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Elephant Elephant Medicine Medicine
E.C. Ramsay, DVM, Dipl. ACZM
University of Tennessee, Knoxville
Asian or Indian elephantAsian or Indian elephant
� Elephas maximus
� 4-5 subspp.
� Range from temperate India to South East Asia, including the islands of Sumatra and Borneo
Asian or Indian elephantAsian or Indian elephant
African elephantAfrican elephant
� Loxodonta africana– ranges throughout
subsaharan Africa
� Steppe or savannah subsp.– Some differentiate
a Cape subsp.
� Bush or forest subsp.
BiologyBiology
� Largest living land mammals
� Graviportal limbs– mesaxonid ungulate
– solid bones
– straight limbs
� Lifespan: ~70 years
but Life Expectancy: 45 years
AnatomyAnatomy
� Lack a pleural space
AnatomyAnatomy
Hindgut digesters
– Lack a gallbladder
HusbandryHusbandry
� Both species hardy
� Males experience “musth”
– thought to be a remnant of a seasonal rutting period
HusbandryHusbandry
Considerable controversy over captive handling
– Approx. 1 elephant keeper killed by elephants each year
Physical RestraintPhysical Restraint
�Elephant Restraint Devices (ERD)
– several types in use
– seldom “crush” the animal
TranquilizationTranquilization--Standing sedationStanding sedation
� Azaperone – Africans 0.06 -0.1
mg/kg IM
� Xylazine– Asians 0.075 mg/kg
IM
– Africans 0.15 - 0.3 mg/kg IM
TranquilizationTranquilization--Standing sedationStanding sedation
� Butorphanol– still determining dosages
– used in combination with other agents
– reversible with nalloxone
� Detomidine– used more frequently now
– alpha-2 agonists reversible with yohimbine
AnesthesiaAnesthesia-- Lateral Lateral recumbencyrecumbency
� Etorphine HCl (M99,
Immobilon®)– 1.0 mg/450 - 600 kg IM
� Carfentanil citrate– 0.9 mg/450-600 kg IM
� Reversible with naltrexone– 100 mg/ 1.0 mg opioid
Inhalation AgentsInhalation Agents
� Most commonly used with young animals
� Halothane or Isoflurane
� Endotracheal intubation– more difficult with aged
animals
� Insufflation– one or both nasal passages
TherapeuticsTherapeutics
� Limited number of pharmacokinetic studies– most indicate dosages
(mg/kg) similar to that in the domestic horse
– see Olsen, J. Antibiotic therapy in Zoo and Wildlife Medicine 4.
� Metabolic scaling may be useful for some drugs
Oral Administration Oral Administration
� Frequently difficult
– depends on the agent and the elephant
� Most commonly used for NSAIDs and anti-mycobacterial drugs
Rectal AdministrationRectal Administration
� Used with bitter tasting drugs
– Isoniazid and other anti-tuberculosis drugs
– Metrodinazole
IntraIntra--muscular muscular InjectionsInjections
� 3.73 cm(1.5”) needles frequently used but probably only deliver sub-cutaneous injections
� Avoid repeated intravascular injections, especially in ear vessels
DiagnosticsDiagnostics
� Blood sampling from ear
or leg veins
DiagnosticsDiagnostics
� Auscultation difficult/unrewarding
� Rectal palpation-unrewarding without ultrasonography (special equipment)
RadiologyRadiology
� In the field it is limited to feet and carpus/tarsus
– see Gage LJ, in Zoo and Wildlife Medicine 4.
RadiologyRadiology
RadiologyRadiology
� Elbows and stifles possible on larger machines or smaller animals
Preventive MedicinePreventive Medicine
� Very few parasite problems
– elephant lice infestations
� Vaccinations
– Tetanus toxoid
– Rabies
� Tuberculosis surveillance
Important Diseases Important Diseases ProblemsProblems-- CaptivityCaptivity
� Musculoskeletal problems
� Teeth
� Hook abscesses
� Tuberculosis
� Herpesvirus infection
Degenerative Joint Degenerative Joint Disease (DJD)Disease (DJD)
� Etiology – unknown– more commonly seen
in Asian elephants
- Most are husbandry related
Probably the most common reason for euthanasia in captivity-fall and cannot rise
Degenerative Joint Degenerative Joint DiseaseDisease
Clinical Signs– lameness (stiffness-
ankylosis), reluctance to lay down
– radiographic signs
� Treatment– Non-steroidal anti-
inflammatory drugs
Feet ProblemsFeet Problems
� Wide variety of problems ranging from minor nail cracks to osteomyelitis of digits and abscesses of foot pad
� What constitutes proper foot care is still controversial-see Csuti, B., et al. The Elephant Foot, Iowa St Press, 2001
Foot ProblemsFoot Problems
� Severe nail cracks and sequelae more common on digits 2-4 of the forefoot
– Asians more commonly affected
Teeth ProblemsTeeth Problems
� Speculated to be the major precursor to death of aged wild elephants
� In captivity tusk problems have received the majority of attention but molar problems are common in older animals
AnatomyAnatomy
� Tusks are modified incisors
– small to absent in female Asian elephants
– continuously growing
Tusk ProblemsTusk Problems
� Problems arise from broken or badly cracked tusks
– Pulpotomy (vital pulpotomy)
– Root canal
– Extraction
Molar ProblemsMolar Problems
� Seldom described in the literature
� Usually a result of uneven wear or malocclusion
� As etiologies vary, no set therapy
TuberculosisTuberculosis
�Etiology- most frequently Mycobacterium
tuberculosis
�Clinical Signs
– wasting, exercise
intolerance, anorexia,
death, occ. cough
TuberculosisTuberculosis
� Diagnosis– clinical history
– weight loss
– intradermal skin test unreliable
– trunk washes and culture
– MAPIA and rapid tests?
Herpesvirus InfectionHerpesvirus Infection
� A recently recognized disease of young elephants
� Etiology- a non-lethal Herpesvirus of African elephants affects Asian elephants– endothelial trophic virus
– possibly related to the virus causing skin papillomas
Herpesvirus InfectionHerpesvirus Infection
� Clinical signs
– rapidly progressive hemorrhagic disease, edema of head and trunk, cyanosis of the tongue
– Antibody and PCR test available for Asian elephants
Herpesvirus InfectionHerpesvirus Infection
�Pathology
– internal hemorrhages
–death caused by myocardial failure
Herpesvirus InfectionHerpesvirus Infection
� Control– unclear how long infection can
persist in adult elephants
– avoid mixing Asian and African species
� Treatment– Famciclovir® reported successful
Schmitt et al, JZWM 31:518-522, 2000
The future?The future?� Highly political animals
– animal welfare concern: difficult to mimic a natural situation in captivity for such large, social animals in most urban zoos
– circuses house more elephants than zoos, in more abnormal situations
– “poster children” for movements
� Herpesvirus Infections – Currently a point bring captive breeding into
focus controversy
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