Medical and Surgical Management of a Debilitated Malaysian Giant River Turtle (Orlitia borneensis)
This turtle was one of approximately 500 endangered Malaysian giant river
turtles (Orlitia borneensis) seized as part of the December 2001 Hong Kong Asian turtle
confiscation. This species is native to Borneo, Sumatra, and the Malay Peninsula (Pritchard,
1979). The adults can reach a maximum straight carapace length of 70 cm and a weight of 30 kg.
They are one of the largest members of the Emydidae, a family of freshwater turtles with a
This 25.5 kg turtle arrived Miami, FL with a shipment of 2200 turtles on
January 12, 2002 through the rescue efforts of the Turtle Survival Alliance (TSA) and affiliated
conservation groups. This animal was one of the last turtles triaged from the shipment and
presented in a severely debilitated condition. It was assigned to triage category three on a
scale from one to five (with five being dead). It was found to have a metal fish hook in its
right central coelomic cavity via metal detector and confirmed with radiography at a local
veterinary clinic. On physical examination, the turtle was weak, severely cachexic, and
dehydrated. There was notable enophthalmia and the mucus membranes were pale. There was little
resistance to oral examination. Full-thickness cutaneous ulcerations were evident over most of
its skin including a significant rostral abrasion. Both the carapace and plastron were in good
A standard treatment protocol for the dehydrated O. borneensis in the
shipment had been designed through experience with two previous shipments of turtles. The
treatment included 20 mls/kg of intracoelomic (ICe) lactated ringers solution (LRS) "spiked"
with ceftazidime and levamisole to yield dosages of 20 mg/kg and 5 mg/kg respectively. The
turtle received this treatment along with an additional 500 mls of straight LRS ICe due to its
severe dehydration. Attempts at giving fluids intravenously were unsuccessful. This turtle was
placed in shallow freshwater overnight. The following day the animal was given 500 mls of ICe
0.9% saline with 2.5% dextrose before being packed in a wooden box for shipment to Raleigh NC,
an eleven hour drive.
Upon arrival at the North Carolina State University College of Veterinary
Medicine (NCSU-CVM) the turtle was placed under the care of the NCSU Turtle Rescue Team (TRT).
Continued medical and supportive care included amikacin (2.5 mg/kg IM q 72
hrs X 5), metronidazole (50 mg/kg PO q. 48 hr X 3, repeated in two weeks), and levamisole
(5mg/kg SQ q. 14 days). Ceftazidime (20 mg/kg IM q. 72 hr for 1 month) was continued on
alternating days with the amikacin. The cutaneous wounds were debrided and cleaned with either
dilute chlorhexidine or dilute povidone iodine every other day and silver sulfadiazine applied
as needed. The turtle was maintained in clean shallow (10-20 cm) fresh water (23-27 degrees C)
and offered a variety of foods. After five days of refusing food the turtle was tube fed, via
red rubber catheter, a 50:50 mixture of Critical Care Diet for Omnivores (Oxbow Inc., Murdock
NE) and either Eukanuba's Maximum Calorie Diet (IAMS Inc., Dayton, OH) or Hill's A/D Diet (Hills
Inc., Topeka, KS). The tube-feeding was continued every other day.
Diagnostic evaluation included blood work (CBC and plasma chemistry panel)
on 1/15/02 and 2/1/02. There was a slight heterophilia (18,700/ul) on initial CBC that was
resolved on 2/1/02. There was a persistent mild anemia with both samples (21% and 19%
respectively). On 2/8/02 the turtle weighted 27.2 kg.
The turtle had several defecations that contained tropical plant materials
including seedpods and large fruit pits, which it had most likely eaten prior to being captured.
The location of the large (4 cm) fishing hook was re-evaluated radiographically on 1/25/02 and
2/1/02. The hook appeared to be in a similar location. On 2/1/02 the turtle was anesthetized
with 6 mg/kg IV propofol for induction and maintained on inhalant sevoflurane. A flexible
endoscope was passed as far as the proximal duodenum and there was no evidence of a fish hook or
other foreign body. Ultrasonography was unsuccessful in identifying the location of the hook so
the decision was made to perform computed tomography. Upon evaluation of the CT images, the fish
hook appeared to be within the stomach wall. The hook did not appear to be causing an
obstruction and the decision was made to postpone surgical intervention until the animal was
stronger. While the animal was anesthetized, an esophagostomy feeding tube was surgically placed
to make force-feeding easier. The current clinical plan is to continue supportive care until the
animal begins eating on its own. If the anorexia persists, surgical removal of the foreign body
will be attempted.
We thank the following people for their assistance with the management of
this case: Mary Beth Goetting, Rob Goodman, Gayle Hahulski, Amy Houser, Mike Lowe, Lenore
Mohammadian, Shanda Gronke, Trisha Ross, Kathy Spaulding, Maureen Trogdon, Shelly Vaden, and the
NCSU-CVM Turtle Rescue Team.
1. Pritchard PCH. 1979. Encyclopedia of Turtles. T.F.H.
Publications, Neptune, NJ. pp. 197-198.