Several new challenges in elephant medicine have emerged over the past several years. Arguably the most critical is elephant endotheliotropic herpesvirus (EEHV), now recognized as a signi cant threat to captive Asian elephant populations in range countries, Europe and Asia (Cracknell et al. 2007; Reid et al. 2007; Richman 2007). Characterized by high mortality as well as stillbirth and abortion, the disease primarily affects juveniles between the ages of 1 and 4 years. Affected animals typically present with mild signs of lethargy which progress within hours or days to cranial and respiratory edema, facial cyanosis, and ultimately death, caused by myocardial failure and damage to the endothelial lining of the microvasculature leading to severe internal hemorrhage. Diagnosis is achieved via PCR testing of whole blood samples from actively viremic animals (Richman et al. 1999; Richman 2007). Current treatment recommendations include large doses of the antiviral drug famcyclovir, along with supportive care (Schmitt et al. 2000). However, in several cases, elephants have died despite early and aggressive treatment for reasons that remain unclear.

We evaluated the oncotic pressure (plasma colloid osmotic pressure, πc) in a group of healthy, captive Asian elephants ( Elephas maximus; n = 21) with a colloid osmometer with a membrane cutoff of >20,000 daltons. The median πc for these elephants was 26.3 mm Hg with an interquartile interval of 25.5–26.8 mm Hg. The mean πc value was 26.0 mm Hg ± SD 1.1. We found moderate correlation between albumin measured by electrophoresis and πc ( r = 0.622; p = 0.003). After a 16-h water deprivation test in a subset of elephants ( n = 16), a difference in πc was not detected, despite a significant increase in serum total proteins, urea, and osmolality. These results indicate that πc is not a sensitive indicator of hydration status in elephants after a short period of water deprivation. Use of oncotic pressure as a diagnostic tool in diseased Asian elephants warrants further investigation.

This report describes the use of custom-made, glue-on shoes for the front feet of two female adult Asian elephants ( Elephas maximus) with conformational abnormalities. Both elephants had unequal leg lengths. The first elephant also had bilateral fetlock varus causing recurrent nail infections of the fourth digits of the front feet. The second elephant displayed weight shifting. Over several years, multiple shoe prototypes were tested. The current version is made of two types of shoe rubber, glued together and attached to the pad of the shorter leg with a liquid adhesive. The first elephant also has bilateral wedge pads to offload pressure from the fourth nails. The shoes are removed each month for foot care, then replaced. Within several months of wearing shoes, the first elephant's nail infections healed and the second elephant stopped weight shifting. Both elephants' gaits became smoother. This is the first description of corrective shoeing in elephants.

Sixteen years of medical records documenting 19 births within a herd of Asian elephants ( Elephas maximus) at a private facility in the southeastern United States were reviewed. Of the 19 calves, 11 were normal at birth, requiring no additional veterinary care, and eight were abnormal, requiring veterinary care immediately or within the first week of birth. Descriptive statistics were used to evaluate morphometrics, vital signs, and behavioral milestones in newborn calves both normal and abnormal. Blood work and urinalysis results from all calves were compared to values for adult elephants. Medical management of abnormal calves is described. All calves had faster heart rates and respiratory rates than did adult elephants, but rectal temperatures were the same. Calves were precocious with regard to sitting and standing but could be very slow to nurse. The most-common medical conditions of newborn calves were umbilical abnormalities and problems associated with nursing. Two calves required cardiopulmonary resuscitation after birth but made full recoveries. Some conditions were not apparent at birth but were recognized a few hours or days later. Following veterinary intervention, six of the eight calves made full recoveries, suggesting that early identification and treatment of problems can greatly decrease mortality. This is the first report of multiple veterinary and behavioral parameters in normal and abnormal neonatal Asian elephants from a facility with a calf survival rate above 90%. This information may be helpful to other elephant-holding facilities in providing care to their newborn elephant calves.

We reviewed medical records documenting 28 pregnancies occurring within a herd of Asian elephants (Elephas maximus) over a 20-yr (1994-2014) period at a private facility in the southeastern United States. Twenty-six pregnancies resulted in live calves and two ended in stillbirths. The 26 live births represented the offspring of 11 cows and 5 bulls. Twenty-four calves survived their first year, including two critically ill calves born after dystocias. Male and female calves occurred in almost equal numbers. Mean duration of labor in this group was 36 hr although the median duration was 13 hr. Although oxytocin was administered to several cows, parturition did not always immediately ensue. Female fecundity ranged from 1-6 calves while female age at parturition ranged from 9-46 yr. Females delivered their first calves between 9 and 26 yr of age whereas bulls sired their first calves in their 20s, on average. The number of live births and the 93% calf survival rate are among the highest reported in any western hemisphere elephant-holding facility. This may reflect the intensive management of cows before, during, and after each pregnancy, the number of experienced multiparous cows, and the skill level of staff, most of whom had worked with each other and with this herd for many years. The data presented here may assist facilities planning to breed Asian elephants.

This epidemiologic study follows a 5-yr-old male African elephant ( Loxodonta africana ) during an episode of hemorrhagic disease (HD) due to elephant endotheliotropic herpesvirus 3B (EEHV3B) utilizing data from complete blood counts, electrophoresis and acute phase protein analysis, and polymerase chain reaction (PCR) of multiple body fluids during and after the clinical episode. The elephant presented with sudden onset of marked lethargy and inappetence followed by hypersalivation, hyperemia of the conjunctivae and focally on the tongue, and swellings on the head and ventrum. A moderate leukocytopenia with band neutrophilia, lymphopenia, monocytopenia, and thrombocytophilia was followed by a rise in all three cell types by day 10. Moderate increases in serum amyloid A and C-reactive protein were noted in the first weeks of illness. Conventional PCR of whole blood yielded a strong positive result for EEHV3B. Quantitative PCR revealed moderate viremia, which slowly returned to undetectable levels by day 35 of treatment. EEHV3B was shed in trunk wash samples starting at day 22 for 10 days at moderate levels, and then at low levels for up to 8.5 mo. All three female herd mates shed low levels of EEHV3B in trunk washes intermittently starting from day 28 of the calf's illness until over 7 mo afterward. The majority of saliva samples from the calf over the 8.5-mo period were also positive for EEHV3B. A subfraction of saliva samples from a female herdmate was positive from days 127-190 following disease onset in the calf. Four elephant gammaherpesviruses were detected sporadically from the calf and female herdmates during this same time period. Treatment was started at the onset of clinical signs and consisted of rectal and oral fluids and oral famciclovir. This is the first case of EEHV3B HD in an elephant species and the first thorough epidemiologic evaluation of EEHV HD in an African elephant.

Although the hematology of healthy elephants has been well-described, published information on hematological changes during disease is limited. The objective of this study was to describe qualitative morphological changes in the leukocytes of Asian and African elephants (Elephas maximus and Loxodonta africana) diagnosed with a variety of inflammatory conditions. Twenty-five of 27 elephants had morphological changes in their leukocytes, although only 16 of these had a concurrent inflammatory leukogram. Morphological changes included heterophil left-shifting with or without concurrent dysgranulopoiesis, toxicity, or hypersegmentation, reactive lymphocytes, plasma cells, and/or vacuolated monocytes. Although the observed leukocyte morphological changes are non-specific, their early recognition upon blood film evaluation may provide important, clinically-relevant information, particularly if the leukogram is normal. This case series is the first description of qualitative morphological changes in the leukocytes of elephants in association with inflammation.

Acute phase protein (APP) immunoassays and serum protein electrophoresis (SPEP) are assays for evaluating the inflammatory response and have use as diagnostic tools in a variety of species. Acute phase proteins are markers of inflammation that are highly conserved across different species while SPEP separates and quantifies serum protein fractions based on their physical properties. In the current study, serum samples from 35 clinically healthy Asian elephants (Elephas maximus) were analyzed using automated assays for C-reactive protein, serum amyloid A, and haptoglobin and SPEP. Robust methods were used to generate reference intervals for the APPs: C-reactive protein (1.3-12.8 mg/l), serum amyloid A (0-47.5 mg/l), and haptoglobin (0-1.10 mg/ml). In addition, SPEP was performed on these samples to establish reference intervals for each protein fraction. A combination of APPs and SPEP measurements are valuable adjunctive diagnostic tools in elephant health care.

Asian elephant (Elephas maximus) dams and their newborn calves were tested for Mycobacterium tuberculosis antibodies in serum. Blood was drawn from dams prior to calving and from calves on their day of birth. All six calves born to tuberculosis-reactive dams were also tuberculosis reactive, suggesting prenatal passive placental transfer of tuberculosis antibodies. In contrast, all three calves born to tuberculosis-nonreactive dams lacked detectable tuberculosis antibodies in pre-suckling or day-of-birth blood samples. Of the living tuberculosis-reactive calves observed from 1 to 11 yr of age, none exhibited clinical signs of tuberculosis infection or became tuberculosis culture positive. This is the first report of prenatal passive placental transfer of tuberculosis antibodies in elephants and demonstrates that detectible tuberculosis antibodies in newborn elephant calves should not be assumed to correlate with clinical tuberculosis.

A 10-year record review from a zoological institution in the western USA identified four cases of severe laminitis resulting in rotation and protrusion of the third phalanx through the sole. Laminitis is reported in a Masai giraffe (Giraffa camelopardalis tippelskirchi), a Sichuan takin (Budorcas taxicolor tibetana), a greater Malayan chevrotain (Tragulus napu) and a giant eland (Taurotragus derbianus). This is the first report of severe laminitis with pedal bone rotation and protrusion in multiple species of non-domestic hoofstock, and the first report of this disease in three of these species (takin, chevrotain, and giant eland).

Elephant endotheliotropic herpesviruses (EEHVs) can cause fatal hemorrhagic disease in juvenile Asian elephants (Elphas maximus); however, sporadic shedding of virus in trunk washes collected from healthy elephants also has been detected. Data regarding the relationship of viral loads in blood compared with trunk washes are lacking, and questions about whether elephants can undergo multiple infections with EEHVs have not been addressed previously. Real-time quantitative polymerase chain reaction was used to determine the kinetics of EEHV1 loads, and genotypic analysis was performed on EEHV1 DNA detected in various fluid samples obtained from five Asian elephants that survived detectable EEHV1 DNAemia on at least two separate occasions. In three elephants displaying clinical signs of illness, preclinical EEHV1 DNAemia was detectable, and peak whole-blood viral loads occurred 3-8 days after the onset of clinical signs. In two elephants with EEHV1 DNAemia that persisted for 7-21 days, no clinical signs of illness were observed. Detection of EEHV1 DNA in trunk washes peaked approximately 21 days after DNAemia, and viral genotypes detected during DNAemia matched those detected in subsequent trunk washes from the same elephant. In each of the five elephants, two distinct EEHV1 genotypes were identified in whole blood and trunk washes at different time points. In each case, these genotypes represented both an EEHV1A and an EEHV1B subtype. These data suggest that knowledge of viral loads could be useful for the management of elephants before or during clinical illness. Furthermore, sequential infection with both EEHV1 subtypes occurs in Asian elephants, suggesting that they do not elicit cross-protective sterilizing immunity. These data will be useful to individuals involved in the husbandry and clinical care of Asian elephants.

Chapter 38 Antimicrobial Drug Use in Zoological Animals Ellen Wiedner, Ellen WiednerSearch for more papers by this authorRobert P. Hunter, Robert P. HunterSearch for more papers by this author Ellen Wiedner, Ellen WiednerSearch for more papers by this authorRobert P. Hunter, Robert P. HunterSearch for more papers by this author Book Editor(s):Steeve Giguère DVM, PhD, DACVIM, Steeve Giguère DVM, PhD, DACVIM Professor, Large Animal Internal Medicine Marguerite Hodgson Chair in Equine Studies, College of Veterinary Medicine, University of GeorgiaSearch for more papers by this authorJohn F. Prescott MA, VetMB, PhD, John F. Prescott MA, VetMB, PhD Professor Department of Pathobiology, University of GuelphSearch for more papers by this authorPatricia M. Dowling DVM, MS, DACVIM, DACVCP, Patricia M. Dowling DVM, MS, DACVIM, DACVCP Professor, Veterinary Clinical Pharmacology Veterinary Biomedical Sciences, University of SaskatchewanSearch for more papers by this author First published: 16 August 2013 https://doi.org/10.1002/9781118675014.ch38Citations: 2 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Summary Results of in vitro susceptibility tests are typically presented to the veterinarian by designating the pathogen as susceptible, intermediate, or resistant. This designation is based on breakpoints established by the Clinical and Laboratory Standards Institute (CLSI). Most injectable antimicrobials are given via the intramuscular route in zoo and wildlife species. Any veterinarian planning to work with wildlife and zoological species should have an understanding of darting equipment and techniques, and its risks, which include stress to the animal, accidental bone fractures or penetration of internal organs and equipment failure, that is, the dart fails to inject its contents either partially or entirely into the animal. An interesting area of antimicrobial research involves wildlife species that actually produce their own antimicrobial substances. Recently, evidence of harmful antibiotic residues in wildlife found causing increased pathology in affected species. Citing Literature Antimicrobial Therapy in Veterinary Medicine, Fifth Edition RelatedInformation

Serum from 21 healthy, captive Asian elephants (Elephas maximus) was evaluated by measured and calculated osmolality. Serum osmolality results for this population of Asian elephants had a median of 261 mOsm/kg and an interquartile interval of 258-269 mOsm/kg when measured by freezing point osmometry and a median of 264 mOsm/kg and an interquartile interval of 257-269 mOsm/kg when measured by vapor pressure osmometry. These values are significantly lower than values reported in other mammalian species and have important diagnostic and therapeutic implications. Calculated osmolality produced unreliable results and needs further study to determine an appropriate formula and its clinical application in this species. A 16-hr water deprivation test in 16 Asian elephants induced a small, subclinical, but statistically significant increase in measured serum osmolality. Serum osmolality, blood urea nitrogen, and total protein by refractometer were sensitive indicators of hydration status. Serum osmolality measurement by freezing point or vapor pressure osmometry is a useful adjunct to routine clinical tests in the diagnostic evaluation of elephants.

Three captive-born (5-day-old, 8-day-old, and 4-yr-old) Asian elephants (Elephas maximus) and one captive-born 22-yr-old African elephant (Loxodonta africana) from three private elephant facilities and one zoo in the United States presented with depression, anorexia, and tachycardia as well as gastrointestinal signs of disease including abdominal distention, decreased borborygmi, tenesmus, hematochezia, or diarrhea. All elephants showed some evidence of discomfort including agitation, vocalization, or postural changes. One animal had abnormal rectal findings. Nonmotile bowel loops were seen on transabdominal ultrasound in another case. Duration of signs ranged from 6 to 36 hr. All elephants received analgesics and were given oral or rectal fluids. Other treatments included warm-water enemas or walking. One elephant underwent exploratory celiotomy. Three animals died, and the elephant taken to surgery was euthanized prior to anesthetic recovery. At necropsy, all animals had severe, strangulating intestinal lesions.

OBJECTIVE:To report stabilization of closed, comminuted distal metaphyseal transverse fractures of the left tibia and fibula in a tiger using a hybrid circular-linear external skeletal fixator.STUDY DESIGN:Clinical report.ANIMAL:Juvenile tiger (15 months, 90 kg).METHODS:From imaging studies, the tiger had comminuted distal metaphyseal transverse fractures of the left tibia and fibula, with mild caudolateral displacement and moderate compression. Multiple fissures extended from the fractures through the distal metaphyses, extending toward, but not involving the distal tibial and fibular physes. A hybrid circular-linear external skeletal fixator was applied by closed reduction, to stabilize the fractures.RESULTS:The fractures healed and the fixator was removed 5 weeks after stabilization. Limb length and alignment were similar to the normal contralateral limb at hospital discharge, 8 weeks after surgery. Two weeks later, the tiger had fractures of the right tibia and fibula and was euthanatized. Necropsy confirmed pathologic fractures ascribed to copper deficiency.CONCLUSION:Closed application of the hybrid construct provided sufficient stability to allow this 90 kg tiger's juxta-articular fractures to heal with minimal complications and without disrupting growth from the adjacent physes.