Brandon has been taking care of Herbie for seven years. Herbie, a box turtle, was a lost soul that Brandon found walking in the street when he was 11 years old and has been part of Brandon’s life ever since. He lives outdoors in the spring, summer and early fall and spends the winters indoors in a heated terrarium.

Herbie has had no health issues while in Brandon’s care until he recently began to develop a swelling or mass on the left side of his head. Brandon noticed Herbie not eating with his normal amount of enthusiasm, especially when it came to snails, Herbie’s favorite food.

For all his seven years with Brandon, the sight of a snail would bring Herbie sprinting for the food dish; of course, sprinting for a box turtle is a relative term.

This decrease in glee over snails became more evident over a few weeks until Brandon finally noticed the swelling.

It is likely not possible to definitively determine the cause of Herbie’s swelling simply by looking. It may be a swelling filled with liquid such as a cyst or it could be a solid mass lesion. In order to figure out how to help Herbie, we need to know what we are dealing with.

The first step would be a simple test called a fine needle aspirate — a needle attached to a syringe is introduced into the lesion to aspirate out some of the material inside. The material would be looked at under a microscope.

It is important to distinguish this procedure from a needle biopsy. A needle biopsy involves actual tissue removal from a lesion with a somewhat larger needle. This harvested tissue is then sent to a pathologist for processing and microscopic examination. This is a more in-depth test and is also better at identifying a mass.

In Herbie’s case, I am confident that a simple fine needle aspirate will give us the necessary information.

Having dealt with many box turtles over the past three decades as a veterinarian, I am going to venture an educated guess that Herbie’s lesion is an abscess in his left ear canal. These are fairly common in some species of turtles, box turtles especially, and are usually caused by an infection that starts in the mouth or throat and goes up the Eustachian tube into the middle ear.

People have this tube too; it’s the one we try to open up when we fly on an airplane to equalize the pressure across the eardrum.

When a bacterial infection sets up shop via this Eustachian tube into the middle ear in a turtle, the infection elicits a reaction from the body which causes pus to form. This develops into an abscess, causing the swelling Brandon has reported in Herbie’s neck.

Reptile pus is very casseous or thick and somewhat chunky, so it cannot be effectively drained with a needle. Instead, Herbie will need an anesthetic procedure to allow surgical lancing and cleaning out of his abscess.

Along with appropriate antibiotic therapy and continued cleaning at home, Herbie’s condition should be entirely curable and return him to his snail-loving self.