DESERT TORTOISE WELLNESS, HUSBANDRY, NUTRITION & MEDICAL CARE

Desert Tortoise Veterinarian & Care in Laguna Beach

 

Desert tortoises are long-lived, highly specialized reptiles whose health depends on appropriate outdoor habitat, natural sunlight, diet, hydration, seasonal management and preventive veterinary care.

Small husbandry errors may take months or years to become visibly apparent. Abnormal shell growth, respiratory disease, nutritional deficiencies, parasites, bladder stones and reproductive problems can develop gradually, even when a tortoise initially appears active and continues eating.

Aliso Beach Animal Clinic provides desert tortoise veterinary care in Laguna Beach, including:

• Routine desert tortoise wellness examinations
• Species identification and sex determination
• Outdoor-habitat and dietary counseling
• Natural sunlight and UVB-lighting reviews
• Shell and beak evaluation
• Annual fecal examinations and parasite screening
• Blood work and urinalysis
• Digital radiographs and selected advanced imaging
• Evaluation of nasal discharge and suspected Mycoplasma infection
• Pre-brumation health examinations
• Assessment of appetite loss, weight loss and dehydration
• Evaluation of egg retention and other reproductive concerns
• Same-day evaluation of many urgent tortoise problems during regular clinic hours

Dr. Bryan Hayter and our veterinary team evaluate the complete patient, including species, size, weight, diet, enclosure, sunlight exposure, UVB equipment, soaking routine, shell growth, fecal history and seasonal behavior.

Call before scheduling or arriving with an urgent concern so we can confirm availability and prepare for your tortoise’s needs.

CALL (949) 499-4190

REQUEST A DESERT TORTOISE APPOINTMENT

Important California Desert Tortoise Laws

California desert tortoises are protected wildlife.

• Never collect a desert tortoise from the wild.
• Never purchase a wild-caught desert tortoise.
• Legal possession requires appropriate California documentation.
• Maintain the permit and identification information provided through the California Department of Fish and Wildlife.
• Never release a captive tortoise into the wild.
• Never relocate a wild tortoise to another property or habitat.

Captive desert tortoises may carry respiratory pathogens that could threaten wild populations. A tortoise that can no longer remain with its custodian should be transferred through an authorized tortoise organization rather than released.

Review the California Department of Fish and Wildlife’s desert tortoise guidance for current legal information.

Is My Tortoise a Desert Tortoise or a Russian Tortoise?

Desert tortoises and Russian tortoises are sometimes confused, particularly when an animal’s history is unknown. Correct identification matters because their legal status, adult size, habitat needs and seasonal care differ.

Typical Desert Tortoise Features

• Usually larger, commonly reaching approximately 9–15 inches as an adult
• High-domed brown or tan shell
• Large, heavily scaled, shovel-like front legs
• Prominent gular projection or “horn” extending from the front of the lower shell
• Native to the deserts of the southwestern United States and northern Mexico
• Protected by California and federal law

Typical Russian Tortoise Features

• Smaller adult size, commonly approximately 5–8 inches
• Rounder, broader and somewhat flatter shell
• Olive, greenish-brown or yellow shell with darker markings
• Four toes on each foot, which is an especially helpful identification clue
• Native to arid regions of Central Asia
• Not a native California desert tortoise

Color and size alone are not always reliable. Bring clear photographs of the shell, underside, head, front legs and rear legs when requesting identification.

See the LafeberVet Russian tortoise identification resource for additional comparison information.

How to Tell Whether a Desert Tortoise Is Male or Female

Sex is most reliably determined after the tortoise has reached sufficient size and sexual maturity. Juveniles may not yet display clear differences.

Adult Male Desert Tortoises Often Have

• A noticeably concave plastron, or lower shell
• A longer, thicker tail
• A cloacal opening positioned farther from the body
• A longer and more curved gular horn
• A more inward-curving rear edge of the shell
• Larger or heavier front claws

Adult Female Desert Tortoises Often Have

• A flatter plastron
• A shorter tail
• A cloacal opening closer to the body
• A shorter gular projection
• A wider, more outward-opening rear shell area that accommodates egg laying

Individual variation occurs, and one feature should not be used by itself. A veterinary examination can combine shell shape, tail anatomy and overall maturity to make the best determination.

How Old Is My Desert Tortoise?

An exact age usually cannot be determined unless the hatch date or long-term records are known.

Shell growth rings are not dependable annual rings. A tortoise may form more than one ring in a productive growth year, less than one during a poor year, or develop rings that later become worn and indistinct.

Veterinarians may provide a broad life-stage estimate using:

• Straight carapace length
• Weight and body condition
• Shell texture and wear
• Growth-ring visibility
• Development of male or female characteristics
• Known previous measurements

A small tortoise is not automatically young. Previous malnutrition or chronic disease may result in poor growth. Conversely, a well-fed captive juvenile may grow faster than a wild tortoise.

Keep annual records of weight and shell length. These measurements are more useful for future medical care than attempting to assign an exact age from appearance.

Outdoor Housing and Natural Sunlight

For a healthy desert tortoise living in an appropriate Southern California climate, a secure outdoor habitat generally provides the best opportunity for natural exercise, grazing, temperature selection and ultraviolet exposure.

Direct, unfiltered sunlight is the preferred UVB source whenever weather and the animal’s health make outdoor exposure safe.

Sunlight through a window does not provide adequate UVB because ordinary glass blocks most useful UVB radiation.

A Safe Outdoor Habitat Should Include

• Direct morning or daytime sunlight
• Shade available throughout the day
• A dry, insulated shelter or burrow
• Well-draining soil
• Protection from flooding and irrigation runoff
• Secure solid fencing that extends below ground
• Protection from dogs, coyotes, raccoons, rats and birds
• Barriers around swimming pools, ponds and steep drops
• Pesticide-free edible plants
• Enough room for walking, grazing and temperature selection

Never place a tortoise in a glass tank, plastic container or other small enclosure in direct sun. The temperature can become fatal within minutes.

Use thermometers to monitor sunny, shaded and burrow temperatures. A tortoise must always be able to escape direct heat.

The UC Davis desert tortoise care guide includes additional information about outdoor housing, heating, hydration and seasonal care.

Indoor Housing and UVB Lighting

Indoor housing may be necessary temporarily during illness, recovery, unusually cold or wet weather, or when a tortoise should not brumate.

An indoor enclosure needs:

• Substantial floor space
• A measured warm basking area
• A cooler retreat area
• A dry hide
• Appropriate UVB lighting
• A normal day-and-night cycle
• Safe, nonslip substrate
• Room for walking and normal feeding behavior

Use a high-quality reptile UVB fixture positioned according to the manufacturer’s instructions. Bulb type, fixture, distance and screen barriers all affect the amount of UVB reaching the tortoise.

Important UVB points include:

• UVB must reach the tortoise directly rather than through glass or plastic.
• Heat and UVB should overlap in the primary basking area.
• The tortoise must be able to move into shade.
• Visible brightness does not prove that adequate UVB is still being produced.
• Replace bulbs according to manufacturer guidance or measure output with an appropriate UV Index meter.
• Turn all visible lights off at night.

Artificial lighting is useful when outdoor exposure is not possible, but it should not be treated as an excuse to keep a desert tortoise permanently in a small indoor aquarium.

What Should a Desert Tortoise Eat?

A desert tortoise is a high-fiber herbivore. The most natural diet consists primarily of pesticide-free grasses, weeds, leaves and flowers rather than grocery-store vegetables or fruit.

Good nutrition supports:

• Normal gastrointestinal movement
• Steady shell and bone development
• Healthy body weight
• Normal beak wear
• Appropriate calcium balance
• Preparation for safe seasonal dormancy

Plants to Grow in a Desert Tortoise Yard

Plant a varied grazing garden so the tortoise can browse naturally. Appropriate choices may include:

• Globe mallow and other safe mallows
• Prickly pear cactus pads and seasonal flowers
• Desert hibiscus or pesticide-free hibiscus
• Dandelion greens and flowers
• Plantain weeds
• Desert or native bunch grasses
• Curly mesquite grass
• Sideoats grama
• Blue grama
• Deer grass
• Bermuda grass in established grazing areas
• Dichondra
• Clover
• Nasturtium
• Petunia flowers and leaves
• Mulberry leaves
• Grape leaves
• Pesticide-free rose petals and leaves

Useful planting resources include:

• Arizona-Sonora Desert Museum tortoise diet and plant list
• Arizona-Sonora Desert Museum guide to building a tortoise garden

Confirm the identity of every plant before allowing access. Do not use herbicides, insecticides, snail bait or systemic pesticides in or near the enclosure.

Foods That May Supplement Natural Grazing

When planted forage is limited, selected foods may include:

• Dandelion greens
• Collard greens
• Mustard greens
• Turnip greens
• Endive
• Escarole
• Watercress
• Grape leaves
• Mulberry leaves
• Opuntia cactus pads with sharp spines removed
• Small amounts of appropriate squash or vegetables when needed

Foods to Avoid or Strictly Limit

• Dog or cat food
• Meat, eggs or insects
• High-protein commercial foods
• Large quantities of fruit
• Bread, cereal or processed human food
• Iceberg lettuce as a dietary staple
• Plants exposed to pesticides or fertilizers
• Oleander
• Tobacco plants
• Unknown mushrooms
• Any unidentified yard plant

Fruit should be rare. Frequent fruit can displace fibrous forage and provides more sugar than a desert tortoise normally consumes.

Calcium, Cuttlebone and Vitamins

A plain cuttlebone may be kept available as an optional calcium source and chewing surface.

• Use plain, unflavored cuttlebone.
• Remove any hard plastic or metal backing.
• Replace it when heavily soiled.
• Do not rely on cuttlebone to correct a diagnosed calcium disorder.

Calcium and vitamin recommendations should be individualized.

A varied planted diet combined with safe outdoor sunlight may provide more complete nutrition than a produce-heavy indoor diet. Some veterinary guidance recommends routine calcium and vitamin supplementation for captive diets, while other husbandry programs caution that additional supplementation may be unnecessary or harmful when a nutritionally complete natural grazing diet is provided.

For this reason, we do not recommend one universal vitamin schedule for every tortoise.

Bring photographs of all supplement labels to your appointment. Excessive fat-soluble vitamins, particularly vitamins A and D, can be toxic.

A tortoise with soft shell, abnormal growth, weakness or suspected calcium imbalance needs veterinary evaluation rather than progressively larger amounts of over-the-counter supplement.

Feeding on a Stone or Marble Surface

Offering supplemental food on a clean, flat stone helps keep food away from soil, sand and gravel. Contact with a slightly textured surface may also encourage gradual natural beak and nail wear.

A clean marble tile can be used as a feeding platform, but a lightly textured unglazed stone, slate tile or rough-sided paver generally provides more useful wear than highly polished marble.

• Choose a stable tile that cannot tip.
• Avoid sharp or broken edges.
• Do not use a surface that becomes dangerously hot in direct sun.
• Clean the feeding surface regularly.
• Do not place all forage on a plate—natural grazing remains important.

An overgrown, cracked or asymmetrical beak should be examined. Filing or trimming without identifying the underlying cause can result in injury.

Water and Regular Soaking

Desert tortoises are adapted to dry environments, but they still require reliable access to hydration.

Provide a shallow water dish large enough for the tortoise to enter, but shallow enough that it can keep its head above water and climb out easily.

For many adult desert tortoises, a supervised warm-water soak for approximately 15–20 minutes once weekly is a reasonable routine. Juveniles, recently emerged tortoises, dehydrated animals and medically ill patients may require more frequent soaking under veterinary direction.

Safe Soaking Guidelines

• Use comfortably warm—not hot—water.
• Keep the water shallow.
• Supervise the tortoise continuously.
• Use a container the tortoise cannot climb out of and fall from.
• Do not allow the animal to become chilled afterward.
• Clean and disinfect shared soaking containers.

Soaking does not replace access to drinking water, appropriate food moisture or treatment of kidney disease, bladder stones or severe dehydration.

Call when your tortoise has sunken eyes, thick or gritty urates, marked lethargy, rapid weight loss or a prolonged lack of urination.

Healthy Shell Growth and Pyramiding

A healthy desert tortoise shell should develop through relatively smooth, even growth. Mild natural contouring is different from pronounced pyramiding.

Pyramiding describes abnormal raised, cone-shaped growth of the individual shell scutes.

It is generally considered a multifactorial husbandry problem. Contributing factors may include:

• Growth that is too rapid
• Excess calories or protein
• Inadequate calcium balance
• Insufficient UVB exposure
• Inadequate hydration
• Improper temperature
• Humidity or microclimate problems during growth
• Limited natural grazing and exercise

Existing pyramiding cannot simply be flattened or reversed. The goal is to improve future growth and determine whether bone density, calcium balance or another medical issue is present.

Veterinary evaluation may include:

• Diet and husbandry review
• Body-weight and growth assessment
• Blood calcium and phosphorus testing
• Ionized calcium in selected cases
• Digital radiographs
• Kidney and liver assessment

LEARN ABOUT DIGITAL X-RAYS & ADVANCED IMAGING

Never Paint, Polish or Decorate a Tortoise Shell

A tortoise shell is living tissue containing bone, blood supply and nerves. It is not an inanimate surface.

Do not apply:

• Paint
• Nail polish
• Glitter
• Permanent markers
• Adhesive decorations
• Resin
• Shell polish
• Oils or cosmetic products

Paint and decorations may:

• Expose the tortoise to absorbed chemicals
• Produce toxic or irritating fumes
• Interfere with normal shell growth
• Trap heat
• Conceal cracks, infections or abnormal growth
• Make the tortoise more visible to predators
• Cause injury when adhesive material is removed

Read the U.S. Fish and Wildlife Service warning against painting living turtle and tortoise shells.

Contact a veterinarian before attempting to remove paint or adhesive from a shell. Solvents can cause additional toxicity and skin injury.

Should a Desert Tortoise Brumate?

Brumation is the seasonal period of reduced metabolism and activity commonly called hibernation.

Healthy desert tortoises naturally brumate, but captive brumation is not risk-free. A tortoise should not be allowed to brumate merely because it becomes inactive in fall.

Arrange a Pre-Brumation Examination

A veterinary examination several weeks before expected brumation may include:

• Accurate weight and body-condition assessment
• Review of appetite and summer weight gain
• Oral and respiratory examination
• Annual fecal and parasite screen
• Blood work when indicated
• Assessment for bladder stones or reproductive disease
• Review of the planned brumation location and temperatures

Do Not Brumate a Tortoise That Has

• Nasal discharge
• Swollen eyelids
• Labored or noisy breathing
• Weight loss
• Poor appetite before the normal seasonal slowdown
• Dehydration
• Diarrhea or heavy parasite burden
• Recent surgery or significant illness
• Shell infection or untreated injury
• Suspected egg retention
• An uncertain medical history

A tortoise that should not brumate must be maintained indoors with appropriate heat, UVB, food, hydration and enough space to remain active.

Healthy Adults

A healthy, weight-stable adult may be allowed to brumate when safe, monitored temperature and moisture conditions can be provided.

Outdoor brumation is risky in areas prone to:

• Flooding
• Wet winter soil
• Rapid temperature changes
• Rodents
• Poorly insulated shelters

Because brumation protocols depend on the individual tortoise and local environment, obtain a specific veterinary plan rather than following a generic calendar.

Record weight before brumation and monitor as directed. Unexpected activity, substantial weight loss, nasal discharge or repeated emergence may indicate a health or environmental problem.

Mycoplasma and Upper Respiratory Disease

Upper-respiratory tract disease associated with Mycoplasma is one of the most important infectious concerns in captive and wild desert tortoises.

Pathogenic species include Mycoplasma agassizii and Mycoplasma testudineum.

Possible Signs

• Clear, cloudy or thick nasal discharge
• Bubbles at the nostrils
• Swollen eyelids
• Sunken or irritated eyes
• Noisy or difficult breathing
• Reduced appetite
• Lethargy
• Weight loss

Signs can be intermittent. A tortoise may appear improved and later relapse, particularly during stress, poor weather or brumation.

Nasal discharge is not automatically Mycoplasma. Other possibilities include:

• Other bacterial infections
• Herpesvirus
• Fungal disease
• Foreign material
• Dehydration
• Environmental irritation
• Oral disease

Testing may involve nasal or oral sampling, PCR testing, antibody testing, radiographs and blood work. Test results must be interpreted with clinical signs and exposure history.

Preventing Disease Transmission

• Do not house desert tortoises with Russian, sulcata or other tortoise species.
• Quarantine new tortoises.
• Do not share soaking tubs, food dishes or enclosure tools.
• Wash hands between animals.
• Do not attend tortoise gatherings with a sick animal.
• Never release a captive tortoise into the wild.

Review the U.S. Fish and Wildlife Service Desert Tortoise Health Assessment Handbook.

Annual Fecal Testing for Pinworms and Other Parasites

Aliso Beach Animal Clinic recommends an annual fecal examination for captive desert tortoises, ideally while the tortoise is active and before any planned brumation.

A fecal screen may identify:

• Pinworms
• Other nematodes
• Protozoal organisms
• Abnormal bacterial or yeast overgrowth in selected cases

Low numbers of certain pinworms may be found in apparently healthy tortoises. A positive result does not always mean immediate medication is necessary.

Treatment decisions depend on:

• Parasite species
• Number of eggs or organisms detected
• Weight and body condition
• Appetite and stool quality
• Whether the tortoise will brumate
• Other medical conditions
• Exposure to additional tortoises

Unnecessary or incorrectly dosed deworming medication can be harmful. Never use livestock, dog or cat dewormers without reptile-specific veterinary instructions.

Common Desert Tortoise Health Problems

Bladder Stones and Urinary Disease

Signs may include straining, infrequent urination, gritty urates, hind-limb weakness, appetite loss or a firm abdominal structure. Radiographs are often important.

Metabolic Bone and Shell Disease

Soft shell, weakness, abnormal shell growth, fractures or a deformed jaw may be associated with nutritional, UVB, calcium or organ disease.

Beak Overgrowth

Beak overgrowth may reflect insufficient abrasive grazing, an overly soft diet, metabolic disease, trauma or abnormal jaw alignment.

Reproductive Disease

Female tortoises may develop retained eggs even when no male is present. Digging, pacing and temporary appetite reduction may precede laying, but prolonged straining, weakness, prolapse or continued abdominal enlargement require examination.

Shell Trauma

Dog bites, lawn equipment, vehicles, falls and enclosure accidents can cause deep shell injuries. Even a small opening may communicate with living tissue or the body cavity.

Heat Stress

Weakness, open-mouth breathing, collapse, excessive salivation or abnormal responsiveness during hot weather is an emergency.

Nutritional Support and Feeding Tubes

A tortoise that stops eating may require more than hand feeding or dietary changes. Appetite loss can result from respiratory infection, dehydration, parasites, bladder stones, reproductive disease, oral pain, organ disease or unsafe temperatures.

An esophagostomy feeding tube may be placed in selected seriously ill tortoises to provide:

• Nutrition
• Fluids
• Medication
• Reduced stress from repeated oral handling
• Longer-term supportive care while the underlying condition is treated

Tube placement, formula, volume and frequency must be prescribed and monitored by a veterinarian. Do not attempt to place or use a feeding tube without training.

LEARN ABOUT VETERINARY PROCEDURES & ANESTHESIA

Diagnostic Testing for Desert Tortoises

Depending on the symptoms, diagnostic testing may include:

• Fecal parasite examination
• Blood-cell evaluation
• Blood chemistry
• Total or ionized calcium
• Urinalysis
• Mycoplasma testing
• Digital radiographs
• Ultrasound
• CT imaging in selected cases
• Cytology, culture or biopsy

Digital radiographs are especially useful for evaluating:

• Bladder stones
• Eggs
• Bone density
• Shell fractures
• Lung changes
• Gastrointestinal material
• Organ enlargement

LEARN ABOUT PET BLOOD WORK & DIAGNOSTICS

LEARN ABOUT DIGITAL RADIOLOGY, ULTRASOUND & CT

When Does a Desert Tortoise Need Urgent Veterinary Care?

Call promptly when your tortoise:

• Has difficulty breathing
• Develops persistent nasal discharge
• Becomes limp, cold or unresponsive
• Stops eating and is losing weight
• Has a prolapse
• Strains without passing urine, stool or eggs
• Has a swollen or painful abdomen
• Has a shell fracture or dog bite
• Has been struck by a vehicle or lawn tool
• Shows signs of heat stress
• Cannot walk normally
• Has severe diarrhea
• Has been exposed to paint, chemicals or toxins
• Emerges repeatedly during brumation and appears weak

Aliso Beach Animal Clinic evaluates many urgent desert tortoise concerns during regular clinic hours when staffing, case volume and the patient’s needs allow.

We are not a 24-hour emergency hospital. Call before arriving so our team can determine whether we can appropriately evaluate the patient or whether immediate referral is safer.

LEARN ABOUT URGENT EXOTIC-PET CARE

Preparing for a Desert Tortoise Appointment

Bring:

• Current and previous weight records
• A fresh fecal sample when requested
• Photographs of the entire enclosure
• Photographs of the shelter and burrow
• Temperature readings
• UVB bulb brand, model and age
• Supplement labels
• A list of yard plants and supplemental foods
• California permit information
• Previous medical records and test results

Transport the tortoise in a secure ventilated container with a nonslip towel. Protect it from direct sun, overheating and cold air-conditioning vents.

Frequently Asked Questions About Desert Tortoise Care

Can I keep a wild desert tortoise I found?

No. Wild desert tortoises are protected and must not be collected. Contact the appropriate wildlife authority when a wild tortoise appears injured or endangered.

Can I release my pet desert tortoise?

No. Captive tortoises must never be released because they may transmit disease and may not survive after long-term captivity.

How can I distinguish a Russian tortoise?

Russian tortoises are generally smaller, rounder and flatter and have four toes on each foot. Desert tortoises are usually larger with heavily scaled shovel-like front legs and a prominent gular projection.

Can shell rings tell me my tortoise’s age?

No exact age can be determined from shell rings. Growth rings vary with nutrition, weather and growth rate and become worn with age.

Should my desert tortoise live outside?

A secure, appropriately planted outdoor habitat with direct sunlight, shade and a safe burrow is generally preferable when local weather and the tortoise’s health allow it.

Does sunlight through a window provide UVB?

No. Ordinary window glass blocks most useful UVB radiation.

Should I soak my desert tortoise?

Yes. Many adults benefit from a supervised warm soak approximately once weekly. Frequency may be increased for juveniles or selected medical patients under veterinary direction.

Does my tortoise need vitamins?

That depends on the complete diet, sunlight exposure, age and health. Excessive fat-soluble vitamins can be toxic, so supplements should be selected rather than given automatically.

Can I provide cuttlebone?

Yes. Plain cuttlebone can be offered as an optional calcium and chewing source, but it does not replace a balanced diet or treatment of calcium disease.

Does feeding on marble maintain the beak?

A flat feeding tile keeps food off soil and may provide modest wear. Lightly textured stone, slate or an unglazed paver generally provides more useful abrasion than polished marble.

Can I paint my tortoise’s shell?

No. Paint, nail polish, markers, glue and decorations may expose the tortoise to toxins, fumes, abnormal heat and impaired shell growth.

Should my tortoise brumate?

A healthy, weight-stable desert tortoise may brumate with an appropriate monitored plan. Sick, underweight, dehydrated or recently ill tortoises should not brumate.

What are signs of Mycoplasma?

Possible signs include nasal discharge, swollen eyelids, sunken eyes, difficult breathing, appetite loss and lethargy. Signs may be intermittent.

Does my tortoise need an annual fecal examination?

Yes. Annual parasite screening is recommended, particularly before planned brumation or when a tortoise has weight loss, appetite changes or abnormal stool.

How much does a desert tortoise appointment cost?

Cost depends on the examination, medical concern and whether fecal testing, laboratory testing or imaging is needed. Our team can provide current examination information when scheduling.

REVIEW VETERINARY PAYMENT OPTIONS

Schedule a Desert Tortoise Veterinarian in Laguna Beach

Long-term desert tortoise health depends on a natural high-fiber diet, safe sunlight exposure, appropriate hydration, smooth shell growth, parasite monitoring and careful seasonal management.

Aliso Beach Animal Clinic provides species-specific veterinary care for legally held captive desert tortoises in Laguna Beach, including wellness examinations, husbandry counseling, annual fecal testing, diagnostic imaging and evaluation of urgent medical concerns.

Call before scheduling so our team can confirm availability and help you prepare for the visit.

CALL (949) 499-4190

REQUEST A DESERT TORTOISE APPOINTMENT

Aliso Beach Animal Clinic
30816 Coast Highway
Laguna Beach, CA 92651
Directly across from the Montage Laguna Beach

Monday–Friday: 7:30 a.m.–4:30 p.m.
Saturday: 8:00 a.m.–12:00 p.m.
Sunday: Closed

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Medical review: Reviewed for medical accuracy by Bryan Hayter, DVM, Owner and Medical Director. Last reviewed July 2026.