Marine Turtle Trauma Response Procedures: A Veterinary Guide
Terry Norton and Nancy Mettee (Editors). 2020. WIDECAST Technical Report No. 20.
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.
| Drug | Dosage | Comments |
|---|---|---|
Meloxicam | 1 mg/kg q 12 hrs sq in kemps, 0.5 mg/kg q 24 hrs sq in greens | Not effective for loggerheads, efficacy of oral dosing has not been confirmed |
Tramadol | 5 mg/kg q 48 hours sq or PO, 10mg/kg q72 hrs sq or PO | |
Ketoprofen | 2mg/kg SQ q24hrs in loggerheads |
| Drug | Dosage | Comments |
|---|---|---|
Dexmedetomidine (DM) | 50-75 micrograms/kg, 5-25 micrograms/kg for debridement or compromised | Often combine with ketamine and/or butorphanol |
Atipamazole (Antisedan) | Same volume as DM IV or IM | Antagonist/reversal DM |
Ketamine | 1.5 mg/kg IV in combo with DM | |
Butorphanol | 0.4 mg/kg IV in combo with Ket/DM | |
Propofol | 5-7 loading IV, 3mg/kg IV maintenance, give to effect | Keep refrigerated |
Lidocaine | 6 mg/kg maximum dose 2 mg/kg intrathecal (preservative free) | Can dilute 1:1 with saline or sodium bicarbonate for local blocks |
| Drug | Dosage | Comments |
|---|---|---|
Fenbendazole (Panacur) | 25 mg/kg SID x 3 days, repeat in 10-14 days | Causes bone marrow suppression in many species, careful in anemic patients |
Biltricide (Praziquantel) | 25 mg/kg x 3 in one day, repeat in 10-14 days | Spirorchid trematode adult stages, not eggs |
Praziquantel | Same as above for flukes, tapeworms 7.5 mg per kg depending on spp of tapeworm | Injectable and tablets |
| Drug | Dosage | Comments |
|---|---|---|
Amikacin | Sea turtles: 5mg/kg (loading), 3mg/kg (maint) SQ q72hrs | 50mg/ml, 250mg/ml. |
Ceftazidime (Fortaz) | 20mg/kg SQ q72hrs | Add 10mL sterile water to vial (100 mg/ml), good for 3 days. Discard or aliquot (freeze). |
Chloramphenicol | 50mg/kg PO SID | WEAR GLOVES-aplastic anemia in humans |
Enrofloxacin (Baytril) | 5mg/kg SQ, or PO SID 20 mg/kg q5 days PO | Irritating to tissue, dilute 1:10 with saline for SQ |
Metronidazole (Flagyl) | 20mg/kg PO SID | |
Danofloxacin (A180) | 6mg/kg SQ q72hrs | |
Ampicillin | 30 mg/kg SQ q24hr | |
Clavomox | 30 mg/kg PO q24hr |
| Drug | Dosage | Comments |
|---|---|---|
Itraconazole | 5mg/kg PO SID or 15mg/kg PO q72hrs | Oral capsules or liquid suspension |
Terbinafine | 20 mg/kg PO SID, 2mg/ml solution (mix tabs with sterile water) in a standard nebulizer for 20-30 minutes once daily for 28 days (minimum) | Oral capsules or liquid suspension |
| Drug | Dosage | Comments |
|---|---|---|
Doxapram (Respiram) | 5mg/kg IM or IV or intratracheal | Respiratory stimulant |
Dexamethasone Na Ph (Dexium SP) | 0.25 mg/kg IV, sq | 4mg/mL |
Methylprednisolone (SoluMedrol) | 20mg/kg IV | Short acting steroid, CNS trauma |
Furosemide (Lasix) | 5mg/kg IM or IV | Diuretic |
Atropine sulfate | 0.02mg/kg IV, IM, SC | Bradycardia (slow HR) |
Epinephrine | 0.1mg/kg IV/IM/IT | Cardiac stimulant |
Diazepam | 0.15mg/kg IV/PO | Seizure control, sedative, appetite stimulant |
Midazolam | 0.3 mg/kg IM/IV (good starting point) | Seizure control, sedative, possible appetite stimulant |
Iron Dextran | 5 mg/kg SQ | Acute blood loss |
Vitamin K | 2 mg/kg SQHepatic disease, coagulopathy | Hepatic disease, coagulopathy |
Calcium gluconate | 0.2ml/kg SQ | 23% solution |
Potassium Chloride | 20 mEq/L of fluid | Hypokalemia (potassium) |
Dextrose | Blood glucose <30 mg/dl=10% dextrose plus LRS or saline IV only, 31-50mg/dl=5% dextrose plus LRS or saline IV only | |
Sodium Bicarbonate | 1 meq/kg IV/SQ | Metabolic acidosis |
Diphenhydramine (Benadryl) | 2 mg/kg IM | Allergic reaction |
| Drug | Dosage | Comments |
|---|---|---|
Euthasol (Sodium Pentobarbital) | 3 ml/10 lbs to start | Often times additional needed, heavy sedation prior to euthanasia recommended |
| Drug | Dosage | Comments |
|---|---|---|
Cisapride | 1 mg/kg PO SID | Gut motility enhancer |
Mineral Oil | Base on animal size and route of administration. Starting point will be similar to tube feeding gruel protocol. | GI lubrication, blockage Administer via feeding tube or gel caps |
Metaclopramide (Reglan) | 0.5mg/kg PO, SQ | Upper GI motility enhancer |
Sucralfate (Carafate) | 500mg for small green, 2000 mg for juvenile loggerhead | Coats gastric ulcers |
Activated Charcoal (Toxiban) | 5 gm/kg PO | Absorbs toxins |
| Drug | Dosage | Comments |
|---|---|---|
Vitamin B Complex | 0.1 ml per kg if thiamine is 100 mg/ml, SQ with fluids | |
Vitamin E (no selenium) | 11iu/kg SQ or IM once or twice weekly | |
Vitamin E/Se | Dose based on instructions on bottle for other species | |
Vitamin K | 2 mg/kg SQ | |
Vitamin C | 10mg/kg SQ or in fluids | |
Iron dextran | 5 mg/kg SQ/IM | Usually one-time dose, more if true iron deficiency documented |
| Drug | Dosage | Comments |
|---|---|---|
Procrit/Epogen (10,000u/mL) | 100-200 units/kg once daily for three days, then every other day until an increase in immature RBC's | Erythropoetin analogue, bone marrow stimulation, non-regenerative anemias only. Fragile, do not shake. Refrigerate. |
Denamarin/Happy liver | Use dog dose | Milk thistle |
| Code | Interpretation |
|---|---|
SID | Once per day |
BID | Twice per day |
TID | Three times per day |
QID | Four times per day |
EOD | Every other day |
q48 | Every 2 days, aka EOD |
q72 | Every 3 days |
q96 | Every 4 days |
q1week | Once per week |
PO | By mouth (per os) |
IM | Intramuscular |
SQ | Subcutaneously |
IC | Intracoelomically |
OU | Both eyes |
OS | Left eye |
OD | Right eye |
Loading | Initial dose given (i.e., Amikacin) |
Maintenance | Long term dose given (i.e., Amikacin) |
mg/kg | Milligrams per kilogram |
mL/kg | Milliliters per kilogram |
mL | Milliliter (also known as CC) |
x | Times (multiplied) |
D/C | Discontinue |
BAR | Bright Alert Responsive |
QAR | Quite Alert Responsive |
WNL | Within Normal Limits |
EENT | Ears Eyes Nose Throat |
CCT | Continue Current Treatment |
Hx | History |
Tx | History |
Tx | Treatment |
Sx | Surgery |
Fx | Fracture |
Bx | Biopsy |
PE | Physical Exam |
S | Subjective |
O | Observation |
A | Assessment |
P | Plan |
1.0lb = 2.2kg |
2.2kg = 1.0lb |
Weight (kg) / 2.2 = weight in pounds |
Weight (lb)x 2.2 = weight in kilograms |
Dosage (mg/kg) X weight (kg) = mg amount |
Dose (mg amount) / concentration = Dose |
Example: Turtle’s weight is 46kg. Amikacin dose is 5mg/kg. 5x46 = 230mg. Amikacin is 50mg/ml. 230mg / 50 = 4.6mL |
This chapter should be cited: Norton, Terry and Brooke Burkhalter. 2020. Formulary. In: Terry Norton and Nancy Mettee, Marine Turtle Trauma Response Procedures: A Veterinary Guide. WIDECAST Technical Report No. 20. Accessed online [date].