Turtle and Tortoise Formulary

Analgesics/NSAIDS

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

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Anaesthetics

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

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Anthelmintics

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

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Antibiotics

DRUG	DOSAGE	COMMENTS
Amikacin	Sea turtles: 5mg/kg (loading), 3mg/kg (maint) SQ q72hrs	50mg/ml, 250mg/ml. Maintain hydration
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, IM injection causes necrosis, and after a single injection, oral therapy is required.
Metronidazole (Flagyl)	20mg/kg PO SID
Danofloxacin (A180)	6mg/kg SQ q72hrs
Ampicillin	30 mg/kg SQ q24hr
Clavomox	30 mg/kg PO q24hr

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Antifungals

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

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Emergency Drugs

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

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Euthanasia

DRUG	DOSAGE	COMMENTS
Euthasol (Sodium Pentobarbital)	3 ml/10 lbs to start	Often additional needed, heavy sedation before euthanasia recommended

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Gastrointestinal

DRUG	DOSAGE	COMMENTS
Cisapride	1 mg/kg PO SID	Gut motility enhancer
Mineral Oil	Based on animal size and route of administration. The starting point will be similar to tube feeding gruel protocol.	GI lubrication, blockageAdminister via feeding tube or gel caps
Based on animal size and route of administration. Starting point will be similar to tube feeding gruel protocol.	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

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Vitamins/Minerals

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	Dose based on instructions on the bottle for other species

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Miscellaneous

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	100-200 units/kg once daily for three days, then every other day until an increase in immature RBCs
Denamarin/Happy liver	Use dog dose	Milk thistle

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Abbreviation Key

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