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