Sea Turtle 911

11pm, August 3, 2011—NAVC immediate Past President, Dr. Doug Mader, was called out on a most unusual emergency call on the island of Big Pine Key, in the heart of the Conch Republic.

Exceptional Veterinary Team spoke with Dr. Mader to learn why.

I see a lot of injured turtles, and with lobster season being huge this time of year, it is common to see a lot more traumatic injuries than usual: boat strikes, propeller cuts, shark bites, swallowed fishing hooks and so forth. JoEllen Basille, the manager of the Marathon Sea Turtle Hospital, called me to let me know she had a sea turtle that had been speared through the head. I knew it couldn’t be good - the only other case of a speared turtle that I’d seen was found dead.

This is a very small community with a lot of pride. When an emergency call goes out on a radio (like a marine radio) for help, it is not uncommon for several people to respond. The local County fire/rescue department and US Fish and Wildlife arrived on scene at the same time I showed up. We’re lucky we live in a small community, because the police and local emergency personnel have enough time to respond and help out on calls like this.

2. What did you find when you got to the turtle and what kind of turtle was it?

It was shortly after 11pm when I arrived and there were already several people standing around the dock looking on. Word travels fast on the Coconut telegraph in this little island nation. They were looking on with both amazement and horror at a 150 pound, female Loggerhead sea turtle with a four-foot long spear sticking out the side of its head. The point of the spear had entered the skull just above the left ear angled downward and caudally. The balance of the weapon, about 3-1/2 feet of it, was sticking out grotesquely like some cartoon TV antenna.

The poor animal was in the stern of a private boat. It was motionless and the free end of the spear had lodged under the captain’s chair. Every time the boat rocked or the turtle tried to move the spear wedged deeper into the head.

This is certainly not a common injury. The first thing we needed to do was cut the spear so we could transport the turtle. I did not want to try and extract the weapon in the field due to the substantial risk of hemorrhage once the spear was removed. However, because of the length of the object and the logistics (and danger to the patient) of trying to move the animal with a spear in its head we knew we had to shorten the projectile. The problem was that it was tempered stainless steel, and traditional bolt cutters aren’t strong enough to cut through this type of metal.

Fortunately, having the fire/rescue department on scene we had access to their sophisticated rescue equipment. Lt. Tillman of the Monroe County Fire and Rescue brought out a diamond-blade cutting tool. The next big obstacle with this was to protect the turtle from, first, the tremendous heat generated by the blade, and second, the vibration that the actual spinning took makes during the cut. I heavily sedated the turtle before we started with the cutting.

3. How did you keep the spear from burning the brain and other tissues in the head?

We got several towels and a bucket of ice water. I did not want to a hot metal rod burning the inside of the head while it was being cut, creating swelling and more damage than the turtle already had. We wrapped the spear with several layers of iced towel approximately 15 cm adjacent to the skull, and again, about 24 cm distal to the saw cut. It seemed to take forever, but the actual cut was fairly quick. I can’t even imagine what the poor turtle was feeling while all these people were holding it, holding the head and cutting away the spear. I can’t imagine what was going through her head during all of this activity (really bad pun intentional).

The towels on either side of the diamond blade were smoking. We kept them constantly drenched with ice water the entire time. Fortunately, the spear adjacent to the skull stayed cool. As soon as the spear was cut we were able to carry the animal to the waiting Sea Turtle Ambulance and get it rushed to the Sea Turtle Hospital, about 25 miles away.

Although an uncommon injury where I have my practice, penetrating wounds like this spear are not at all uncommon in certain regions. Hunting dogs can be accidentally shot and injured by arrows while bow hunting. Pelicans and other shore birds are occasionally shot by the similar kinds of weapons. It is interesting that will all the turtles that we see at the Turtle Hospital this is only the second one reported in the 17 years I have worked there.

I am not a spear fisherman, so I have little knowledge of the sport or the hardware used. I was told by experts that the spear in this case was a case hardened, high velocity weapon, shot from a pneumatic gun – the type used to bring down large game fish. This was not your average recreational diving equipment—this was equipment used by someone with significant experience with the ocean. A regular spear wouldn’t have gone all the way through.

On the way to the hospital I was told that the crowd that had gathered around to watch the rescue decided to name the turtle Sara after the daughter of the boat captain that found the turtle. It happened to be the daughter’s birthday.

4. What did you do once you got her to the hospital and was there any particular imaging or diagnostic equipment used to determine the extent of the head wound before surgery was initiated?

Once at the hospital we treated Sara with fluids, antibiotics and pain medications. We collected blood samples and got some radiographs of the skull.

What we saw was daunting – the spear entered the left side of the skull, crossed completely through and wedged into the medial side of the opposite mandible. Of significance was a three-inch expanded metal barb, like the end of a toggle bolt, fully open inside the skull!

Surprisingly, Sara hadn’t lost a lot of blood, or as much as you might have thought. I anesthetized her, and placed a large oral speculum so that we could try and remove the spear. You could clearly see the weapon enter the back of the oropharynx on the left side of the skull, passed across the throat directly between the epiglottis and the glottis (partially blocking the airway), and exited the opposite side of the throat where the point lodged into the mandibular bone.

There was no way to back this spear out (due to the large barb) without doing tremendous damage. I was able to use long needle nose pliers to reach inside the mouth and collapse the barb. Then, with great care, back the point out of the mandible and redirect it through the soft tissue region just behind the jaw, in an area known as “Viborg’s triangle,” in mammals. It is a very small target of soft tissue that lied between several very delicate structures (to all the freshman veterinary students reading this – see – anatomy IS important!). From there I made a small incision in the tissue and pulled the spear completely though and out the opposite from where it entered. I was prepared to pack the wound with hemostatic gel if hemorrhage had been a problem, but, fortunately, it was not.

5. Do sea turtles need any other particular care during intensive recovery, beyond treating the wounds? A specialized diet, isolation from other turtles, etc.?

Even though sea turtles live in the water all the time, they are air breathers (with lungs) like a mammal. So, if they have has anesthesia and surgery they are kept out of the water for at least 24 hours and carefully monitored. When fully recovered from the anesthesia we put them in a special recover tank where we can monitor their swimming and breathing. During the first critical couple of days they can still drown.

Sara is off all medications now. She is free swimming and starting to use her jaw to eat. I expect it won’t be long before she is back swimming with the fishes. She is one lucky turtle.

Fortunately for Sara (and all turtles for that matter), she has a very small brain for her size (not to be disrespectful!). The spear just happened to miss it and all the vital structures in the head.

6. Along those lines, I guess we can all learn a “cross-species” lesson in perseverance from Sara’s extraordinary survival. It doesn’t seem like there’s anything tougher than surviving a spear gunshot to the head, while trying to stay afloat for days in the open ocean?

Absolutely. Although she hadn’t lost as much blood as was originally feared, she was still bleeding out there in the water. There are sharks out there and with her being injured and floating, she was easy prey for some large Bull or Reef shark. Also, bobbing like a cork in the waves, she was an easy accidental target for speeding boats. We estimate that the wound was less than 3 days old. Any longer than that, and I doubt she would have made it.

These animals date back to the Carboniferous period, (http://science.nationalgeographic.com/science/prehistoric-world/prehistoric-time-line/), and are one of the few animals that have been here on earth almost since time immortal. They’re tough little critters. Without any doubt, their biggest threat to existence is man.

7. The reward money for any information leading to the arrest and conviction of the individual(s) responsible for shooting Sara has recently gone up to almost $14,000. It’s impressive to see a community care so much about its wildlife and show so much respect for the animals around them.

Yes, and if you’ll notice, there’s been quite a bit of in-kind exchange as well. People have really stepped up to the plate to help (http://www.turtlehospital.org/blog/?s), even if they don’t have any money. People really do care about everyone else here, animals included.

8. If people are interested in donating funds to help the Turtle Hospital continue to save these marine animals, what should they do?

Please visit us at www.turtlehospital.org and http://www.turtlehospital.org/blog/?page_id=476 (How You Can Help). We’re trying to post daily updates on Sara too, if you’d like to see how she’s doing.

Thank you Dr. Mader, and thank you to everyone who helped saved this sea turtle and many others like her!