Marine Turtle Trauma Response Procedures:   A Veterinary Guide

Mettee, Nancy (2014) WIDECAST Technical Report No. 16

Formulary

The pharmacokinetics of many drugs have not been determined in sea turtles. Most drug dosing is based on work done in other species. As new work becomes published, these doses may change.

 

Analgesics
NSAIDS should be used with caution in any turtle with blood loss due to potential platelet effect.

Carprofen (Rimadyl)

4 mg/kg

SQ, PO

 

q24hr

Butorphanol (Torbugesic)

0.1-0.5 mg/kg

IM

 

q12-24hr

Meloxicam (Metacam)

*maintenance dose

0.2 mg/kg

0.1 mg/kg

SQ 

SQ

 

q24hr

q24hr

Buprenorphine (Buprinex)

0.03 mg/kg

IM, IV

SQ

 

q24hr

Tramadol

5-10 mg/kg

PO

 

q72hr

Lidocaine

< 2 mg/kg

SQ

 total dose

 

Bupivicaine

< 2 mg/kg

SQ

 total dose

 

Ketoprofen

2 mg/kg

SQ

 

q48

 

 

 

 

 

Anesthetics

Dexmeditomidine (Dexdomitor)

*may combine with ketamine

50-100 mcg/kg

IM, IV

 

 

Ketamine

*with Dexdomitor

5 mg/kg

IM, IV

 

 

Atipamazole (Antisedan)

*for reversal

equivalent volume to Dexdomitor

IM, IV 

 

 

 

Butorphanol (Torbugesic)

*maybe be combined with Dexdomitor and Ketamine

0.4 mg/kg

IM, IV

 

 

Propofol

*for induction, also may use as CRI

3-6 mg/kg

IV

 

 

Lidocaine

< 2 mg/kg

SQ

 total dose

 

Bupivicaine

< 2 mg/kg

SQ

 total dose

 

 

 

 

 

 

Antibiotics
It is always advisable to get a culture and sensitivity to aid in antibiotic selection. If that is not practical, broad spectrum coverage, including pseudomonas is the best option. Oral route preferred if possible to avoid injection site infection.

TMPS 

20-25 mg/kg

PO

 

q24hr

Amikacin

*fluids given if not eating

5 mg/kg

IM

10 doses

q48hr

Ceftiofur (Naxcel)

*after reconstitution, good for 2 months frozen, 7 days refrigerated, 12 hours at room temperature. Only freeze/thaw one time.

4 mg/kg

IM

14 doses

q24hr

Ceftazidime (Fortaz)

*after reconstitution, good for 3 months frozen, 7 days refrigerated 

20 mg/kg

IM

7 doses

q72hr

Enrofloxacin (Baytril)

*large animal 100mg/ml may be used IC or SQ if diluted 5:1 in normal saline.

5-10 mg/kg

ICo, PO

SQ, IV    

10 doses

q24hr

Chloramphenicol

50 mg/kg

PO

 

q24hr

Metronidazole

10-25 mg/kg

PO, ICo

 

q24hr

Ampicillin sodium

*loading dose

*maintenance dose

May be frozen for 72 hrs

 

20 mg/kg

10 mg/kg

 

IV

IV, IM

 

 

q24hr

 

q24hr

 

Piperacillin

40-50 mg/kg

IM

 

q24hr

Clindamycin

 5 mg/kg

IM, PO

 

q24hr

Danofloxacin

6 mg/kg

SQ

 

q72hr

 

 

 

 

 

Antifungals
Severely immune compromised turtles (cold stunned, etc.) are treated prophylactically with antibiotics and antifungals.

Fluconazole (Diflucan)

*maintenance dose

21 mg/kg

10 mg/kg

SQ, PO

SQ, PO

 

loading dose

q5 days

Itraconazole

*alternative dose:

*liquid is preferred due to pH effect

5 mg/kg

15 mg/kg 

PO

PO 

 

q24hr

q72hr 

Ketoconazole

10 mg/kg

PO

 

q24-48hr

 

 

 

 

 

Dewormers
Sea turtles normally carry a wealth of parasites. Strategic deworming is done with Droncit and Panacur even if fecal examinations are negative for ova. Any turtle displaying neurologic symptoms receives Droncit at the trematode dose.

Ivermectin should NEVER be used in chelonians due to potential toxicity!

Fenbendazole (Panacur)

*use with caution in anemic turtles due to potential bone marrow suppression

50 mg/kg

PO

2 doses

q14day

Praziquantel (Droncit)

*for trematode infection

25 mg/kg

IM, PO

3 doses

q3hr

 

 

 

 

 

Gastrointestinal:
Gas production and ileus are common complications of illness and may be treated symptomatically.

Metoclopramide (Reglan)

0.5 mg/kg

IM, PO

 

q24-48hr

Lactulose

1 ml/kg

PO

 

q24hr

Cisapride

0.5 mg/kg

PO

 

q24hr

Famotidine

0.5 mg/kg

PO

 

q24hr

Simethicone

20 mg/kg

PO

 

q24hr

 

 

 

 

 

Minerals:

Calcium injections are reserved for those individuals with clinical signs of hypocalcemia (muscle fasciculations, etc.) and not based on plasma levels as they are frequently very low.

Iron

12 mg/kg

IM

 

q3-4days

Calcium gluconate

10-100 mg/kg

ICo, IM

 

q12-14hr

Calcium glubionate

1 ml/kg

PO

 

q12-24hr

 

 

 

 

 

Miscellaneous

Propofol

3-6 mg/kg

IV

single dose

 

Aminophylline

*used as diuretic for drowning

10 mg/kg

IM

 

q4-6hrs

DexSP

0.1-1 mg/kg

IV, IM

 

single dose or q12hr

EDTA (chelation)

ethylene diamine tetra-acetic acid

40 mg/kg

IM

 

q12hr

Acyclovir

80 mg/kg

PO

 

q24hr

Furosemide (Lasix) 

*for brevetoxicosis

 

*for salt water drowning

 

5 mg/kg

 

 

5 mg/kg

IM

 

 

IM

 

q24hr x 

1-3 days

 

q4-6hrs

Diphenhydramine (benadryl)

2 mg/kg

IM

 

q24hr

Oxytocin

5 IU/kg

IM

may repeat

 

Valium

*may be used for seizure control

*low dose may be used for appetite stimulant

0.1-0.5 mg/kg

IM, IV

PO   

 

q6-12hrs

 

 

 

 

 

Ophthalmic
Ointments are preferred over drops due to longer persistence on the eye. Temporary dry docking may increase effectiveness of drug. When corneal ulceration is present, drops are preferred to ointments but will need to be applied with a greater frequency (q4hr).

Terramycin ophthalmic

 

 OU

 

 q12hr

 Gentocin ophthalmic

 

 OU

 

 q12hr

 Ciprofloxacin ophthalmic

 

 OU

 

 q12hr

 Flurbiprofen ophthalmic

 

 OU

 

 q12hr

 Miconazole ophthalmic

 

 OU

 

 q12hr

 Artificial tears ointment

 

 OU

 

 q8-12hr

 Dicolfenac ophthalmic

 

 OU

 

 q12hr

*when dry docked for any significant duration (> 30 minutes) eyes should be lubricated

 

 

 

 

 

Topicals

Those in a petroleum base will persist longer in water, but best results may be achieved if topicals are applied and then the animal is dry-docked for 12-24 hours to maximize contact time. Honey and sugar wound packing requires daily lavage and repacking.

Silver sulfadiazine cream 1%

 

topical

 

q24hr

Nolvasan cream

 

topical

 

q24hr

Honey/sugar

 

topical

 

q24hr

 

 

 

 

 

Vitamins
Vitamin supplementation is given to all turtles that require hospitalization.

Vitamin K

0.5-1 mg/kg

(max 5 ml)

IM

2 doses

q14day

Vitamin B

25 mg/kg

(max 5 ml)

IM

2 doses

q14day

Vitamin C

10 mg/kg

(max 5 ml)

IM

2 doses

q14day

Vitamin A/D

0.1 ml/10kg

IM

2 doses

q14day

Vitamin E

100 IU/kg

IM

2 doses

q14day

 

 

This chapter should be cited: Mettee, Nancy. 2014. Formulary. Marine Turtle Trauma Response Procedures:  A Veterinary Guide. WIDECAST Technical Report No. 16. Accessed online [date].

Updated 3/2014