Kathy – South Carolina Aquarium

Loggerhead (Caretta caretta)

Stranding Location: North Myrtle Beach, SC
Arrival Date: 11/1/2017
Age: Subadult
Weight: 56.26 kg (123 pounds)

Case History

Kathy was found by sanitation workers in the Horry County Unincorporated section of North Myrtle Beach near the waterline. Kathy was covered in barnacles and marine leeches. She was unresponsive and clearly in need of medical attention. After South Carolina Department of Natural Resources (SCDNR) was contacted, SCDNR volunteer Linda Mataya quickly responded to the call. Once she had eyes on Kathy, she instantly knew she had Debilitated Turtle Syndrome (DTS). Linda made the 5 hour round trip to get Kathy to the Sea Turtle Care Center (STCC) for immediate care.

Treatment

At first glance, STCC staff saw that she had a significant amount of leeches present on her eyelids and nares, as well as on the soft tissue areas of her neck, flippers and on the inside of her mouth. Kathy was also covered in barnacles, pluff mud and sand. A heart rate and body temperature was taken and then blood was drawn to run diagnostics. A thorough physical was done resulting in the discovery of a healed boat-strike wound on the right side of her carapace (top shell) that was underneath the sand and mud. Her blood work results indicated that she was both dehydrated and slightly anemic, but were not as poor as other DTS patients that have been previously admitted. Kathy received vitamins diluted in a bolus of fluids that were given under the skin (subcutaneously) and was started on injectable antibiotics. Associate veterinarian, Dr. Julie Cavin administered Hetastarch intravenously. Hetastarch works quickly by pulling in fluids and vitamins into the vascular space so they can be circulated through the bloodstream and throughout the body more effectively. After triage, Kathy was placed in a freshwater dip for a few hours to help kill and remove the marine leeches. The salinity of Kathy’s waterbed was slightly increased and she spent the night in shallow water and on foam.

Updates

November 5, 2017: Kathy has been doing well so far. She received more Hetastarch and fluids and was then placed in a tank with shallow brackish water. The majority of the leeches on her eyelids and nares have fallen off or have been carefully removed. Kathy was offered a few pieces of salmon and mackerel and is eating well! Over the next week we will continue to slowly increase her diet, water depth and salinity, and hopefully Kathy will continue on this upward trend.

November 15, 2017: Kathy is slowly but surely making progress. Kathy is a severe DTS patient, and we are slowly reintroducing food and increasing her diet- the good news is that she has quite the appetite and eats everything we offer her. Kathy’s rear flippers seem to have been affected by the old boat-strike injury, and appear to have minimal movement in them. Kathy received a CT scan on our new CT machine to better access the injury to her spine and carapace (top shell). Kathy is hanging in there, but she has a long way to go on the road to recovery.

December 1, 2017: Kathy underwent a CT scan to assess her old boat-strike wound. There is no severe damage to her spine. We have also seen her move her rear flippers more often in her tank, and she’s reacting to staff evaluating them. We are unable to leave Kathy in deep water because she is still very weak and does not use her rear flippers to their full extent. Kathy also defecated two pieces of plastic. We have been monitoring her fecal matter for more foreign material but so far have not found anything odd. Because Kathy is still very thin and weak, we continue to monitor her closely every day.

December 15, 2017: We have been keeping Kathy in low water and feeding her a variety of fish each day. Dr. Boylan continued her calcium and antibiotic injections to help her heal inside and out. She is starting to defecate more frequently but we can tell by the way they look that she still has a long way to go. Anytime we go into the tank to do her injections we move her rear flippers around to give her some physical therapy. She is able to move them on her own, which we found out during these session because she pulls her flippers close to her body away from our touch. However she still does not use them in the tank to swim. We hope that with time and supportive care that she will begin to use them to swim in her tank. You can do it Kathy!

January 15, 2018: In recent weeks, Kathy has become more lethargic and is not as active in her tank. We have done physical therapy with her rear flippers to help her increase her strength and mobility by passive range of motion. Kathy still has a good appetite, but is still a very sick patient who is going to need a long time to make a full recovery.

February 1, 2018: Kathy has been eating much better in the last few weeks, and we are still doing physical therapy with her to strengthen her flippers. We have seen an improvement in the use of her rear flippers, and she is slowly but surely making a little progress. Kathy is hanging in there, but she’s going to be with us for a long while.

February 15, 2018: Kathy has been hanging in there and is eating much better on her own.

March 1, 2018: Kathy was pulled for a physical exam and blood work. Overall, her blood work has improved tremendously from when she was first admitted. We continue to work with her to improve her mobility in her hind limbs, and she is getting stronger, but we’re still not out of the woods with her just yet.

March 15, 2018: STCC staff has noticed that Kathy is starting to get a little stronger in her front flippers, and we are hoping this improvement continues. Kathy received an eye exam from Dr. Anne Cook of Animal Eye Care of the Lowcountry to check for cataracts; luckily her corneas are clear.

April 1, 2018: Kathy is still doing about the same – no major improvements have been made. Last week staff noticed that she was more lethargic so we did a full work up, including blood work, another CT scan and physical exam. Kathy’s blood values were fairly within normal range, however her heterophil count was elevated indicating inflammation. Kathy was started on antibiotics and steroid to see if that helps reduce the inflammatory response. We have also been doing physical therapy with Kathy to help strengthen her front flippers.

April 15, 2018: Kathy is starting to get stronger in her front flippers, and we are continuing to do physical therapy with her to help her regain both full range of motion and strength.

May 15, 2018: Kathy is still doing about the same but appears to be stronger in the use of her front flippers.

June 1, 2018: Kathy continues to be one of our more critical care patients. We have recently moved her into a larger tank to give her additional room to swim. Given her inability to reliably come up for air, her tank level remains low. Staff is noticing an increase in her ability to use all four flippers, which is a hopeful sign. She is being tong-fed a nutritious diet of salmon, which she eats a majority of the time. Given that she has plateaued some in her rehabilitation process, Dr. Shane will be starting her on a nerve pain medication. Kathy has a long road of recovery ahead of her.

June 15, 2018: Kathy continues to be a picky eater and routinely mashes up her fish pieces. This has made it challenging to give her any oral medications. Staff has gotten really good at strategically hiding it in her food and using gel capsules to disguise it. Kathy received a monthly physical exam last week. Despite not being the best eater, her body condition is improving, and she is gaining weight.

July 1, 2018: Kathy is doing about the same. Nothing new to report about her currently.

July 15, 2018: Due to Kathy’s recent regression and loss of appetite, we performed a full veterinary examination on Thursday. This was conducted by both our chief and associate veterinarians, Dr. Shane and Dr. Bryan. They pulled out all the stops with CT scans, endoscopy to assess the GI tract and an ultrasound. Further diagnostics are needed to figure out what our next course of action will be, but for now we are providing Kathy with supportive care and monitoring her closely for defecations and eating.

August 1, 2018: We have started to “swim” Kathy in our exercise tank once a week as a form of physical therapy. During this therapy, a staff member joins her in the tank and supervises her. This allows Kathy the chance to utilize her flippers, stimulates her to swim, and will hopefully aid in gut motility. To all of our surprise, she is swimming much better than we expected! She can move and use both her front flippers and, to a lesser degree, her right hind limb. We are hopeful that the physical therapy will help her regain strength and muscle tone.

January 1, 2019: Kathy hasn’t eaten for a couple of weeks, so we have started giving her partial parenteral nutrition (PPN). PPN is a solution that contains essential nutrients and is given through IV. She’s also receiving fluids and extra vitamins to make sure she is getting everything her body needs. She’s defecating every other day or so which is a good sign. Next week, we have a CT scheduled along with a surgical procedure to find what’s causing issues with her gastrointestinal tract.

January 15, 2019: Last week, Kathy received an extensive 6-hour surgery, 2 CT scans and an ultrasound. An ultrasound was given before the surgery to help find what our vet team suspected: a megacolon. A megacolon is an abnormal dilation of the colon which can trap food, feces and fluids and cause major issues. Dr. Boylan was able to make a large incision in the soft tissue near her right rear flipper and locate the megacolon in her GI tract using an endoscope. Dr. Boylan was then able to remove fluid and other debris from it. After a few days of resting comfortably on foam post-op, she was placed back in a shallow water tank. Kathy’s prognosis is highly guarded at this point in time. We are continuing to closely monitor her, and give her PPN and fluids every few days. Kathy will receive another CT and ultrasound this week to see how everything is healing overall.