Health Disorders, Diagnostic Approaches, and Preventive Husbandry of the Pig-Nosed Turtle (Carettochelys insculpta) Under Human Care: A Structured Narrative Review

The pig-nosed turtle, Carettochelys insculpta, is the sole living representative of Carettochelyidae and one of the most specialized freshwater turtles. It is maintained in zoological collections, rescue programs, and private facilities, yet species-specific clinical information remains sparse and fragmented. This structured narrative review consolidates published evidence on health disorders, diagnostic approaches, rehabilitation, and preventive husbandry in C. insculpta, while clearly separating direct evidence from extrapolation based on other chelonians. A structured literature search was conducted through 25 June 2026 using the scientific and common names of the species combined with veterinary, pathological, husbandry, nutritional, parasitological, and rehabilitation terms. Direct species-specific evidence was dominated by reports involving confiscated or wild-caught hatchlings. The best documented disease syndrome is shell and systemic hyalohyphomycosis associated with Paecilomyces lilacinus, currently classified as Purpureocillium lilacinum, in which biopsy, histopathology, and fungal culture were more informative than superficial scraping. A separate cohort of confiscated hatchlings demonstrated malnutrition, dermal disease, septicemia, systemic fungal infection, and suspected yolk peritonitis; descriptive plasma biochemical data were generated after rehabilitation but do not constitute reference intervals for healthy adults. Several helminths have been described from free-ranging pig-nosed turtles, although their pathogenic importance is unknown. Available husbandry reports emphasize stable warm water, rigorous water-quality management, physical space, underwater cover, varied feeding, individual monitoring, and attention to aggression. Important gaps include validated hematologic and biochemical intervals, adult clinical data, controlled nutritional studies, antimicrobial and antifungal pharmacokinetics, objective water-quality thresholds, and prospective outcome reporting. Current evidence supports a prevention-first approach centered on water quality, nutrition, quarantine, low-stress handling, longitudinal body-weight monitoring, and early tissue-based investigation of persistent shell lesions. This manuscript is a preprint and has not undergone formal peer review.