Pain Management / Assessment
The presence of pain in reptiles can be difficult to assess. Typical parameters such as increased respiratory rate, heart rate, and blood pressure will most likely not be evident, nor will the vocalizations often seen in mammals. For sea turtles at normal temperature, use the following as reasonable indicators of pain: activity level, utilization of environment, appetite, and mentation. For example, a depressed, inactive, or anorexic turtle is likely in pain. Note that for cold turtles, these indicators are unreliable.
Signs of pain in sea turtles:
- Immobility
- Lameness
- Anorexia
- Absence of normal behaviors
- Hyperesthesia
- Abnormal posturing
Assuming that an injury or surgery is painful, treatment using combination therapy with both an opiate (buprenorphine or butorphanol) and an anti-inflammatory (meloxicam) for the first 12 – 48 hours is appropriate. For more extended pain control, the use of an anti-inflammatory at a reduced dose and in combination with an antacid is indicated. Combination NSAID therapy with tramadol can safely reduce pain without resultant sedation. If renal disease is suspected, use tramadol instead of an NSAID. Research in humans and other mammals indicates that early dosing of pain medication (before surgery or debridement) may enhance efficacy. As far as pain medication goes, early and often is the rule.
Pain medication options:
- NSAIDS (Carprofen, Meloxicam, Topical Diclofenac)
- Opioids (Buprenorphine, Butorphanol)
- Local (Lidocaine, Bupivicane)
- Tramadol
For drug dosages and routes of administration see Formulary
Resources
Pain Management in Small Mammals, Birds and Reptiles PDF
This chapter should be cited: Mettee, Nancy. 2014. Pain. Marine Turtle Trauma Response Procedures: A Veterinary Guide. WIDECAST Technical Report No. 17. Accessed online [date].
Updated 2/2014