Marine Turtle Trauma Response Procedures:  A Veterinary Guide

Norton, Terry and Nancy Mettee (2020) WIDECAST Technical Report No. 20

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

DrugDosageComments
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

Anesthetics

DrugDosageComments
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

Anthelminthics

DrugDosageComments
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

Antibiotics

DrugDosageComments
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

Antifungals

DrugDosageComments
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

Emergency Drugs

DrugDosageComments
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

Euthanasia

DrugDosageComments
Euthasol (Sodium Pentobarbital)
3 ml/10 lbs to start
Often times additional needed, heavy sedation prior to euthanasia recommended

Gastrointestinal

DrugDosageComments
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

Vitamins/Minerals

DrugDosageComments
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

Miscellaneous

DrugDosageComments
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

Abbreviation Key

CodeInterpretation
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

Weight Conversion

1.0lb = 2.2kg
2.2kg = 1.0lb
Weight (kg) / 2.2 = weight in pounds
Weight (lb)x 2.2 = weight in kilograms

Calculating Doses

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].

Updated July 2020

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