PHARMACOKINETICS OF RECTALLY AND ORALLY ADMINISTERED LEVOFLOXACIN IN ASIAN ELEPHANTS (ELEPHAS MAXIMUS).

Appropriate and effective antibiotic use is a critical component of veterinary medicine, but there are variations across species regarding dosage and administration of these drugs. Oral or rectal routes of administration are typically used in elephants, but not all medications can achieve adequate concentrations rectally. The fluoroquinolone antimicrobials are used in elephants because of their favorable antimicrobial spectrum and pharmacokinetics compared with other oral agents. They are commonly used as part of multiple antibiotic regimens for the treatment of tuberculosis (Mycobacterium tuberculosis). The objective of this study was to determine the pharmacokinetic profile of levofloxacin after oral and rectal administration in Asian elephants (Elephas maximus). Dosages of 5 mg/kg orally and 15 mg/kg rectally were evaluated in 13 Asian elephants. Blood was collected at various time points from 0 to 72 h for pharmacokinetic analysis. Pharmacokinetic parameters were determined and reached concentrations above minimum inhibitory concentrations of various bacterial organisms via both routes. A pharmacokinetic-pharmacodynamic assessment was used to estimate appropriate minimal inhibitory concentrations for bacteria that could be potentially treated with this antimicrobial. Based on these findings, levofloxacin may be a consideration for administration orally (5 mg/kg) and rectally (15 mg/kg) in Asian elephants. Antimicrobial stewardship principles, culture and susceptibility of suspected pathogens, and blood level monitoring should be used to tailor administration of levofloxacin in this species.

Intralesional application of ribavirin in two American flamingos (Phoenicopterus ruber) with poxvirus infection.

We report the successful treatment of poxvirus lesions in two juvenile American flamingos (Phoenicopterus ruber) with experimental low-dose intralesional ribavirin injection. In the first flamingo, the size and location of a beak verrucosity interfered with feeding, and after multiple surgical interventions, an experimental therapy of low-dose intralesional ribavirin was implemented with close blood parameter monitoring to minimize any potential side effects due to systemic antiviral administration. The second flamingo had a poxvirus lesion on the tibiotarsus, which recurred after unsuccessful conservative medical treatment and surgical intervention and a course of intralesional ribavirin therapy was implemented. Regression of the lesions in both flamingos commenced within 3 days of ribavirin treatment resulting in complete resolution within 6 weeks of onset of ribavirin treatment.

LIP-TO-LID TRANSPOSITION AND HUSBANDRY MANAGEMENT FOR SEVERE BILATERAL EYELID COLOBOMA IN THREE SNOW LEOPARDS (PANTHERA UNCIA).

Three sibling snow leopard (Panthera uncia) cubs were evaluated shortly after birth and found to have bilateral eyelid colobomas involving >50% of the upper central and lateral lid margins. The cubs also had iris to cornea persistent pupillary membranes and developed varying degrees of keratitis caused by trichiasis and exposure. No fundic abnormalities were noted. Given the severity of the defects an extensive surgical correction was required. Prior to surgical correction, the cubs were separated from the dam daily and a human-animal socialization plan was enacted to prepare the cubs for the intensive postoperative care that would be required. Bilateral lip commissure to eyelid transposition surgeries were performed on one cub at a time at 2 wk intervals starting at 3 mo of age. Postoperative care was labor and time intensive and each cub was maintained at the zoo's veterinary hospital for 11-21 days with daily supervised visits with the cub's siblings. All cubs were successfully reintroduced together and with the dam at the end of each hospitalization. The surgical procedure yielded fully functional eyelids and an excellent cosmetic appearance in all three cubs. The planned consistent human interaction with the cubs before and during the postoperative period made the procedure and its intensive aftercare possible and was crucial to the successful outcome of the surgeries.

PHARMACOKINETICS OF CEFTIOFUR CRYSTALLINE FREE ACID, A LONG-ACTING CEPHALOSPORIN, IN AMERICAN FLAMINGOS (PHOENICOPTERUS RUBER).

Antibiotic usage is a vital component of veterinary medicine but the unique anatomy of some species can make administration difficult. The objective of this study was to determine the pharmacokinetic parameters of ceftiofur crystalline free acid (CCFA), a long-acting cephalosporin antibiotic, after parenteral administration in American flamingos ( Phoenicopterus ruber ). A dose of 10 mg/kg of CCFA was administered intramuscularly to 11 birds and blood was collected at various time points from 0 to 192 hr. Pharmacokinetic parameters for ceftiofur equivalents were determined and reached levels above minimum inhibitory concentrations of various bacterial organisms in other avian species through 96 hr in 9/11 birds. Based on these findings and comparison to other avian studies, ceftiofur crystalline free acid appears to be a long-acting antibiotic option for American flamingos. Administration of this antibiotic should be utilized in conjunction with culture and sensitivity of suspected pathogens.

Gastric pneumatosis with associated eosinophilic gastritis in four black and white ruffed lemurs (Varecia variegata variegata).

Pneumatosis cystoides intestinalis (PCI) with associated eosinophilic inflammation was documented in the gastric tissues of four black and white ruffed lemurs (Varecia variegata variegata). Pneumatosis cystoides intestinalis is an uncommon disease described in humans and characterized by multilocular gas-filled cystic spaces located within the wall of the gastrointestinal tract. These cystic spaces can occur in any location along the gastrointestinal tract as well as within the associated connective and lymphatic tissues. The exact cause of this disease is unknown. The four black and white ruffed lemurs described in this case series were captive born and had been housed in zoological institutions at two separate locations. Three of the four cases were female lemurs, and two of the affected lemurs were directly related. The individual disease presentations spanned a 5-yr time period. Two lemurs presented dead with no premonitory signs, whereas the other two lemurs presented with clinical signs of gastrointestinal disease and nonspecific signs of weakness. Gastric pneumatosis, diagnosed either grossly or histopathologically in each of these four lemurs, is described as a subset of PCI in which cystic spaces are localized to the stomach wall. Significant eosinophilic inflammatory infiltrate was identified on histopathology of gastric tissues and found to be associated with the cystic lesions in each lemur. No classic etiology, such as a fungal infection or a parasitic infection, was identified as the cause of the eosinophilic gastritis. This case series demonstrates that gastric pneumatosis with associated eosinophilic gastritis may be a significant gastrointestinal disease in black and white ruffed lemurs.

Vaccination of llamas, Llama glama, with an experimental killed encephalomyocarditis virus vaccine.

Encephalomyocarditis virus (EMCV) is a pandemic virus that has caused mortality in numerous captive wildlife species worldwide. An experimental killed vaccine was created from two EMCV isolates associated with zoo animal mortality in the southern United States. The vaccine was tested for safety and efficacy in eleven llamas (Llama glama). All animals received an initial vaccination and a second booster vaccination 4 wk later. Serum antibody responses were monitored at initial vaccination and at 4 wks, 8 wk, 6 mo, and 12 mo postvaccination. Eight of the 11 llamas vaccinated experienced at least a 4-fold increase in serum antibody titers to EMCV. Antibody titers of those eight animals remained elevated above prevaccination levels when measured at 12 mo. The experimental killed EMCV vaccine tested may be a useful tool to prevent EMCV infection in llamas when given in 2 doses 4 wk apart, and then revaccinated or with antibody levels monitored annually thereafter.

Guidelines for zoo and aquarium veterinary medical programs and veterinary hospitals.

These guidelines for veterinary medical care and veterinary hospitals are written to conform with the requirements of the Animal Welfare Act, which states that programs of disease prevention and parasite control, euthanasia, and adequate veterinary care shall be established and maintained under the supervision of a veterinarian. Ideally the zoo and aquarium should be providing the best possible veterinary medical care for the animals in their collections. Many of these animals are rare and endangered and the institutions should endeavor both to provide for the long term health and well being of these animals and to advance the field of non-domestic animal medicine. It is hoped that this publication will aid in this process.

Suspected seminal vesiculitis in an Asian elephant (Elephas maximus).

A 32-year-old male Asian elephant (Elephas maximus) underwent routine transrectal stimulation for semen collection as part of an artificial insemination program. The procedure consisted of a preinsemination semen collection followed by two consecutive days of semen collections for artificial insemination. The second day's sample contained large numbers of inflammatory cells, intracellular bacteria, and phagocytized sperm. Semen was submitted for culture and sensitivity. Culture revealed Acinetobacter lwoffii, Staphylococcus intermedius, Kocuria roseus, and an unidentified gram-positive organism. Empirical antibiotic therapy with trimethoprim sulfa was initiated and then changed to enrofloxacin based on sensitivity panel results for a total of 28 days of treatment. Diagnostic semen collections were performed during treatment and 2 wk posttreatment to determine the success of therapy. Posttreatment collections revealed resolution of the inflammation. The origin of the infection was suspected to be the seminal vesicles.

Retrospective evaluation of idiopathic hematuria and associated pathology in Grant's gazelles (Gazella granti): 10 cases.

Ten cases of hematuria in Grant's gazelle (Gazella granti) (two male and eight female) from five institutions were examined and the clinicopathologic data summarized. Five gazelles died spontaneously and five were euthanized. All gazelles had marked hematuria without pyuria. Mean age at the onset of clinical signs and time of euthanasia or death was 5.0 +/- 1.4 yr and 8.2 +/- 3.7 yr, respectively. The severity of clinical signs with hematuria ranged from episodes of chronic intermittent hematuria to marked dysuria, with urinary bladder rupture secondary to obstructive blood clots in one case. Submandibular edema was the most common associated clinical sign (five of 10 cases). Serum chemistries from eight gazelles obtained during hematuria episodes revealed hypocalcemia (8/8), hypoproteinemia (7/8), hypoalbuminemia (7/8), and hyperphosphatemia (6/8). Fifty percent of the gazelles (4/8) developed anemia over the course of hematuria episodes. Prothrombin times and partial thromboplastin times were presumed increased in two of four animals evaluated. The predominant histologic lesions in seven of 10 gazelles reviewed were vascular necrosis, vasculitis, and perivasculitis in the urinary tract. Lesions in necropsied gazelles were identified in the urinary bladder (7/10 gazelles), kidney (3/10), and ureter (3/10). Additional urinary tract lesions included tubulointerstitial nephritis (5/10 gazelles), hemorrhagic cystitis (4/10), renal tubular necrosis (4/10), and subacute renal infarcts (2/10). Polymerase chain reaction testing on paraffin-embedded urinary tract tissue for alcelaphine herpesvirus-1 and -2, ovine herpesvirus-2, bluetongue virus, and epizootic hemorrhagic disease virus was negative for the six cases tested. One gazelle that had been vaccinated for Leptospira interrogans had a titer to serovar icterohaemorrhagiae, but serum from the six other gazelles tested was negative for all L. interrogans serovars. No exposure to any toxic agent was identified. An underlying cause for vascular lesions associated with episodic hematuria in Grant's gazelles remains to be determined.

Acquired umbilical hernias in four captive polar bears (Ursus maritimus).

Umbilical hernias are a common occurrence in domestic animals and humans but have not been well documented in polar bears. Surgical reduction and herniorrhaphies were performed to correct acquired hernias in the region of the umbilicus in four adult captive polar bears (Ursus maritimus) housed in North American zoos. Two of the four bears were clinically unaffected by their hernias prior to surgery. One bear showed signs of severe discomfort following acute enlargement of the hernia. In another bear, re-herniation led to acute abdominal pain due to gastric entrapment and strangulation. The hernias in three bears were surgically repaired by debridement of the hernia ring and direct apposition of the abdominal wall, while the large defect in the most severely affected bear was closed using polypropylene mesh to prevent excessive tension. The cases in this series demonstrate that while small hernias may remain clinically inconsequential for long periods of time, enlargement or recurrence of the defect can lead to incarceration and acute abdominal crisis. Umbilical herniation has not been reported in free-ranging polar bears, and it is suspected that factors such as body condition, limited exercise, or enclosure design potentially contribute to the development of umbilical hernias in captive polar bears.

Correction of angular limb deformity in two subspecies of flamingo (Phoenicopterus ruber) utilizing a transphyseal bridging technique.

Three hand-raised American flamingo (Phoenicopterus ruber ruber) chicks and one hand-raised Chilean flamingo (Phoenicopterus ruber chilensis) developed valgus angular limb deformities of the proximal tarsometatarsal bone. All flamingos underwent surgical correction to unequally retard the growth plate using transphyseal bridging. Positive profile pins were placed in the proximal epiphysis and distal to the growth plate in the metaphysis on the convex side of the affected tarsometatarsus. Various banding techniques were used in each flamingo to create tension. Three of the four flamingos responded in 7-14 days with correction or slight overcorrection of the valgus limb deformity. The fourth flamingo's leg deformity did not improve for reasons thought to be related to improper implant placement. Growth plate retardation by transphyseal bridging proved successful in correcting valgus limb deformity of the proximal tarsometatarsus. This technique may be considered as an option for correction of angular limb deformities of the proximal tarsometatarsus in flamingos less than 90-120 days of age.

Serologic responses after vaccination of fennec foxes (Vulpes zerda) and meerkats (Suricata suricatta) with a live, canarypox-vectored canine distemper virus vaccine.

Fennec foxes (Vulpes zerda) and meerkats (Suricata suricatta) are considered to be susceptible to canine distemper virus (CDV) infection. Although no definitive clinical cases of natural CDV infections have been reported, mortalities due to CDV have been suspected and are reported in other closely related species. A commercially available monovalent, live, canarypox-vectored CDV vaccine induced neutralizing antibody titers that were maintained for at least a year in both fennec foxes and meerkats.