolapse in the first place.

Keep your turtle’s enclosure clean with daily spot cleaning to remove uneaten food and poop. Once every second week, do a thorough clean of the enclosure, disinfecting and rinsing all the items, including decorations.


Pay close attention to the substrate you use in your box turtle’s enclosure. Small pebbles, gravel, and sand are not recommended. These substrates can increase the risk of impaction.


Diet can increase your pet’s chance of diarrhea, metabolic bone disease, and vitamin deficiencies, which is why you want to ensure you provide your pet with a well-balanced and nutritious diet.

Too much fruit, for example, can increase your pet’s risk of diarrhea and prolapse, as a result.


Ensure your box turtle’s enclosure always offers optimum humidity. Bladder stones can be prevented by providing good hydration and humidity to your pet.

Remember to mist the enclosure a few times a day to ensure your optimum humidity levels are maintained.

Use a digital hygrometer to accurately monitor the humidity inside the enclosure.

Nesting Areas for Female Box Turtles

Egg binding can be caused by a number of factors, from stress to poor diet, but sometimes it can be something as simple as your turtle not having anywhere to lay her eggs.

If your female box turtle is gravid, provide her with a nutritious diet and plenty of humid nesting areas for her to lay her eggs, reducing the risk of egg binding.


Prolapse in box turtles is very serious and should always be followed up with a veterinary examination.

While male box turtles will commonly prolapse their sex organ, it should return within a few minutes.

Any other organs seen outside the box are definitely not normal and require urgent veterinarian treatment.

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