North Carolina Six

On December 21, 2009, there was a large cold stunning event in North Carolina and we were asked to assist by taking some of the affected turtles. On December 29, 2009, 6 turtles were transferred from the Karen Beasley Sea Turtle Rescue and Rehabilitation Center with the help of the North Carolina DNR, the South Carolina DNR, and the South Carolina Aquarium. It was a great example of dedicated conservationists and conservation organizations coming together to help these endangered turtles.  Carolina, Lookout, Kiwi, and Jill have all been successfully released!

Crow

Crow is a juvenile green sea turtle who has 2 boat propeller wounds on the right side of the carapace (top of the shell) in addition to having been cold stunned.  The propeller injury appeared to be older and we suspect happened before he/she was cold stunned.  It was difficult to tell how severe this wound was until the dead bone surrounding it was removed. It is very deep and their may be a small area exposing the body cavity.   In addition to cleaning the wound and removing dead bone and tissue (debridement), we have tried a number of therapies including Medi-honey (sterile honey impregnated gauze), bone cement and doxirobe.  We are now using doxirobe on most of the wound and filling in exposed areas with bone cement. This has allowed us not to have to bandage the wound, which seemed be irritating the surrounding shell. We remove the materials once weekly, debride the wound and the replace it.   Crow is doing well and is eating on his/her own.

Cape

Cape is a juvenile green sea turtle who was thankfully uninjured other than having been cold stunned.  Upon arrival, X-rays revealed a heavy metal density circular foreign object in his/her gastrointestinal tract.  The movement of the metal object was monitored with serial X-rays and he/she eventually passed it.  In addition to our regular blood work (complete blood count and plasma chemistry panel, we submitted whole blood to an outside laboratory to measure lead levels due to the possibility that the metal object might be a lead sinker.  The lead levels were low and considered to be within normal limits.  Cape is doing very well and will likely be released this spring when the water warms up.

All of the 6, with the exception of Crow, were stranded near Cape Lookout, North Carolina and were rescued by park rangers there.  Crow was found near Crows Nest Marina in Atlantic Beach, North Carolina.

Al

Al is a juvenile green sea turtle who stranded on St. Augustine Beach, Florida on December 15, 2009, just one day after Thalassia. Al was in good body condition upon arrival, however he/she had a lot of gas in his/her gastrointestinal tract which was causing him/her to float. Since the turtle had been floating, there was increase exposure to sunlight on the exposed carapace, which caused green algae to grow on it. Can you guess how Al got his/her name? Correct, “Al” is short for algae. Despite Al’s problems with buoyancy, he/she had a good appetite and was defecating well almost immediately. That made his treatment much easier. After being rehydrated and placed on antibiotics, we began treating Al with Cisapride and Reglan to get his/her bowels moving again. Within a week, Al began to become less buoyant and on Christmas morning we found Al resting peacefully on the bottom of his/her tank. We could not have asked for a better Christmas gift from Al. He/she is now swimming normally within the water column. Since his/her arrival Al developed some raised lesions on his/her skin. Skin biopsies were obtained to determine the cause. The pathologist has reported these to be small bacterial abscesses. Treatment with injectable and topical antibiotics has resolved this problem. We expect Al to be released sometime this spring when the water warms up.

Thalassia

Thalassia is a juvenile green sea turtle who stranded in St. Augustine, Florida on December 14, 2009. He/she was named Thalassia because it is part of the scientific name of turtle grass (Thalassia testudinum), which is the primary diet, along with algae, of the green sea turtle when they return from their pelagic (deep ocean) phase of their life cycle. The green sea turtle is the only herbivore (plant eater) of all the sea turtle species. Upon arrival a physical examination was performed and there was an obvious healed propeller injury to the back end of her carapace (top of the shell). Although the wound had healed amazingly well in the wild, the injury involved the vertebrae and spinal cord which are attached to the carapace. The injury to the spine has caused partial paralysis of his/her rear flippers and compromised the normal movement of her gastrointestinal tract. All our patients receive a radiograph (X-ray) upon arrival. X-rays on Thalassia revealed that he/she had a very full gastrointestinal tract with a lot of gas and plant material and a healed femur fracture that probably occurred at the same time as the carapace injury. For about a month we had a hard time getting Thalassia to eat and therefore had to place a tube in her stomach and feed her a special gruel for herbivores. Thankfully he/she is eating veggies very well and some seafood. Although Thalassia still has buoyancy issues, he/she is able to dive to the bottom to obtain food and is much more active. The turtle is currently on Cisapride (a gastrointestinal tract mobility enhancing drug) and we are monitoring his/her floating and defecation. There is a possibility that we will have to find a permanent home in captivity for Thalassia, but due the dramatic improvement we are seeing, we are going to give it some more time before making a final decision.

Knievel and Peppermint Patty

We received these two Kemps ridley sea turtles from the University of New England’s Marine Science Center (UNE MSC) in Biddeford, Maine. Both of these patients were originally cold stunned during the winter of 2008, and have subsequently developed secondary medical problems from a compromised immune system secondary from being hypothermic. The UNE MSC needed more space to prepare for the upcoming cold weather and the possible influx of new cold stunned patients, so the GSTC offered to help.

Peppermint Patty originally stranded at Cole Road Landing in Brewster, Massachusetts. He/she developed an osteomyelitis (bone infection) in her right front elbow and is on medications to aide in her recovery. Once the turtle arrived at the GSTC, xrays were taken of the affected elbow.  The bone infection appears to be resolving thus he/she has been taken off all medication. Joint aspirates will be performed in the near future to further evaluate the healing progress.

Knievel originally stranded in Duck Harbor in Massachusetts. The water temperature was 48°F when he/she was found. He/she developed a suspected bacterial pneumonia and has been treated with a long course of antibiotics. Radiographs (xrays) were performed to evaluate the lungs upon arrival at the GSTC. There appears to still be significant changes in the lungs. He/she is now off all antibiotics and will be reevaluated with bronchoscopy and culture in the near future. Both of these patients are now eating fairly well and seem otherwise healthy and very active.

Ed

Ed (short for edema) was found stranded on Cumberland Island, Georgia on September 12, 2009. GSTC staff and AmeriCorps members picked up Ed from the ferry terminal in St. Mary’s and transported the turtle to the center. Ed had severe edema (fluid build up) around is eyes, head and neck when he/she first arrived and floated when he/she was placed in shallow water overnight. Initially Ed did not eat and required tube feeding for medication and nutritional support. Thankfully, Ed is now eating seafood and vegetables from tongs very well. A barium contrast study was performed to highlight Ed’s gastrointestinal tract and revealed that the right lung was smaller than the left. To further evaluate this issue a CT scan was performed and revealed a right sided space occupying mass or fluid that was pushing on the right lung. Last week (November 12), a laparoscopic examination and bronchoscopy was performed on Ed under anesthesia. Our colleagues from University of Florida came up to assist Dr. Norton with the procedure. We determined that Ed or maybe now Edwina is a young female because we could directly visualize the ovary with the laparoscope. Edwina had clear fluid in her body cavity, the mass on the left side appeared to be outside the body cavity lining and may be clotted blood possibly secondary to trauma. Due to the compression on the lung, the lung edge is curled over abnormally and may be the cause of the buoyancy problems. The bronchoscopy allowed us to evaluate Ed’s trachea, bronchi and internal lung structure. Thankfully everything looked healthy. We are going to give Ed a bit more time before pursuing any further diagnostics. Hopefully a tincture of time will do the trick.

Emma

Emma is a juvenile green sea turtle of unknown gender who was found floating in the river off of the Fernadina dock in northern Florida on August 9, 2009. Jason, an employee of the Fernadina Port Authority found him/her and delivered him/her to the Amelia Island Sea Turtle Watch for transport to the GSTC. Emma (short for emerald) has a very severe boat strike injury to his/her carapace. The fracture runs about 2/3 of the way down his/her carapace, paralleling her spine. The lung is actually visible from the wound. It took her a couple of weeks, but she finally started eating on her own (a very good sign). We have been treating her with a sterile honey coated bandage called Medi-honey (often used in human burn victims) during the day and utilizing Vacuum Assisted Wound Care (VAC) at night. VAC therapy encourages blood flow to the wound, removes fluid, infection and debris, and ultimately stimulates a healthy granulation bed (this is the goal of wound care). This combination therapy has worked well for other severely injured turtles and tortoises, although Emma probably has the most severe wound that we have treated to date. She also most likely has a bacterial pneumonia due to the open body cavity and exposed lung. Bacterial cultures have revealed antibiotic resistance which is making her therapy challenging. Boat strike injuries are found in over 20% of the stranded sea turtles that are seen on the Georgia coast and are a huge issue worldwide.

Phantom

Phantom is a sub-adult loggerhead sea turtle who stranded on Little St. Simons Island, Georgia on July 30, 2009. Phantom was found moving around on the beach, which is unusual for a sub-adult loggerhead because she/he was too young to nest. She/he was brought to the GSTC where it was very obvious what was wrong with her/him. Phantom had a severe head injury and was missing her/his left eye and half of her/his upper jaw. Originally we believed that this was due to a boat propeller strike, but a couple of days later we took radiographs (x-rays) of her/him and discovered part of a large fish hook that was embedded in the soft tissue of her/his neck. Re-inspection of the oral cavity revealed the cut end of the hook was just barely protruding into the back of the throat. This led us to believe that someone had cut the hook and line and most likely caused the head wound in the process. Surprisingly, she/he was in fairly good body condition upon arrival and the head wound was almost healed. The GSTC staff tube fed Phantom for over a month. Surgery was performed to remove the hook, which proved to be very difficult because there was scar tissue and infection surrounding it. The wound was left open due to the infection. The wound was packed with honey and honey comb and suture loops were placed around the wound, which allowed it to be closed with shoe lace like material called umbilical tape. This allowed for regular debridement (removal of dead tissue) of the wound and repacking it with honey until it was healed. Once the infection was resolved, another surgery was performed to suture the wound closed. When she recovered, we began to try a variety of things to get Phantom to eat. She/he was obviously very interested in food but just could not figure out how to eat it with her half missing upper beak. One of our volunteers built a PVC box contraption that allowed Phantom to push food into a corner rather than the rounded edges of the tank. We also began using our hands to cover the hole in her face to hold the food in (do not try that at home!). Phantom has learned to live with her disability and is now regulating the force with which she expels extra salt water and can eat fish off of the bottom of her tank. Additionally on October 19th, Phantom killed and ate a live crab (one of her natural prey items) on her own; a feat we didn’t believe was possible. It just goes to show you, never give up on one of these amazing animals!

Erika

Erika is an adult female loggerhead sea turtle who was found floating on the inshore side of Seahorse Key near the University of Florida’s Marine lab dock on July 10, 2009. Erika was named after our former Hospital Coordinator, Erika Kemler. A group of teachers found her while out kayaking and brought her to shore. After being evaluated we determined that she was floating due to a large amount of air in her body cavity presumed to be secondary to a lung tear. This is a very common problem in sea turtles and one of the most common causes of buoyancy abnormalities. It is thought that these tears occur as a result of blunt force trauma such as a boat strike. We have been removing the air from Erika’s body cavity on a regular basis, sometimes up to 45,000 ml with a needle and syringe. In most cases these tears will heal in a much shorter time period than has been the case with Erika. Unfortunately, when she first arrived, Erika was very depressed and not eating on her own. She was a challenge to tube feed due to her size and often regurgitated. Finally, after months of tube feeding, she began eating on her own and is now a healthy 215 pounds! We have actually had to cut back on her diet due to her being slightly over weight. Her attitude and activity level have improved dramatically. We are giving her some time to see if she will be able to heal the tear on her own. Last Friday (November 13) we aspirated 12,000 ml of air from both sides of her body cavity and she became lower in the water column and seems to be remaining low. This may indicate that the leak has at least slowed down some and possibly some healing has taken place. We will continue to draw air out more aggressively if it continues to help her buoyancy problem. If she continues to float, we may have to take more drastic measures such as surgically repairing the lung via a laparoscope. Cross your fingers.

Caretta Hope (I’m adoptable!)

Caretta Hope is a subadult female loggerhead sea turtle who was found in the Matanza River in St. Johns County, Florida on June 11, 2009. Upon arrival, her packed cell volume (a measure of the amount of red blood cells present in the circulation) was 8% (normal being around 30%), and for a brief time she was put on Procrit. Procrit is a synthetic erythropoietin analogue. Erythropoietin is a hormone produced by the kidney that stimulates the bone marrow to produce red blood cells. Amazingly, this drug works in other species including turtles. It is used in human cancer patients to treat anemia. Physical examination revealed that Caretta Hope was missing most of both of her rear flippers. The injuries were old and already healed on the day of arrival. These injuries may have resulted from a shark bite or even fishing line wrapped around them that ultimately caused the loss of the limbs. Caretta Hope was named by our first sea turtle summer camp! Caretta Hope is now healthy and doing well. She is even healthy enough that we were able to determine her gender with a blood testosterone level and she is a female. Dr. Norton has given the “okay” and we will be releasing Caretta Hope when water temperatures become warm enough sometime this spring.

Caton (I’m adoptable!)

Caton is a sub-adult female loggerhead sea turtle that was found stranded on South Beach of Blackbeard Island, Georgia on June 2, 2009. Caton was named after Jan Caton, a former JIA employee and founder of the Jekyll Island Sea Turtle Project. Upon arrival, it was discovered that she was floating. Radiographs revealed a blockage caused by shell and crab parts which lead to excess gas build up in front of the blockage. She was rehydrated and treated with Cisapride (a gut motility enhancing medication) and numerous other drugs and supportive medications. After several months of treatment, Caton had improved and was swimming normally in her tank. Blood testosterone levels revealed that Caton is a female. She was scheduled for release on October 9, 2009 but after her final physical and satellite transmitter placement she stopped eating and defecating. Radiographs revealed a large quantity of crab parts and fish bones that were causing another blockage. Endoscopy of her distal rectum and cloaca revealed severe irritation to the lining of the GI tract and was diagnosed as an ulcerative colitis. She was started on a treatment regimen of enemas, corticosteroid repositories, antibiotics, anti-parasite drugs and tube feedings of mineral oil and a nutrient rich gruel. Unfortunately she missed her release date and will be spending the winter with us. She is now back to normal and is eating and defecating normally.

We attempted a 2nd release of Caton on December 28, 2009 from Cape Canaveral National Sea Shore, FL where the ocean temperatures are still within an acceptable range. However, the release was unsuccessful. She became lethargic and susceptible to waves coercing her back onshore. The decision was made to return her the the GSTC for further care.

Varun

Varun (means “God of the Water” and is the name of our IT specialist) is a juvenile green turtle that originally stranded in the St. Johns River in Florida on January 6, 2009. Varun was struck by a boat and had very severe carapace, bridge, and plastron fractures. Once the dead bone was removed, we could see the organs and lung in the body cavity from the outside of the wound. We felt the prognosis to get this wound healed was grave but decided to see how the turtle would do with aggressive treatment. After spending a night in dry dock, out of water, Varun was placed in water and amazingly started to eat on his/her own! Initially, Vacuum Assisted Wound (VAC) care was used and alternated with debridement and Medi-honey (sterile gauze impregnated with honey). Varun was treated daily for months. He eventually started putting on some weight and that is when the wound really started to heal. After more than a year of treatment, the wounds are almost completely healed and our biggest problem is keeping Varun from becoming a butterball. We have cut his/her diet way back. Varun has been known to steel food from his tank mates despite there being a barrier between them. Interestingly during the course of all of this, Varun developed 2 wart like masses on the skin/shell interface next to the hind flippers. Biospies revealed that these masses were fibropapillomas and DNA testing revealed a herpesvirus. The masses were surgically removed and have not returned since that time. This tough little turtle is doing very well, and we hope to be able to release him/her this coming summer!

Soleil Moon Frye

Soleil Moon Frye is a juvenile green that stranded on Cumberland Island, GA on October 15, 2008. Frye was found floating and covered in epibiota. Upon arrival to the GSTC, Frye continued to float, but started eating on his/her own. It became apparent after observing him/her that there were some visual deficits. Frye also showed neurological signs sporadically when examined-nystagmus and has a fluid and air filled tympanum (middle and inner ear). Numerous x-rays, CT scans, blood work, ear aspirations have not revealed a cause to the visual deficits and neurological issues. Frye is eating great and has put on weight despite the various medical issues. The first CT scan was not of high quality because we could not get Frye to sit still and did not want to sedate him/her because of the risks at that time. Since he/she was much more stable, we recently repeated the CT scan under sedation. This time we were able to make a diagnosis. Unfortunately, he/she has a fractured skull which involves the neurocranium (encases the brain). While he/she still spends most of the time swimming at the surface of the tank, Frye has started to spend more time at the bottom. We are looking for a good captive facility for Frye because we do not feel he/she will do well in the wild. We hope Frye will be an ambassador for other sea turtles.

Tinkerbell

Tinkerbell is one of the “New England Seven” that has had some extra complications over the past 2 years. One of the most severe problems has been disuse of the right front flipper. X-rays and CT scans revealed a severe osteomyelitis or bone infection. Dr. Bo Sasser was consulted to perform an arthroscopic examination of the shoulder. Biopsies and cultures were taken. Based on the diagnostic workup, we suspected Tinkerbell had a mixed bacterial and fungal osteomyelits. He/she was placed on an extended course of antibiotics and antifungal drugs. Additionally, he/she received a glycoaminoglycan that is commonly used in dogs and horses called Adequan. Tinkerbell has gone through bouts of not eating and has had to be fed through a stomach tube. Tinkerbell’s condition appeared to be resolved in September of 2009 and we were discussing potentially releasing the turtle before the water got cold. He/she must have heard us because he she developed a severe ulcerative shell infection with lesions that extended through the outer keratin into the deep bone of the shell. We suspect that bacteria from the shoulder osteomyelitis traveled through the circulation to the shell. This was extremely challenging to treat and required daily debridements initially. A variety of topical medications were used ranging from silver sulfadine cream to doxirobe gel to bone cement. Thankfully, Tinkerbell has finally recovered from all of her ailments and we are planning on a release when the water warms up. That day will be a very special for us at the GSTC.

Griffin

Griffin, an adult male loggerhead sea turtle, was originally stranded off Daytona Beach, Florida and was taken to the Volusia County Marine Science Center. He was unable to dive, was thin, and could not eat on his own. After several weeks of care and various diagnostic tests, the staff there decided that they would like to transfer him to the Georgia Sea Turtle Center (GSTC) to see if we could help figure out what was wrong with him. X-rays were repeated and we found excessive gas in his gastrointestinal (GI) tract and significant changes to the lungs. Both conditions could be responsible for the flotation abnormality. The initial treatment consisted of antibiotics, GI motility enhancing drugs, tube feeding, and Simethicome (Gas X). He was definitely a challenge to tube feed because of his size. Despite aggressive treatment, Griffin continued to float and was still not eating on his own. We elected to anesthetize Griffin to conduct further more invasive tests. We used a flexible endoscope and bronchoscope (a long flexible tube with a camera on it) to evaluate his lungs, stomach, small intestine and colon. Griffin still had a bacterial pneumonia and stomach ulcer. His antibiotics were changed based on culture and antibiotic sensitivity results from samples obtained directly from his lung. We also treated the stomach ulcer with a drug that increases the pH of the stomach by blocking hydrochloric acid production (Zantac/ranitidine) and a drug that is used to coat the ulcer (Sucralfate). After 4 months, Griffin finally started to eat on his own, the GI gas and pneumonia resolved. Unfortunately he continued to float. We tried placing him in fresh water because this has helped other patients that were abnormally floating. Unfortunately it did not help. To further evaluate Griffin, we conducted an open MRI of his body cavity, but did not find any pockets of air that might be making him float. Multiple aspirations of the body cavity were attempted but we were never able to get any air out. As Griffin’s attitude improved, it became apparent that he was not normal neurologically. It was almost as if he was relearning how to be turtle. We decided to conduct another MRI, but this time to evaluate Griffin’s brain. Our consulting veterinary radiologist evaluated the MRI results and felt that there were abnormal changes in the brain, consistent with some type of vascular event—like a stroke in a human. This really fit what we were observing with Griffin clinically. One of the possible causes of this in a sea turtle is a brain parasite infection where eggs and adult flatworms (called Spirorchid trematodes) block the blood vessels in the brain and other body organs. He was treated with a drug used for Schistosomiasis in humans called praziquantel on multiple occasions. Griffin has become a celebrity at the GSTC. He received the distinguished honor of being patient of the year in 2008. He is currently eating very well, even live crabs, but unfortunately continues to float and has difficulty diving. Physical therapy is conducted on Griffin every other day and he has improved his swimming skills dramatically. We are now trying to teach Griffin how to dive again. Recently, with the help of engineers from Georgia Technical College in Savannah, we have developed a new weight belt for Griffin. This helps him to sit lower in the water and also makes it easier for him to dive to the bottom of his tank. Unfortunately, we still have to assist Griffin with this, so the staff gears up in waders and gets into the tank with him to entice him with pieces of blue crab. Griffin has a long way to go, but he continues to impress us daily with his determination.