Metabolic Bone Disease in Reptiles Causes, Treatment, and Prevention By Lianne McLeod, DVM Lianne McLeod, DVM Lianne McLeod, DVM, is a small animal and exotic pet expert with over a decade of experience writing about veterinary care. After caring for animals in her veterinarian practice, Lianne went on to study biology and research water quality and chronic disease at the University of Saskatchewan. Learn more about The Spruce Pets' Editorial Process Updated on 01/16/26 Radiograph (x-ray) of an iguana with metabolic bone disease. Credit: grecosvet / Getty Images Key Takeaways Metabolic bone disease (MBD) in reptiles is caused by an improper calcium-to-phosphorus ratio, leading to weakened bones and other symptoms.Proper husbandry, including a balanced diet, UVB exposure, and correct habitat conditions, is essential to prevent and treat MBD.Early diagnosis and treatment of MBD, including calcium and vitamin D supplementation, can lead to full recovery in many cases. Metabolic bone disease (MBD) is a well-recognized and common disease seen in pet reptiles. Metabolic bone disease results from an improper calcium to phosphorus ratio in the body, causing softened and damaged bones. Other terms which may be used for this disease include fibrous osteodystrophy, osteomalacia, secondary nutritional hyperparathyroidism, osteoporosis, and rickets. What is Metabolic Bone Disease in Reptiles? Metabolic bone disease is a complex disease. The primary problem is a disruption of calcium metabolism which causes a host of related problems. Due to the importance of calcium in bone formation and muscle function, most of the signs and symptoms are related to bone and muscle development. There is no single cause of MBD and the disease is not as simple as calcium deficiency. Symptoms of Metabolic Bone Disease in Reptiles Symptoms of MBD vary based on severity and duration, and are best identified by a reptile and amphibian specialist. Key symptoms include: Symptoms Leg abnormalitiesSpinal aberrationsJaw distortionsShell softeningUncontrollable movementsAnorexiaDefecating issuesBone fracturesReluctance to move Leg Abnormalities A reptile's legs can become bowed or swollen if it has MBD. Bumps may develop on the long bones of the legs. The bumps are the body's attempt to strengthen the skeletal structure with fibrous tissue to compensate for the lack of calcium in the bones. Spinal Aberrations A reptile with this symptom will have an arched spine. Or bumps will develop along the bones of the reptile's spine as well as the base, which are other areas of the skeletal structure that the body is trying to strengthen with fibrous tissue. Jaw Distortions The bones of the jaw can also become depleted of calcium which will cause it to malfunction. The jaw of a reptile will soften and there may be swelling of the jaw (which is why this disease is sometimes called "rubber jaw"). In addition, the lower jaw of the reptile may recede in response to calcium deficiency. Shell Softening In turtles, such as yellow-bodied sliders, softening of the carapace or plastron (the shell) occurs with MBD. Uncontrolled Movements MBD results in reptiles developing muscle tremors, jerky movements, or twitching in the muscles of the legs and toes. Anorexia The reptile will not be able to eat or drink once the disease affects its jaw and tongue. Defecating Issues MBD causes a reptile to become constipated or experience obstipation (not defecating at all). Bone Fractures MBD causes the bones to break due to bone weakness and lack of calcium. Reluctance to Move Weakness, lameness, and even partial paralysis can occur with MBD. The reptile will sometimes be unable to move its legs or lift its body off the ground because of how weak and lethargic it feels. This is also due to the depleted calcium in the reptile's bones. Causes of Metabolic Bone Disease Normally, the ratio in a reptile's body of calcium to phosphorus ratio should be around two parts calcium and one part phosphorus (2:1). When the calcium level is relatively low the body tries to compensate by taking calcium from wherever it can, including from the bones. This leads to a softening of the bones making them susceptible to fractures and also leading to a deposition of fibrous tissue as the body tries to strengthen the bone in an absence of available calcium. Calcium also impacts a number of other physiological systems, including muscle contraction and blood clotting. An ideal 2:1 calcium to phosphorus ratio is essential in a reptile’s diet. However, calcium metabolism is complex and requires adequate vitamin D (particularly D3) to function properly. Because some reptiles struggle to absorb vitamin D, exposure to ultraviolet light is necessary for them to synthesize it, which complicates achieving the right balance. Basic factors that can skew the calcium to phosphorus ratio include: Too little calcium or too much phosphorus in the diet Presence of substances in the diet that impair the absorption of calcium Vitamin D deficiency Lack of exposure to the UVA and UVB necessary for the reptile to produce its own vitamin D Inadequate protein Kidney or liver disease Small intestinal disease Disease of the thyroid or parathyroid glands Living in cool temperatures, which impairs digestion and affects calcium absorption Diagnosing Metabolic Bone Disease in Reptiles Metabolic bone disease is distinctive enough that a diagnosis is usually made based on the symptoms, physical exam, and a discussion of proper husbandry (meaning the equipment used to care for the reptile and the habitat in which it lives). Radiographs (X-rays) may be taken to confirm the diagnosis and monitor treatment. Calcium levels in the blood may also be tested. Treatment Treatment of MBD depends on the severity of the disease. For very mild cases, a switch to a balanced diet and appropriate husbandry may be enough. Severe cases require intensive calcium and vitamin supplementation as well as an increase in high-intensity UVB rays under an exotics veterinarian's care. Prognosis for Reptiles with Metabolic Bone Disease A diagnosis of metabolic bone disease requires timely treatment or the reptile will not survive. The prognosis for reptiles with mild symptoms is positive as treatment is tolerated quite well. Even reptiles with more severe symptoms and treated will make a full recovery. Though it may be difficult, it is not impossible for a reptile with an extreme case of metabolic bone disease to recover with the right treatment. How to Prevent Metabolic Bone Disease MBD is almost always a result of poor husbandry but it is also generally preventable by providing a proper environment and diet specifically for your type of reptile. This is not always easy or inexpensive for a reptile owner to do but is vital to the health of all pet reptiles. Proper husbandry is more than just providing the right diet. The following are important in both the prevention and treatment of metabolic bone disease: A diet balanced in calcium and phosphorus, protein, energy, and other reptile-specific nutrients Exposure to UVA/UVB invisible light rays Proper heat gradients Proper light/dark cycles Adequate enclosure and/or room to exercise Explore more: Reptiles & Amphibians Bearded Dragons