Abstract

A sub adult female loggerhead sea turtle that presented to Clearwater Marine Aquarium in good body condition was lethargic and non-responsive to handling. Blood work and radiographs did not reveal any reason for the animal's condition, though it did clinically resemble a possible lethargic loggerhead. Nutritional support of non-responsive depressed loggerhead sea turtles is a continual challenge for the clinician. Common methods of supplementation such as tubing with formulas or force feeding are considered potentially dangerous since the individual is more likely to aspirate material placed in the esophagus. After 27 days with no measureable response to fluids and dextrose, it was decided to place a long term in-dwelling intravenous catheter to deliver total parenteral nutrition (TPN). A 16 gauge double lumen catheter was placed under ultrasound guidance into the left dorsal cervical vein sinus. After successful placement, the IV catheter was flushed daily with heparin and saline. Dextrose and saline solutions were administered before beginning the use of the TPN formula. Over the 12 day period the percentage of fats and protein were increased while decreasing the amount of carbohydrates based partially on blood sample results and a predetermined plan developed by the TPN provider and the veterinary staff. Amino acid and fatty acid samples were taken at intervals after alterations in the TPN formula. On day 12, during ultrasound examination of the catheter, a large blood clot 3 cm long by up to 1 cm wide was present along the length of the catheter. After evaluating numerous options, euthanasia was elected and the animal was necropsied to better understand the reason for extensive clot formation and the effect of fats supplementation.

Acknowledgements

The authors wish to thank Mr. Mike Anderson and Joe Widlansky from Clearwater Marine Aquarium for tireless work with this case, Mr. Patrick Thompson from the University of Florida, Aquatic Animal Health Program for his assistance with laboratory work and presentation preparation, and the University of Florida, College of Veterinary Medicine for financial support.

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