Burmese Brown Tortoise

GIVING INTRAMUSCULAR INJECTIONS IN CHELONIANS (Turtles and Tortoises)

Ill turtles and tortoises often require medications as part of their road to recovery.  Oral administration of drugs is difficult in many chelonians and certain drug formulations can not be giving by mouth.  When these situations arise intramuscular (IM) injections are required. 

The pectoral muscle is the best location to give intramuscular injections in a turtle or tortoises.  With the front limb held to the side one can feel this muscle resting against the inside of the plastron (the bottom part of the shell) with a gentle downward pressure of an index finger.  With some tortoises this is a two person job.  One person slowly moves the front arm to the side while another person administers the IM injection.  If the turtle or tortoise is one that attempts to bite, a cotton ball can be used to push the head gently back into the shell and keep fingers safe.  After feeling for the location of the pectoral muscle, aim your syringe at a 45 degree angle down towards the bottom of the shell (plastron) and insert the needle into the muscle.  Pull back on the syringe slightly to ensure that no blood or fluid is present where you have inserted the needle.  If you aspirate fluid remove your needle from the area and try again at a different position.  If nothing is aspirated you can give the injection.  Switching from side to side between injections will help prevent excessive soreness from repeated injections in the same place.  A little bit of patience and slow gradual movements will result in successful IM injection experiences.

A red-eared slider is given an IM injection into its left pectoral muscle.

Some tortoises, such as large sulcatas (African spur thigh tortoises) often make it very difficult to gain access to their pectoral muscles due their excellent strength.  In this situation the next best place to administer IM injections is in the muscles of their upper thighs.  It is important to insert the needle as close to the bottom portion of the shell (plastron) as possible.  Injecting medication higher up (more dorsal) on the hind leg or further down the leg can cause irritation of the major nerves in those areas.  If these nerves become irritated it can result in weakness of the leg or even loss of function.  These adverse effects may last a few days to weeks or may be so severe that they are permanent.  Due to this possible complication, this site should only be used as a last resort.  Before injecting medication into the thigh area of the hind leg, always pull back on the syringe plunger slightly to ensure that no blood or fluid is aspirated into the syringe.  Alternate sides with each administration to help prevent excessive soreness.

It can be hard to give an IM injection in the pectoral muscle of a tortoise.  The pelvic muscles (red arrow) may be used as a last resort.

The proper injection site (red arrow) of the pelvic muscles of a yellow-bellied slider.

HOW TO HANDLE THE USED NEEDLES AND SYRINGES (See Arizona Department of Environmental Quality: http://www.azdeq.gov/environ/waste/solid/ic.html#sharps)

The handling and disposal of used home generated medical sharps such as needles, syringes, and lancets, are exempted from regulation in Arizona's Medical Waste Regulations (Arizona Administrative Code (A.A.C.) R18-13-1401 et seq.). However, these materials still need to be handled safely. ADEQ needs your help in ensuring that medical sharps are disposed of in a manner that helps minimize health risks to garbage haulers, landfill personnel and the community.

Medical sharps should be placed in either a purchased medical sharps container (from a pharmacy or health care provider) or a heavy-plastic or metal container. The containers should be puncture-proof with a tight-fitting lid. Household containers such as plastic detergent bottles can be used if the following precautions are observed:

• Use heavy-duty tape such as electrical or duct tape to secure the lid to the container.
• Write the words "Not Recyclable" on the container with a black indelible marker. This helps to ensure the container will not be inadvertently mingled with recyclable materials.
• Do not use a clear or glass container.
• Do not over-stuff the containers with medical sharps (fill only to approximately: full). This can increase pressure on the lid and cause a release of the medical sharps.

While waiting for a full container, keep out of reach of children and pets. Always wash your hands after handling or touching medical sharps. Once you have followed these precautions, the container may be placed in your regular trash for disposal.