🦴 Nutritional Secondary Hyperparathyroidism in Reptiles: Vet Diagnosis, Treatment & Prevention Guide 2025 🦎

By Dr Duncan Houston, BVSc

Nutritional Secondary Hyperparathyroidism (NSHP) is the most common form of metabolic bone disease affecting captive reptiles. This condition, also known as "rubber jaw" disease, occurs when reptiles suffer from calcium deficiency, excess phosphorus, or insufficient vitamin D3 and UVB light exposure. In this in-depth 2025 veterinary guide, we'll explore the causes, signs, diagnosis, treatment, and most importantly, how to prevent this debilitating disease. 🩺☀️

📉 What Causes NSHP?

NSHP develops when reptiles don’t receive enough calcium through their diet or lack proper UVB lighting, which is crucial for converting vitamin D3 into its active form to absorb calcium. When calcium levels are low, the parathyroid gland produces excess parathyroid hormone, causing the body to steal calcium from the bones—leading to weakened, deformed, or soft bones. 🧬

🔄 Contributing Factors:

• 🥗 Low-calcium or high-phosphorus diets
• 💡 Inadequate UVB or unfiltered sunlight exposure
• ❌ Poor vitamin D3 supplementation
• 🐣 Higher needs during growth or breeding seasons

🔍 Who’s at Risk?

NSHP can occur in any reptile or amphibian but is most commonly seen in:

• 🦎 Insectivores (e.g., bearded dragons, leopard geckos)
• 🐢 Herbivores (e.g., iguanas, tortoises)
• 🐣 Young reptiles with rapid bone development
• 👩‍🦱 Breeding females (higher calcium demands)

🧠 Clinical Signs of NSHP

🐉 Physical Symptoms:

• 🦵 Swollen, hard hind legs
• 🦴 Soft, rubbery jaw or drooping lips
• 🧊 Misshaped or undersized shell in turtles and tortoises
• 🌀 Spinal deformities (curves, kinks, bumps)
• 🚶 Difficulty walking or lifting the body off the ground
• 😵 Jerky limb/head movements, seizures, or paralysis
• 🍽️ Inability to eat or handle prey, especially in chameleons

🚨 Systemic Symptoms:

• 🥚 Egg-laying issues
• 💩 Constipation or bloating
• 😴 Lethargy and stunted growth
• 🧻 Prolapses (organs protruding from the cloaca)

Early recognition of these symptoms is key to a successful recovery. 🩺

🔬 Veterinary Diagnosis

Your veterinarian will begin with a detailed dietary and husbandry history and a full physical exam. Common diagnostic tools include:

• 💉 Blood tests (calcium, phosphorus levels)
• 🩻 X-rays to assess bone density and fractures

X-rays also help monitor healing progress over time. 🧪

💊 Treatment of NSHP

Most reptiles respond well with timely and appropriate veterinary care. Treatment typically includes:

📋 Treatment Steps:

• 🔥 Warming the animal to proper basking temp for absorption
• 💧 Fluids for dehydration
• 💉 Injectable calcium if seizures or tremors occur
• 🍼 Oral calcium supplements for 1–3+ months
• ☀️ Vitamin D3 injections (if indicated)

🦎 Cage Adjustments:

• 🏠 Reduce climbing risk—remove high branches
• 🛏️ Use soft bedding and limit handling
• 🐢 Apply splints or use cage rest for fractures

🧼 Constipation Relief:

• 🛁 Warm water soaks
• 💆 Gentle massages
• 🧴 Warm water enemas if needed

🧬 Monitoring and Follow-up:

Regular check-ups are essential. Your vet may take follow-up X-rays to ensure bones are healing properly. In some cases, a medication called calcitonin is used to speed up bone rebuilding. With calcitonin, healing may occur in 2–3 months instead of 4–6. 🧠

😷 Long-Term Effects:

Bone deformities like spinal curves or jaw misalignments may remain even after recovery. These can be managed with gentle oral care and protective balms. 🩹

⚠️ Vitamin D3 Toxicity:

Too much vitamin D3 can cause toxicity, especially in reptiles kept outdoors with natural sun exposure. Be cautious with supplements. Only use D3-free supplements outdoors. 🌞

🛡️ Prevention: The Gold Standard

NSHP is almost entirely preventable with proper care. Here's how to keep your reptile healthy in 2025 and beyond:

💡 UVB Lighting Tips:

• ☀️ Use unfiltered sunlight when possible
• 💡 Use full-spectrum UVB bulbs for 10–12 hours/day
• 📏 Keep bulb within 12–16 inches of basking site
• ⏳ Replace bulbs every 12 months for optimal output

🥦 Feeding Guidelines:

For Insect-Eaters (Insectivores):

• 🦗 Gut-load feeder insects with dark leafy greens or commercial cricket food
• 🌫️ Dust with calcium + D3 before feeding (2–3x/week)

For Plant-Eaters (Herbivores):

• 🥬 Feed greens with a high calcium-to-phosphorus ratio (e.g., collard greens, dandelion greens)
• 🍉 Limit fruit to 10% of the diet
• 🌾 For tortoises, include grass hays (e.g., Russian tortoises)
• 🧂 Dust salads with calcium carbonate (½ tsp per 100g food, 2–3x/week)

📈 Long-Term Success

When NSHP is caught early and properly treated, most reptiles recover well. With corrected lighting, diet, and supplements, recurrence is rare. Long-term care should focus on monitoring nutrition, replacing bulbs annually, and scheduling annual vet visits. 🦎📆

📲 Need Help With Your Setup?

If you suspect NSHP or want help optimizing your reptile’s diet and lighting, reach out to Dr Duncan Houston through AskAVet.com or the Ask A Vet app for tailored, species-specific advice. 🧑‍⚕️📱

Your reptile deserves a strong, healthy skeleton—let’s make 2025 their best year yet! 🐢💚