- page 1 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== .....1994... 7.Oct.1994 Stressed, assertive at times, agitated, pacing. (per keeper) (DWA) 8.Oct.1994 Still very agitated today. Feces very loose. Fecal sample taken for O/P, possible culture. Appeared calmer at closing. (DWA) 9.Oct.1994 Much more calm today. (DWA) 26.Oct.1994 Intra-oral exam by researcher. Some evidence of small cavities. (MAS) 5.Nov.1994 Swelling in right shoulder still present and warm, though much more firm and less painful than earlier in year. KUO and consider ultrasound evaluation. (DWA) .....1995... 26.Jan.1995 No further problems with swelling. Resolved without further treatment. (DWA) 27.Feb.1995 Problem: localized swelling - right front limb (Confirmed) 3.Mar.1995 Problem: localized swelling - right front limb (Confirmed) Lump on right leg near elbow is back again (for last 5 days.) It is very firm and appears unattached to musculature deep to it. There is no pain, fluctulance, or heat associated with it. keepers will continue to treat daily with DMSO. An ultrasound consult will be pursued. (DWA) 20.Mar.1995 Problem: localized swelling - right front limb (Confirmed) Lump resolving per keepers - U/S consult will be cancelled. (DWA) 29.Mar.1995 Problem: localized swelling - right front limb (Confirmed) Right forelimb swollen from shoulder to elbow today. Slight heat. Lump is still present, but is smaller in size than before. Will arrange ultrasound consult. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 2 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 2.Apr.1995 Problem: localized swelling - right front limb (Confirmed) Swelling reduced, but still present. Lump is stil unchanged in middle of swollen area. U/S consult pending. Begin DMSO mixed in K-Y jelly SID and warm soaks on that limb. Suspect abscess?? (DWA) 3.Apr.1995 Problem: localized swelling - right front limb (Confirmed) Lump warm today - DMSO gel discontinued by keepers. (DWA) 4.Apr.1995 Problem: localized swelling - right front limb (Confirmed) Lump examined today. Area of initial swelling is slightly enlarged and warmer than on earlier exams. Generalized swelling noticed last week that spread over most of the area proximal to the elbow is reduced today. This area is not warm to the touch. Winky is tolerating the DMSO gel well. Keepers will begin using this again today and arrangements will be made to ultrasound the lesion. (AED) 7.Apr.1995 Problem: localized swelling - right front limb (Confirmed) Lump examined today. Has appearance of an abscess about to rupture. Center of lump has swollen outward to 4cm beyond the skin margin and the outer skin layers are parting over the peak. The peak of the lump is red, very warm and seems tender. Elephant is blowing on area touching the swelling occasionally. DMSO gel was applied by hand. KUO (AED) 8.Apr.1995 Problem: localized swelling - right front limb (Confirmed) Abscess still is peaked but has not ruptured. Keepers have been instructed to alert vet staff once ruptured so that culture can be taken. Will continue DMSO gel. (AED) 9.Apr.1995 Problem: localized swelling - right front limb (Confirmed) Abscess very near rupture - KUO. (DWA) 10.Apr.1995 Problem: localized swelling - right front limb (Confirmed); abscess - right front limb (Confirmed) Lanced abscess. Large quantities of caseous paste-like pus were flushed out with hose, though animal would not tolerate flushing with betadine or 0.2% nitrofurazone in 5:1 NFZ:DMSO mixture. Keepers instructed to hose 2-3 times daily with betadine and soak or hose with warm water before every flush. Also ASAP, nitrofurazone with DMSO should be flushed in and allowed to stand in wound overnight. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 3 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 11.Apr.1995 Problem: abscess - right front limb (Confirmed) Much more comfortable today. Keepers hosing as requested. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 4 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 11.Apr.1995 Problem: abscess - right front limb (Confirmed) <<< Microbiology >>> Laboratory: Accession #:3555 [ ] Vet Research Collection Date: 04/11/95 [X] AHDL Submission Date:04/12/95 [ ] Other : Report Date:04/18/95 Submission type: [X] aerobic bacteriology Sample source: Abcess [X] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [X] mycobacterial Organism: Growth: heavy moderate light 1.Staphyloccocus species [ ] [ ] [ ] 2.Streptococcus Group b [ ] [ ] [ ] 3.Acinetobacter anitratus [ ] [ ] [ ] 4.Group D Streptococcus - non Enterococcus Sensitivity: 1 | 2 | 3 | 4 Amikacin: | | S | Amoxicillin: | | | Amoxicillin/Clavulanate: | | | Augmentin : | | S | Ampicillin: R | S | R | S Carbenicillin: | | | Cefoxitin: | | S | Ceftiofur: S | S | | S Cephalothin: | | | Ciprofloxacin: | | S | Chloramphenicol: | | | Clindamycin: R | R | | S Doxycycline: | | | Enrofloxacin: | | | Erythromycin: S | S | | S Gentamicin: S | S | | S Kanamycin: | | | Naladixic Acid: | | | Neomycin: | | | Nitrofurantoin: R | S | R | S Norfloxacin: | | | Oxacillin: S | S | | R Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 5 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 11.Apr.1995 Problem: abscess - right front limb (Confirmed) Penicillin: R | S | | S Piperacillin: | | S | Sulfamethoxazole: | | | Tetracycline: S | S | S | R Ticarcillin: | | | Tribrissen : S | R | S | R Trimethoprim/Sulfa: | | | Vancomycin: | | | Comments: Three types of Staphuloccocus species were isolated. No mycobacterium isolated. (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 6 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 12.Apr.1995 Problem: abscess - right front limb (Confirmed) Abscess checked. Pain is reduced and keepers are flushing and treating without problems. (AED) (DWA) 14.Apr.1995 Problem: abscess - right front limb (Confirmed) Abscess pocket looks very good today. Swelling is further decreased, pocket is open and able to drain. There is no pus or drainage evident. Keepers have finished the nitrofurazone first dispensed today. (AED) 15.Apr.1995 Problem: abscess - right front limb (Confirmed) Examined abscess area today before any treatment or flushing. Skin has closed over opening almost completely trapping some pus. Swelling is still reduced, esp. generalized swelling present before lancing abscess. Keepers were given a refill of Nitrofurazone/DMSO, 600cc total, and will continue to hose and flush once with betadine and once with Nitro/DMSO each day. Keepers were told to report back to me if abscess pocket does not remain open. (AED) 20.Apr.1995 Problem: abscess - right front limb (Confirmed) Abscess is healing very well. Only small amounts of pus present. Is healing from the deepest aspect outward. Opening of pocket is remaining large, allowing good drainage and flushing. Keepers are still flushing with betadine in the morning and nitrofurazone in the afternoon. Swelling is almost completely resolved. No heat or pain. (AED) 1.May.1995 Problem: abscess - right front limb (Confirmed) No heat or pain. Crust over 2 cm diameter external opening was removed allowing scant pus to be cleaned. Looks good. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 7 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 4.May.1995 Problem: abscess - right front limb (Confirmed) <<< Urinalysis >>> Sample Accession #:3555 Laboratory: Collection Date:05/04/95 [X] Detroit Zoo Date received: [ ] Vet Research Report Date:05/04/95 [ ] Other: Sample collection: Sample storage: [ ] floor [ ] room temperature [X] mid-stream [X] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: Yellow Appearance: [ ] clear Specific Gravity: 1.018 [ ] hazy / slightly cloudy [ ] cloudy / turbid Dip stick test: Microscopic Exam: Glucose: Neg RBC's: Neg Bilirubin: Neg WBC's: Neg Ketones: Neg Epithelial cells:Squamous 1+ Sp Gravity: 1.018 Blood: Neg Casts:None pH: 8.0 Crystals: Calcium oxalate - few Protein: Trace Other: Urobilinogen: Normal Nitrite: Neg Leucocytes: Neg Comments: (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 8 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 2.Jun.1995 Problem: abscess - right front limb (Confirmed) Abscess almost completely healed. (AED) 18.Jun.1995 Problem: abscess - right front limb (Confirmed) Abscess healed. (MAS) 24.Aug.1995 Conditioning session for annual exam. (AED) 25.Aug.1995 Conditioning session for annual exam. (AED) 26.Aug.1995 Conditioning session for annual exam. (AED) 31.Aug.1995 Bled via ear vein for CBC, chem, bank. Tetanus toxoid 1 cc IM, PPD bovis 0.1 ml ID in left caudal fold. Recheck daily for 3 days. (DWA) 1.Sep.1995 24 hr TB test negative. Area on Left shoulder where she received Tetanus vaccine is swollen but no heat or pain associated w/ it. (CAB) 2.Sep.1995 48 hr TB test negative. Swelling in left shoulder from tetanus injection. DMSO on shoulder and warm water soaks. (DWA) 3.Sep.1995 72 hr TB test negative. Swelling in shoulder reduced. Kprs to apply DMSO daily and rinse w/ warm water to encourage swelling to decrease. (DWA) 5.Sep.1995 Conditioning session for annual exam. (AED) 6.Sep.1995 Conditioning session for annual exam. (DWA) 11.Oct.1995 Previous day, keepers reported loose stool w/ small rocks in it (2-4 cm diameter.) Today, elephant appears normal, w/ normal gut motility and borborygami. Stool was passed and appeared normal overnight. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 9 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== .....1996... 11.Feb.1996 Conditioned for blood, TB, tetanus on right side. (DWA) 27.Mar.1996 Bled via right ear vein for CBC, chem, and bank. TB test 0.1 ml PPD bovis ID in right caudal fold. 1 cc IM tetanus toxoid in right shoulder. (DWA) 28.Mar.1996 24 hour TB test negative. Tetanus site inflamed today. Kprs to hose w/ cold water today, warm water TID tomorrow and UFN. Will send DMSO. (DWA) 29.Mar.1996 48 hr TB test negative. Tetanus site less swollen today. (AED) 30.Mar.1996 72 hr TB test negative. Tetanus site swelling almost completely resolved. Kprs using DMSO last two days. (AED) 9.Apr.1996 Tetanus swelling resolved. Conditioned for exam today, left side. (AED) 23.Jun.1996 Conditioned for bleeding today. (DWA) 4.Dec.1996 PE of feet of all three elephants today. All look good. (AED) .....1997... 22.Jan.1997 Drew blood for annual check up, TB tested, mammalian, left caudal fold and gave tetanus toxoid in left tricep area. (CAB) 23.Jan.1997 24 hr TB test NEG. Slight swelling in region of tetanus injection. (DWA) 25.Jan.1997 72 hr TB test negative. Very little swelling associated with vaccine. Bloodwork WNL. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 10 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 18.Apr.1997 Conditioned elephants. (AED) 3.Nov.1997 Per keeper had diarrhea, though sample submitted appeared fairly normal. Leaning against wall with tail and some restlessness observed, though appetite was good. Fecal collected for culture and ova/parasite exam. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 11 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 4.Nov.1997 <<< Microbiology >>> Sample Accession #: L6257422 Laboratory: [x] Vet Research Collection Date: 04 Nov 97 [ ] AHDL Submission Date: 04 Nov 97 [ ] Other: Reporting Date: 08 Nov 97 Sample source: Feces Submission type: [x] enteric pathogen screen [ ] Group sample [x] Individual sample Organism: Negative for Salmonella, Shigella, Yersina, and Campylobacter. Comments: Organism #1 - Coliforms Organism #2 - Bacillus species (non-pathogenic) Organism #3 - Enterococcus ( Non-pathogenic flora) (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 12 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 4.Nov.1997 Normal feces this morning. Normal activity. (DWA) .....1998... 25.Jan.1998 Problem: crack - left rear foot (Confirmed) Kprs able to inspect feet. Found crack and soft area in center toe nail of left rear foot. Discussed trimming w/ kprs. Asc curator had already developed good plan. (DWA) 15.May.1998 Problem: crack - left rear foot (Confirmed) Conditioning for blood draw and vaccination going very well. Plan to do "real" procedures next week. (AED) 23.May.1998 Problem: crack - left rear foot (Confirmed) Bled successfully via ear vein and operant conditioning. CBC, chem, bank. Vaccination as well on left shoulder. Rx: TETANUS TOXOID 1 ml IM SID for 1 day. (DWA) 4.Jun.1998 Problem: crack - left rear foot (Confirmed) Winky appears hot during bath. There is steam coming off her back and her skin feels warm. After bath she feels cooler. Feces are still decreased in volume compared to usual. Kprs to measure temp of fecal ball immed after dropping. I found source of bran and bought molasses and coffee to give tomorrow. (AED) 5.Jun.1998 Problem: crack - left rear foot (Confirmed) Gave 1/2 gal min oil and bran until a moist flaky texture. She loved it. Then added approx 1/3 of a 2lb can of coffee to similar mixture and she wouldn't eat it, even when further diluted with min. oil and bran. Tomorrow to give 1/2 gal min oil, bran and 1c coffee in am and see if she'll eat it. Her behavior is normal but fecal output decreased today. Appetite remains very good. (AED) 6.Jun.1998 Problem: crack - left rear foot (Confirmed) Yesterday afternoon started passing more feces. This am passed a large amount of feces with rocks, up to 4cm in diameter, and lots of sand. Also started drinking large amounts of water from both tank and pool. Took temp of fecal ball and was 97F and she has not appeared warm since 2 days ago. Kprs tried bran/oil with small amount of coffee with no success. Gave 1/2L min oil and bran this am and to repeat this afternoon, and bid tomorrow. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 13 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 25.Jun.1998 Problem: crack - left rear foot (Confirmed) First of 3 trunk washes today. Went very well. Frozen immediately to be shipped once all 3 collected. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 14 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 25.Jun.1998 Problem: crack - left rear foot (Confirmed) <<< Mycobacteriology >>> Sample Source: trunk wash Laboratory: Accession #:98-28505 thru 98-28507 [ ] Antech Collection Date:6-25 6-27 6-28 [ ] AHDL Submission Date:07/02/-98 [X] Other :Natioal Vet Services Lab Report Date:09/09/98 Submission type: [ ] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [X] mycobacterial Organism: Growth: heavy moderate light 1.No isolation made [ ] [ ] [ ] 2. [ ] [ ] [ ] 3. [ ] [ ] [ ] Comments: (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 15 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 27.Jun.1998 Problem: crack - left rear foot (Confirmed) Second of 3 trunk washes today. Frozen immediately. (CAB) 3.Jul.1998 Problem: crack - left rear foot (Confirmed) Decrease in stool quantity noted by keepers and treated with mineral oil. Discussed today with vet, and they indicated flatulance also present - suggesting no blockage and no stones have passed. Suspect simple partial anorexia due to heat and recommended lots of fluids but no mineral oil and bran. KUO. (DWA) 28.Jul.1998 Problem: crack - left rear foot (Confirmed) Keepers concerned about foot lesions on right front and left rear - appear to be weaknesses in the pad/nail connection. Recommend careful paring out of lesions and treating open areas with dilute betadine. Will pursue other treatment options for strengthening the laminae. (DWA) 3.Sep.1998 Problem: crack - left rear foot (Confirmed) Animal painful and colicky in PM. Discontinued new Hoof Conditioner. Keepers to administer 1 gallon mineral oil PO and vet will recheck tomorrow and late tonight. (DWA) 4.Sep.1998 Problem: crack - left rear foot (Confirmed) Appeared more active this morning. Observed her eating hay. Keepers reported increased interest in produce this morning. (NDS) 5.Sep.1998 Problem: crack - left rear foot (Confirmed) Attitude is improving. Feces appear normal. (AED) 13.Sep.1998 Problem: crack - left rear foot (Confirmed) Off feed again - not eating hay even. Per Dr. Burns - OK to give 1/2 gal of mineral oil and bran. (MAS) 14.Sep.1998 Problem: crack - left rear foot (Confirmed) COntinue mineral oil and bran x 5 days. Winky has been mopey all day, though appetite has picked up a little. She also passed a few rocks this PM in her feces. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 16 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 22.Dec.1998 Problem: crack - left rear foot (Confirmed) Conditioned today for January preventative health procedures - techs and vet to continue regular conditioning sessions. (DWA) 23.Dec.1998 Problem: crack - left rear foot (Confirmed) Winky has a large firm feeling swelling on her ventral abdomen (left side). Does not appear to bother her. (CAB) 26.Dec.1998 Problem: crack - left rear foot (Confirmed) Lump shrinking - no treatment. (DWA) .....1999... 6.Jan.1999 Problem: crack - left rear foot (Confirmed) Conditioned today with Margaret, CB, MS and myself in attendance. Discussed long-term medical training goals of touching elephants everywhere, IM injections in hip, and throwing pills/meds directly into mouth. PM training for this month going well. (AED) 27.Jan.1999 Problem: crack - left rear foot (Confirmed) Rx: TETANUS TOXOID 1 ml IM SID for 1 day. (AED) 27.Jan.1999 Problem: crack - left rear foot (Confirmed) Drew blood from left ear. Gave Tetanus toxoid IM (Left shoulder- 22ga 1" needle). She was great. (CAB) 29.Jan.1999 Problem: crack - left rear foot (Confirmed) Both elephants have swellings at their vaccination sites and are not participating in training as willingly as usual. (AED) 30.Jan.1999 Problem: crack - left rear foot (Confirmed) Visual check today of swelling- is reduced and animals are eating and behaving normally today. RESOLVED. (AED) 3.Feb.1999 Problem: crack - left rear foot (Confirmed) National Veterinary Service Laboratories Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 17 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 3.Feb.1999 Problem: crack - left rear foot (Confirmed) Date Recieved: 02 April 1999 Specimens examined: Trunk Wash Isolation: No isolations made. The trunk wash samples from this elephant were submitted on the same day, no isolations were made for any of the three samples. (CUL) 8.Feb.1999 Problem: crack - left rear foot (Confirmed) crack in left rear toe softening on bottom slightly. Will discuss with asc curator. (DWA) 27.Feb.1999 Problem: crack - left rear foot (Confirmed) Kprs report sensitivity to flushing of right tusk pocket. On exam notice no sharp edges, redness or inflammation of pocket. They report some gunk and foul smell around tusk too. Will instruct them to flush bid with betadine for 10 days and i'll recheck. (AED) 14.Apr.1999 Problem: crack - left rear foot (Confirmed) Kprs report fecal volume reduced for last week. To give mineral oil and bran daily for 3 days and report back. (AED) 16.Apr.1999 Problem: crack - left rear foot (Confirmed) Feces more normal in consistancy, however no rocks yet. Kprs instructed to skip 2 days and treat again for 2 days if necessary. (AED) 19.Apr.1999 Problem: crack - left rear foot (Confirmed) Feces more normal, and one pile of rocks produced. Inspected left rear foot- there is a soft spot between toes. Area approx 3cm by 2cm on sole of foot is soft, and feels spongy. It is likely that it is an abscess, and will likely need to be cored out. Will evaluate with Shelia tomorrow. (AED) 20.Apr.1999 Problem: crack - left rear foot (Confirmed) Sheila opened up soft area very slightly. I examined today. Area Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 18 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 20.Apr.1999 Problem: crack - left rear foot (Confirmed) needs ot be opened up more. Tissueee needs to be removed over soft area, and vet should bee present to see the quality of the cut surfaces. A conservative approach is ok, but we do need to find out how deep area is. I advised kprs not to flush betadine into an area that will trap the fluid d.t. concerns of carrying bacteria into pocket and that trapped betadine might be irritating. If possible will work w/ Sheila tomorrow. More likely she will not be available until 22nd. (AED) 21.May.1999 Problem: crack - left rear foot (Confirmed) Looked uncomfortable yesterday in am, but pooped a large volume and improved by pm. No trt. (AED) 2.Jun.1999 Problem: crack - left rear foot (Confirmed) EXamined foot yesterday. DEcision made to photograph foot w/ digtal camera. The soft spot has filled in, but remains spongy, and kprs report brown goo exuding from it on occasion. I told them to bring us sample of goo for cytolog. (AED) 29.Jun.1999 Problem: crack - left rear foot (Confirmed) Right rear foot - opened up soft area until bled a little. Cultured deepest aspect of wound. Will cut with blade next wk and explore options for rads. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 19 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 29.Jun.1999 Problem: crack - left rear foot (Confirmed) <<< Microbiology >>> Sample Source:wound in foot Laboratory: Accession #:ad7323406 [x] Antech Collection Date:29June99 [ ] AHDL Submission Date:29June99 [ ] Other : Report Date:02July99 Submission type: [x] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [ ] mycobacterial Organism: Growth: heavy moderate scant 1.Klebsiella species [x] [ ] [ ] 2.Citrobacter freundii [x] [ ] [ ] 3.Beta hemolytic Streptococcus [ ] [ ] [x] Sensitivity: 1 | 2 | 3 | Amikacin: s | s | | Amoxicillin: | | | Amoxicillin/Clavulanate: s | r | s | Ampicillin/Sulbactam: | | | Ampicillin: r | r | s | Carbenicillin: r | s | | Cefoxitin: | | | Ceftiofur: | | | Cephalothin: r | r | s | Ciprofloxacin: | | | Chloramphenicol: s | s | s | Clindamycin: | | s | Doxycycline: s | s | | Enrofloxacin: s | s | s | Erythromycin: | | s | Gentamicin: s | s | r | Kanamycin: | | | Naladixic Acid: | | | Neomycin: s | s | r | Nitrofurantoin: | | | Norfloxacin: | | | Oxacillin: | | | Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 20 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 29.Jun.1999 Problem: crack - left rear foot (Confirmed) Penicillin: | | | Piperacillin: | | | Sulfamethoxazole: | | | Tetracycline: s | s | s | Ticarcillin: | | | Tobramycin: | | | Trimethoprim/Sulfa: s | s | r | Vancomycin: | | | Comments: (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 21 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 31.Aug.1999 Problem: crack - left rear foot (Confirmed) Winky lost part of nail on left front foot last week. Kprs noticed nail was lifting up d.t. debris collecting behind. There was an entry hole at the proximal aspect of the nail. Kprs removed an area of nail about 8cm by 6cm, not including the upper edge of the nail under the cuticle. After debris removed, there was little sign of problem. Kprs also trimmed nail so that less wt. is beared by weak spot. Today examined foot, and found a soft spot on the pad of the foot, 1cm caudal to nail, just lateral to nail defect. This spot will have to manages as others have been, with weekly trimming. KUO. (AED) 29.Sep.1999 Problem: crack - left rear foot (Confirmed) Winky had diarrhea on 25th, very watery. Improved next day and since. Today normal. (AED) 30.Sep.1999 Problem: crack - left rear foot (Confirmed) Winky appears colicky today. Standing quietly, left leg stretched backward. Less willing to come when called, although she came for bagels while i was there. Kprs to give her 2g bute, mineral oil with bran and lots of water today. She ate a very lg amt of bananas yesterday, and I suspect this might be problem. (AED) 1.Oct.1999 Problem: crack - left rear foot (Confirmed) Winky normal today. Pooped in the am, and may be slightly slow and stiff, but alert, active and eating. Yesterday they got 1-2g bute into her, but she showed signs of improving before given the meds. She will get the mineral oil and bran today and tomorrow. (AED) 2.Nov.1999 Problem: crack - left rear foot (Confirmed) Examined left rear foot. Soft spot getting smaller and firmer and healing well. Decided plan for front of nail is to core out center of fissure and leave edges alone. Front foot looks very good. (AED) 7.Dec.1999 Problem: crack - left rear foot (Confirmed) Left rear foot has 3 soft spots connecting to each other (2 new ones). Will probably need to be cored out. Will discuss with Ann and examine again tomorrow. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 22 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 8.Dec.1999 Problem: crack - left rear foot (Confirmed) Examined bottom of foot. The original soft spot is improved, and the caudal most spot appears to just be a superficial divit. The new spot just caudal to the nail is worrisome. It is quite spongy and soft, and there is a fissure just behind nail that has trapped some debris. rick has shortened nail and carved out a little of the spongy material. This will be repeated next tuesday. Keepers to scrub area with nolvasan scrub using a toothbrush once daily in the meantime. we might take rads tomorrow. (AED) 9.Dec.1999 Problem: crack - left rear foot (Confirmed) Foot check by Sheila and us today. Kprs trimmed more of the nail and some of the pad over the spongy areas and opinion is that soft areas are superficial and similar to what's been seen in the past. To do a comprehensive on her and then prolong time beteen comps for the winter. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 23 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 21.Dec.1999 Problem: crack - left rear foot (Confirmed) <<< Urinalysis >>> Sample Accession #: Laboratory: Collection Date:21 Dec 99 [x] Detroit Zoo Date received:21 Dec 99 [ ] Vet Research Report Date:21 Dec 99 [ ] Other: Sample collection: Sample storage: [ ] floor [x] room temperature [x] mid-stream [ ] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: dark yellow Appearance: [ ] clear Specific Gravity: 1.027 [x] hazy / slightly cloudy (Refractometer) [ ] cloudy / turbid Dip stick test: Microscopic Exam: Urobilinogen: 0.2 RBC's: Glucose: neg WBC's: Ketones: trace Epithelial cells: Biliruben: neg Protien: trace pH: 8.0 Crystals: Occult Blood: neg Nitrite: Casts: Leukocytes: Bacteria: Other: Other: Comments: (U/A) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 24 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== .....2000... 7.Jan.2000 Problem: crack - left rear foot (Confirmed) Re: Urine scalding- Legs look better after consistently soaping them, but smell is still prominent. (per keeper) 2.Feb.2000 Problem: crack - left rear foot (Confirmed) Rx: PETROLATUM, WHITE ml topically SID for 21 doses. Drew blood from ear. Was only able to get a small amount in red top tube for chem. Will try again in 2 days. (CAB) (AED) 4.Feb.2000 Problem: crack - left rear foot (Confirmed) Drew blood (from ear) for CBC/banking. Has swelling on left shoulder from tetanus vaccine. The swelling is soft and body temp. (CAB) 9.Feb.2000 Problem: crack - left rear foot (Confirmed) S: L eye has been draining today. O: Stained eye, + stain uptake in center of cornea, vertical line approx 3-4mm long. Superficial. Unable to look under nictitating membrane for FB. Difficult to examine as Winky does not like the bright light shined in her eyes and she tightly closes her eyes when fingers are close. A: superfical corneal ulcer P: Rx atropine and BNP OS. Recheck in 1 week. Kprs will work on desensitizing her to a light shined in her eyes. Rx: TRIPLE ANTIBIOTIC OPHTHALMIC OINT topically OS BID for 7 days. Rx: ATROPINE OPHTHALMIC OINTMENT topically OS BID for 7 days. (CKS) 11.Feb.2000 Problem: crack - left rear foot (Confirmed) Eye improved. (AED) 12.Feb.2000 Problem: crack - left rear foot (Confirmed) PE of eye. Looks much better. She seems much less painful, and is holding eye fully open. (AED) 15.Feb.2000 Problem: crack - left rear foot (Confirmed) Eye looks good, and there are no signs of discomfort. RESOLVED (AED) 18.Feb.2000 Problem: crack - left rear foot (Confirmed) Trunk wash sample sent to National Veterinary Services Lab for tuberculosis mycobacteria isolation testing. No isolation made on Feburary 15th, 17th, or 18th. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 25 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 20.Feb.2000 Problem: crack - left rear foot (Confirmed) Kpr a little concerned this am as Winky was placing lg amts of fecal material into her mouth. This is usually a stress response for her. Smoke detector did go off 2 nights ago. She has been eating normally and seems ok now. Will KUO. L pupil still dilated, last dose of topical atropine was 4 days ago. (CKS) 2.Jun.2000 Problem: crack - left rear foot (Confirmed) Winky seemed nervous in the am. By 1130 she was exhibiting signs of moderate to severe colic. She stretched til her belly touched the ground about 15 times in an hour, and had periods when she stood very still and "zoned". She was also opening her mouth very wide, a behavior Michelle said she does when stressed. When separated from Wanda, she was not concerned, because she was distracted by discomfort. She would not do any behaviors. We pole syringed her 2500mg banamine IM. Within 20 min. she appeared more comfortable, and did not stretch again. She began eating, and consumed about 2 lb of bran mixed with mineral oil, browse, apples and some hay. She then began pacing in two stalls. Attempts were made to draw blood, without success, but she was somewhat willing to perform behaviors. Did not give ABx d.t. high number of injections required with pole syringe. Elephant will be checked again constantly until 6pm and then again at 10pm tonight. She will also be fed 2 lb beet pulp pellets with mineral oil tonight, and alfalfa hay. (AED) 3.Jun.2000 Problem: crack - left rear foot (Confirmed) Winky appeared about the same in the morning. She was pacing, and opening mouth occasionally. She pooped 8 dry pool balls in am, and then again 2-3 times before 11am- the last feces was normal in consistancy. We gave her a bran/mineral oil dose and 2g banamine granules orally in omalene before 10am, and she seemed to improve to normal behavior and physical activity. Kprs still speculate that it could all be stress. Door workers will be working in bldg today. Elephants are in yard for the day. Plan is to repeat bran/min oil at end of day and reassess in the morning. (AED) 4.Jun.2000 Problem: crack - left rear foot (Confirmed) Winky looks better today. She pooped a normal amt overnight, and feces appear normal. Will be given mineral oil/bran today and tomorrow, once. Did not document that she was offered dogwood for the first time, I think a small quantity, and was offered more the day he was colicky. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 26 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 5.Jun.2000 Problem: crack - left rear foot (Confirmed) Was a still little lethargic yesterday afternoon, but interested in training session. Kpr reports doing well this am. (ARM) 7.Aug.2000 Problem: crack - left rear foot (Confirmed) Early afternoon animal still appeared stressed to kprs. Hadn't eaten and was pacing. Had not received Banamine yet. Late afternoon observed in yard, look good and doing better per kpr. Able to give banamine in sweet potato. (ARM) 7.Aug.2000 Problem: crack - left rear foot (Confirmed) Winky stressed with diarrhea from the wolverine and people in and around the exhibit this am. Will give some bran mixed with water and 1 dose of banamine to try to prevent her from being colicky. Appeared ok an hour after all the excitement. Rx: FLUNIXIN MEGLUMINE 2000 mg PO SID for 1 dose. (CKS) 14.Oct.2000 Problem: crack - left rear foot (Confirmed) Kprs gave cardboard boxes to the elephants yesterday and this am Winky is stretching her back legs and opening her mouth. The kprs gave her bran (4 cups) and mineral oil (2 cups). Gave her 1750mg Banamine po with more moistened bran. KUO. Rx: FLUNIXIN MEGLUMINE 1750 mg PO SID for 1 dose. (CKS) .....2001... 3.Jan.2001 Problem: crack - left rear foot (Confirmed) Started conditioning today for vaccinations, blood collection etc for annual exam. (AED) 5.Jan.2001 Problem: crack - left rear foot (Confirmed) Conditioned for blood draw and Vx. Both elephants harder to work with than last year. Wanda was more cooperative, and I was able to push fake needle onto vein and go thru Vx training. Winky still needs work to get her into position. (AED) 25.Jan.2001 Problem: crack - left rear foot (Confirmed) Attempted blood draw on 23Jan01. Animal moved alot. Tried at different door, but still moved. Today went back to just conditioning. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 27 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 29.Jan.2001 Problem: crack - left rear foot (Confirmed) TB culture sent out. (ARM) 30.Jan.2001 Problem: crack - left rear foot (Confirmed) Trunk wash sample sent to National Veterinary Services Lab for tuberculosis mycobacteria isolation testing. No isolation made. (CUL) 15.Feb.2001 Problem: crack - left rear foot (Confirmed) Animal still is not coperating well for venipunture. Talked to keepers about trying new position. (ARM) 23.Feb.2001 Problem: crack - left rear foot (Confirmed) Winky is colicky this morning. She is opening her mouth, stretching her back legs and having diahrrea. She may be stressed from the workers in her building. Will give bamamine in sweet potato. We have no bran. Will try Equi Aid (natural psyllium fiber) 10 scoops mixed with sweet feed. She was starting to look better even before starting meds. Early afternoon winky was eating and drinking. She did not like or eat any of the Equi-Aid. By the end of the day Winky was back to normal. (CAB) 23.Feb.2001 Problem: crack - left rear foot (Confirmed) Rx: FLUNIXIN MEGLUMINE 2000 mg PO SID for 1 dose. (CKS) 25.Feb.2001 Problem: crack - left rear foot (Confirmed) Both elephants consumed a large amt of mud today. Wanda is acting colicky. Gave Winky 1000mg Banamine prophylactically. (CKS) 28.Feb.2001 Problem: crack - left rear foot (Confirmed) Winky lost her left tusk o/n. She had been chewing on her scratching post yesterday. It is approximately 5cm long and 3.5cm wide. Both tushes palpate ok. Kprs concerned that she may be painful as she's not eating quite as much as usual. Will give 6- 800mg ibuprofen tonight. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 28 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 1.Mar.2001 Problem: crack - left rear foot (Confirmed) Winky is not eating quite as much today. On visual exam she is active and alert. Will KUO. (CKS) 2.Mar.2001 Problem: crack - left rear foot (Confirmed) Kprs. report this AM that Winky is repeatedly stretching and yawning, and her eyes are rolling back. Observed for 10 min., saw her stretch twice, keepers felt she was improved from earlier this AM. Was given 1000mg Banamine (4 packets) mixed with bran and mineral oil. Kprs.to give lots of exercise today. At 1020, Winky was eating a small amount of alfalfa and produce. By mid-afternoon, Winky was drinking, acting normal, and both elephants were let out into the yard. Access to hay provided. (MSW) 3.Mar.2001 Problem: crack - left rear foot (Confirmed) Per kpr, Winky is putting things up her L tush. Will give her 6-800mg ibuprofen to see if that helps. KUO. Examined tushes this afternoon. The L tush has a few minor abrasions. She does not seem painful when I put my hand inside and touch the tusk. She is eating produce and pellets but not much hay. Kprs will flush the tush bid w/nolvasan soln. Will keep her on 6-800mg ibuprofen bid for 2 days. Recheck in 2 days. Rx: IBUPROFEN 4800 mg PO BID for 2 days. (CKS) 5.Mar.2001 Problem: crack - left rear foot (Confirmed) Examined L tush- abrasions have healed. Eating normal amts. Will d/c ibuprofen. (CKS) 25.Mar.2001 Problem: crack - left rear foot (Confirmed) Alan Roocroft has been here for 3 days working on the elephants. Winky's LF foot has had a major trim. All of the cuticles have been taken back. Alan is interested in making more of a separation between the digits so that the area can be cleaned easier. Winky has more wear on her 1st toe d/t her unusual wrist conformation. The nail on D1 is worn close to the coronary band and is softer than the other nails. (CKS) 7.Apr.2001 Problem: crack - left rear foot (Confirmed) Rx: TETANUS TOXOID 1 ml IM SID for 1 day. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 29 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 17.Apr.2001 Problem: crack - left rear foot (Confirmed) Visual exam of small abrasion on medial aspect of R pinna. No tx needed. (CKS) 5.Jun.2001 Problem: crack - left rear foot (Confirmed) Rx: IBUPROFEN 4800 mg PO BID for 3 days. Winky is behaving as if she has pain on the right side of her mouth. She is chewing slowly and carefully, placing most food on left side. She winces occasionally. On PE her head and jaw area looks normal. Used flashlight to examine mouth. Could see all of upper arcade well. Could see much of tongue. Caught glimpses of lower teeth. Gave her ibuprofen. Will check again tomorrow. (AED) 6.Jun.2001 Problem: crack - left rear foot (Confirmed) Today I stood on a chair and was able to see lower dental arcade too. No abnormalities seen except a very small (4mm diam) bright red area on the buccal mucosa adjacent to the lower teeth. She ate more hay overnight and appears more comfortable today. KUO. (AED) 7.Jun.2001 Problem: crack - left rear foot (Confirmed) PROC: Visual examination of oral cavity. ASS: Could not see lower gingivae and dental arcade. Upper RHS of caudal portion of hard palate (demarcation with soft) appeared mildly inflamed. Possibly small healing ulcer (0.5cm) in same region but very unsure. View was poor and fleeting. Discussed with keepers and all agreed on the importance of access to teeth and feet as the elephants age. Things seem to be going well in this direction. PLAN: Reassess Saturday (SRH) 9.Jun.2001 Problem: crack - left rear foot (Confirmed) Keeper (Mary) thinks there is a definite improvement in Winky's demeanour and food intake even though the ibuprofen was finished two days ago.....although still not 100% at this stage. PLAN: Visually examine 10/6/01 and KUO. (SRH) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 30 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 10.Jun.2001 Problem: crack - left rear foot (Confirmed) Winky has been acting better. Tried to examine teeth on R side, able to see the uppers ok but Winky was holding her tongue and cheek over the lower arcade. (CKS) 14.Jun.2001 Problem: crack - left rear foot (Confirmed) Started weekly traing sessions to facilitate monthly blood draws with CB/AM. Some reluctancy to partcipate. No props, just touching ears. (ARM) 19.Jun.2001 Problem: crack - left rear foot (Confirmed) Performed weekly blood draw session. Winky did well for touching of ear. CB and AM were present. (CAB) 20.Jun.2001 Problem: crack - left rear foot (Confirmed) Yesterday Winky had a large amount of sand in her stool. Kprs authorized to give her mineral oil and bran once. Today her stool does not have sand in it but is dry. She is doing fine. (AED) 28.Jun.2001 Problem: crack - left rear foot (Confirmed) Kpr found a large area on the R front pad that was pulled away from the base. She is overdue for a comprehensive trim. PE: Center of R front pad has peeled away in an area about 12cm long x 8cm wide that extends caudally. Kpr trimmed and removed the flap of tissue which was about 6-8mm thick. There is one spot caudally that was grey in color and had an odor. She does not seem tender except at that spot. There was no bleeding during the trimming but the underlying pad is white and soft. Rec soaking the foot in Nolvasan tonight. Kpr will trim the entire pad tomorrow. Will have Simon examine the foot tomorrow. It does not appear to be a problem, esp if the surface of the pad evens out during the comprehensive trim and if the tender area firms up. KUO. (CKS) 29.Jun.2001 Problem: crack - left rear foot (Confirmed) PROC: Visual Examination. ASS: There is a pocket underlying the remaining sole slipper leaving an exposed edge contigous to the part that pulled away (alluded to in Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 31 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 29.Jun.2001 Problem: crack - left rear foot (Confirmed) earlier clinical note). The exposed area is a irritating Winky a little and she keeps rubbing it but is still weight bearing fully on this limb and allows palpation. Could get my finger under the pocket formed by the remaining sole slipper and underlying structures but could not delineate margins, however the area appears extensive and covers a significant portion of the sole. Spoke to Mitch Finnegan at Portland Zoo and he had a similar case many years ago. He said his first inclination was to remove the remaining sole but his senior vet at the time did the following for treatment: 1. Bevel back the leading edge of the remaining sole slipper so that it forms a slope and therefore does not stand as much chance of getting traumatically injured. 2. Find the margins of the pocket and mark them on the sole. Make a small hole (his was roughly 4 x 4 cm) and again bevel back the edges of this hole. 3. Run a water pik (or other flushing device) through this new hole and thus keep clean. New sole eventally grew out over a year from the underlying papillary structures found underneath the digital cushion. 4. This treatment alleviates the concern of an abcess forming in the pocket (by providing through and through flushing) but also provides protection (by not removing the remaining sole) while new sole is growing out in the traumatised area. 5. He suggested if Winky is intolerant to do this bit by bit over a number of days and load her up with treats in the process. Also suggested calling Allan Roocroft who has seen probably 20 more of these than him. (SRH) 30.Jun.2001 Problem: crack - left rear foot (Confirmed) NOTE: Did not view today but keeper (Rick) told me they had shaved back some of the sole exposing a soft area of underlying papilla surrounding a hole the depth of which was not ascertained. Informed him and patti of what Mitch Finnegan had recommended and that they should probably try and retain the remaining sole slipper, ascertain the extent of the vertical pocket (in sterile fashion) and the horizontal plane between the sole slipper and underlying structures, and establish "through and through" drainage (i.e hole to hole). Suggested it might be a good idea as it has been the most succesful way I have done this at other zoos is the keepers, staff vets and other parties sit down and establish a long term management plan once the problem has been further defined. (SRH) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 32 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 1.Jul.2001 Problem: crack - left rear foot (Confirmed) Examined R front foot. The area of the pad that was separated and removed on 28 June, no longer appears depressed. It is firming up and looks good. There is a soft region in the very center of the foot towards the right side (between nail 2 and 3) that has a 5mm wide hole. Kprs are waiting to hear from Alan Roocroft before proceeding. I do not see any more pockets or undermined sole. The kprs have yet to trim the pad for Winky's comprehensive trim, but it does not look like the separated region went too deep into the sole. I think gradual trimming of the hole will help resolve her current problem. (CKS) 2.Jul.2001 Problem: crack - left rear foot (Confirmed) Rechecked foot w/AD. Rick cut to the bottom of the hole, not very deep. Will leave the comprehensive trim until the hole grows out. We all agree that the foot lesions are not too serious at this point. (CKS) 3.Jul.2001 Problem: crack - left rear foot (Confirmed) Worked on conditioning animal for blood draw from ear. Stood very good today for hot compress and touch. Worked with animal outside. (CAB) 19.Jul.2001 Problem: crack - left rear foot (Confirmed) PROC: Visual examination and mineral oil in bran administered for very mild colic signs. ASS: Winky had a "saw horse stance" with mouth agape for a short period the morning. However when examined she moved over to the fence and did not exhibit any more signs. Tx: 1/2 gallon mineral oil mixed with 2lb bran. Taken readily and keeper reports looking much brighter. PLAN: If signs continue consider a dose of flunixine meglumine. (SRH) 13.Oct.2001 Problem: crack - left rear foot (Confirmed) During the night one of the elephants got a hold of a rubber tube and tore a 1 ft by 2 ft section out of it. This piece is missing and presumed to have been eaten by Wanda. Give Winky 1 gallon of mineral oil mixed with bran once today as a precaution. KUO. Feed normally otherwise. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 33 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 27.Oct.2001 Problem: crack - left rear foot (Confirmed) Winky was offered grass from the pampas yesterday am and by afternoon looked a little uncomfortable. Gave her a gallon of mineral oil with bran. Today she is behaving normally, but has defecated very little (on am rounds). Kprs to give more mineral oil and bran if she doesn't defecate a good volume today. (AED) 1.Dec.2001 Problem: crack - left rear foot (Confirmed) Looked at all feet. Look very good. The middle nail on both rear feet, esp left is long on the medial aspect. Keepers have been filing. The soft spot remains on one right rear, but is healing well and expect to have it filled in well in the next month. (AED) 19.Dec.2001 Problem: crack - left rear foot (Confirmed) Animal is aggitated. Kprs believe it is due to the arrival of peccaries. Animal would not go outside yesterday and had diarrhea. Still agitated today and is head tossing. Kpr concerned about colic potential. (ARM) 21.Dec.2001 Problem: crack - left rear foot (Confirmed) Elephants remain agitated, although they did go outside a few times today. Winky's feces were very small. Gave her mineral oil to avoid a problem. (AED) 22.Dec.2001 Problem: crack - left rear foot (Confirmed) Lots of poop in stalls overnight. Elephants a little less stressed today. (AED) .....2002... 5.Jan.2002 Problem: crack - left rear foot (Confirmed) Winky has generally been more stressed than usual. She is not wanting to do training, and is pacing more. She is responding to any small stressors with more agitation than you would expect. Yesterday she had mild diarrhea and today her fecal output is low, as expected. Perhaps Patty and Erin M. are making her crazy (their theory). I told them not to give mineral oil today, but to wait and see what happens with her feces tomorrow. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 34 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 16.Jan.2002 Problem: crack - left rear foot (Confirmed) Winky has 2 cuts right next to each other on the upper part of her trunk. She may have cut it on a tree trunk that she was playing with. These were flushed with dilute nolvasan. (CAB) 20.Jan.2002 Problem: crack - left rear foot (Confirmed) Sent trunk was samples to National Vet Services Lab in Ames, Iowa. Samples from 18 Jan, 19 Jan , and 20 Jan 2002 were all negative. (CUL) 28.Jan.2002 Problem: crack - left rear foot (Confirmed) Trunk wash submitted for TB culture. (ARM) 15.Feb.2002 Problem: crack - left rear foot (Confirmed) Blood draw from right ear (used 21 gauge butterfly cath.). Will perform CBC/Chem. She was very good today! (CAB) 1.Mar.2002 Problem: crack - left rear foot (Confirmed) Vaccinated in right shoulder with 1ml rabies IM and 1ml tetanus toxoid IM. (Used 22 gauge 1-1/2 in needle). She was very good. (CAB) 26.Mar.2002 Problem: crack - left rear foot (Confirmed) WEST NILE VIRUS TESTING Lab: Animal Health Diagnostic Laboratory-Cornell P.O. Box 5786 ITHACA, NY 14852-5786 (607)253-3943 FAX: (607)253-3943 Submission Taken:09/03/01 Summary Received:26/03/02 West Nile Virus SN:Negative 1:40 Date:21/01/03 (CAB) 10.May.2002 Problem: crack - left rear foot (Confirmed) Winky was normal in am and then had profuse, foul-smelling diarrhea around 10 am. She did not appear uncomfortable afterward. Normal appetite and behavior. No treatment for now. No known changes in diet or otehr factors. Seemed a little stressed in the am. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 35 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 11.May.2002 Problem: crack - left rear foot (Confirmed) Keepers reported that Winky was showing some signs of colicing this AM (stretching and opening mouth). She was better latter in the AM. There was alot of stool in the stalls over night. Some was a little soft but note runny. Both animals are passing stool. Will KUO. No treatment for now. (CAB) 16.May.2002 Problem: crack - left rear foot (Confirmed) Tried to examine tail but Winky was not cooperative. (CKS) 22.Jun.2002 Problem: crack - left rear foot (Confirmed) Winky was buckling legs at 6am this morning. She was improved but not quite normal at 8am, normal by 11am. Assessment is that she is tired because the girls were up late last night at Sunset (the party) and keepers woke them at 6am. I recommended a nap. (AED) 3.Jul.2002 Problem: crack - left rear foot (Confirmed) Winky has a firm lumpy growth hanging down from her ventral abdomen. It is about 1-1/2 inches around. (CAB) 7.Jul.2002 Problem: crack - left rear foot (Confirmed) Examined ventral abdominal soft tissue mass. Unable to palpate it for very long. It appears to be slightly tender to Winky when the mass is manipulated. Kpr will try to hose the abdomen so that the mass can be rechecked when it is free of dirt. (CKS) 12.Jul.2002 Problem: crack - left rear foot (Confirmed) Recheck: pedunculated, 3cm diameter, 3cm long mass from ventral midline. Appears almost eve Base of mass is within the skin, not attached to subQ tissues at this time. Non-painful on palpation today (very cooperative). Keepers feel it looks smaller today. Plan is to get a cytology on Tuesday. Originally planned on applying panalog topically but will wait as may change cytologic interpretation. (ALM) 16.Jul.2002 Problem: crack - left rear foot (Confirmed) Recheck: mass is about 25% smaller than 4 days ago. Still raw in the center. When grasped firmly, she reacted as if painful and there was blood tinged fluid on the gauze. Will monitor to see if continues to shrink in size, and if does not, will biopsy. To dispense lidocaine gel to desens her to the smell and feel. Rx: LIDOCAINE HYDROCHLORIDE topically SID for 7 days. (ALM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 36 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 24.Jul.2002 Problem: crack - left rear foot (Confirmed) From 7/23: mass is appreciably smaller, approx 1/2 original diameter and feels scabbed over at this point. Continue to monitor. (ALM) 25.Jul.2002 Problem: crack - left rear foot (Confirmed) Rx: LIDOCAINE HYDROCHLORIDE topically SID for 7 days. (ALM) 25.Jul.2002 Problem: crack - left rear foot (Confirmed) Drew blood for CBC/Chem and bank. She was very good. (CAB) 8.Aug.2002 Problem: crack - left rear foot (Confirmed) Mass on ventrum has resolved almost completely. Continue to monitor. (ALM) 23.Aug.2002 Problem: crack - left rear foot (Confirmed) Winky has very mild colic this am. Had lot of elm browse yesterday. This am she looked fine first thing, then when out in yard did a little stretching etc. Resolved somewhat by 900 when I examined her. She will be given bran/mineral oil and no grain today. (AED) 10.Sep.2002 Problem: crack - left rear foot (Confirmed) Lab Wildlife Concervation Society - Nutrition Laboratory Sample: serum analyzed: 23 Jan 03 a-toc: 0.727 ug/ml g-toc: n.d. retinol: 0.005 ug/ml Comments: n.d. = not detected; Vitamin A normally quite low in elephants - these values are within expected ranges for the species. 10.Sep.2002 Problem: crack - left rear foot (Confirmed) Drew blood to be sent in for herpes testing (Johns Hopkins School of Medicine) and banking. (CAB) 26.Oct.2002 Problem: crack - left rear foot (Confirmed) Ophtho exam by Dr. Morreale: could not identify any abnormalities; saw little vascularity in fundus which is probably normal in elephants. Reportedly has had decreased vision in right eye but no structural changes visible in eye. (ALM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 37 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 29.Dec.2002 Problem: crack - left rear foot (Confirmed) Did not eat hay today, ate grain and produce fine. In addition, she is eating wood shavings. They are out of bran. Given mineral oil, stool production is decreased slightly. Is not painful or uncomfortable at this time. (ALM) 30.Dec.2002 Problem: crack - left rear foot (Confirmed) Still not eating hay very well. Requested that they not feed her grain until she starts eating her hay again. Feces were scant this morning and she has not passed any oil yet. On auscultation, no obvious gassy sounds. Motility seems less than expected but she is not uncomfortable. (ALM) 31.Dec.2002 Problem: crack - left rear foot (Confirmed) Winky: is starting to increase her hay intake. Passing stool with oil and sand in it so suspect sand colic. Will add bran to diet on a regular basis. (KSB) .....2003... 3.Jan.2003 Problem: crack - left rear foot (Confirmed) There is a small cut on the left front leg. Kprs washed with nolvasan and put triple Abx ointment. No trt needed. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 38 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 8.Jan.2003 Problem: crack - left rear foot (Confirmed) <<< Urinalysis >>> Sample Accession #: 3555 Laboratory: Collection Date: 01/Jan/2003 [x ] Detroit Zoo Date received:01/Jan/2003 [ ] Vet Research Report Date:01/Jan/2003 [ ] Other: Sample collection: Sample storage: [x ] floor [x ] room temperature [ ] mid-stream [ ] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: yellow Appearance: [ ] clear Specific Gravity: 1.025 [ ] hazy / slightly cloudy (Refractometer) [x ] cloudy / turbid Dip stick test: Microscopic Exam: Urobilinogen: 1-Normal RBC's: None seen Glucose: negative WBC's: none seen Ketones:negative Epithelial cells: None seen Biliruben: negative Protien: 10 pH: 8.0 Crystals: Amorphous Phosphate 4+ Occult Blood:negative Nitrite: Casts:None seen Leukocytes: Bacteria: None seen Other: Other: Comments: (U/A) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 39 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 17.Jan.2003 Problem: crack - left rear foot (Confirmed) Drew blood (left ear) for annual CBC/Chem. She was very good. (CAB) 19.Jan.2003 Problem: crack - left rear foot (Confirmed) Taken from kprs daily report. Winky has had a fould smelling tush for the past weeek. Have been flushing it daily with dilute Nolvasan. It appears that she has been packing the area with shavings. (ARM) 19.Jan.2003 Problem: crack - left rear foot (Confirmed) Trunk wash performed for TB culture (60cc syringe and a red rubber catheter). Sample frozen. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 40 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 19.Jan.2003 Problem: crack - left rear foot (Confirmed) <<< Microbiology >>> Sample Source: truck wash Laboratory: Accession #: 235091 [ ] Antech Collection Date: 19 Jan 03 [ ] AHDL Submission Date: 22 Jan 03 [x] Other : NVSL (Ames,IA) Report Date: 02 Apr 03 Submission type: [x] mycobacterial Comments: No isolation made. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 41 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 20.Jan.2003 Problem: crack - left rear foot (Confirmed) Yesterday Winky was eating Wanda's feces and acting quiet. She is acting almost normal today - per keeper. (CAB) 21.Jan.2003 Problem: crack - left rear foot (Confirmed) 2nd trunk wash performed for TB culture. Winky was not as cooperative today and it took 3 times to get the sample. Sample frozen. Mtg w/kprs and curators to discuss dietary changes. Will limit Winky to 1 sweet potato/day until they can find other ways to give her hoof supplement. Will discontinue using leaf eater biscuits and omolene except in emergency situations. When more browse is available, they will cut back on the amount of timothy hay offered. Will offer 1 coconut/month at the most. Cereal and pasta will need to be purchased for use in their toys. Sugar cane is only to be used for training purposes. The elephants will receive 10# produce, 10# elephant supplement, and 1.5-2 bales of hay per day. Elephants will be weighed monthly. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 42 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 21.Jan.2003 Problem: crack - left rear foot (Confirmed) <<< Microbiology >>> Sample Source: truck wash Laboratory: Accession #: 235092 [ ] Antech Collection Date: 21 Jan 03 [ ] AHDL Submission Date: 22 Jan 03 [x] Other : NVSL (Ames,IA) Report Date: 02 Apr 03 Submission type: [x] mycobacterial Comments: No isolation made. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 43 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 22.Jan.2003 Problem: crack - left rear foot (Confirmed) 3rd trunk wash performed for TB culture. Sample frozen. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 44 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 22.Jan.2003 Problem: crack - left rear foot (Confirmed) <<< Microbiology >>> Sample Source: truck wash Laboratory: Accession #: 235093 [ ] Antech Collection Date: 22 Jan 03 [ ] AHDL Submission Date: 22 Jan 03 [x] Other : NVSL (Ames,IA) Report Date: 02 Apr 03 Submission type: [x] mycobacterial Comments: No isolation made. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 45 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 25.Jan.2003 Problem: crack - left rear foot (Confirmed) Drew blood for serum bank. (CAB) 31.Jan.2003 Problem: crack - left rear foot (Confirmed) Drew blood for serum bank. (CAB) 15.Feb.2003 Problem: crack - left rear foot (Confirmed) Drew blood for bank. Doing very well. Discussed lack of produce with kprs. They are compensating by feeding cereal, crackers etc. Explained that overall goal is to loose weight and we have to give new diet a real try. (AED) 17.Feb.2003 Problem: crack - left rear foot (Confirmed) Present for a squeeze desens. Animal did very poorly. According to kprs last session went well and they were able to bring squeeze all the way in. Today Winky started spinning in circles and pushing against the sides when the squeeze was only half shut. Would not go back into the squeeze stall until after everyone left the catwalk. (ARM) 18.Feb.2003 Problem: crack - left rear foot (Confirmed) Vaccinated with 1ml rabies IM and 1ml tetanus toxoid IM (in left shoulder). Erin drew blood (for banking) from left ear for 1st time. (CAB) 22.Feb.2003 Problem: crack - left rear foot (Confirmed) Worked on blood draw training with keepers. (CAB) 14.Mar.2003 Problem: crack - left rear foot (Confirmed) Worked on blood draw training with keepers. (CAB) 15.Mar.2003 Problem: crack - left rear foot (Confirmed) Worked on blood draw training with keeper. Patty collected blood for serum bank. (CAB) 1.May.2003 Problem: crack - left rear foot (Confirmed) Took radiographs on winky's front left foot. Tried a lateral view and it came out okay will need to work on technique. Head on view a little dark for distal part of digit, will work on technique. It is very different from wanda because winks feet are larger. Will take more on sunday. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 46 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 28.May.2003 Problem: crack - left rear foot (Confirmed) Kprs to get current weight on June 3rd. (ARM) 17.Jun.2003 Problem: crack - left rear foot (Confirmed) Worked on blood draw training with keepers. (CAB) 20.Jun.2003 Problem: crack - left rear foot (Confirmed) Worked on blood training with keepers. (CAB) 29.Jun.2003 Problem: crack - left rear foot (Confirmed) Seems colicy today. Squatting in stalls, not interested in sugar cane and standing with her eyes closed. Has had browse (silver maple) everyday this week. Advised no browse today, small amounts of hay and produced used only for training. Keepers to give bran mixed with mineral oil and banamine. 9:30am seemed a little better. Talked to RW at the end of the day and he said Wink was about 90% normal. Told him we would re evaluate in the am and decide about further medication. (ARM) 29.Jun.2003 Problem: crack - left rear foot (Confirmed) Rx: FLUNIXIN MEGLUMINE 2000 mg PO SID for 1 day. (CKS) 30.Jun.2003 Problem: crack - left rear foot (Confirmed) Winky appears comfortable this morning. She has been eating well and hasn't been acting colicky since yesterday am. (CKS) 31.Jul.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Cracks and abscesses reported in the nails on the front right leg. Examination: multiple small areas of abscessation to one of the nails. Abscess has ruptured in one area both ventrally and dorsally while in the other area, a small amount of pus has erupted dorsally with an area of hemorrhage noted ventrally. Asked keeper to trim this area as well as flush the through and through abscess area thoroughly. Rear right limb- defect in the pad with necrotic tissue underneath. To be cored out and flushed with betadine. Schedule radiographs of both right feet in the near future to check for foreign bodies in these areas due to recurrent abscessation/nail issues. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 47 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 5.Aug.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Took radiographs of Winky's front left front. It was a little hectic due to lack of keepers and construction being done in elephant bldg. Xrays did not come out due to devolper problems. Will re take this week or next week. (ARM) 28.Aug.2003 Weight: 3825 Kg (8433 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Drew blood for CBC/Chem and WNV. Did not send out WNV because we had just sent that out about 1 mo ago. Banked WNV blood. (CAB) 2.Sep.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) S: Winky has been very aggressive with logs/trees in her exhibit for the past week. She has been throwing logs into the moat and wedging them near the building. Training regimen appeared normal, she willingly opened her mouth, lifted her trunk etc. O: There is a small cut on Winky's hard palate. The upper left molars may be causing her some pain although there is no visible irritation. RW was unable to touch the tooth but thought it appeared different. A: R/O pain but concerned about other causes for the behavior changes. P: Will start ibuprofen and reassess. Will also consult with Dr. Laurie Gage. KUO. Rx: IBUPROFEN 8000 mg PO BID for 5 days. (CKS) 3.Sep.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Kpr reports sighting 3 raccoons in the wood pile this am. This may be causing some of her tirades. KUO. (CKS) 4.Sep.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Winky is acting aggressive again today. Kprs trapped a skunk o/n. Kprs found numerous hornets. Will bring the girls inside and get rid of the wood pile and anything that lives in there. KUO. (CKS) 11.Sep.2003 Weight: 3789 Kg (8353 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Winky weighs 8350# today. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 48 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 12.Sep.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) In the am kprs report that Winky continues to be aggressive, esp at night. This am the hot wire is broken down in 3 places. Discussed possible causes. Later in am noticed that there was a bee hive in the fence post that she had knocked over. Smart girl. (AED) 18.Sep.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Keepers reported at 5:45pm that Winky was shaking her trunk and blowing water and air out of it repeatedly. On physical exam she had a carrot wedged in the left nostril. It was occluding 90% of the hole and she was wheezing through it. Tried all kinds of things to remove it. After 30 minutes I was able to get one side of a pair of forceps behind and break it and she swallowed it. (ARM) 24.Sep.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Blood drawn for ESR study. (Erythrocytes sedimetaion rate) Baseline chemistires/cbc/fibrinogen submitted. (ARM) 1.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Patti tried to collect blood for ESR/WBC study, unsuccessful. Candace will try tomorrow. (ARM) 2.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Blood draw training. (CAB) 3.Oct.2003 Weight: 3837 Kg (8459 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Blood drawn for ESR study. (ARM) 3.Oct.2003 Weight: 3837 Kg (8459 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed) Blood draw for CBC and ESR. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 49 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 5.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed) Numerous nodular white lesions inside the left nares. May be granulation tissue from lesions. Aerobic culture taken. Unable to collect any samples for histopath. Recheck animal Tuesday. Animal reportedly has some vaginal lesions as well but unable to observe them today due to reticence of animal to allow it. (CST) 6.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed) Check animal feet lesions today. She has two abscesses (one on her front left and one on her back right) Per kpr they are looking better. The one on her rear foot is the worst, with a crack present in her nail and a large soft spot on her pad. Animal is not co-operativing for her rear foot soaks. Suggested finding a spot in her stall where the floor dips and trying to do a nolvasan soak there while tthey continue to train her for soaking in a bucket. They are still waiting to hear back from Ala R. (ARM) 7.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) Blood draw desens with erin mac today. Winky has a cut on her tongue that appears pretty deep. Doctor to examine. (ARM) 7.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) 4 inch older laceration over the left side of the tongue. Lesions within left nares of trunk are resolving nicely. Appears that the animal is eating/rubbing against sharp object(s). Keepers will keep an eye out for continued lacerations as well as possible causes in yard and building. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 50 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 8.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) <<< Microbiology >>> Sample Source: Lesions in nares Laboratory: Accession #: 3555 [ ] Antech Collection Date: 5 Oct. 03 [ ] AHDL Submission Date: 6 Oct. 03 [X] Other : PetLabs, Inc. Report Date: 8 Oct. 03 Submission type: [X] aerobic bacteriology Results: Heavy growth of mixed enteric & normal skin flora with: Organism: Growth: heavy moderate light 1. Beta hemolytic streptococcus group C [X] [ ] [ ] Comments: Beta hemolytic streptococci are predictably sensitive to penicillin & its derivatives. No further testing performed. Mixed enteric & normal skin flora isolated including Klebsiella sp., Enterobacter sp., Citrobacter sp., non hemolytic streptococci, coagulase negative staphylococci, & corynebacterium. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 51 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 17.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) Blood draw for ESR/WBC study. (CAB) 21.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) PR collected blood for ESR study. (CKS) 29.Oct.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) Blood draw attempted by EM. (ARM) 6.Nov.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) Blood collection attempted for ESR study. Animal was uncooperative and left in the middle of the session. both elephants have been acting up the last couple of days. Will try again in 2 days, if she is still acting up ww will give her a week off. (ARM) 8.Nov.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) Blood draw for ESR/WBC study. She was very good. (CAB) 7.Dec.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed) Blood drawn for ESR study and Vitamin E levels. Asked PK to incorporate warm water bath to ear prior to blood draw for the winter weather. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 52 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 10.Dec.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed); abscess - nail (Confirmed) Alan Ruecroft in town. Discussed elephants. He feels this animal needs to lose at least 500 pounds. (CST) 21.Dec.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed); abscess - nail (Confirmed) Digital images taken of all feet. (ARM) 28.Dec.2003 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed); abscess - nail (Confirmed) Vitamin E level on this animal came back at 1.23 ug/ml. This is in the high normal range for elephants for the Mich. State lab. No supplemental vitamin E at this time. Check vitamin E levels annually while doing vaccinations and Tb checks. (CST) .....2004... 6.Jan.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); mass - nares (Confirmed); laceration - tongue (Confirmed); abscess - nail (Confirmed) Examined "abscessed" nail on right rear limb. No infection present, keepers are keeping up with trimming on the area. Will heal with time. (CST) 17.Jan.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed) Winky is again showing mild signs of colic. Sleeping in am, then rocking, planting rear foot and holding mouth open. Visual exam at 10 am- she seems anxious. She is bright and alert and responsive to commands and contact. Kprs to give 18,000 mg ibuprofen this am and report her response. If not improved will draw blood today or tomorrow. Addendum: Got ibuprofen around 1300 hrs. Mary says even before had drugs she looked improved. KUO. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 53 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 20.Jan.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); tuberculin testing First of three sterile trunk washes performed this morning. Videotape from last night shows that Winky is waking Wanda up repeatedly through the night. (CST) 22.Jan.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); tuberculin testing Second of three sterile trunk washes performed this morning. (CST) 26.Jan.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed) Kprs report that Winky is shuffling on her front left leg. (ARM) 27.Jan.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); tuberculin testing ; vaccination Third of three sterile trunk washes performed. Vaccinated for tetanus and rabies. Rx: TETANUS TOXOID 1 ml IM once for 1 day. Rx: RABIES VACCINE (KILLED - 3 YEAR) 1 ml IM once for 1 day. (CST) 5.Feb.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed) Started on cosequin. Starting dose 4 scoops BID for the first month. Rx: POLYSULFATED GLYCOSAMINOGLYCAN mg PO BID for 30 days. (CST) 7.Feb.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed) Dispenced 1 bottle of ibuprofen and 1 tub of biotin for the girls. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 54 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 19.Feb.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed) Largest polyp is raw and bleeding. Cleaned with Nolvasan, dried it off and took 2 samples on slides. Also swab for culture. AED to check tomorrow. (ARM) 23.Feb.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Large polyps on the vulva. Slide shows some crystals from urine along with debris. Discussed getting a biopsy of one of hte masses with the keepers. Desens to take place and to attempt to get a small sample early next week. (CST) 4.Mar.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Kprs reported that the diet and exercise program is going well. They are using small pieces of food and pellets for training. Animal is not happy and is spitting out the pellets, but is still doing the behaviors. Erin and Mary have written schedules for feet care, baths, and enrichment. The elephants are responding positively to have a routine. (ARM) 15.Mar.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood draw desens today. Winky did okay. Will try for blood leter this week. (ARM) 18.Mar.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood draw desens today. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 55 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 24.Mar.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Collected blood for ESR and banking. (ARM) 31.Mar.2004 Weight: 3843 Kg (8472 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Keepers believe scale is inaccurate, will get it calibrated (ARM) 12.Apr.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky is acting aggressive again. Wedging logs and breaking toys. She has minor abrasions on her trunk. Doctor to exam. (ARM) 12.Apr.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined. Minor abrasions over the dorsum of the trunk. Minor abrasion in rostral dorsal soft palate. Nolvasan topically. Watched video. Animal was highly highly aggressive towards one of her logs last night. Possibly going through a menopause of sorts? Collect blood for possible hormone analysis to see if she is cycling/having aberrant cycles. (CST) 22.Apr.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood draw attempted by kpr PR (ARM) 3.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood draw session attempted, Winky was very bad. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 56 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 8.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); colic (Suspected) Windy colicky this am. She had access in the am, and went out as soon as kpr arrived. Kpr observed two piles of diarrhea in yard. Winky was stretching, yawning, appearing uncomfortable. She got to the point she almost layed down. She improved while we were on our way. She had two soft bowel movements in the yard. We couldn't get her in. Left 2 tubes of banamine (6000lb dose) for kpr to give if possible. Appears she will improve. Addendum- Winky took about 3/4 of the total dose of banamine above, and is doing better. Kpr to repeat mineral oil tonight and see how she is. She is eating and pooping normally and behaving normally. (AED) 9.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); colic (Suspected) AM: Winky is still moderately colicky this morning. Stretching as if she wants to lay down, distended gassy abdomen. Decided to treat with banamine. Later AM: Winky is acting better. Released to go outside after receiving mineral oil and one tube (3000# dose) of banamine. (CST) 10.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); colic (Suspected) AM: Slightly colicky. One tube of banamine dispensed. PM: Normal stool passed. Doing better. (CST) 11.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); colic (Suspected) Doing much better today. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 57 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 15.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); colic (Suspected) 17.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Almost out of glycoflex large animal granules. Discussed with keepers. Neither elephant has been off cosequin or glycoflex to see if it is having a positive affect. D/C both for now pending changes in arthritis/large animal glycoflex order. (CST) 20.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Changed mind on d/cing joint supplements due to several factors. Restarted today on cosequin. (CST) 27.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Abscess in left rear foot pad. May be due to foreign body. Animal is resistant to being touched in this area. Keepers are debriding and pulling out necrotic tissue. Suggested flushing out wound with nolvasan solution daily as well as trying to open up the wound more to allow drainage. Will try emla cream in a few days to see if this decreases reaction to tissue manipulation. (CST) 29.May.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined abscess on foot. Keepers are treating daily. Used hoof knife to open abscess some around central fissure. Concerned that shape of fissure will allow wicking of dirt and contaminants. Elephant is less sensitive than she was a few days ago. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 58 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 10.Jun.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Rx: CEFTIOFUR SODIUM/DMSO 50/50 mixture topically SID for 7 days. (CST) 12.Jul.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Started taking radiographs on Winkys front right foot. (ARM) 5.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Took radiographs of Winky's front left foot. She was very uncooperative today. Kprs have been noting that winky's wrist appear to be jutting out more than normal. (ARM) 12.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky was evaluated by Physical Therapist Mary Ann Uznis. On visual exam winky's carpal joints seem to be more prominent on the medial aspect than they have been in the past. Kprs put Winky through different exercises and the PT will send a protocol for exercises that may strengthen her lateral muscles. (ARM) 15.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky is alternating holding her left front/right leg up and swinging it lately. Did get okay radiographs on her today. Will need to work on positioning. Kprs report that yesterday at pm session Winkys front legs buckled while she was standing there. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 59 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 16.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Rx: IBUPROFEN 8000 mg PO BID for 1 day. (AED) 16.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Additional radiographs taken on her front legs. Still developing a technique. The exposure is good, but positioning is hard. (ARM) 17.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Elephants were both stiff this am. Kprs think increased rat activity is causing them to rest less. Will be treating exhibit for rats tomorrow am. Winky is stiff on both wrists today and is moving slower than usual. Kprs gave 10 ibuprofen tablets yesterday and gave 20 today at 230ish pm. At days end she does not seem improved. (AED) 18.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Colorado State University did a new investigative ELISA test for TB on serum from our elephants. The values for our elephants were not consistent with values typical for MTB infected elephants. The values were consistent with values typical for non-infected elephants. testing performed by Scott Larsen, U Cal Davis. Winky is stiff today still. She is lingering on the right front so that she spends as little time as possible on the left front. No abnormalities noted visually. She got 20 ibuprofen yesterday, 10 the day before. Sending up a script for the next 3 days. Rx: IBUPROFEN 23200 mg PO BID for 3 days. (AED) 18.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood draw desens. Radiographs taken of the front right foot (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 60 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 24.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) No negative change in the last several days in terms of pain. No further meds at this time. (CST) 28.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Visual check of both elephants today. Winky is doing ok off meds, but still looks a bit stiff. (AED) 30.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) AM: Winky looks stiff and mildly ADR according to keepers. Examined. She appears to be suffering from some mild pain but does not appear colicky. Treated with mineral oil and bran to be safe. Started on ibuprofen 15 pills BID x 2 days. Rx: IBUPROFEN 12000 mg PO BID for 2 days. 6 pm: Keeper called to say that Winky still does not look/act quite right. Defecated today. All pain meds given. Will try ketofen again on her in the morning (she would not eat it today). Holding tail in "curled up position". (CST) 31.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky took half or a bit more ketofen paste this am. She spit the rest out. Will give mineral oil, bran today this afternoon, and will give 29 tablets of ibuprofen tomorrow am to make sure she gets a full dose of a pain reliever since paste is so difficult to give. On visual exam, Winky is quiet, sometimes sleepy looking. I can see that she is reluctant to put weight on the left front much of the time. The kpr describes that she is rocking back on her rear foot, sometimes with her tail curled up tightly like a pig, with her right rear toes all the way off the ground. At times she holds the left front off the ground also. Assessment is that Winky is uncomfortable. We will give the ibuprofen because we can more reliably get that into her. We are increasing the Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 61 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 31.Aug.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) dose significantly. Winky has not defecated to the knowledge of the kpr today. She is monitoring. Also, some of the hay has very fine material within it, almost like nesting material. The elephants do not seem interested in eating this part of the hay. (AED) 1.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky looks more uncomfortable today. She is showing the behaviors the kprs described yesterday almost constantly. She is rocking back on both rear feet, in a sitting posture, taking all of the weight off the left front. She is at times holding her mouth open also. She is moving slowly, and when moving I saw her drag her right front leg once. She is also rubbing the outside of her right leg with her trunk. The kpr thinks she appears very tired. She got 29 tablets ibuprofen this am, then 3500mg acetominophen PO at about 1100 am. Then attempted to collect blood without success. Plan is to repeat ibuprofen and tylenol this pm and attempt blood collection again at 300pm. Rx: IBUPROFEN 23,200 mg PO BID for 4 days. Rx: ACETAMINOPHEN 3500 mg PO BID for 4 days. (AED) 2.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Visual check of Winky in am. Winky is still doing behavior where she rocks back on rear feet. She looks sleepy, with her eyes partially closed at times. Yesterday they treated the Africa train station for rats and started with poison in elephant building again after a period of reduced rat activity. Hopefully this will help. (AED) 2.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky still rocking back on rear feet today, Mary videotaped apprx. five minutes of this behavior. Blood collection attempted, able to stick her but then she walked away. Much better than the prior day. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 62 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 3.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky is still doing rocking behavior. She might be slightly improved today. She is taking some but not all meds. Today they are being introduced to crate and kprs don't have time to do blood collection. (AED) 4.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Visual exam of Winky in the am. Kpr reports that rats are more of a problem. The rat poison was finished quickly and will be replaced today. She thinks she is tired from rat activity. They will set rat traps in area of hay storage today. Winky is not rocking back during brief visit. She still looks tired. She is interested in the crate and put one foot in yesterday. To be safe, am going to continue ibuprofen and tylenol for 4 more days, beginning tomorrow. (AED) 5.Sep.2004 Weight: 3711 Kg (8181 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Rx: IBUPROFEN 23200 mg PO BID for 4 days. Rx: ACETAMINOPHEN 3500 mg PO BID for 4 days. (AED) 5.Sep.2004 Weight: 3711 Kg (8181 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood draw attempted. Blood in Butterfly catheter and then Winky walked away. Plan on doing desens on Tues and try to draw on Wed. (ARM) 5.Sep.2004 Weight: 3711 Kg (8181 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined on exhibit this morning. Keepers have been finding fair numbers of dead rats in the area and suspect that is the cause for Winky's aberrant behaviors of late- sleeplessness from the rats. 24 hours video monitoring is nonfunctional. Upper left quadrant of mouth still has retained portion of fifth set of teeth. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 63 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 6.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Taking most of her medications. Doing about the same./ (CST) 11.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky has been off antiinflammatories for 4 days and is about the same. She is sleepy in appearance, and when I looked at her she was leaning on the ERD and wall with her eyes closed. She has been laying down on a new tall pile of sand for the last four days, which is very good news. The rat activity seems diminished. Winky has responded well to crate training and has gone all the way into the crate already. (AED) 12.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Attempted blood draw with Winky. She is extremely bad. They have been working her outside. Suggested desens being done inside and outside. (ARM) 16.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Elephants are not eating their hay well. Core samples taken and submitted for analysis. (CST) 17.Sep.2004 Weight: 3665 Kg (8080 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Collected blood for CBC/Chem. She did well today. (CAB) 18.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) CBC and chemistries back. Slightly elevated total protein and globulins. All else within normal limits. Discussed with keepers. Awaiting vitamin E level from MSU. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 64 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 19.Sep.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Acting off still this morning. Treated with ketofen paste. Successful this time in getting it to her. Moderate improvement. Based on normal bloodwork and more normal behavior with pain alleviation, suspect much of her recently off behaviorisms are due to pain. (CST) 20.Sep.2004 Weight: 3666 Kg (8082 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Per kprs they have had a new batch of hay for a few days and the girls were still not eating it. Last night both girls ate the majority of their hay. (ARM) 20.Sep.2004 Weight: 3666 Kg (8082 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Continuing to lose weight. Tackling possible bad hay issue with commissary supervisor. As keepers are able to get the ketofen in her, started on ketofen paste. Rx: KETOPROFEN PASTE 5143 mg sid for 10 days. (CST) 4.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Epiphora in the right eye. Stained with fluorescein. No uptake. Likely a bit of sand which washed away. No further treatment. Continue to monitor. (CST) 6.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Rx: TOCOPHEROL, ALPHA 50 ml PO sid until further notice. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 65 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 7.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Collected blood for Herpes testing. (CAB) 12.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Radiographs attempted (ARM) 16.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Winky gained 200lbs at last check. She is eating new hay much better. (ARM) 19.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Not taking liquid vitamin E well. Switched to softgels. (CST) 20.Oct.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Rx: TOCOPHEROL, ALPHA 8000 iu PO SID until further notice. (CST) 5.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Phone conversation with Laura Richman re Herpes virus testing. Emailed Erin Latimer to get actual results sent. Winky's test is negative for herpes virus. Her titer is the same as background, which is interpreted as negative. Will be sending additional samples to the lab. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 66 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 9.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Kprs called at close, on visual Winky has a very minor cut on her left ear from a toy. (ARM) 10.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Mixed nolvasan solution with silver sulfadiazine and gave to keepers to apply until ear lesion resolves. (CST) 15.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Two small 2x2 cm skin abscesses over the left rear rump. One 2x2 cm skin abscess over the left thoracic region. Culture taken from abscess. Oral examination unremarkable. Unable to do a rectovaginal exam due to animal's reluctance to do behavior. Will obtain blood tomorrow to check immune system. (CST) 16.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Drew blood for CBC/Chem. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 67 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 17.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) <<< Microbiology >>> Sample Source: SKIN ABSCESS Laboratory: Accession #: [ ] Antech Collection Date: 15 NOV 04 [ ] AHDL Submission Date: 15 NOV 04 [X] PetLabs, Inc. Report Date: 17 NOV 04 Submission type: [X] aerobic bacteriology Organism: Growth: heavy moderate light 1. Pseudomonas aeruginosa [X] [ ] [ ] 2. Proteus mirabilis [X] [ ] [ ] Sensitivity: 1 | 2 | 3 | Amikacin: S | S | | Amoxicillin/Clavulanate: R | S | | Ampicillin: R | S | | Carbenicillin: S | S | | Ceftazidime: S | S | | Ceftiofur: R | S | | Cephalothin: R | S | | Ciprofloxacin: S | S | | Chloramphenicol: R | S | | Enrofloxacin: I | S | | Gentamicin: S | S | | Nitrofurantoin: R | R | | Piperacillin: S | S | | Tetracycline: R | R | | Ticarcillin: S | S | | Tobramycin: S | S | | Trimethoprim/Sulfa: R | S | | Comments: Heavy growth of normal skin flora. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 68 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 20.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Culture of skin over papules show no staph. There is heavy growth of pseudomonas and proteus- normal skin flora. Dispensing silvadene to encourage healing. Rx: SILVER SULFADIAZINE 1 gm topically SID for 14 days. (AED) 21.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined. Skin lesions are healing in nicely. Normal bloodwork. Suspect night outside last week led to mild immunosuppression leading to pustular papules. (CST) 22.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Faxed herpes results to Dr. Barrie at Columbus Zoo per his request. (CST) 27.Nov.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Skin lesions continue to heal. There are really only two remaining, and kprs continue to treat with silvadene. (AED) 6.Dec.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood drawn for Vitamin E levels. Will submit when we get blood on Wanda. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 69 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 10.Dec.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) <<< Microbiology >>> Sample Source: stool Laboratory: Accession #: [ ] Antech Collection Date: 09 DEC 04 [ ] AHDL Submission Date: [X] PetLabs, Inc. Report Date: 10 DEC 04 Submission type: [X] Comprehensive Comments: Light growth of normal enteric flora. No Salmonella, Shigella, or Campylobacter isolated. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 70 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 14.Dec.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) <<< Microbiology >>> Sample Source: Stool Laboratory: Accession #: [ ] Antech Collection Date: 11 DEC 04 [ ] AHDL Submission Date: 12 DEC 04 [X] Other : Report Date: 14 DEC 04 Submission type: [X] enteric pathogen screen Comments: Moderate growth of normal enteric flora. No Salmonella, Shigella, or Campylobacter isolated. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 71 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 14.Dec.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Multiple skin lesions present particularly in folds of skin. Adding BID betadine solution to daily treatment regimen. Rx: BETADINE SOLUTION 1 ml topically BID until further notice. (CST) 27.Dec.2004 Weight: 3784 Kg (8342 Lb) Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Wt decreasing, animal is not eating hay well. Hay quality bad. (ARM) 30.Dec.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Kprs called late in the day with a abscess on Winky's front left foot. There are three areas that have pus present- one on the bottom, one on the lateral aspect, and in front of the cuticle. Culture was taken and refrigerated in case AED wants to send it out. Kprs instructed to soak the foot until a vet can come up and look at it. (ARM) 31.Dec.2004 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Visual exam of abscessed nail. There is an eruption of a new abscess that appears it will require extensive care and a long period of treatment to resolve. Kprs to start epsom salt, nolvasan baths now, and to open up the various areas of drainage. They have already removed the nail at the top, and some at the interdigital area. Looks like at least the lateral aspect of the nail will be lost. Recommended against applying ointments yet, instead allowing full drainage to occur. Foot soaks should help. (AED) .....2005... 2.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Kprs report that there appears to be a conection between the cuticle rupture and the bottom of the nail that extend behind the nail. Kprs are concerned that this area will trap debris and bacteria. Radiographs taken. Exposure needs to be adjusted. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 72 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 3.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Radiographs taken. Exposure need to be adjusted. (ARM) 3.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined. Asked keepers to flush with nolvasan and then apply gentocin ophthalmic solution along the top of it to have some local effects. Cultures taken of sand in exhibit to match with cultures from Winky's and Wanda's recent abscesses. Worried about retention of fecal matter/urine/microorganisms in the soil. Rx: GENTAMICIN OPHTHALMIC SOLUTION (CST) 4.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Rx: TOCOPHEROL, ALPHA 8000 iu PO SID until further notice. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 73 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 5.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) <<< Microbiology >>> Sample Source: ABSCESS Laboratory: Accession #: [ ] Antech Collection Date: 02 JAN 04 [ ] AHDL Submission Date: 03 JAN 04 [X] PetLabs, Inc. Report Date: 05 JAN 04 Submission type: [X] aerobic bacteriology Organism: Growth: heavy moderate light 1. Streptococcus Group G [X] [ ] [ ] Comments: Beta-haemolytic Streptococcus are predictably sensitive to penicillin and its derivatives. Cephalosporins are also recommended, this per NCCLS guidelines. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 74 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 5.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) <<< Microbiology >>> Sample Source: exhibit substrate - sand Laboratory: Accession #: [ ] Antech Collection Date: 03 JAN 05 [ ] AHDL Submission Date: [X] PetLabs, Inc. Report Date: 05 JAN 05 Submission type: [X] aerobic bacteriology Comments: Heavy growth of mixed normal environmental flora. Growth included coagulase negative Staphylococcus, alpha-heamolytic Streptococcus and Bacillus species, all of which is considered normal flora. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 75 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 5.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Exam of left front foot. The tissues are less red than before. The nail has been filed as per Allan Roocroft, to allow the tissue beneath the nail to dry out. There are two soft, moist areas in the area just below the cuticle that the kpr opened with forceps. The fissure at the bottom of the nail has a wedge of necrotic debris that should be removed with a sharper blade. This will help allow the necessary drainage. The soft tender area at the lateral distal tip of the nail is unchanged since last check. Allan Roocroft will be ehre in 3 days to assess and trim. BID soaks with nolvasan and epsom salts continue. (AED) 5.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Radiographs taken. (ARM) 5.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Culture results came back as heavy growth of Strep Group G, a beta hemolytic Strep. Substrate grew mixed normal environmental flora including coag neg staph, alpha hemolytic strep, and bacillus. Winky and Wanda grew the same bugs out of their abscesses but it may not be due to contamination from the dirt floor. (CST) 8.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Allan Roocroft here to examine Winky and trim lightly. His assessment is that the abscess began as a laminitis from pressure necrosis d.t. a change in her weight bearing. He suspects she is weaker, d.t. lack of exercise and age, and has changed her wt. bearing stance- she bows out more now. He can see that the filing of the front of the nail has helpled, and used the hoof knife curved tip to lift off the nail and show it is no longer attached. Filed nail front and removed some of it. He said we should only use fine side of rasp b/w nails. The area of necrosis on the lateral edge of the nail was trimmed a bit. He said to clean this area daily so can see exactly what is Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 76 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 8.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) going on, but don't need to trim a lot every day. May need to thin nail above this area too. Can use a credit card to protect the cuticle along the edge. There are good signs of healing on the other side below the cuticle. This are is drying up nicely. Tehre is a band of new healthy nail. Will need to trim the dead nail surface off as this grows down to allow full healing. Asked his twice if he would use topicals and he said no. (AED) 14.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined foot and watched keeper do trimming. The new nail has grown down a few mm. Patty removed a bit of the nail of the hourglass area filed by Allan last saturday. There is a crack in this area that is extending upward, perhaps from nail pushing up. There is an area medially that seems loose and and area laterally that is warm to the touch. Goal will be to remove the nail in these areas. Patty filed a bit laterally to further thin the nail there. Recommended they work a bit on plantar surface to help deliniate where abscesses would most like to drain. (AED) 16.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Went to elephant building to examine. Animals in process of getting weighed. (CST) 19.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Radiographs taken today of her front left foot. (ARM) 26.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Observed in stall in the am. Standing with left front foot elevated off of the ground in abnormal posture. Discussion at elephant meeting to put sand down in stall 4 in addition to stalls 1 and 2. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 77 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 28.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); tuberculin testing - trunk wash Collected trunk wash #1 for tb culture series. (ALC) 30.Jan.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Observed Winky standing with wt shifted off of her right front leg. Kprs report that she does this occasionally, more so in the morning. (ARM) 1.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); tuberculin testing - trunk wash Second trunk wash of three in series done successfully today. Both elephants did a great job. (AED) 4.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); tuberculin testing - trunk wash Collected trunk wash #3 for tb culture series. (ALC) 9.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Examined in stall. Keeper reports that Winky has been stiff in the right front leg lately. KUO. Keepers emailed pictures of Winky's nail lesion to Alan Roocroft for advice. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 78 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 10.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) observed in stall; keepers state that she has been shifting her weight more in the front and seems to be favoring her left front; examined bottom of left front foot; keepers continue to work on trimming soft crab tissue beneath toe 2; this area could be uncomfortable; did not palpate any heat or swelling associated with the carpus; continue to monitor (ALC) 11.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) rechecked this morning as keeper reports there may be increased heat in toe 2 (left front); that toe is slightly warmer than the other toes; no significant swelling present today; this toe is currently active with proliferative tissue (NBA) present; participated in trimming of excessive tisse assoc with that toe; bled readily; accomplished a minimal amount of trimming; able to remove a small pebble that had collected on the palmar aspect; her foot was soaked; will try to trim more tomorrow. observed trailer conditioning; she went in almost completely (98%). (ALC) 13.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Observed in stall this am. Resuming ESR testing with this animal. (CST) 14.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed) Blood drawn for ESR. Result-54 (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 79 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 18.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed); ultrasound - right front foot a 2.5cm circular production of "crab meat" tissue is established in the center of the right front foot pad. photos taken. ultrasound evaluation to ruleout foreign body. inconclusive, but there is a suspect circular finding in the center of the tissue ~1-2 cm deep. recheck with ultrasound weekly. initiated new topical treatment which has been reported to be successful by colleagues: combination of 5%-10% benzoyl peroxide cream mixed with five 500 mg metronidazole tabs crushed. this lesion presents challenges as it is on the palmar surface of the foot. continue to monitor Rx: METRONIDAZOLE/benzol peroxide cream topically BID for 10 days. (ALC) 19.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Examined. Pretty cool. Have not seen a lesion in this location before. Concur with Dr. Case that likely a foreign body present deep in the footpad tissues. Hopeful that Case miracle combination #541 will be effective in clearing up the cheese. (CST) 20.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Fecal hemoccult test negative. (RAJ) (ADD) 21.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Kprs report that Winky is doing increasingly more wt shifting in the am. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 80 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 22.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Examined new lesion on right foot pad today. The lesions is 3.5 cm in diameter, soft and bleeds easily upon trimming according to keepers. The soft tissue is not malodorous, which is unusual. She is tender when they trim, which is not typical for her. They continue with ointment. Kprs also report that she is swinging her right leg, and generally seeming a bit more uncomfortable. Discussed trying adequan with her. There are 2.5 weeks worth in stock, so will get more before initiating. (AED) 25.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Drew blood for CBC and ESR study. She was not very cooperative today. She walked away in the middle of the blood draw. (CAB) 27.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed); ultrasound - right front foot ; visual inspection - RECHECK repeat ultrasound of right front foot pad lesion. nsf. the suspect area measures approx 5cm deep. will continue to monitor. no significant drying or change at this point on the benzoyl peroxide. added dmso/gent to topical tx plan for this lesion. this will be applied once daily with the benzoyl peroxide being applied once daily (either morning or evening). contact time is decreased with the lesion and treatments on the pad. continue to monitor. keepers doing great job trimming/treating. (ALC) 28.Feb.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) There is some moderate soft tissue swelling present in the medial aspect of the right rear limb. The area is NOT warm to the touch nor does it have a doughy consistency. Area is just ventral to bone and may be a seroma or fluid pocket of sorts. Continue to monitor at this time. No treatment. Rx: GENTAMICIN AND DMSO topically to abscess SID for 10 days. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 81 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 1.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Negative hemoccult on feces. (ADD) 1.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Negative for Encephalomyocarditis virus according to lab results from Texas VMDL. (CST) 2.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Observed Dr. Case teaching the keepers how to take a pulse utilizing the ear of the elephant as a method of monitoring pain levels in the two cows. (CST) 4.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Drew blood for CBC/ESR study. Will vaccinate next week. (CAB) 8.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Examined feet today. The lesion on the pad of the right front foot is different. There is a hole in the cranial aspect of the lesion, that you can advance a finger into approximately 6mm. Generally the tissue in the demarcated area is drier. Plan is to ultrasound in 3 days. The lesion on the left front is slow to heal. The crack on the front of the nail is growing proximally, and is only 5mm from the cuticle. The soft area of abscessation adjacent to the lateral distal edge of the nail is still about 2 cm in diameter, soft, bleeds easily. Advised kprs to use hoofflex at top of nail crack. May consider using epoxy to reinforce nail here and avoid further proximal splitting. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 82 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 9.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Rx: POLYSULFATED GLYCOSAMINOGLYCAN 25000 mg IM q72h for 12 doses. (AED) 10.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) attempted to inject first dose of adequan. only administered ~2mls. keepers will continue to condition. Winky is suspicious of me. techs may have more success as my approach may be different. (ALC) 11.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed); ultrasound - right front foot Rx: TETANUS TOXOID 1 ml IM SID for 1 dose. Rx: RABIES VACCINE (KILLED) 1 ml IM SID for 1 dose. (AED) 11.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed); ultrasound - right front foot repeat ultrasound of right front foot pad lesion. no significant findings other than infiltration of "crab meat" tissue. continue to monitor. (ALC) 11.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed); ultrasound - right front foot Vaccinated with tetanus toxoid and rabies IM in the left front leg. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 83 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 14.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Fecal hemoccult test negative. (RAJ) (ADD) 14.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Winky did very well for adequan injection today. It was decided to work our way up to a full does. Gave 15ml's via injection today. (ARM) 16.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Decided to try apple cider vinegar soaks for 2 weeks to see if this treatment helps with healing of abscesses (AED) 17.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Rx: ETODOLAC 18900 mg PO SID for 28 days. Rx: APPLE CIDER VINEGAR 64-150 oz topically BID for 14 days. (AED) 20.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Attempted to treat with adequan IM today. Winky was not agreeable and wouldn't stand for the injections. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 84 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 22.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Attempted to give adequan. Winky was very uncooperative, she would not let anyone touch her. (ARM) 23.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Winky was better today. Let me touch her and scratch her shoulder. (ARM) 24.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Observed Winky holding her leg up this am. She holds her front right leg up and supports it on her left leg. Desens for Adequan injections. (ARM) 24.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Winky is holding her leg up in the mornings according to the keeper. Doing well otherwise. (CST) 27.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Kprs report that Winky is still acting colicky, stretching and acting uncomfortable. Has not defecated since this morning. Per CST give more mineral oil (okay to give with more beet pulp) and will start her on banamine. Will also contact Beth tomorrow about having bran on hand. Winky defecated in the afternoon, the bolus was dry and hard. Kprs were able to get 1/2 dose of banamine in her and will continue to try to get the rest in by close. On exhibit she is extremely sleepy and continues to wt shift. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 85 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 27.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Keeper reports that Winky is colicky this morning. Acting painful. Moved outside. She managed to defecate with some straining. Visual exam at 9 am. Doing well. Eating. ACting normally. Social dynamic between Wanda and Winky may be changing. Wanda may be taking on top position in the hierarchy at the moment based on their behaviors. Trailer training did not go well yesterday with Bunnyville ongoing. Rx: FLUNIXIN MEGLUMINE 1750 mg PO SID for 1 dose. (CST) 28.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Examined in am. Doing better. Noon- starting to decline again. Smaller firm stool. Hemoccult test negative yesterday. Trailer training is not happening due to her colic. No bran on grounds as transition has been made from bran to beet pulp over the last few weeks. She is not taking mineral oil in items that are being offered. 4 pm- unable to get banamine into animal. Bran will arrive at 8 am tomorrow morning. Will reassess first thing tomorrow. Depending on situation, may need to inject banamine. (CST) 29.Mar.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) AM: Reported to be doing better. Held off on banamine at this time. Pm: Examined. Winky had just finished a trailer session and done extremely well with it. Bright, alert, active, had eaten three pounds of bran at this time. Sedimentation test requested by Dr. Case showed very small amount of sand in the bottom of the glove. Fecal collected by keeper staff firm and dry. Continue to monitor closely. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 86 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 3555 Common Name: Asiatic elephant Female Name: WINKY Birth: 26.Sep.1952 (Estimated) =============================================================================== 3.Apr.2005 Problem: crack - left rear foot (Confirmed); abscess - right front foot (Confirmed); abscess - right rear pad (Confirmed); abscess - nail (Confirmed); polyp - vagina (Confirmed); abscess - right front pad (Confirmed) Observed during training session. Margaret has her extremely well trained and odds are good that they will be loaded up in two days. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 1 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== .....1994... 9.Nov.1994 Problem: quarantine Arrived today. Difficult to unload. Required sedation. Appeared to be lethargic at closing and at 1 AM check. KUO. (DWA) 10.Nov.1994 Problem: quarantine Much improved today, though some sedation is still evident. Keepers able to approach. (DWA) 11.Nov.1994 Problem: quarantine Doing better. No sedative effects. KUO (DWA) 12.Nov.1994 Problem: quarantine Doing well. Off chains today and interacting more normally. Appetite returning. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 2 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 16.Nov.1994 Problem: quarantine <<< Microbiology >>> Sample Accession #: 4468 Laboratory: [ ] Bayshore Collection Date: 11/16/94 [ ] Great Lakes Submission Date: 11/16/94 [ ] Medical Complex Reporting Date: 11/22/94 [X] Other: Vet Research Submission type: [ ] aerobic bacteriology Sample source: [ ] anaerobic bacteriology [ ] mycology [x] Individual sample [x] enteric pathogen screen [ ] Group sample [ ] mycobacterial Organism: Negative for Salmonella, Shigella and Campylobacter. Sensitivity: 1 | 2 | 3 | Amoxicillin/Clavulanate: | | | Ampicillin/Sulbactam: | | | Ampicillin: | | | Cefoxitin: | | | Cephalothin: | | | Ciprofloxacin: | | | Clindamycin: | | | Erythromycin: | | | Gentamicin: | | | Nitrofurantoin: | | | Norfloxacin: | | | Penicillin: | | | Piperacillin: | | | Sulfamethoxazole: | | | Tetracycline: | | | Trimethoprim/Sulfa: | | | Vancomycin: | | | (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 3 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Nov.1994 Problem: quarantine Large lump on left hip with heat and some sensitivity. Probable tissue reaction to darting. Keepers will hose with warm water or use towels soaked in warm water twice daily and apply DMSO UFN. (DWA) 21.Nov.1994 Problem: quarantine Swelling spreading and dispelling. Less warm, less pronounced. KUO. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 4 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Nov.1994 Problem: quarantine <<< Microbiology >>> Sample Accession #: 4468 Laboratory: [ ] Bayshore Collection Date: 11/29/94 [ ] Great Lakes Submission Date: 11/29/94 [ ] Medical Complex Reporting Date: 12/02/94 [X] Other: Vet Research Submission type: [ ] aerobic bacteriology Sample source: [ ] anaerobic bacteriology [ ] mycology [x] Individual sample [x] enteric pathogen screen [ ] Group sample [ ] mycobacterial Organism: Negative for Salmonella, Shigella and Campylobacter. Sensitivity: 1 | 2 | 3 | Amoxicillin/Clavulanate: | | | Ampicillin/Sulbactam: | | | Ampicillin: | | | Cefoxitin: | | | Cephalothin: | | | Ciprofloxacin: | | | Clindamycin: | | | Erythromycin: | | | Gentamicin: | | | Nitrofurantoin: | | | Norfloxacin: | | | Penicillin: | | | Piperacillin: | | | Sulfamethoxazole: | | | Tetracycline: | | | Trimethoprim/Sulfa: | | | Vancomycin: | | | (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 5 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 3.Dec.1994 Problem: quarantine <<< Microbiology >>> Sample Accession #: 4468 Laboratory: [ ] Bayshore Collection Date: 11/29/94 [ ] Great Lakes Submission Date: 11/29/94 [ ] Medical Complex Reporting Date: 12/03/94 [X] Other: Vet Research Submission type: [ ] aerobic bacteriology Sample source: [ ] anaerobic bacteriology [ ] mycology [x] Individual sample [x] enteric pathogen screen [ ] Group sample [ ] mycobacterial Organism: Negative for Salmonella, Shigella and Campylobacter. Sensitivity: 1 | 2 | 3 | Amoxicillin/Clavulanate: | | | Ampicillin/Sulbactam: | | | Ampicillin: | | | Cefoxitin: | | | Cephalothin: | | | Ciprofloxacin: | | | Clindamycin: | | | Erythromycin: | | | Gentamicin: | | | Nitrofurantoin: | | | Norfloxacin: | | | Penicillin: | | | Piperacillin: | | | Sulfamethoxazole: | | | Tetracycline: | | | Trimethoprim/Sulfa: | | | Vancomycin: | | | (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 6 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.Dec.1994 Problem: quarantine Swelling enlarging again, with some heat and significant tenderness. Keepers will apply DMSO daily and soak with warm water twice daily. Instructed to expect an abcsess (sterile or otherwise) to rupture soon. (DWA) 10.Dec.1994 Problem: quarantine ; abscess - left hip region (Confirmed) In AM, keeper reported skin flaking off swollen area. At PM, keeper reported that abscess had ruptured and pus was erupting. Animal was very agitated and would not tolerate handling. Keepers instructed to hose with warm water 4 or more times daily, to keep it open and draining. Prescribed 262 g Uniprim (7 bags) SID x 7 days PO. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 7 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 10.Dec.1994 Problem: quarantine ; abscess - left hip region (Confirmed) <<< Microbiology >>> Sample Accession #: 4468 Laboratory: [ ] Bayshore Collection Date: 12/10/94 [ ] Great Lakes Submission Date: 12/10/94 [ ] Medical Complex Reporting Date: 12/17/94 [X] Other: Vet Research Submission type: [ ] aerobic bacteriology Sample source: [ ] anaerobic bacteriology [ ] mycology [x] Individual sample [x] enteric pathogen screen [ ] Group sample [ ] mycobacterial Organism: Negative for Salmonella, Shigella and Campylobacter. Sensitivity: 1 | 2 | 3 | Amoxicillin/Clavulanate: | | | Ampicillin/Sulbactam: | | | Ampicillin: | | | Cefoxitin: | | | Cephalothin: | | | Ciprofloxacin: | | | Clindamycin: | | | Erythromycin: | | | Gentamicin: | | | Nitrofurantoin: | | | Norfloxacin: | | | Penicillin: | | | Piperacillin: | | | Sulfamethoxazole: | | | Tetracycline: | | | Trimethoprim/Sulfa: | | | Vancomycin: | | | (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 8 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 11.Dec.1994 Problem: quarantine ; abscess - left hip region (Confirmed) Still draining pus today but swelling has decreased some. Able to obtain sample for culture today. Keeper able to flush into openning with dilute Betadine and peroxide and warm water. Continuing hosing. Appetite still good and she is active. (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 9 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 12.Dec.1994 Problem: quarantine ; abscess - left hip region (Confirmed) <<< Microbiology >>> Sample Accession #: 4468 Laboratory: [ ] Bayshore Collection Date: 12/12/94 [ ] Great Lakes Submission Date: 12/12/94 [ ] Medical Complex Reporting Date: 12/16/94 [X] Other: Vet Research Submission type: [X] aerobic bacteriology Sample source: Abcess [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [ ] mycobacterial Organism: Growth: heavy moderate light 1. Citrobacter freundii [ ] [ ] [X] 2. alpha hemolytic Streptococci [ ] [ ] [X] 3. [ ] [ ] [ ] Sensitivity: 1 | 2 | 3 | Amikacin : S | S | | Amoxicillin/Clavulanate: | | | Ampicillin/Sulbactam: | | | Ampicillin: | | | Carbenicillin: S | S | | Ceftiofur : S | S | | Ciprofloxacin: | | | Chloramphenicol: S | S | | Clindamycin: | | | Erythromycin: R | S | | Gentamicin: S | S | | Kanamycin : S | R | | Neomycin: S | S | | Norfloxacin: | | | Oxacillin: | | | Penicillin: R | S | | Piperacillin: | | | Sulfamethoxazole: | | | Tetracycline: S | S | | Tobramycin: | | | Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 10 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 12.Dec.1994 Problem: quarantine ; abscess - left hip region (Confirmed) Trimethoprim/Sulfa: S | S | | Vancomycin: | | | Comments: (MAS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 11 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Dec.1994 Problem: quarantine ; abscess - left hip region (Confirmed) Draining abscess is resolving. Swelling, pain, and exhudate are all reduced. Keepers will continue to flush QID and monitor. Last day of medications. (DWA) .....1995... 1.Jan.1995 Problem: quarantine ; abscess - left hip region (Confirmed) 8.Jan.1995 Problem: abscess - left hip region (Confirmed) Wanda's abcess hosed and betadined- some pus- per keeper. (CAB) 9.Jan.1995 Problem: abscess - left hip region (Confirmed) Abscess closing over, but some heat and swelling is still present. Keepers instructed to use end of catheter tip syringe to keep wound open and draining. They will continue to flush BID. (DWA) 21.Jan.1995 Problem: abscess - left hip region (Confirmed) Abscess still enlarged and warm. Drainage site has closed over. Keepers instructed to treat with warm water twice daily, and continue flushes. Tomorrow, the abscess will be lanced again, with local anesthesia. (DWA) 22.Jan.1995 Problem: abscess - left hip region (Confirmed) After local injection of 6 cc 2% lidocaine, a stab incision was made to increase the diameter and depth of the draining hole in the abscess. The tissue in the area of the abscess felt fibrous, with a small inner cavity, with no pustular contents. The cavity was digitally enlarged, and the draining tract opened. Flushing did not bring out any pus. Keepers will flush twice or three times daily with betadine, and use warm water for 5 minutes on the abscess three times daily. They will make an effort to keep the tract open and draining. Begin uniprim (7 bags) SID x 7 days. (DWA) 23.Jan.1995 Problem: abscess - left hip region (Confirmed) Keepers report increased swelling and heat below abscess. KUO. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 12 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 26.Jan.1995 Problem: abscess - left hip region (Confirmed) Swelling and heat reduced in abscess. With ball-tipped syringe, 0.2% nitrofurazone:DMSO (5:1), 1 L total, was flushed into abscess at suggestion of Dr. Michael Schmidt. Keepers instructed not to flush wound again today and resume normal flushing schedule tomorrow (ie TID). (DWA) 30.Jan.1995 Problem: abscess - left hip region (Confirmed) Swelling has gone down considerably. Very little heat present. Still flushing out some pus. (MAS) 5.Feb.1995 Problem: abscess - left hip region (Confirmed) Swelling still going down, but some heat and swelling still present. Keepers will flush again with DMSO and nitrofurazone once and continue betadine flushes twice daily after. (DWA) 11.Feb.1995 Problem: abscess - left hip region (Confirmed) Swelling still going down, with very little heat or swelling present. Keepers will flush again with DMSO and nitrofurazone once and continue betadine flushes twice daily after. (DWA) 3.Mar.1995 Problem: abscess - left hip region (Confirmed) Keepers have not gotten pus out of wound in 5 days. Swelling and heat are significantly reduced. Catheter only penetrates 1 cm into abscess hole. Vet recommends discontinuation of betadine flush and continuance of warm water soaks and cleaning of area around wound. KUO. (DWA) 13.Mar.1995 Problem: abscess - left hip region (Confirmed) Slight amount of pus draining daily from abscess, but abscess is cool and shrinking in size. Keepers will continue betadine flush SID and hot water spray BID. (DWA) 29.Mar.1995 Problem: abscess - left hip region (Confirmed) Abscess still draining small amounts of pus daily. Size and heat continue to diminish. Keepers will continue betadine flush and warm water spray BID. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 13 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 2.Apr.1995 Problem: abscess - left hip region (Confirmed) Scant pus today. No heat or swelling. (DWA) 1.May.1995 Problem: abscess - left hip region (Confirmed) Keepers still report scant pus, but swelling is reduced from last check. No heat or pain. KUO. (DWA) 2.May.1995 Weight: 4005 Kg (8829 Lb) Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) Animal did not eat or defecate overnight and appeared listless in AM, leaning and closing eyes, standing still instead of her characteristic weave and allowing her trunk to lay flaccid on the ground. Rectal temp 98.7 F, rectal culture taken, animal felt cold on shoulders, ears and cheeks. NO appetite for any foodd (except Famous Amos cookies.) Some gut movement was noted on left side. Advised keepers to walk well after lunch, and submit feces and urine if they are produced. Feces and urine produced during bath. Fecal and UV WNL. Defecation was scant and had thick strands of hay, were very dry, but no sand in it. KUO Consult w/ Dr. M. Schmidt: suggested ddx included Salmonella, sand colic. Recommended immediate initiation of Naxcel IM SID 4 g x 7-10 days. 1800 check showed animal very depressed and down on right side. Did arise when disturbed, but immediately leaned against a wall. Called zookeepers in for handling during injection of Naxcel. Only 3 g were on hand and these were administered. (DWA) 3.May.1995 Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) Standing and more active in AM. Defecated feces with higher component of undigested hay than usual in afternoon. Given 4.0g naxcel IM.=============================Page Break============================= <<< Microbiology >>> Sample Accession #: 4468 Laboratory: [X] Vet Research Collection Date: 05/04/95 [ ] AHDL Submission Date: 05/04/95 Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 14 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 3.May.1995 Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) [ ] Other: Reporting Date: 05/09/95 Sample source: Feces Submission type: [x] enteric pathogen screen [ ] Group sample [X] Individual sample Organism: Negative for Salmonella, Shigella, Yersina, and Campylobacter. Comments: (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 15 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 4.May.1995 Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) Behaviors, activity and appetite returning to normal although not 100% yet. Given 4.0g IM Naxcel. Fecal output more normal, consistancy more normal. (AED) 5.May.1995 Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) Wanda improving further today. Behaviors very normal, including usual stereotypic ones. Fecal and urine output good. Appetite almost normal. Did not eat all produce. Collected urine by catch. Very cloudy. Microscopically contained small amorphous stuff, possibly crystals- couldn't tell. No glucose in urine. KUO. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 16 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.May.1995 Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) <<< Urinalysis >>> Sample Accession #: 4468 Laboratory: Collection Date: 05/05/95 [X] Detroit Zoo Date received: [ ] Vet Research Report Date:05/05/95 [ ] Other: Sample collection: Sample storage: [ ] floor [ ] room temperature [X] mid-stream [X] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: Light yellow Appearance: [ ] clear Specific Gravity: 1.015 [X] hazy / slightly cloudy [ ] cloudy / turbid Dip stick test: Microscopic Exam: Glucose: Neg RBC's: Neg Bilirubin: Neg WBC's: Neg Ketones: Neg Epithelial cells: Few squamous Sp Gravity: 1.015 Blood: Neg Casts:Neg pH: 8.0 Crystals: Few Amorphous phosphate Protein: Trace Other: Urobilinogen: Normal Nitrite: Neg Leucocytes: Neg Comments: (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 17 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.May.1995 Weight: 3978 Kg (8770 Lb) Problem: abscess - left hip region (Confirmed); decreased activity (Suspected) Continued improvement. (AED) 2.Jun.1995 Problem: abscess - left hip region (Confirmed) Keepers report that they are still getting pus from abscess (L hip) with each daily flush. She is more painful during flushes last few days. No heat or swelling. Will continue to flush and KUO. (AED) 17.Jun.1995 Problem: abscess - left hip region (Confirmed) Keepers report that wanda is more tender around abscess. They have started flushing twice daily. On exam she responds to even light touch. There is no heat but some increase in amount of swelling. (AED) 18.Jun.1995 Problem: abscess - left hip region (Confirmed) Abscess opening stretched slightly. Keepers will flush BID and hose with warm water. KUO. Nitrofurazone for flush on order. (MAS) 25.Jun.1995 Problem: abscess - left hip region (Confirmed) Abscess unchanged - continue soaks and flushes. Nitrofurazone on order. (DWA) 3.Jul.1995 Problem: abscess - left hip region (Confirmed) Dispensed nitrofurazone and DMSO solution for flushing abscess for next three days. (GL) 10.Jul.1995 Problem: abscess - left hip region (Confirmed) Abscess improved. Swelling reduced, no heat, and no pain despite much pushing. Keepers report less pus with morning flushes and much less response to swabbing. (AED) 30.Jul.1995 Problem: abscess - left hip region (Confirmed) No change in abscess. Begin again 60 cc 0.2% Nitrofurazone mixed 5:1 Nitrofurazone:DMSO flushed into abscess daily for 5 days. Repeat in two weeks if necessary. (DWA) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 18 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 21.Aug.1995 Problem: abscess - left hip region (Confirmed) Begin again 60 cc 0.2% Nitrofurazone mixed 5:1 Nitrofurazone:DMSO flushed into abscess daily for 5 days. Repeat in two weeks if necessary. No heat, but pus exuded daily from hole. (DWA) 22.Aug.1995 Problem: abscess - left hip region (Confirmed) Conditioning session for annual workup next week. (AED) 24.Aug.1995 Problem: abscess - left hip region (Confirmed) Conditioning session for annual exam. (AED) 25.Aug.1995 Problem: abscess - left hip region (Confirmed) Conditioning session for annual exam. (AED) 26.Aug.1995 Problem: abscess - left hip region (Confirmed) Conditioning session for annual exam. (AED) 31.Aug.1995 Problem: abscess - left hip region (Confirmed) Bled via ear vein for CBC, chem, bank. Tetanus toxoid 1 cc IM, PPD bovis 0.1 ml ID in left caudal fold. Recheck daily for 3 days. (DWA) 1.Sep.1995 Problem: abscess - left hip region (Confirmed) 24 hr TB test negative (CAB) 2.Sep.1995 Problem: abscess - left hip region (Confirmed) 48 hr TB test negative. (DWA) 3.Sep.1995 Problem: abscess - left hip region (Confirmed) 72 hr TB test negative. (DWA) 5.Sep.1995 Problem: abscess - left hip region (Confirmed) Conditioning session for annual exam. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 19 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.Sep.1995 Problem: abscess - left hip region (Confirmed) Conditioning session for annual exam. (DWA) 11.Oct.1995 Problem: abscess - left hip region (Confirmed) Swelling over abscess extending dorsally 6-7cm. No heat or pain. KUO. Keepers will soak w/ warm water packs for 15 min daily. (DWA) 6.Dec.1995 Problem: abscess - left hip region (Confirmed) Yesterday examined abscess. Keepers report that has been no pus production lately. Seems quiescent- no sign of inflammation. Will continue "no flush" approach. (AED) .....1996... 11.Feb.1996 Problem: abscess - left hip region (Confirmed) Conditioned for blood sample and TB testing/tetanus Vx on Right side. Abcess quiet, firm. Resolved. Lump may remain permanently. (DWA) 26.Mar.1996 Small amount of pus from old abcess on left side of hip area. (MAS) 27.Mar.1996 Bled via left ear vein for CBC, chem, and bank. TB test 0.1 ml PPD bovis ID in right caudal fold. 1 cc IM tetanus toxoid in right shoulder. Scant pus expressed from abscess - no heat; swelling scant and not increased in last few weeks. (DWA) 28.Mar.1996 24 hour TB test negative. Tetanus site inflamed today. Kprs to hose w/ cold water today, warm water TID tomorrow and UFN. Will send DMSO. (DWA) 29.Mar.1996 48 hr TB test negative. Tetanus site slightly inflamed today. Abscess looks good despite recent expulsion of pus. (AED) 30.Mar.1996 72 hr TB test negative. Tetanus site swelling almost completely resolved. Kprs using DMSO last two days. (AED) 9.Apr.1996 Tetanus swelling completely resolved. Conditioned today on left side. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 20 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 23.Jun.1996 Conditioned for bleeding today. (MAS) 4.Dec.1996 PE of feet of all three elephants today. All look good. (AED) .....1997... 23.Jan.1997 24 hr TB test NEG. Slight swelling in region of tetanus injection. (DWA) 24.Jan.1997 Drew blood for annual check up, TB tested, mammalian, left caudal fold and gave tetanus toxoid in left tricep area. (CAB) 25.Jan.1997 72 hr TB test negative. Very little swelling associated with vaccine. Bloodwork WNL. (AED) 18.Apr.1997 Conditioned elephants. (AED) 15.Nov.1997 Kprs report change in gait. On right rear, as she walks she settles her weight into the fetlock, like the proximal aspect of the joint shifts and then clicks into place. Doesn't occur with each step, and she doesn't appear hesitant to put weight on the foot. Also notice that left stifle appears stiff, and she holds it fairly straight as she moves the leg forward. KUO. (AED) 20.Nov.1997 Kprs report that she has held rear right foot up when working the front left a few times in the last 5 days. Today looks normal on visual exam. (AED) 26.Nov.1997 Front leg is still a little stiff when doing laps. (MAS) .....1998... 5.May.1998 Kprs report that Wanda has been pulling at her left nipple 2-3 times each day (approx) for last 2 weeks. Does both when on exhibit and in holding. Most commonly seen during training sessions when she wants Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 21 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.May.1998 training to end, similar to swaying behavior she shows in same situation. Nipple appears elongated and slightly red at the tip. Mammary tissue on both sides symmetrical. Assumption is that once starting the behavior, inflammation has caused a self perpetuation of the behavior. Kprs to discuss with curator today, and with Gail Laule when possible. (AED) 15.May.1998 Conditioning for blood draw and vaccination going very well. Plan to do "real" procedures next week. (AED) 23.May.1998 Rx: TETANUS TOXOID 1 ml IM SID for 1 day. (DWA) 26.May.1998 Successfully bled via ear vein and operant conditioning for CBC, chem, bank. Also vaccinated in left shoulder with tetanus toxoid. (DWA) 25.Jun.1998 First of 3 trunk washes today. Went very well. Frozen immediately to be shipped once all 3 collected. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 22 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 25.Jun.1998 <<< Mycobacteriology >>> Sample Source: trunk wash Laboratory: Accession #:98-28508 thru 98-28510 [ ] Antech Collection Date:6-25 6-27 6-29 [ ] AHDL Submission Date:07/02/-98 [X] Other :Natioal Vet Services Lab Report Date:09/09/98 Submission type: [ ] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [X] mycobacterial Organism: Growth: heavy moderate light 1.No isolation made [ ] [ ] [ ] 2. [ ] [ ] [ ] 3. [ ] [ ] [ ] Comments: (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 23 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.Jun.1998 Second of 3 trunk washes. Frozen immediately. (CAB) 3.Jul.1998 Decrease in stool quantity noted by keepers and treated with mineral oil. Discussed today with vet, and they indicated flatulance also present - suggesting no blockage and no stones have passed. Suspect simple partial anorexia due to heat and recommended lots of fluids but no mineral oil and bran. KUO. (DWA) 21.Nov.1998 Elephant is very stiff on left front leg- not bending carpus or elbow at all and pulling leg forward, scraping of soul of foot on ground when walking. Will bear full wt. and no warmness felt. Given 4g of bute during day and then, when let out walked completely normlally just moments after lame. Kprs to trt with 4g bute in am if needed. Rx: PHENYLBUTAZONE 4 gm PO SID for 1 day. (AED) 22.Nov.1998 Rx: PHENYLBUTAZONE 3 gm PO SID for 1 day. (AED) 22.Nov.1998 Keepers noticed shaking in left front leg but no lameness. Offered 3 grams of Bute. Keepers had a hard time getting her to take meds. Walked normally when let out in afternoon. (MAS) 23.Nov.1998 Wanda is walking normal today. No sign of front leg lameness per keeper. Discontinue Bute. (CAB) 13.Dec.1998 Kprs report stiffness of L front leg 2 days ago after rocking- she warmed out of it quickly. Fine today. I think her cuticles are longer than in the past. (AED) 22.Dec.1998 Conditioned today for January preventative health procedures - techs and vet to continue regular conditioning sessions. (DWA) .....1999... 6.Jan.1999 Conditioned today with Margaret, CB, MS and myself in attendance. Discussed long-term medical training goals of touching elephants everywhere, IM injections in hip, and throwing pills/meds directly into mouth. PM training for this month going well. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 24 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.Jan.1999 Rx: TETANUS TOXOID 1 ml IM SID for 1 day. (AED) 27.Jan.1999 Drew blood from left ear for CBC. Gave tetanus toxoid IM in left shoulder (22ga 1" needle). She was great. (CAB) 29.Jan.1999 Both elephants have swellings at their vaccination sites and are not participating in training as willingly as usual. (AED) 30.Jan.1999 Visual check today of swelling- is reduced and animals are eating and behaving normally today. RESOLVED. (AED) 3.Feb.1999 National Veterinary Services Laboratory Date sample was recieved: 03 Feb. 99 Specimen examined: Trunk Wash Isolation: No isolation made Three seperate samples from this elephant were submitted on the same date. All came back with no isolation. (CUL) 26.May.1999 Examined both eyes. Last few days has had white discharge similar to that seen in previous years. Assume is d.t. lg amt of wind and pollen last few days. KUO. She is also placing less wt on right rear leg and swaying more. (AED) 1.Jun.1999 Wanda is holding left rear foot up and placing foot farther under her when standing. examined foot and saw no lesions, no heat, no pain. (AED) 2.Jun.1999 Rx: PHENYLBUTAZONE 3 gm PO SID for 3 days. (AED) 7.Jun.1999 Keepers called to report that Winky slammed Wanda into wall and in the process Wanda got an abrasion over left eye. On visual exam it Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 25 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 7.Jun.1999 appeared to be about 3 inches in length and looked raw but not bleeding. Gave dilute betadine with 0.9 saline(1:40 dilution per opthomologist at MVS) to flush wound with. Also gave pet guard gel to protect from flies. Will have Vet decide on frequency of flush on tuesday. (AED) 8.Jun.1999 Rx: PHENYLBUTAZONE 3 gm PO SID for 3 days. (AED) 10.Jul.1999 wanda stiff on left rear leg. Kprs told to start a calendar of possible inciting causes and let me know if stiff enough to warrent bute. KUO. (AED) 27.Jul.1999 Rx: PHENYLBUTAZONE 3 gm PO SID for 10 days. (AED) 28.Jul.1999 Wanda has shifted her stereotypic pacing, suggesting that she is painful in left rear leg. She is also throwing sand at this leg. Dispensed bute to try for 10 days and see if she improves. Discussed plans for xrays with assc. curator and kprs. (AED) 30.Jul.1999 Wanda remains stiff. Has taken bute successfully for 2 or 3 days. (AED) 4.Aug.1999 Rx: PHENYLBUTAZONE 3 gm PO SID for 4 days. Looking into other trt options. (AED) 7.Aug.1999 Rx: SULFADIAZINE/TRIMETHOPRIM (5:1) 1600 mg PO SID for 12 days. (AED) 10.Aug.1999 Kprs having trouble getting ABx into Wanda. (AED) 22.Aug.1999 No appreciable improvement in stiffness with ABx. (AED) 25.Aug.1999 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 26 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 31.Aug.1999 Wanda continues to appear stiff. Was stretched out by kprs last week and appeared stiff afterwards. Demonstrated training techniques being used to prepare for rads of foot. (AED) 1.Sep.1999 Wanda very stiff on LF leg, and reluctant to bend elbow and carpus so that she is sort of dragging foot. This episode is not as severe as that seen on 21 Aug. KUO. Rx: PHENYLBUTAZONE 4 gm PO BID for 3 days. (AED) 3.Sep.1999 Yesterday stiffness lessened, and today she looks normal. Ordered ibuprofen as an option for trt. (AED) 8.Sep.1999 Rx: IBUPROFEN 11200 mg PO bid for 21 days. (AED) 22.Sep.1999 Rx: IBUPROFEN 9600 mg PO BID for 28 days. (AED) 13.Oct.1999 Gave Michelle K. new bottle of ibuprofen to take to elephants to finish 28 days prescription. Will check with keepers to see if they need new treatment sheet. (CDD) (AED) 22.Oct.1999 Rx: IBUPROFEN 8000 mg PO BID for 30 days. (AED) 2.Nov.1999 Wanda ate 3 feet of coaxial cable at 2pm. Will check feces tomorrow. (AED) 22.Nov.1999 Rx: IBUPROFEN 8000 mg PO SID for 45 days. (AED) 13.Dec.1999 Rx (refil): IBUPROFEN 8000mg PO BID x 30 days. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 27 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Dec.1999 <<< Urinalysis >>> Sample Accession #: Laboratory: Collection Date:18 Dec 99 [x] Detroit Zoo Date received: 18 Dec 99 [ ] Vet Research Report Date:18 Dec 99 [ ] Other: Sample collection: Sample storage: [x] floor [ ] room temperature [ ] mid-stream [x] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: light yellow Appearance: [x] clear Specific Gravity: 1.022 [ ] hazy / slightly cloudy (Refractometer) [ ] cloudy / turbid Dip stick test: Microscopic Exam: Urobilinogen:0.2 RBC's: rare Glucose: neg WBC's: 0 Ketones: trace Epithelial cells: none Biliruben: neg Protien: neg pH: 8.0 Crystals: none Occult Blood: neg Nitrite: Casts: Leukocytes: Bacteria: Other: Other: Comments: (U/A) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 28 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== .....2000... 8.Jan.2000 Took xrays of left front foot. She would not put toes all the way down on plate, and rocks slightly so there was movement during the long exposure. Kprs are to add a board to the platform so she doesn't have to lower toes as much and see if she holds still. Exposures 80, 20, 1.5sec, 30 inches 100, 20, 1.5, 30 in. The exposures look very similar. The distal phalenges are burned through or not close enough to plate to see clearly. Once get positioning steady will try 80 and 70 kvp exposures and maybe aim differently. (AED) 14.Jan.2000 Rx: IBUPROFEN 8000 mg PO BID for 60 days. (AED) 2.Feb.2000 Drew blood for CBC/Chem. 1ml tetanus toxoid IM in left shoulder. (AED) 5.Feb.2000 Two new radiographs taken of left front foot. Getting closer to a good technique. First view there was movement. Used 80kvp, 1.5 sec at approx 30 inches. Second view I held machine at 22 inches and decreased time to 1.25. This view was better. Wrote plan for next views in technique book. (AED) 15.Feb.2000 Two new rads of LF foot using 70,20, 1.25sec and 60, 20, 1.25 sec. She is moving too much, and even 60 kvp film is too dark to see edge of foot. Next time will try faster time and little higher kvp. Maybe 80kvp and 0.75 sec. Also, will try to leave target handle on foot to keep it steady. Distance was 24 inches. (AED) 18.Feb.2000 Trunk wash sample sent to National Veterinary Services Lab for tuberculosis mycobacteria isolation testing. No isolation made on Feburary 15th, 17th, or 18th. 25.Feb.2000 Margaret from AE thinks Wanda has changed her gait since her last visit. Kprs do not appreciate a difference, and Margaret could not really describe the change, just that there is a difference. We had already figured out annual cost of cosequin, and submitted paperwork for imprest cash purchase, which we got today. Will start her tomorrow. Kprs to video her first so we can document any gait changes. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 29 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 26.Feb.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 27.Feb.2000 Sent new bottle of 800 mg Ibuprofen to elephants. Treatment sheet they have should go to mid March. 5.Mar.2000 Sent one jar of cosequin up to elephants so they could continue treatment. 6.Mar.2000 Wanda has appeared drowsy the last 3 days. She and Winky were both more drowsy after first 2 days in yard during current warm spell. Maybe d.t. increase in exercise. Wanda remains more sleepy. Called Nutramax to see if there is any reports of this in animals, specifically those also being treated with NSAIDS. None reported. Talked with a technician. A vet, Barbara Eves will be available tomorrow if needed. I do not think this is the problem. We will collect blood tomorrow for a CBC and chem. (AED) 7.Mar.2000 Blood collected for CBC/chem panel. (CKS) 8.Mar.2000 Bloodwork WNL. (CKS) 13.Mar.2000 Kpr noted swelling of L rear leg. Dorsolateral aspect of distal tibia on L leg is not as wrinkled as R rear leg. No swelling palpable. Skin may be "baggier" or more loose on the left leg. Other kprs unsure as to whether she's always been like this. No tx. Will monitor. (CKS) 15.Mar.2000 Rx: IBUPROFEN 8000 mg PO BID for 30 days. (CKS) 23.Mar.2000 Sent new bottle of ibuprofen to elephants to continue Wanda's perscription. 28.Mar.2000 Kpr concerned about gait and L rear leg, seemed to hesitate when she walked. Visual exam: walking normally in the yard and actually walked very quickly at one point. Will KUO. (CKS) 3.Apr.2000 Dispensed one bottle of cosequin to elephant keeper to continue Wanda's prescription. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 30 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 13.Apr.2000 Rx: IBUPROFEN 8000 mg PO BID for 30 days. (CKS) 27.Apr.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. (CKS) 28.Apr.2000 Kpr reports Wanda has been rocking more lately. Also concerned about L rear leg. Measured circumference of both rear legs- R rear is 1/2 inch larger than the L. Suspect rocking is more behavior related, Winky has been acting stressed too. Has been on Cosequin for 2 months, kprs unsure if there is any difference, want to wean her off ibuprofen. Will cut ibuprofen dose by half to 5, 800mg tabs BID and evaluate her gait. (CKS) 6.May.2000 She has callouses on her elbows. A chunk of skin is flapping, exposing a pink area. Will dispense silvadene today, and check tomorrow. Rx: SILVER SULFADIAZINE 1 gm topically SID for 5 days. (AED) 7.May.2000 L elbow callus has the center portion peeled away. Small area of irritated skin. Looks like it will do ok. Kprs will apply Silvadene at night. So far no problems with decreasing the ibuprofen dosage. (CKS) 13.May.2000 Examined L elbow. Has healed fine. No further trt. Contines to do well at decreased ibuprofen dose. Perhaps d.t. cosequin. (AED) 15.May.2000 Kpr reported Wanda was sore on her left back leg. Will increase ibuprofen to 10 tabs bid for a few days to see if it helps. Rx: IBUPROFEN 4000 mg PO BID for 30 days. (CKS) 17.May.2000 Per kpr, Wanda doing much better. (CKS) 20.May.2000 Wanda has diarrhea today, only in the am. Appetite normal. Kprs to reduce ibuprofen to 5 tablets twice daily starting tonight, and we will see how she does. (AED) 25.May.2000 Wanda visual check today and attempt to draw blood. One keeper is Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 31 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 25.May.2000 worried about Wanda's behavior, other's think she is fine. Wanda has not been participating in training well for last 3 wks and has been rocking more. According to PK she is doing well, as per clin note on 20 May. Today Wanda is a stellar trainee, and moved extremely well during training. Decided to stay with lower ibuprofen dose, and draw blood at some point. (AED) 28.May.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 14.Jun.2000 Rx: IBUPROFEN 4000 mg PO BID for 30 days. (CKS) 29.Jun.2000 Kprs reported that the lateral nail on the right foot has a soft spot. The kprs have been trimming it proximally for up to 3 weeks (kprs today don't know). Today on exam the nail has been trimmed 4cm proximally over the last week, exposing a soft spot 1 cm in diameter. I probed this soft spot and determined that the probe can easily be passed proximally to a depth of 1cm. At this point the probe hit a tender spot. When pressing on the nail, the cuticle, and the skin proximal to the nail, there is no sign of pain. No other abnormalites seen on other nails. Kprs are going to increase dose to 10 tablets twice daily for 5 days. Wanda is rocking steadily the last few days. She is throwing dirt on both back legs every few minutes. Kprs were instructed to try providing a betadine foot bath twice daily. She is not trained to do this foot, so they don't know if this will be possible. They were also instructed NOT to squirt anything up the hole, d.t. concern that infection might travel. They CAN apply betadine topicall to area, esp if foot baths don't work. Rick will be in tomorrow am, and I will talk more with him at that time. (AED) 30.Jun.2000 Rick trimmed nail proximally again today, going in the direction of the pocket I found yesterday. Were able to trim a little. She became aggressive. Able to soak foot with nolvasan for almost 10 minutes off and on. Water became very dirty cause she had to put her foot back in so many times. Hopefully the behavior will improve. Kprs to soak twice daily. Add Bute to analgesic plan if ibuprofen alone doesn't work. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 32 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 1.Jul.2000 <<< Microbiology >>> Sample Source:Abcess under nail Laboratory: Accession #:CHAB06085829 [x] Antech Collection Date:01 July 00 [ ] AHDL Submission Date:01 July 00 [ ] Other : Report Date:08 July 00 Submission type: [x] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [ ] mycobacterial Organism: Growth: heavy moderate light 1.Enterobacter Cloacae [x] [ ] [ ] 2.Escherichia Coli [x] [ ] [ ] 3.Bacillus Species [ ] [ ] [x] 4.Group D Enterococcus [ ] [ ] [x] Sensitivity: 1 | 2 | 3 | 4 Amikacin: s | s | s | r Amoxicillin: r | s | r | s Amoxicillin/Clavulanate: | | | Ampicillin/Sulbactam: | | | Ampicillin: r | s | r | s Carbenicillin: r | s | | Cefoxitin: | | | Ceftiofur: | | | Cephalexin : r | r | r | r Ciprofloxacin: | | | Chloramphenicol: s | s | s | s Clindamycin: | | s | r Doxycycline: | | | Enrofloxacin: s | s | s | s Erythromycin: | | s | s Gentamicin: s | s | s | s Kanamycin: r | s | | Furadantin : s | s | | Neomycin: s | s | s | r Nitrofurantoin: | | | Norfloxacin: | | | Oxacillin: | | r | r Penicillin: | | r | s Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 33 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 1.Jul.2000 Polymyxin B : s | s | r | r Sulfamethoxazole: | | | Tetracycline: s | s | s | s Ticarcillin: | | | Tobramycin: s | s | | Trimethoprim/Sulfa: r | s | r | r Vancomycin: | | s | s Comments:Anaerobic culture: No anaerobes isolated in 5 days. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 34 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.Jul.2000 Wanda was aggressive yesterday for no apparent reason. She was also rocking this morning. Examined R rear foot, still has a soft spot near the base of the nail. Will continue soaking and cut away at the nail next week. Will start her on the dietary hoof supplement and put the topical hooflex on all her nails. (CKS) 11.Jul.2000 Today rechecked nail of lateral digit of right rear foot. The soft spot seems larger, as if it has extended distally. Kpr has not trimmed since I last watched. Trimmed nail superficially, going proximally until we reached the deepest aspect of the thickest track. There were multiple fissures fanning over most of the caudal aspect of the nail, and a large amt of nail tissue was removed. Trimming did not seem painful. When done, there were still black, soft fissures, but the area was fairly well debrided. Sprayed fresh surface with gentocin spray. Kprs will use spray after foot soaks, waiting until nail is partially dry before applying. Rx: GENTAMICIN SULFATE 2-4 spr topically BID for 10 days. (AED) 13.Jul.2000 Today rechecked nail on RR foot. There is granulation tissue forming over the soft nail. There is no black tissue exposed, and the softest area is the proximal-most aspect where the deep tract ended. Shelia also looked at the foot, and recommended taking up the whole pad of the foot and trimming all the nails shorter. The nail cranial to the lateral-most nail is buckling from too much pressure, likely because she holds this leg under her when she puts wt on it. This nail and the infected one will be especially short. Soaks and gentocin will be continued bid, and betadine added once daily. KUO. (AED) 17.Jul.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. Rx: IBUPROFEN 5600 mg PO BID until further notice. (AED) 22.Jul.2000 Rx: GENTAMICIN SULFATE 2-4 spr topically BID for 10 days. (CKS) 17.Aug.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 21.Aug.2000 Examined nail on RR foot. It is spongy and soft, approx 1.5cm wide. Kprs are applying betadine soln bid. Rec treating w/Koppertox once after the betadine and rechecking in 2-3 days. Will also try to cut back the ibuprofen to see how she does. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 35 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 7.Sep.2000 Sheila looked at the RR foot 2 days ago while it was being trimmed. It is still soft and spongy and has a bit of an odor. The kprs are to cut away at it every 5-7 days. Will start epsom salt soaks twice weekly and KUO. (CKS) 8.Sep.2000 Rx: EPSOM SALTS soak q72 h until further notice. (CKS) 9.Sep.2000 Examined foot today. S. Green had checked 4 days ago also. The affected area has grown down and caudally, and does appear to be growing out of the foot. There is a 1.5cm square area now at distal aspect of trimmed nail that is very soft and is deeper than previously seen. The area still smells very bad. You can pull soft chunks of necrotic debris/tissue out of this area with your fingers. I am encouraged by the position change of the soft spot. It is impossible to say if the infected tissue extends proximally. Plan is as follows: Kpr is to trim every 5-7 days and soak with epsom salts afterward. Kprs are to soak on additional time each week. No more betadine trt or soaking is to occur. We will check periodically. (AED) 11.Sep.2000 Examined R rear foot. Kpr cut away some tissue yesterday, only able to cut a small amt of mushy tissue today. The smell is a lot less apparent. (CKS) 16.Sep.2000 Examined toe today. Kpr cut away more tissue yesterday, revealing a 1cm round area of very soft pulpy tissue. Still no softness to tissues proximal to nail. Area of infection now appears deeper and larger than previously apparent. Will continue epsom salt soaks, and trimming every 5-7 days. (AED) 19.Sep.2000 Rx: IBUPROFEN 5600 mg PO BID until further notice. Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 23.Sep.2000 Kprs concerned that area is not drying up. I explained that the surface of the open area is necrotic tissue, and that until we are dealing with vital tissue it will remain soft. Recommended discontinuing soaks for the time being. I will be attending next trimming, and will try to pull necrotic tissue out. At that time I will decide on soaking recommendation. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 36 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.Sep.2000 I debrided soft area today. Used hemostats and forceps to remove necrotic tissue and pus. The soft area is very deep. Flushed pocket with nolvasan peroxide and then coated with betadine. Will do this daily or every other day. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 37 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.Sep.2000 <<< Microbiology >>> Sample Source:Foot abscess Laboratory: Accession #:CHAB08424708 [x] Antech Collection Date:27 Sept 00 [ ] AHDL Submission Date:27 Sept 00 [ ] Other : Report Date:01 Oct 00 Submission type: [x] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [ ] mycobacterial Organism: Growth: heavy moderate light 1.Enterobacter sp. [ ] [x] [ ] 2.Proteus mirabilis [ ] [ ] [x] 3.Klebsiella pneumoniae [ ] [ ] [x] 4.Beta Hemoytic Streptococci ( ) ( ) (x) Sensitivity: 1 | 2 | 3 | 4 : Amikacin: S | S | S | R : Amoxicillin: R | S | R | S : Augmen/Clavamox : R | S | S | S : Ampicillin/Sulbactam: | | | : Ampicillin: R | S | R | S : Carbenicillin: S | S | R | : Cephalexin: R | S | S | S : Ceftiofur: | | | : Cephalothin: | | | : Ciprofloxacin: | | | : Chloramphenicol: S | S | S | S : Clindamycin: | | | S : Doxycycline: | | | : Enrofloxacin: S | S | S | S : Erythromycin: | | | S : Gentamicin: S | S | S | S : Kanamycin: S | S | S | : Furadantin: S | R | S | : Neomycin: S | S | S | R : Nitrofurantoin: | | | : Norfloxacin: | | | : Oxacillin: | | | S : Penicillin: | | | S : Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 38 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.Sep.2000 Polymyxin B : S | R | S | R : Sulfamethoxazole: | | | : Tetracycline: S | R | S | S : Ticarcillin: | | | : Tobramycin: S | S | S | : Trimethoprim/Sulfa: S | S | S | S : Vancomycin: | | | S : Comments: (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 39 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Sep.2000 Debrided soft area slightly. Nail needs to be cut more before more progress can be made. Soft pus covering open spot today. Flushed wth nolvasan, peroxide and coated with betadine. kprs to condition for rads. She was not as cooperative as usual. (AED) 29.Sep.2000 Not very compliant today. Could barely clean area. Instructed kprs to trim more nail, soak in nolvasan 83cc per gallon once daily UFN, preferably just before I go up there. Will decrease visits to eod. (AED) 30.Sep.2000 Wanda allowed a 15 minute soak today and it effectively removed gunk from hole. It appears as if there is slight swelling behind nail. Increased ibuprofen to 8g bid starting this afternoon. (AED) 1.Oct.2000 Wanda does have swelling over an area the size of my hand, proximal and caudal to the affected nail. The keepers used cold water to soak this am, just prior to my arrival, so hard to tell if area warm. Will continue increased ibuprofen dose UFN. Soaking cleaned pus well. Kprs will soak again later today and continue twice daily, cold in the afternoon, warm in the afternoon. They will also continue rad training and try to take more nail around the infected tissue. (AED) 3.Oct.2000 Checked foot today after am soak with M S-K and SG. Shelia had instructed kprs to remove more pad last week, which was my understanding. This was not done, so she told them to do it again. We agreed that they should also take more nail face, leaving 2or so mm along the cuticle for new growth and support. There still is pus coming from small hole. Swelling remains. Will continue rad training at try later this week if possible. (AED) 5.Oct.2000 Lateral radiograph taken of right rear foot, concentrating on the effected toe. The most successful technique was 60, 20, 2.0sec at 40 inches. Can see bones clearly. There does not appear to be bony involvement in the infection. (AED) 7.Oct.2000 Kprs trimmed 4 days ago and foot looks much better. The swelling has gone down, there is no palpable heat. The are of open nail is now 3cm at least in diameter, and it appears that tissue caudal is quite soft and we may need to trim more in that direction. The main drainage still is coming from same hole. Kprs still soaking bid, cold in am warm in pm. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 40 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 11.Oct.2000 Checked foot again today. The soft area still has pus on it before twice daily soaks, but it does not smell as foul. The area opened by trimming 8 days ago has grown in about 3mm from all margins, and there is a 4mm rim of dry, dark granulation tissue just inside the nail margin. She is still sensitive to touch, but today let me at least touch the area. Meeting with unit and SC to discuss overall progress and rad findings. Think we should trim every 4 days and keep it open and continue for 2 weeks before reassessing. Kprs to do warm baths bid and lower ibuprofen dose to 7000mg bid. (AED) 22.Oct.2000 Rx: IBUPROFEN 5600 mg PO BID until further notice. Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 4.Nov.2000 Wanda has developed a new soft spot on the right front foot, lateral toe. This area was present a month ago, but apparently became soft sometime during the last 2 wks. There is now a triangular area of nail that has been trimmed away. Kprs have been soaking in apple cider vinegar for last 3 days. They read about it somewhere. It looks dry and is not draining at all. Recommended they trim nail just outside triangular defect to decrease strain on nail wall there. The nail on the RR foot looks good. The abscess is open and draining some. Kprs noticed a soft spot near cuticle and cut some nail here, but not full thickness. There is no swelling proximal to nail. Appears as if it might drain out at cuticle eventually. KUO. (AED) 19.Nov.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 27.Nov.2000 Checked lateral nail on RF foot. Yesterday kprs noticed an odor during the pm soak. This am she was tender near the cuticle. PE:This afternoon there is swelling along the cuticle of the nail and it is slightly tender. There is also some soft mushy tissue along the base of the nail. Would like to get a culture of the probable abscess material. May need to open the area up to drain. AD to examine tomorrow. (CKS) 29.Nov.2000 Checked RF foot. There is a new area of swelling cranial to where it has been in the past, just cranial to midline of nail. This area is Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 41 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 29.Nov.2000 very warm, and painful, and feels like it is a pocket that has lost some of its interior contents. Kprs report that it drained well yesterday, a white, foul-smelling material from tissues along cuticular margin. Cuticle in this area looks very good. Has not drained much today. She was very aggressive during today's check. Kprs to continue soaking in very warm water twice daily. Swab from yesterday will be turned into lab today. I agree that may need to open to drain. Will monitor. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 42 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 30.Nov.2000 <<< Microbiology >>> Sample Source:rt. foot/nail area Laboratory: Accession #:chab09869386 [x] Antech Collection Date:30 Nov 00 [ ] AHDL Submission Date:30 Nov 00 [ ] Other : Report Date:02 Dec 00 Submission type: [x] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [ ] mycobacterial Organism: Growth: heavy moderate light 1.Group D Enterococcus [ ] [ ] [x] 2.Corynebacterium species [ ] [ ] [x] 3.Enterobacter species [ ] [ ] [x] Sensitivity: 1 | 2 | 3 | Amikacin: r | s | s | Amoxicillin: s | s | r | Augmentin/Clavamox : s | s | r | Ampicillin/Sulbactam: | | | Ampicillin: s | s | r | Carbenicillin: | | s | Cefoxitin: | | | Ceftiofur: | | | Cephalexin : s | s | r | Ciprofloxacin: | | | Chloramphenicol: s | s | r | Clindamycin: s | s | | Doxycycline: | | | Enrofloxacin: | | | Erythromycin: s | s | | Gentamicin: s | s | s | Kanamycin: | | s | Naladixic Acid: | | | Neomycin: s | s | s | Nitrofurantoin: | | | Norfloxacin: | | | Oxacillin: r | r | | Penicillin: s | s | | Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 43 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 30.Nov.2000 Polymyxin B: s | s | s | Sulfamethoxazole: | | | Tetracycline: s | s | s | Ticarcillin: | | | Tobramycin: | | s | Trimethoprim/Sulfa: r | s | s | Vancomycin: s | s | | Comments: (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 44 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 2.Dec.2000 Checked RF foot again. The area of swelling proximal to the nail is more pronounced today. It remains warm. The most superficial layer of skin peeled off yesterday. It really looks like it will rupture on its own. Today Wanda's attitude is much better and she allowed me to touch the area. Began by using betadine surgical scrub brush on cuticular area. She did not object to this. I removed a superficial layer of cuticle, and another loose piece of cuticle was below it. We soaked her foot for 5+ minutes in nolvasan. Then we used a blade to remove another piece of cuticle. She did not object. Then we used forceps to remove necrotic debris from nail opening. This needs to be done very regularly, and I left forceps with keeper so she can repeat it. There was slight bleeding and the goo was stinky. The hole is closing up again and needs to be trimmed. KUO. (AED) 21.Dec.2000 Rx: COSEQUIN 33 gm PO BID for 30 days. Rx: IBUPROFEN 5600 mg PO BID until further notice. Checked right front foot again. Kprs have been in communication with Allen Roocroft, and he suggested trimming nail all the way to cuticle in the center where softest. This trimming is to be completed over a 5 day period. Today is day #2, and it looks fairly good. At the lower aspect of the nail the track is still quite deep. Nail in center at cuticle is soft and diseased anyway. The swelling and heat above the cuticular margin is minimal. Are using a hemostat to pick out the gunk along open area. Suggested they try a ice bath today cause she is scratching foot on log. Suggested they provide her a tub of snow too. (AED) .....2001... 3.Jan.2001 Checked foot today. The trimming is helping considerably. Kprs have been very aggressive since consulting with A. Roocroft. The nail is trimmed deeply over heart of abscess. Kprs are picking dead stuff/ pus out with hemostats and forceps at least twice daily at soaking time. Have been soaking twice in nolvasan, but will go to once with other soak being hot water. AR suggests all soaks be in water as hot as she will tolerate. Started conditioning today for vaccinations, blood collection etc for annual exam. (AED) Working animal in squeeze cage. Seemed nervous,kpr thought it may be possibly due to new restraint device or new person attempting draw blood.. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 45 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.Jan.2001 Conditioned for blood draw and Vx. Both elephants harder to work with than last year. Wanda was more cooperative, and I was able to push fake needle onto vein and go thru Vx training. Winky still needs work to get her into position. (AED) 14.Jan.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 23.Jan.2001 Attempted blood draw today. Animal did well, but no success. (ARM) 24.Jan.2001 Radiographed front R foot using 3 techniques. We did not get as much of the foot on the plate this time, but the technique is good for P3 of the lateral toe on 2 of the films. The edges of P3 are crisp and clear, and there is no lysis evident. We should have A. Roocroft look at films when he comes in 6 weeks. (AED) 28.Jan.2001 Blood drawn for CBC/Chem. (ARM) 29.Jan.2001 Tb culture sent out. (ARM) 30.Jan.2001 Two trunk wash sample sent to National Veterinary Services Lab for tuberculosis mycobacteria isolation testing. No isolations made. (CUL) 7.Feb.2001 Vaccinated yesterday, tetanus toxoid and rabies IM. Today she is not uncomfortable and handled foot soak well. (AED) 24.Feb.2001 Dispensed cosequin and ibuprofen (1 bottle each). (CAB) 25.Feb.2001 16:00 S/O Wanda went down inside and stayed down for about 5 minutes before slowly getting up. She was shaking and twitching her L rear leg as she got up. Wanda's eyes were rolling back and she appeared painful. Today she was seen eating mud and bark. Neither elephant has eaten much hay today. Wanda went down one more time while I was there but got back up ok. She has not had her pm ibuprofen. A:Suspect she is colicky. P:Gave her 2000mg of banamine in sweet potato and ~1 gallon Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 46 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 25.Feb.2001 of mineral oil. Tried to get her walking but she started resting her head on her trunk and her eyes started rolling back again. She seemed lethargic. 17:30 Took a couple laps and looks better. KUO. Rx: FLUNIXIN MEGLUMINE 2000 mg PO SID for 1 day. (CKS) 26.Feb.2001 07:30 Wanda resting her head on her trunk. Seems depressed. Gave 1000mg banamine in sweet potato. During the day Wanda got about 1 gallon of mineral oil and 3# of rice bran. She ate some produce and pellets but only about 50% of normal. Ate a flake of alfalfa hay. Passed a fair amt of stool that was not formed but more moist than last night's. Went outside but seemed subdued. 15:00-16:00 Gave 2000mg banamine mixed in sweet potato. 16:30 Kprs bathed her to encourage her to drink water. She has not passed more stool since late morning. Walked the two elephants up and down through the stalls a couple times. Wanda got excited and started tooting. Mixed some stool in water and only found a very small amt of sand at the bottom. Will monitor her stool to help determine whether she's suffering from sand colic. Suspect it is the mud that is causing her GI upset. Will keep her separated tonight until 22:00. If she hasn't passed any stool, SC will make her do some laps. Overall, she doesn't act as painful as last night. 22:30 Wanda defecated a large amt per SC. Rx: FLUNIXIN MEGLUMINE 3000 mg PO SID for 1 day. (CKS) 27.Feb.2001 7:45 Wanda moving around looking more like her normal self. Lots of oily loose stool around. Placed some stool in an ob sleeve w/water- no sand present. Will not give her the ibuprofen this am and monitor her throughout the day. KUO, showing good improvement. 14:30 Wanda appears depressed. She is walking around outside but is more sluggish than this am. Wanda not interested in eating the rice bran and mineral oil mixture. Need to p/u the wheat bran at the feed store. Kprs will bathe her to encourage water consumption. Will give 2000mg banamine mixed in sweet potato and try to exercise her. Rx: FLUNIXIN MEGLUMINE 2000 mg PO SID for 1 day. (CKS) 28.Feb.2001 07:45 Wanda has defecated a moderate amt of loose stool o/n. Will see what her appetite is like today. 15:00 Wanda has been eating produce, pellets, and alfalfa hay. She is drinking water. Seems about 80% of normal. Her stool is firming up slightly. She has been eating wheat bran mixed w/water today. No banamine needed today. Will give her pm ibuprofen. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 47 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 1.Mar.2001 Wanda is eating a normal amt of hay today and looks good. (CKS) 3.Mar.2001 Per kpr, Wanda's stool is firming up and she is eating well and looking pretty good. (CKS) 17.Mar.2001 Rx: IBUPROFEN 5600 mg PO BID until further notice. (AED) 17.Mar.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (CKS) 25.Mar.2001 Alan Roocroft did major trim work on 3 of Wanda's toes. 4th toe on the LR and RR are affected. The LR foot has the newest and the largest lesion. The lesion on the RR foot is nearly grown out. The RF foot has been cut away and was bloody but is growing out well. Alan feels the front toe lesion may be due to Wanda's rocking. (CKS) 14.Apr.2001 NOTE: Keepers report crack on face to which vaseline had been applied has opened up. ASS: Advised keepers verbally to flush with dilute nolvasan solution gently and to discontinue vaseline cover (to prevent sealing off a possibly infected area) PLAN: Vet to check with keepers + examine 15/04/2001 (SRH) 15.Apr.2001 SOA: BAR. Cracked skin on R-lateral face in a region where Wanda places pressure when she lays down. There are five small lesions in this area, 4/5 are healing without incident. P: Kprs to flush wiht Novalsan 2-3 times daily until resolved. Rx: DILUTE NOVALSAN 5 ml topically TID for 10 days. (BTH) 24.Apr.2001 Rx: IBUPROFEN 5600 mg PO BID until further notice. Rx: COSEQUIN 33 gm PO BID for 30 days. (CKS) 28.May.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. Rx: IBUPROFEN 5600 mg PO BID until further notice. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 48 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.Jun.2001 Examined back right foot. There is a new toe that has an abscess under the nail at the bottom. Kprs first noticed about 10 days ago and they trimmed it a little 4 days ago. Have been soaking foot bid for 2 days after each trim, sid for next two days and then not at all until next trim. Rick has been doing trimming. Suggested they aggressively trim nail as advised by A. Roocroft for her other abscesses. This should be done soon. Front right foot looks great. Left rear looks good too. Wanda has a discolored area over the right temple as if gland is not draining well. Suggested hot soaks during bath to help with drainage. Advised keepers that they should look for a good time to dicontinue ibuprofen for a period to see if the cosequin has had any impact. They should let the vet staff know that they are discontinuing and have time to monitor her stiffness. (AED) 13.Jun.2001 Wanda is going to be weaned from ibuprofen beginning this evening. We will see how she responds. If there is any reason to believe her level of discomfort increases she can immediately be started on same dosage again. PK will be here to assess her comfort daily. KUO. (AED) 14.Jun.2001 Started doing weekly training sessions to facilitate monthly blood draws with CB/AM. Just ear touching, no props. (ARM) 19.Jun.2001 Performed weekly blood draw session with CB and AM. Did well in beginning for touching ear but near the end she was reluctant to give ear. (CAB) 20.Jun.2001 Wanda has been off ibuprofen for a week and is doing well. This might indicate that Cosequin has had a positive effect. The back right toe abscess is markedly improved after one aggressive trim done soon after last exam and one moderately aggressive trim more recently. They are still soaking the foot. (AED) 26.Jun.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 3.Jul.2001 Worked on conditioning animal for blood draw from ear. Stood very good today for hot compress and touch. Worked with animal outside. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 49 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 26.Aug.2001 Kpr reports that animal not using trunk well, not eating with it. Feels that it may due to the animal using it to to move large piece of tree. Kpr gave 7 Ibuprofen (800mg) tablets. (ARM) 27.Aug.2001 Talked to kpr, animal appears to be feeling fine today. (ARM) 7.Sep.2001 Wanda has had foamy liquid at corner of left eye some mornings and at close. None seen this am. None seen last night. (AED) 12.Sep.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 12.Oct.2001 Rx: IBUPROFEN 5600 mg PO BID for 3 days. (CKS) 13.Oct.2001 Rx: COSEQUIN 33 gm PO SID for 30 days. During the night one of the elephants got a hold of a rubber tube and tore a 1 ft by 2 ft section out of it. This piece is missing and presumed to have been eaten by Wanda. Give Wanda 1 gallon of mineral oil mixed with bran twice today for 2 days. KUO. Feed normally otherwise. (AED) 14.Oct.2001 Per kpr- animal took bran and mineral oil combination and seems to be acting normal, no signs of colic. Kpr reports that there has been no evidence of rubber tub. (ARM) 15.Oct.2001 Keeper reported that elephant passed a piece of the rubber tub she consumed. 29.Oct.2001 Rx: IBUPROFEN 5600 mg PO BID for three days. (CKS) 7.Nov.2001 Worked on rear leg blood draw. (ARM) 13.Nov.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 13.Nov.2001 Worked on rear leg blood draw. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 50 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 19.Nov.2001 Gave elephant staff new container of cosequin. 24.Nov.2001 Keeper reports she has been holding left rear leg up in the last 2 days. Started her on Ibuprofen 4000 mg BID PO x 14 days. (AED) 1.Dec.2001 Looked at all feet. Look very good. Wanda went into squeeze very well and I was able to touch her and look at her foot. Amazing progress by keeper staff. (AED) 10.Dec.2001 Worked on training for blood draw. Have been going up twice a week, kprs hope to do actual draw on Dec 24th. (ARM) 12.Dec.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 23.Dec.2001 Blood drawn from ear vein for CBC/Chemistries. WIll continue to do weekly training and try again in Jan. (ARM) 30.Dec.2001 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 30.Dec.2001 Rx: IBUPROFEN 4000 mg PO BID for 30 days. (CKS) .....2002... 16.Jan.2002 Will try reducing the amt of cosequin to once daily for maintenance. Kprs will give 10 scoops sid (18 g glucosamine). We may be able to eventually place her on 5 scoops daily. Wanda has been acting fine. Will decrease the ibuprofen to 2400 mg bid. (CKS) 20.Jan.2002 Blood draw session. (ARM) 28.Jan.2002 Trunk wash submitted for TB culture. (ARM) 29.Jan.2002 Sent trunk was samples to National Vet Services Lab in Ames, Iowa. Samples from 18 Jan, 19 Jan , and 20 Jan 2002 were all negative. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 51 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 1.Feb.2002 Rx: COSEQUIN 33 gm PO BID for 30 days. (AED) 1.Feb.2002 Rx: IBUPROFEN 2400 mg PO BID for 30 days. (CKS) 14.Feb.2002 Wanda is doing well on 3 ibuprofen bid. The kprs have heard more "cracking" when she walks. (CKS) 1.Mar.2002 Kpr reported that Wanda was holding up her R rear leg yesterday and her joints were cracking louder. She was increased to 5 ibuprofen (4000mg) bid 3 days ago. Will increase her to 7 ibuprofen bid for the next 2 days then take her back to 5 bid and monitor. (CKS) 10.Mar.2002 Vaccinated with Rabies and Tetanus IM. Used 20 gage 1&1/2 needle. (ARM) 10.Mar.2002 Rx: IBUPROFEN 4000 mg PO BID for 30 days. (CKS) 24.Mar.2002 Tried to examine Wanda's tail. She was not terribly cooperative with the exam. Got a quick look at what appears to be a crusty region on the R lateral aspect of the tail tip. She has recently regrown hair as Winky tends to handle her tail a lot. R/O ingrown hairs, infection, dermatitis. Kprs will work on the tail command and try to re-examine her in 2-3 days. (CKS) 26.Mar.2002 WEST NILE VIRUS TESTING Lab: Animal Health Diagnostic Laboratory-Cornell P.O. Box 5786 ITHACA, NY 14852-5786 (607)253-3943 FAX: (607)253-3943 Submission Taken:23/12/01 Summary Received:26/03/02 West Nile Virus SN:Negative 1:40 Date:21/01/03 (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 52 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Mar.2002 Rechecked tail. Wanda was a little more cooperative with the exam but I could only look for a few seconds at a time. Removed some crusty debris manually. Slight amt of bleeding present plus some white discharge. Cultured. Tried to flush w/Nolvasan soln but she was not cooperative. Still cannot tell if it is more than infected/ingrown hairs. Kprs will work on training and will recheck in 3 days. Rx: NOLVASAN (DILUTED 1 OZ/GALLON) topically to tail lesion SID for 7 days (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 53 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Mar.2002 <<< Microbiology >>> Sample Source:tail Laboratory: Accession #: 0001377 [ ] Antech Collection Date:28 Mar 2002 [ ] AHDL Submission Date:28 Mar 2002 [x] Other : Pet Labs Report Date: 2 April 2002 Submission type: [x] aerobic bacteriology [x] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [ ] mycobacterial Organism: Growth: heavy moderate light 1. Enterobacter aerogenes [ ] [x] [ ] 2. Streptococcus agalactiae [ ] [x] [ ] 3. [ ] [ ] [ ] Sensitivity: 1 | 2 | 3 | Amikacin: s | | | Amoxicillin: | | | Amoxicillin/Clavulanate: r | | | Ampicillin/Sulbactam: | | | Ampicillin: r | | | Carbenicillin: s | | | Ceftazidime: s | | | Ceftiofur: s | | | Cephalothin: r | | | Ciprofloxacin: s | | | Chloramphenicol: s | | | Clindamycin: | | | Doxycycline: | | | Enrofloxacin: s | | | Erythromycin: | | | Gentamicin: s | | | Kanamycin: | | | Naladixic Acid: | | | Neomycin: | | | Nitrofurantoin: s | | | Norfloxacin: | | | Oxacillin: | | | Penicillin: | | | Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 54 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Mar.2002 Piperacillin: s | | | Sulfamethoxazole: | | | Tetracycline: s | | | Ticarcillin: s | | | Tobramycin: s | | | Trimethoprim/Sulfa: s | | | Vancomycin: | | | Comments: (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 55 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 31.Mar.2002 Culture is growing a Gm neg bacillus and beta hemolytic Strep. Examined the tail outside. It was helpful to have a kpr hold the tail. Flushed w/Nolvasan soln. R lateral aspect is soft and mushy. Able to remove some crusts and see more white discharge underneath. Easily removed some hairs in the lesion. Kprs will try to soak the tail in dilute Nolvasan soln for 5 min. Would like to examine the tail after soaking. May need to squeeze Wanda to debride the tail and bandage. Discussed w/curator. Planning to have a mtg w/the kprs regarding restraint and discuss tx plan. Rx: NOLVASAN (DILUTED 1 OZ/GALLON) topically SID for 3 days. (CKS) 1.Apr.2002 Kprs were able to soak the tail in dilute Nolvasan soln. Tried to examine the tail afterwards but I wasn't able to debride. Having her inside, perpendicular to the cat walk was helpful. Will try to work on having a kpr hold the tail and not bend it too much. Kprs will soak the tail twice daily. (CKS) 2.Apr.2002 Today backed Wanda up to the squeeze wall with her head at the catwalk and had kpr pull the tail through and hold it with two hands. She behaved better than she has so far. Able to pull 4-5 moist scabs off of underside of tail, removed 7 or eight loose hairs in the process. The scab are very loosely adhered. The tissue underneath is pink. The scabs to not smell, but the tissue underneath is moist. Has dried out some since nolvasan soaks. Will try this all again tomorrow. (AED) 3.Apr.2002 Flushed and cleaned tail. New area above previous hole that appears to be a moist dermatitis. Switched from Nolvasan solution soaks to Nolvasan scrub soaks BID. Plan to flush and clean daily. (AED) 3.Apr.2002 Rx: NOLVASAN (DILUTED 1 OZ/GALLON) topically BID for 7 days. (CKS) 3.Apr.2002 <<< Cytology Results >>> Sample Accession #: ISIS#:4468 Laboratory: Collected by: arm [ ] Pet Labs Collection Date: 03 April 02 [ ] AHDL Analysis Date: 03 April 02 Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 56 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 3.Apr.2002 [x] Detroit Zoo Report Date: 03 April 02 [ ] Antech Type of sample: [ ] post mortum [x] impression smear [ ] aspirate Laboratory Information Lab tech: Stain used: Acid-fast Stain: [x] Diff Quik [ ] positive [ ] Wrights [ ] negative [ ] Acid-fast [ ] suspect [ ] Gram [ ] NMB Cytology: Bacteria numerous chains of cocci, moderate rods Cells seen____________ Comments0-1 budding yeast phf ______________________ (CUL) 4.Apr.2002 Rx: CHLORHEXIDINE DIACETATE BID for 7 days. (AED) 5.Apr.2002 Wanda has not let kprs hold her tail til today. Soaked in nolvasan scrub this am. Picked a large moist pus covered scab off the area higher up on her tail today. Flushed with nolvasan. Slow but steady progress. (AED) 6.Apr.2002 Wanda was very good today. She held very still while I removed soft white material from underside of tail. Removed 3-4 hairs and some scabs also. Material does not smell bad. Used a guaze square to remove then flushed with nolvasan. Will continue daily. (AED) 7.Apr.2002 Examined Wanda's tail. Removed more crusts. White material underneath. Budding yeast found on smear. Will continue daily soaks (extended to 10min) until the center crust is freed. May need to bandage tail w/miconazole at that point. KUO. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 57 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 7.Apr.2002 <<< Cytology Results >>> Sample Accession #: ISIS#:4468 Laboratory: Collected by: CKS [ ] Pet Labs Collection Date: 7 April 02 [ ] AHDL Analysis Date: 7 April 02 [x] Detroit Zoo Report Date: 7 April 02 [ ] Antech Type of sample: [ ] post mortum [x] impression smear [ ] aspirate Laboratory Information Lab tech: Stain used: Acid-fast Stain: [] Diff Quik [ ] positive [ ] Wrights [ ] negative [ ] Acid-fast [ ] suspect [ ] Gram [ ] NMB Cytology: Gram Stain: Bacteria seen_________ # of Rods____________ Cells seen____________ # of cocci___________ Comments_large amount of # of yeast___________ budding yeast, 20 + phf # of bacteria________PHF (CUL) 8.Apr.2002 Smear also revealed fungal hyphae. Examined tail. Removed more crusts cranial to the initial region. It appears that an area approx 9cm long on the R side is affected. Flushed w/Nolvasan soln, debrided, applied miconazole cream. Wanda is good for about 10-15 minutes of treatment. Will continue daily until the lesion is open. (CKS) 9.Apr.2002 Wanda was not very cooperative today. The more proximal part of the tail remains most problematic. There seems to be new soft white material and crusts each day. No odor to the removed tissues today. Kprs told to clean the tail before soaking if possible. Might need to sedate her to properly clean the tail. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 58 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 10.Apr.2002 The tail had not been soaked, and so the surface was harder and did not come off. It looked somewhat better, but maybe just because it wasn't soft. Tried to pick hairs- found no more loose ones. Tried to cut hairs- scissors not strong enough, maybe orange handled ones would work. AM to condition for possible IV injection. Waiting on culture. Applied thick coat of miconazole. (AED) 11.Apr.2002 Examined tail after it had been soaked. The right side is still mushy and Wanda was very sensitive. Unable to remove many crusts because of her walking away. Coated affected area w/miconazole. Will continue the daily tx. Called Earhardt at Pet Labs and he will have the cytology slide read by one of the pathologists at Ohio State. Results should be back late tomorrow. (CKS) 14.Apr.2002 Soaked Wanda's tail. Flushed w/Nolvasan soln to remove dirt and debris. There may be a little less soft mushy tissue. Able to debride a couple crusts. Applied miconazole cream. Placed some purple vetrap on the tail tip to see how Winky responds. Kprs will remove the bandage at the end of the day. Will work on devising a water proof tail bandage, may use an empty IV fluid bag. Recheck tomorrow. (CKS) 14.Apr.2002 <<< Cytology Results >>> Sample Accession #: PL1-02, 4S,615 ISIS#:4468 Laboratory: Collected by: [x] Pet Labs Collection Date: 14 April 02 [ ] AHDL Analysis Date: 14 April 02 [ ] Detroit Zoo Report Date: 14 April 02 [ ] Antech Type of sample: distal tail [ ] post mortum [x] impression smear [ ] aspirate Laboratory Information Lab tech: Stain used: Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 59 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 14.Apr.2002 [ ] Diff Quik [ ] Wrights [ ] Acid-fast [ ] Gram [ ] NMB [x] not specified Cytology: Bacteria seen-includes rods and cocci Comments- Moderate number of keratin flakes and numerous extracellular bacteria seen. The bacteria are interpreted as fecal contaminants. No evidence of inflammtion or etiologic agents were seen. (CUL) 15.Apr.2002 Winky left yesterday's tail wrap alone and kprs removed it ok. Today I flushed the tail w/Nolvasan soln. Tail was nice and clean as it was just soaked. There are 2 crusty areas that were too firm to remove. Removed one loose hair. Overall it appears that the tail shape is better on the R lateral aspect and that it is healing ok. Affected area appears to be about 6cm long. Applied miconazole cream. Placed some purple vetrap on the tail tip. Kprs will remove the bandage at the end of the day. Left Nolvasan soln in a squirt bottle for the kprs to flush the tail to remove loose debris following the tail soak. (CKS) 16.Apr.2002 Blood desens not going well. Animal is stretching ear is out of reach and flapping ear back and forth. At this point it is probably not possible to get blood or give injections. Will continue to work on it daily. (ARM) 16.Apr.2002 Hosed Wanda's tail with water then flushed w/Nolvasan soln. The crusts are firm. Able to cut and remove a piece of crust using bandage scissors. Applied miconazole and wrapped the tail w/vetrap. Kprs to remove bdg at the end of the day. Will try to work on Wanda earlier in the day tomorrow. Spoke w/Earhardt regarding cytology report. We are most interested in determining if the yeast are Malassezia and confirming the presence of fungal hyphae. Will submit fresh crust material to Earhardt if it has white discharge present so that he can do another bacti/fungal at no charge. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 60 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Apr.2002 11:00 Hosed tail w/water to remove dirt. Obtained 2 easily epillated hairs w/white debris at the base along with one crust for a repeat bacti/fungal. Flushed tail w/Nolvasan soln. Applied miconazole cream and placed a light wrap. Kprs will remove at the end of the day or if it gets wet. Kprs will try to soak prior to the tx tomorrow am. Tail is healing. Sample material placed in a RTT w/sterile saline to ship to Earhardt at Pet Labs. Rx: CHLORHEXIDINE DIACETATE tail soak BID for 7 days. (CKS) 18.Apr.2002 Examined Wanda's tail following her tail soak. There is still a 5-6cm region that is soft on the R side. Debrided manually. Removed one loose hair. Applied miconazole. Venipuncture conditioning following tail tx went well. Having AM stand on the xray board worked well. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 61 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Apr.2002 <<< Microbiology >>> Sample Source: tail Laboratory: Accession #: [ ] Antech Collection Date:18 April 2002 [ ] AHDL Submission Date:18 April 2002 [x] Other : Pet Labs Report Date:26 April 2002 Submission type: [x] aerobic bacteriology [ ] anaerobic bacteriology [ ] mycology [ ] enteric pathogen screen [x] mycobacterial Organism: Growth: heavy moderate light 1. Candida parapsilosis [x] [ ] [ ] 2. [ ] [ ] [ ] 3. [ ] [ ] [ ] Drug/N MIC range % susceptible AMB/152 :0.03-2.0 | 99 | 5FC/76 :<.125-4.0 | 100 | FLU/251:0.25->64 | 97 | Itra/137:0.015->8 | 99 | Keto/37 :<0.03-1.0 | 100 | Mon/4 :0.06-0.5 | 100 | Comments:MIC provided by the University of Texas Health Science Center. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 62 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 19.Apr.2002 Examined tail. Kprs said they had just soaked tail- the area is less soft than on other days that it had been soaked. Removed one hair and one large crust. Applied miconazole. (AED) 20.Apr.2002 Examined tail. Kprs soaking it when I arrived. Looks worse today. There are some soft areas and crusts. I pulled 3 hairs and can see a few more that are loose. She was not easy to work with today. Coated area with miconazole. Talked with Earhardt about preliminary culture results. He says there is both a fungal organism in low numbers and heavy growth of a gram negative bacterium. He is trying to narrow down species of both and is doing sensitivies on both for topical treatments. This should be available in 3-4 days. Discussed this with MSK and RW. (AED) 21.Apr.2002 Rx: SILVER SULFADIAZINE 3 gm topically SID for 7 days. (AED) 21.Apr.2002 Spoke with Earhardt. He has grown a yeast that he thinks is Candida. He recommends betadine for soaking the tail. Will d/c the Nolvasan and switch to betadine soln. 14:45 Examined tail. Unable to remove any crusts easily. Wanda walked away quickly. Kept the tx session short. Applied miconazole cream. Will try to treat early tomorrow to wrap the tail. Rx: BETADINE, DILUTED topically BID for 14 days. (CKS) 22.Apr.2002 Treated Wanda's tail. Unable to remove much infected tissue today. Coated w/miconazole and wrapped in vetrap and then placed an IV fluid bag over the end of the tail. 14:00 Tail wrap looks good. Will leave until tomorrow. (CKS) 23.Apr.2002 Removed tail wrap, tape was loosening so it was not waterproof. Vetrap was wet. Kprs bathed Wanda yesterday. Soaked tail in betadine soln for 5 minutes, lightly debrided tail lesion, flushed w/Nolvasan soln. Applied miconazole and bandaged. Placed a new IV fluid bag over the tail. If it stays dry tomorrow, will leave in place for 2 days. So far Winky and Wanda are leaving the tail wrap alone. (CKS) 26.Apr.2002 Tail soaked in betadine for 10 minutes. The tail seemed worse today. The lower area is expanded distally. There is a new area proximal to Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 63 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 26.Apr.2002 the upper area. Removed a lot of soft scabs and about 25 hairs. The tissues beneath bled. Rinsed. Applied miconazole and some betadine ointment. Placed a vet rap bandage only because kprs said the bath did not contribute to excessive moisture in IV bag (said she didn't have a bath so I am confused by above, which I had read and asked them about). (AED) 27.Apr.2002 Tail soaked in betadine for 10 minutes. It looks worse today. The tissues are macerated and soft. In one area there is white exudate. Collected some soft material for cytology and found large numbers of small bacteria. The tail smelled foul under the wrap. Assessment is that tail is worse. Perhaps the bacterial component of the infection has gained ground. Today used both betadine and miconazole again, but perhaps we should use just betadine or use betadine in the am and miconazole overnight. Wrapped with vet rap and will see how she does over night. If it looks worse tomorrow will leave wrap off overnight. Will consider sedation to aggressively debride the tail and discuss options with SC. (AED) 28.Apr.2002 Wrap was coming off by 18:00 last night, kprs left bandage off o/n. 14:30 Tail soaked by kprs in betadine soln. Rinsed w/Nolvasan soln. Debrided manually. Able to remove a few soft crusts. The center portion is bloody. Only able to remove a few hairs today. Affected region appears to be about 9cm long. Applied silvadene and did not wrap. Will recheck in the am tomorrow. Need to order Dermaclens ointment to assist with the debriding. (CKS) 29.Apr.2002 Blood collection desensitization training. (ARM) 29.Apr.2002 10:00 Hosed tail w/water, soaked in warm betadine soln. Manually debrided tail while flushing w/Nolvasan soln. Wanda is sensitive to probing the soft area. Applied miconazole cream and a light vetwrap bandage. Kprs will remove the bandage tonight and give Wanda a bath. KUO. PetLabs culture grew hvy growth of Candida parapsilosis. (CKS) 30.Apr.2002 Tail looks the same or a little worse today. Theres a spot to the right of the distal spot that has a large amount of necrotic debris. This area is more inflammed and bleeds easily. Cleaned, coated with silvadene and miconazole and bandaged. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 64 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 1.May.2002 Desens going well. Will do actual draw when primary trainer is back. (ARM) 1.May.2002 14:00 Kprs soaked tail in dilute betadine soln. Lots of silvadene still present on the tail. Hosed tail w/water, scrubbed w/a tooth brush. Removed a few hairs. Applied dermaclens cream to the periphery and a combination of silvadene/miconazole to the center. Wrapped w/vetrap. Will recheck tomorrow am. (CKS) 2.May.2002 Kprs removed bandage and soaked tail. Wanda was not terribly cooperative for the tail soak. She and Winky have been acting a little irritable this am. They may have some GI upset d/t the large amt of bamboo consumed over the past 4 days. Kprs will give moistened bran and mineral oil. Tail tx: Flushed w/Nolvasan and scrubbed w/a tooth brush. The proximal 2cm region is soft and sensitive. Applied dermaclens to the periphery and silvadene/miconazole to the center. Bandaged w/vetrap. Kprs will remove wrap if it is wet, otherwise it will stay on o/n. (CKS) 3.May.2002 Kprs removed bandage this am and soaked tail. Wanda was very good for treatment. There seems to be an improvement in the level of tissue degradation around the hair follicles. Pulled about 8 more hairs. Coated tail with betadine and wrapped. Will treat in the am tomorrow. (AED) 4.May.2002 Kprs removed bdg in am. Tail is red tinged and there is more dead tissue overlying affected area. Rinsed well, wiped with guaze and pulled 8 more hairs. Applied dermacleans and wrapped. This afternoon will remove bandage and apply new one with miconazole and silvadene. Will not use betadine for now. Tomorrow recommend dermacleans in am if dead shreds of tissue present with micon and silvadene in afternoon. Kprs can apply if necessary. (AED) 5.May.2002 11:00 Wanda out sleeping in the yard this am. Kprs report she is laying down more inside and outside. She is currently getting 5 ibuprofen bid. Ok'd bedding her stall in the evening. Will collect blood from her tomorrow. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 65 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.May.2002 Tail tx: Bandage still in place but the long proximal hairs were wrapped inside touching the lesion. Rinsed w/a hose, soaked in Nolvasan soln. Scrubbed w/a tooth brush while flushing w/Nolvasan soln. Lesion measures 10cm x 3 cm. Removed an easily epillated hair. Trimmed the short hairs in the lesion using hoof nippers. Applied Dermaclens to the periphery and miconazole/silvadene to the center region. Wrapped tail w/vetrap leaving the long hairs out. Will trt in the late afternoon if time. (CKS) 6.May.2002 8:00 Wanda's wrap was removed last night as it was muddy. This am the kprs gave Wanda a bath and soaked her tail in Nolvasan soln. Scrubbed the tail w/a toothbrush. Debrided some chunks of necrotic tissue along the ventrolateral aspect while flushing w/Nolvasan. Applied Dermaclens ointment along the entire lesion and wrapped. Afternoon tx scheduled for 14:30. 14:30 Removed bandage. Flushed w/Nolvasan soln, debrided slightly. Wanda was very good. Applied Silvadene and miconazole to the lesion, wrapped w/vetrap. (CKS) 7.May.2002 7:30 Soaked the tail in Nolvasan, lightly debrided w/a brush. Applied Dermaclens and wrapped. Angel collected blood from the ear for CBC/chem panel. Rx: TRIOMYCIN to facial lesion SID for 14 doses. Rx: IBUPROFEN 4000 mg PO BID for 30 days. (CKS) 8.May.2002 11:30 Kprs removed the bandage and soaked the tail prior to my arrival. Lavaged w/Nolvasan soln and debrided w/a tooth brush. Tail looks slightly improved. Applied miconazole/Silvadene and wrapped the tail. Wanda was very cooperative. (CKS) 9.May.2002 Kprs unwrapped the tail, soaked it and brushed the tail using a soft grooming brush. Lesion measures 10cm x 3cm. Lavaged the tail w/Nolvasan and debrided using the tooth brush. Once Wanda settled down she was very cooperative. Applied Dermaclens to the entire region and wrapped w/vetrap. On a healing scale of 1-10, she's about a 6. Will try to re-wrap this afternoon. Wanda has 2 pressure sores on the R side of her head. Will switch Protecta pad for the neosporin they are currently using. (CKS) 10.May.2002 Kprs soaked in nolvasan. The tail looks much better. The face of the lesion is narrower, and the surface is less red and necrotic. Cleaned with guaze soaked with nolvasan and coated area with miconazole and silvadene. Wrapped with vet rap and guaze. Wanda was very cooperative. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 66 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 11.May.2002 Scrubed wound on tail with brush and nolvasan. Applied miconazole and silvadene then wrapped up tail. (CAB) 12.May.2002 13:00 Kprs removed wrap and soaked the tail in Nolvasan soln. Lightly debrided tail using the tooth brush and Nolvasan soln. The lesion is noticeably smaller. Will measure tomorrow. Applied Dermaclens ointment and bandaged. (CKS) 13.May.2002 8:30 Kprs removed bandage, soaked and scrubbed tail. Lightly debrided lesion, measures about 8cm x 2.5cm. Applied silvadene/miconazole and bandaged. Wanda was very good. Will try to tx again this afternoon. CBC/chem panel WNL. (CKS) 14.May.2002 8:30 Kprs removed bandage and soaked tail. Lightly debrided. Applied Dermaclens and wrapped. (CKS) 15.May.2002 Kprs removed bandage and soaked tail. Cleaned and removed thickened skin at the left edge of the wound. There are new hairs growing in the affected area that look OK. Applied miconazole and silvadene and wrapped. (AED) 16.May.2002 Kprs removed bandage and soaked tail. Lightly debrided tail lesion and flushed w/Nolvasan soln. Looks good. Applied dermaclens and wrapped tail. Wanda has 3 facial pressure sores. The 2 rostral ones are newer. Kprs report that the protecta pad helps to prevent bedding material from adhering to the lesions. May switch to prep H topical tx. KUO. (CKS) 17.May.2002 Wandas tail soaked and miconazole, silvadene bandage applied. (AED) 18.May.2002 Soaked tail in dilute nolvasan. Applied miconazole , silvadene and replaced bandage. (CAB) 19.May.2002 Soaked tail in dilute nolvasan. Applied miconazole, silvadene and replaced bandage. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 67 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 20.May.2002 Keepers soaked tail in dilute nolvasan for 15 min. There was an area just proximal to area we have been bandaging that was bleeding slightly around several hair follicles. Applied silvadene and miconazole and replaced bandage. 21.May.2002 Rx: SILVER SULFADIAZINE gm topically SID for 21 days. Rx: MICONAZOLE ointment topically SID for 21 days. Rx: PROTECTA-PAD topically SID for 21 days. Rx: NOLVASAN, DILUTE soak tail SID for 21 days. Removed bandage, soaked, debrided with toothbrush, dried and applied miconazole and silvadene and bandage. Istructed keepers to do the same, and we will go up 1-2 times weekly to check progress. (AED) 26.May.2002 Kprs unable to rebandaged last night, animal wouldn't come in due to thunderstorm. Looks good today but dry. (ARM) 28.May.2002 Checked tail today. Picked a few peices of dead tissue off skin and caused a small amt of bleeding. Applied miconazole and bandage. Talked with keepers and informed them that exercise is very important for Wanda d.t. her increased laying down and inactivity. Told them they need to make exercise a priority to help with arthritis and overall health. Rick was present. (AED) 4.Jun.2002 Wanda is acting strangely today. She laid down twice, but only stayed down for a few minutes before getting up. On Visual exam initially she appears normal . She was eating. When moving she appears stiff on the right front leg. She is bearing wt with the elbow in a straight position, and is throwing her head up just prior to bearing weight. We will give her 8000mg ibuprofen this pm and tomorrow am. She has been getting 5000mg. She appears more pigeon toed on this foot than usual today too. She is alert, responsive to commands and in good spirits. She has been moody, esp in the am for over a week. (AED) 5.Jun.2002 Wanda is better today, and is moving more comfortably. Will continue 10 ibuprofen today bid and tomorrow bid. Reevaluate in am friday. (AED) 8.Jun.2002 Rx: IBUPROFEN 6400 mg PO BID for 30 days. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 68 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 13.Jun.2002 Did blood dens today. Went well. will attempt an actual draw next week. (ARM) 13.Jun.2002 Examined Wanda's tail outside. The bandage has been off since yesterday. The tail lesion appears healed. There is no thickened area and the center of the lesion is only slightly soft. Hairs are growing in well. Would like to examine the tail again after the kprs clean it with Nolvasan/toothbrush. Wanda's R facial pressure sores are healing and look ok. (CKS) 16.Jun.2002 Examined Wanda's tail following the Nolvasan soak. The most proximal region is the only part soft today. Kpr reports there was a drop of blood in this area. The tail continues to looks good and is healing nicely. (CKS) 29.Jun.2002 Wanda's tail is almost completly normal. (AED) 7.Jul.2002 Talked with kprs regarding blood draw desens. Will try going twice a week and work on both ear and rear leg desens. (ARM) 11.Jul.2002 Rx: IBUPROFEN 6400 mg PO BID for 30 days. (CKS) 15.Jul.2002 Blood desens session, went well. (ARM) 8.Aug.2002 Lame on LF for past two days; was running heavily 3 days ago. On visual, stiff at carpus, does not want to bend. Recommend training for radiographs. Continue increased dose of ibuprofen 10 tabs (800mg tabs) twice daily for 3 days then reassess. Need to assess diet and vitamin E levels and reduce weight. (ALM) 11.Aug.2002 Kpr reports that Wanda is not favoring her LF leg today. Rx: IBUPROFEN 6400 mg PO BID for 30 days. (CKS) 12.Aug.2002 Blood drawn for serum banking. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 69 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 16.Aug.2002 Wanda remains stiff at times on 10 ibuprofen bid. Will go to 12 bid UFN to see if this helps. (AED) 23.Aug.2002 12 ibuprofen bid is helping considerably. Wanda has a much more serene attitude and appears more comfortable. We will maintain this dose thru the winter, increasing it in the cold weather or sooner if necessary. (AED) 26.Aug.2002 Worked on rear leg blood draw today. Discussed with kprs some changes in presentation. Needs to work on holding steady as Wanda was being very kicky today. May need to put barrier by foot to decrease the chance of getting kicked. (ARM) 5.Sep.2002 Worked on blood desens session for blood draw next week. Wanda did very well. (ARM) 10.Sep.2002 Lab Wildlife Concervation Society - Nutrition Laboratory Sample: serum analyzed: 23 Jan 03 a-toc: 0.369 ug/ml g-toc: n.d. retinol: n.d. ug/ml Comments: n.d. = not detected; Vitamin A normally quite low in elephants - these values are within expected ranges for the species. 10.Sep.2002 Drew blood to be sent in for herpes testing (Johns Hopkins School of Medicine) and banking. (ARM) (CAB) 14.Sep.2002 Rx: IBUPROFEN 9600 mg PO BID for 30 days. Rx: COSEQUIN 33 gm PO BID for 30 days. Dispensed one 1400gm container of cosequin. (CKS) 30.Oct.2002 Rx: IBUPROFEN 9600 mg PO BID for 30 days. Rx: COSEQUIN 33 gm PO BID for 30 days. (CKS) 3.Nov.2002 We have been out of shavings for the past week so Wanda has been Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 70 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 3.Nov.2002 laying on the cement floor to sleep. She just started getting a pressure sore on the left side of her head. It is approx 2cm wide w/debris in the center. Kprs will clean it and apply Protecta-pad daily or prn. Will try giving her a black mat to see if she uses it. New shavings are expected in a couple weeks. Rx: PROTECTA-PAD topically SID for 14 days. (CKS) 25.Nov.2002 Kprs have been removing stuck shavings from Wanda's pressure sore (left side of head) daily. It has become more scab-like and Wanda has gotten a little sensitive to the picking. PE: lesion is approx 2.5cm wide with shavings firmly adhered to the skin. Lavaged with warm water and picked out debris. There is healthy granulation tissue present and the wound is fairly superficial. Rec cleaning face eod to q 3 days and letting a scab form. Kprs can use protecta-pad prn. (CKS) 1.Dec.2002 Rx: IBUPROFEN 9600 mg PO BID for 30 days. (CKS) 2.Dec.2002 First session for xraying her feet. Discussed with kprs the angeles and positiosn needed. Did a mock session with her front legs. There is some question on still she can hold her foot and also how flat she can put it. May have to do multiple shots to get a good view. Kprs feel she will be ready to try next week. She had been preivously trained for this. They will then start training for her rear legs. This will be more difficult due to limited access. Kprs also to work on lateral views. This will probably be done outside so it will be only as weather permits for now. (ARM) 17.Dec.2002 Took radiographs on wanda's left front foot, concentrating on the lateral toe. Was able to get a good exposure for bone and a seperate exposure for soft tissue. Will continue to work around the toe to get different angles. (ARM) 24.Dec.2002 Worked on getting xrays of middle, lateral, and medial toes. Tried to get higher up on foot. Worked very well. Xrays came out great. Used smaller Quata cassettes to get more of foot on cassette. (ARM) .....2003... 4.Jan.2003 Rx: IBUPROFEN 9600 mg PO BID for 30 days. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 71 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.Jan.2003 Tried to work on carpus area of front leg. Is not possible inside. Have figured out a way to do it outside. Will do them when the weather is better. Will continue to get toes on remaining feet next week. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 72 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 8.Jan.2003 <<< Urinalysis >>> Sample Accession #: 4468 Laboratory: Collection Date:08/Jan/2003 [x ] Detroit Zoo Date received:08/Jan/2003 [ ] Vet Research Report Date: 08/Jan/2003 [ ] Other: Sample collection: Sample storage: [x ] floor [x ] room temperature [ ] mid-stream [ ] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: Yellow Appearance: [ ] clear Specific Gravity: 1.025 [ ] hazy / slightly cloudy (Refractometer) [x ] cloudy / turbid Dip stick test: Microscopic Exam: Urobilinogen: 1-Normal RBC's: None seen Glucose: Negative WBC's: None seen Ketones: Negative Epithelial cells: None seen Bilirubin:Negative Protein: 10 pH: 8.0 Crystals:Amorphous Phosphate 4+ Occult Blood: Negative Nitrite: Casts: None seen Leukocytes: Bacteria:None seen Other: Other: Comments: (U/A) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 73 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 19.Jan.2003 Trunk wash performed for TB culture (60cc syringe and a red rubber catheter). Sample frozen. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 74 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 19.Jan.2003 <<< Microbiology >>> Sample Source: truck wash Laboratory: Accession #: 235088 [ ] Antech Collection Date: 19 Jan 03 [ ] AHDL Submission Date: 22 Jan 03 [x] Other : NVSL (Ames,IA) Report Date: 02 Apr 03 Submission type: [x] mycobacterial Comments: No isolation made. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 75 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 21.Jan.2003 2nd trunk wash performed for TB culture. Sample frozen. Mtg w/kprs and curators to discuss dietary changes. Will limit Wanda to 1 sweet potato bid until they can find other ways to medicate her. Will discontinue using leaf eater biscuits and omolene except in emergency situations. When more browse is available, they will cut back on the amount of timothy hay offered. Will offer 1 coconut/month at the most. Cereal and pasta will need to be purchased for use in their toys. Sugar cane is only to be used for training purposes. The elephants will receive 10# produce, 10# elephant supplement, and 1.5-2 bales of hay per day. Elephants will be weighed monthly. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 76 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 21.Jan.2003 <<< Microbiology >>> Sample Source: truck wash Laboratory: Accession #: 235089 [ ] Antech Collection Date: 21 Jan 03 [ ] AHDL Submission Date: 22 Jan 03 [x] Other : NVSL (Ames,IA) Report Date: 02 Apr 03 Submission type: [x] mycobacterial Comments: No isolation made. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 77 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 22.Jan.2003 3rd trunk wash performed for TB culture. Sample frozen. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 78 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 22.Jan.2003 <<< Microbiology >>> Sample Source: truck wash Laboratory: Accession #: 235090 [ ] Antech Collection Date: 22 Jan 03 [ ] AHDL Submission Date: 22 Jan 03 [x] Other : NVSL (Ames,IA) Report Date: 02 Apr 03 Submission type: [x] mycobacterial Comments: No isolation made. (CUL) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 79 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 30.Jan.2003 Worked w/Wanda to collect blood from the ear. Unsuccessful using a 20g 1.5" needle and a syringe. Wanda was very good. (CKS) 31.Jan.2003 Blood draw attempt unsuccessful. Will try again on tue. after a warm bath. (CAB) 3.Feb.2003 Rx: IBUPROFEN 9600 mg PO BID for 30 days. (CKS) 6.Feb.2003 Attempted blood collection on the cranial (anterior) aspect of the pinna. Unsuccessful using a 21ga butterfly. The vein was fairly small. Wanda was very good. Tried to look for the vein on the medial aspect of the rear legs and had difficulty visualizing it and palpating it. Need to train her for blood collection from her legs. (CKS) 11.Feb.2003 ARM took rads of the RF foot. (CKS) 16.Feb.2003 Blood collection!!! (ARM) 17.Feb.2003 Desens today. Did well. Plan on doing another session on Thurs. (ARM) 18.Feb.2003 Vaccinated with 1ml rabies IM and 1ml tetanus toxoid IM (in left shoulder). (CAB) 5.Mar.2003 Rx: IBUPROFEN 9600 mg PO BID for 60 days. (CKS) 10.Mar.2003 Wanda has been acting crabby and charging at people. Will increase her ibuprofen to 14 tablets bid for a couple days to see if this helps. The weather is supposed to be good at the end of the week so she may be able to go outside as well. KUO. (CKS) 13.Mar.2003 Radiographs taken of Wandas right front foot. Concentrated on her abcess toe. Slightly dark for cuticles but good for bone. May need to repeat some views, but may wait until the weather is warmer and do outside. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 80 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 14.Mar.2003 Worked on blood draw training. (CAB) 20.Mar.2003 Blood collected for banking. Animal did well. (ARM) 14.Apr.2003 Mary Mutty collected blood on Wanda today. She will try again next week. (ARM) 17.Apr.2003 Xrays taken of her left rear foot. I was able to get most of her digits except medial toe. Will have to try a different angle to get that digit. possibly outside. Kprs to start working on training outside to lateral views of her leg (ARM) 22.Apr.2003 Weight: 4256 Kg (9383 Lb) Kprs to get current weight on June 3rd. (ARM) 4.May.2003 Started working with Wanda outside, for better postioning on rear legs and lateral views of ankles. She did not cooperate. (ARM) 5.May.2003 Blood draw desens. (ARM) 6.May.2003 Rx: IBUPROFEN 9600 mg PO BID for 60 days. (CKS) 16.Jun.2003 Will decrease Wanda's ibuprofen to ten 800mg tablets bid and see how she does. (CKS) 21.Jun.2003 Animal has been aggressive the last couple of days. Kprs will increase ibuprofen to twelve 800mg tablets for a few days and see if there is a n improvement in her attitude. (ARM) 4.Jul.2003 Rx: IBUPROFEN 9600 mg PO bid for 60 days. (AED) 7.Aug.2003 Rx: IBUPROFEN 9600 mg PO bid for 60 days. (CKS) 18.Aug.2003 Patron observed Wanda getting her front right foot stuck in the tire Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 81 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Aug.2003 in the yard. She struggled to get it out for awhile and when she did she stumbled and fell, putting her wt on her front right carpus. On visaul she was very reluctant to walk and when she would turn she would not use the leg at all and was down in the rear legs. Winky made it very difficult to get Wanda inside by going to her and comforting her and not listening to kpr commands. Mary was the only kpr on duty, so Hdkpr Pat and I helped coax them inside. In the hallway Winky was acting very strange by putting her trunk over Wanda and trying to push her down. Once inside they acted a little better. Wanda was extremely lame when she came inside. She would stand for a few seconds on all feet then hold up her front foot. She struggled to take any steps. Per CKS instructed to hose Wanda's foot with cold water for 20min., give an additional dose of 9600mg Ibuprofen (total dose of 18000mg for pm and redose with 18000mg first thing in the am) , heavily bed the stall and limit access to stalls for the night. Initially instructed to seperate the girls in case Winky continued to act dominant but kprs think they will be more comfortable together. PK-Rick to come and check on her tonight. Also advised per CKS that she may not get up in the am if the foot swells (this is the foot she puts wt on when rolling from a down position). Decision was made to give the girls access to the first three stall, so there would be access to the squeeze and hoist if needed. Talked to Ass. curator and curator- offered to call relief vet, but they were comfortable with CKS instructions and would like Wanda to be evaulated in the am. (ARM) 19.Aug.2003 Wanda examined this am. She is walking slowly, and moves right front up slowly. She will bear full weight for a long time on right front foot. She appears stiff. Will give 24 tablets ibuprofen bid today, 18 tabs bid tomorrow. She was let outside today with instructions to hose with cold water first and bring her in if any worsening noted or her activitiy level increased. (AED) 19.Aug.2003 6:15am- Wanda was up and standing this am. She is walking better, but still favoring her right front leg. When she is standing she shifts her weight to her other feet. Whne PK-Rick checked on her last night she was laying down sleeping. AED to check on this am and let them know if she should be kept inside. (ARM) 21.Aug.2003 Doing much better today. Continue to monitor. (CST) 28.Aug.2003 Drew blood for CBC/Chem and WNV. Did not send out WNL because we had just sent that out about 1 mo ago. Banked WNV blood. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 82 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 7.Sep.2003 Rx: IBUPROFEN 9600 mg PO bid for 60 days. (CKS) 24.Sep.2003 Blood drawn by Mary Mutty for ESR study (Erythrocyte sedimentation rate). Baseline Chemistires/CBC/Fibrinogen submitted. (ARM) 1.Oct.2003 Blood drawn for ESR/WBC study. (ARM) 2.Oct.2003 Blood draw training. (CAB) 8.Oct.2003 Problem: leukocytosis (Suspected) Rx: IBUPROFEN 9600 mg PO bid for 60 days. (CKS) 8.Oct.2003 Problem: leukocytosis (Suspected) White blood cell count is elevated. Has gone up since the last time blood was collected. Continue to monitor. Secondary to long term ibuprofen? GI ulceration leading to mild bacterial sepsis? (CST) 10.Oct.2003 Problem: leukocytosis (Suspected) Blood drawn for ESR/WBC study. (CST) 13.Oct.2003 Problem: leukocytosis (Suspected) Per Dr. Ursula Bechert's pharmacology study with ibuprofen in elephants, ideal dosing is 6mg/kg BID for Asian elephants. Wanda's dose is approx 2.2 mg/kg BID which means she should be increased for effective pain control. (CKS) 15.Oct.2003 Problem: leukocytosis (Suspected) Blood drawn for ESR study. (ARM) 21.Oct.2003 Problem: leukocytosis (Suspected) Based on elevated ESR will increase ibuprofen. Dispensed today to start tomorrow. (AED) 21.Oct.2003 Problem: leukocytosis (Suspected) RW attempted blood draw for ESR- not successful. Try again Thurs. (CKS) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 83 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 22.Oct.2003 Problem: leukocytosis (Suspected) Rx: IBUPROFEN 20800 mg PO BID for 14 days. This is a 5mg/kg dose, the dose used clinically at Oregon Zoo where Ursula did her study. Rx: SILVER SULFADIAZINE 1 gm topically BID for 14 days. (AED) 23.Oct.2003 Problem: leukocytosis (Suspected) Blood draw for ESR & WBC study. (CAB) 28.Oct.2003 Problem: leukocytosis (Suspected) Rx: BETADINE OINTMENT topically to temporal gland BID for 14 days. (AED) 29.Oct.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Examined infected area on right side of face. The hole that I cleaned pus out of is contracted and no longer contains pus. There has been some additional loss of the skin overlying the infected area. There is a small area caudal to this that contained scant pus. Cultured, cleaned and applied betadine ointment to both areas. Appear to be areas of pressure necrosis with secondary infection. Silvadene helped and could switch back to that if needed. (AED) 29.Oct.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Blood draw attempted by MM. (ARM) 31.Oct.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Blood drawn for ESR/WBC study - by Mary M. (CAB) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 84 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 2.Nov.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) <<< Microbiology >>> Sample Source: Temporal gland Laboratory: Accession #: CHAC09182700 [X] Antech Collection Date: [ ] AHDL Submission Date: 30 Oct. 2003 [ ] Other : Report Date: 2 Nov. 2003 Submission type: [X] aerobic bacteriology Organism: Growth: heavy moderate light 1. Staphylococcus aureus [X] [ ] [ ] Sensitivity: 1 | 2 | 3 | Amikacin: S | | | Amoxicillin: R | | | Amoxicillin/Clavulanate: S | | | Ampicillin: R | | | Cephalexin: S | | | Chloramphenicol: R | | | Clindamycin: S | | | Enrofloxacin: S | | | Erythromycin: S | | | Gentamicin: S | | | Neomycin: S | | | Oxacillin: S | | | Penicillin: R | | | Polymyxin B: R | | | Tetracycline: S | | | Trimethoprim/Sulfa: S | | | Vancomycin: S | | | Comments: (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 85 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.Nov.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Attempted blood collection for ESR study. Wanda was not very cooperative and has been aggressive for the last couple of days. Will try again in 2 days and then take a week off if she is still uncooperative. (ARM) 7.Nov.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Wanda is doing very well with higher dose of ibuprofen (5mg/kg). Will maintain that dose for another 2 months. The wound on the side of her face is improving slowly. The culture showed staph aureus. There is good contraction and granulation, although granu. is slight redder than i would expect. No pus. There is a small area ventral and one caudal that are still a little moist. Rx: IBUPROFEN 20800 mg PO BID for 60 days. (AED) 8.Nov.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Attempted blood draw. Wanda moved away after inserting needle. Did not try again. (CAB) 22.Nov.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Visual check of dermatitis on face. There remains a very small area of exudate and crusting. Keepers are still cleaning it daily. Recommended they use a warm water towel compress on area also before applying betadine. The majority of the infected area is resolved. (AED) 7.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed) Attempted blood draw for ESR and Vitamin E levels. Animal was good in the beginning, but then started to stand tall. Will attempt again on Tuesday. (ARM) 10.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Discussed abscess on the middle toe of the back right rear foot of animal with Alan Ruecroft. Area is about 5x5 cm and fairly deep. He feels it is due to the animal not lying down and supporting much of it's weight on this toe while resting. Necrotic tissue now visible in this area. Keepers to work on the area daily. Vet staff to work on the area twice weekly. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 86 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 10.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Both animals also continue to be obese. Alan suggested getting at least 500 pounds off of each in the near future to decrease pressure on their feet, especially on the concrete in the building in the winter. Will also help with arthritis. (CST) 13.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Keeper (MM) drew blood from ear for ESR and WBC study. Also serum for Vit E testing. (CAB) 14.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Trimmed abscess out. Applied betadine and powder. (CST) 17.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Trimmed abscess. Applied powder. Rick and Mary will be trimming it out fully tomorrow. (CST) 18.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Discussed angles needed for ankle radiographs. It may involved removing the foot care bars from one door to get the correct position. Kpr to discuss with Scott Carter and let us know. (ARM) 18.Dec.2003 Problem: leukocytosis (Suspected); dermatitis - face (Confirmed); abscess - right rear limb (Confirmed) Keeper called. Holding right front foot up. Will examine later this morning. Animal appears painful on the right front leg. Placing small amount of weight on it. Looking into treatment with adequan to see if it would be helpful in this situation. Radiographs to be taken of the "wrist" on that limb. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 87 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 21.Dec.2003 Problem: abscess - right rear limb (Confirmed) Attempted blood collection for vit E levels. Did not complete the process due to Wanda trying to punch the keeper. Digital images taken of all feet. (ARM) 22.Dec.2003 Problem: abscess - right rear limb (Confirmed) Atemptted blood colllection, animal still agitated with us. Did make moves to grab at us. We will discontinue blood draw until it is safer. Today (ARM) 23.Dec.2003 Problem: abscess - right rear limb (Confirmed) Once adequan comes in, will treat her with one vial a week (250 mg) for 5 weeks in a row and monitor behavior (and hopefully bloodwork) for any changes. (CST) 25.Dec.2003 Problem: abscess - right rear limb (Confirmed) worked on getting ankle views of Wnada's front right leg. It went very well, but uncertain of exposure or positioning. (ARM) .....2004... 6.Jan.2004 Problem: abscess - right rear limb (Confirmed) Started Wanda on weekly adequan for 5 weeks. 500 mg/treatment. Injected into musculature of right front limb in case there are any local effects. Rx: POLYSULFATED GLYCOSAMINOGLYCAN 500 mg IM q7d for 35 days. (CST) 7.Jan.2004 Problem: abscess - right rear limb (Confirmed) Rx: IBUPROFEN 20800 mg PO BID for 60 days. (AED) 13.Jan.2004 Problem: abscess - right rear limb (Confirmed) Treated with adequan IM. She is behaving during treatments though she does like to test the limits. (CST) 20.Jan.2004 Problem: abscess - right rear limb (Confirmed); tuberculin testing Slightly lame in the left front yesterday according to keeper. Adequan injection given in right front leg IM. First of three sterile trunk washes performed this morning. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 88 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 22.Jan.2004 Problem: abscess - right rear limb (Confirmed); tuberculin testing Second of three sterile trunk washes performed this morning. (CST) 26.Jan.2004 Problem: abscess - right rear limb (Confirmed) Kprs report that Wanda is rocking continuall. She is also shuffling on her front left leg and greatly favoring her front right leg. (ARM) 27.Jan.2004 Problem: abscess - right rear limb (Confirmed); tuberculin testing Third of three tb sterile trunk wash tests done. Vaccinated for rabies and tetanus. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 89 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 7.Feb.2004 Problem: abscess - right rear limb (Confirmed) <<< Urinalysis >>> Laboratory: Collection Date: 7 Feb. 2004 [X] Detroit Zoo Date received: 7 Feb. 2004 [ ] Vet Research Report Date: 7 Feb. 2004 Sample collection: Sample storage: [X] floor [X] room temperature [ ] mid-stream [ ] refrigerated [ ] catheter [ ] frozen [ ] cystocentesis Color: light yellow Appearance: [ ] clear Specific Gravity: 1.021 [ ] hazy / slightly cloudy (Refractometer) [X] cloudy / turbid Dip stick test: Microscopic Exam: Urobilinogen: 1 (NORMAL) RBC's: none Glucose: neg WBC's: none Ketones: neg Epithelial cells: none Bilirubin: neg Protein: 10 pH: 8.0 Crystals: calcium carbonate 4+/hpf Occult Blood: neg amorphous phosphate 4+/hpf Nitrite: ---- Casts: none Leukocytes: --- Bacteria: moderate cocci Other: --- Other: Comments: (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 90 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 7.Feb.2004 Problem: abscess - right rear limb (Confirmed) Dispensed 1 bottle of ibuprofen and 1 tub of biotin for the girls. (AED) 14.Feb.2004 Problem: abscess - right rear limb (Confirmed) Wanda continues to hold right front foot up. She appears less willing to bear weight on right rear at times too, but may be part of rocking behavior. She is not using dirt bed and kpr doesn't think she is going to be willing to lay down. Discussed down elephant plan with Erin. We need to make sure we procure the items needed. I am going to add tylenol to her therapy to see if we can get more relief of pain. (AED) 15.Feb.2004 Problem: abscess - right rear limb (Confirmed) Observed animal. Large degree of stereotypical behavior present including shaking behavior. (CST) 16.Feb.2004 Problem: abscess - right rear limb (Confirmed) Rx: ACETAMINOPHEN 3500 mg PO BID for 30 days. (AED) 16.Feb.2004 Problem: abscess - right rear limb (Confirmed) Keepers report that Wanda is basically standing on two limbs today. Further analgesics tomorrow/more research into what other zoos are doing. (CST) 17.Feb.2004 Problem: abscess - right rear limb (Confirmed) Blood drawn by kpr MM. Session went well, used lidocaine gel. Applied gel and waited 20mins before starting session. Also was told that 20 yards of sand will be delivered tomorrow for bedding 2-3 stalls and that there will be a shavings available for heavy bedding (limit will 2,000 bales/ year) (ARM) 17.Feb.2004 Problem: abscess - right rear limb (Confirmed) Acetaminophen is not in yet and Wanda is displaying notable signs of pain. Started on 3 days of oral phenylbutazone paste. AM talked with Syracuse and they have found ketoprofen paste works wonderfully there. AM calling pharmacists to get some compounded to give it a try. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 91 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Feb.2004 Problem: abscess - right rear limb (Confirmed) Elephant meeting held late am. Discussed what happens if Wanda goes down and stays down. Crane operator to be contacted to be sure crane will work through skylights. Belly bands, straps to be gathered and desens started. Scott to discuss with Ron the situation with Wanda. Rx: PHENYLBUTAZONE 3 gm PO SID for 3 days. (CST) 18.Feb.2004 Problem: abscess - right rear limb (Confirmed) Sand moved into stalls to provide more of a cushion. Ketoprofen paste ordered. (CST) 19.Feb.2004 Problem: abscess - right rear limb (Confirmed) Bloodwork back in. Normal. Continue desens to allow phlebotomy quarterly as well as when needed. sidenote: Potassium and iron low in the animal at Syracuse. (CST) 20.Feb.2004 Problem: abscess - right rear limb (Confirmed) Tylenol therapy decision is based on earlier research done by me during which I consulted several zoos and current literature regarding pain management in elephants. Exact dosing regime in this case based on elephants at Portland Zoo and LA Zoo. Went to pharmacy today to buy tylenol. Elephant will be started tomorrow. She is not to be taken off this treatment until after consulting me. (AED) 21.Feb.2004 Problem: abscess - right rear limb (Confirmed) Visual check of Wanda. She is holding her right front up much of the time. Two of stalls completely dirt, which they like once it's packed down some. Started tylenol today. (AED) 22.Feb.2004 Problem: abscess - right rear limb (Confirmed) Per kpr animal is still holding leg up almost continually today. (ARM) 23.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed) Holding leg up and twirling it today according to keeper. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 92 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 23.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed) Observed: Standing in stall 5 with dirt. Holding right leg up. Fairly normal gait when walked up to stall doors. Keepers said there was improvement on the phenylbutazone but animal has been acting painful since going off of it. (CST) 25.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Started on ketoprofen paste. Does not appear to be very fond of peppermint paste. Apple sized swelling on right flank noted today. Area is not hot to the touch but is firm. Vaccination reaction from last month? Something else? KUO. Animal is exceptionally obese. At it's highest weight at a time that it needs to be slim due to the severe arthritis. Candy removed from barn. (CST) 26.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Omalene removed from barn. Replaced with leaf eater. Animal weighed. Down forty pounds from two months ago. Cereal removed from barn. Discussing diet with nutritionist from Fort Worth. We need to get weight off and stop killing her with kindness. (CST) 27.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Wanda took all of meds today but is still holding foot up. Kprs report behavior changes. One keeper said she looked sleepy, the other says she is alert but zoned and inactive. Will see if can get full dose into her tomorrow and monitor. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 93 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Wanda took 75% of meds today. Today may be a bit better, but yesteray didnt' start holding leg up til days end so may start later today. (AED) 29.Feb.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Rx: GLYCOFLEX II EQ 40000 mg (20 level scoops) PO BID for 7 days. Discontinue Cosequin. (AED) 4.Mar.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Kprs reported that the diet and exercise program is going well. They are using small pieces of food and pellets for training. Animal is not happy and is spitting out the pellets, but is still doing the behaviors. Erin and Mary have written schedules for feet care, baths, and enrichment. The elephants are responding positively to have a routine. (ARM) 5.Mar.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Visual check of arthritis. Increased dose of glycoflex pellets to 15 scoops bid, hoping that we may go to 17 if needed. Kprs are still having some trouble getting acceptance, but it's improving. She is holding right front foot up, but keepers report increased activity and decreased aggression. Took up two weeks of ketofen and put rest in hospital kitchen refrigerator. Rx: KETOPROFEN PASTE 6000 mg PO BID until further notice. (AED) 15.Mar.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Blood draw desens today. Did very well with Erin driving. Wanda is moving very well, she comes running when called. She did not swing her leg at all when I was there. Her attitude is much improved. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 94 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Mar.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Wanted to blood draw today, but animal would not cooperate (different diver) Will work on it next week. (ARM) 24.Mar.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Collected blood for CBC/Chem and ESR. (ARM) 31.Mar.2004 Weight: 4256 Kg (9383 Lb) Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Keepers believe that scale is inaccurate, will get it calibrated. (ARM) 22.Apr.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Blood draw attempted by kpr MM (ARM) 30.Apr.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Dispensed 28 tubes (2wks worth) of ketoprofen paste. (CAB) 3.May.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Blood draw session attempted, Wanda was very bad. (ARM) 17.May.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Almost out of glycoflex large animal granules. Discussed with keepers. Neither elephant has been off cosequin or glycoflex to see if it is having a positive affect. D/C both for now pending changes in arthritis/large animal glycoflex order. (CST) 20.May.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Changed mind on d/cing joint supplements due to several factors. Restarted today on cosequin. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 95 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.May.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Raw area on the right side of face from rubbing. Prescribed protecta pad SID to be applied to area to help prevent sores. (CST) 28.May.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Rx: PROTECTA-PAD gm topically SID for 14 days. (CST) 7.Jun.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed) Wanda appears stiff today. She is swinging her left front and won't bend it when she walks. She has been off the Ketoprofen for 2 days. (ARM) 8.Jun.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Wanda to be started on ketofen as soon as it arrives today. Apparently it is becoming a necessary component for her pain relief as her arthritis continues to advance. (CST) 12.Jun.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Vastly improved once back on ketofen. (CST) 21.Jun.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Given extra half tube of ketofen at close today due to noted pain/stiffness. (CST) 22.Jun.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Examined. Doing well this morning. Appears to be mechanical stiffness in the joint rather than pain at this point this morning. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 96 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 24.Jun.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Acting "stiffly" according to keeper this morning. This is two hours after ketofen paste treatment. Gave permission to keeper to give extra 1/2 tube this afternoon if she still appears painful. Asked keeper to contact Dr. Duncan tomorrow with progress report. (CST) 5.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Took radiographs of Wanda's left front ankle. They came out okay, but need to increase the KVP. (ARM) 8.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Increased KVP on ankle exposure. CST would like comparative views of other ankle and possibly Winky. (ARM) 12.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Took more radiographs of Wanda's left front foot. Started taking radiographs on her right front foot. (ARM) 16.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Dispensed 14 tubes of ketophen paste. (CAB) 18.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Attempted radiographs today. Wanda was very uncooperatvie. Different crew then last time. Will try original crew tomorrow and see how it goes. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 97 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 19.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Wanda did wonderful today. PR and MM worked her and she was perfect! Will stick with this crew if possible. PK-RW aware of this. Took more radiographs of her front ankles. (ARM) 20.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Continued to work on radiographs. Wanda is doing very well. (ARM) 22.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Additional radiographs taken. (ARM) 25.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Physical therapist Manry Ann Uznis and Gretchen Uznis here to evaluate Wanda's front legs. Discussed findings with CST. (ARM) 27.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Rx: DIMETHYLSULFOXIDE 90% ml topically SID for 7 days. (CST) 28.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Received recommendations from Physical therapist. Gave to CST. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 98 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Wanda was referred to Physical Therapy for stiffness of the left forelimb & non-weight bearing of the right forelimb. Her radiographs show osteoarthritis with osteophytes & lytic lesions. Wanda is 47 years old. She can follow her trainer to the right & left, bow, lie down, stand up, place foot on step, place foot in bucket of water. The trainer states she used to enter the pond but no longer does so because of fear of falling. Wanda has difficulty with balance since the ground was tilled (uneven surface). Impression: Wanda ambulates with internal rotation of the forelimbs, left forelimb straight. When standing, she often raises her right forelimb & holds it in a flexed position. When asked to bow down, she can flex her left forelimb well & weight bear on it. She also weight bears on a flexed right forelimb but more weight is on the left forelimb. Goals: Reduce inflammation & pain in both forelimbs. Increase flexion of left forelimb while ambulating (is she fearful of bending the left forelimb while all her weight is on the right forelimb? Increasing strength & stability of the right forelimb should give her the confidence to flex the left). Increase weight bearing on the right forelimb. Improve balance. Treatment Plan: Massage liniment on both forelimbs-Biofreeze has been used on dogs & horses, non-Hazardous, the company will donate. Whirlpool forelimb-begin with limb in hot water (106) & progressively increase flow of water as tolerated-15 minutes per session-Cyman Therapy Products will donate a whirlpool: either 22" deep X 5' or 32" deep X 3' whichever one Wanda will be able to put her limb in. Low level light therapy-am researching this-expensive Exercises & activities: Install a cable perpendicular to the barrier- 18-24" high - she will have to step over cable (flex her left forelimb) to follow trainer with food. Practice bowing repetitively (use it or lose it!) - you can increase difficulty by placing left limb on stool then bow or uneven ground. Practice lying down Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 99 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Jul.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) repetitively. To facilitate more weight bearing on the right: Feed her standing by her right side. Her right forelimb on lower ground than her left forelimb. Place her left forelimb on the step & feed her from her right side. Encourage digging with forelimbs (hide food in ground?). Encourage ambulation on uneven ground - especially around barrier since you can give her positive reinforcement (slope the ground, place obstacles on ground). Kick toy. Surface by barrier should be dirt & not cement to improve shock absorption. Please discuss the feasibility of the above suggestions & let me know when a follow up visit can be made. Mary Ann Uznis, PT (PT) 5.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) CST received approval from SC to receive donation of a portable whirlpool and Biofreeze (liniment) from companies. (ARM) 12.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) PT- Mary Ann Uznis here with whirlpool company. Discussed with kprs the use of pool and equipment. PT reevaluated Wanda and added more exercises to her protocol. She will send us an updated copy. (ARM) 14.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Kprs unable to do much with whirlpool desens due to lack of staff. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 100 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 15.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Observed training session for whirpool therapy. Went okay. Wanda's behavior has ben off the past couple of days. Slightly crabby, not really interested in toys, and resting her legs on things alot. (ARM) 16.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Per AED okay to increase Wandas ketoprofen today. Will do as previously done and give additional 1/2 tube at the end of the day (she had already had her am dose by the time this was decided.) (ARM) 17.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Elephants were both stiff this am. Kprs think increased rat activity is causing them to rest less. Will be treating exhibit for rats tomorrow am. Visual check of Wanda in am. Yesterday, Given ketofen increase at days end, so hard to know if it helped. This am she is moving slowly and stiffly. Will wait and see how she does before increasing again today. Put her right front foot into the whirlpool bath for the first time today. At days end today, kpr says she is still rocking a lot and stiff. Gave the go ahead to give half dose ketofen this pm today only. (AED) 18.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Wanda remains stiff, especially on the left front today. Yesterday and today she allowed a whirlpool bath of the wrist on that leg, and she had DMSO treatment. Are going to give half a dose of ketofen again this pm to see if this helps. Colorado State University did a new investigative ELISA test for TB on serum from our elephants. The values for our elephants were not consistent with values typical for MTB infected elephants. The values were consistent with values typical for non-infected elephants. testing performed by Scott Larsen, U Cal Davis. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 101 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Blood collected for Fibrinogen and banking. (ARM) 23.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Film crews et al out to film Wanda using whirlpool. (CST) 28.Aug.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Visual check of Wanda. She is doing fairly well. (AED) 12.Sep.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Keepers are doing pyhsical therapy on Wanda daily. Observe her working an obstacle course. After the session Wanda was able to bend her front left leg completely. (ARM) 16.Sep.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Elephants are not eating their hay well. Core samples taken and submitted for analysis. (CST) 18.Sep.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Need to get blood sample on Wanda for vitamin E analysis. (CST) 20.Sep.2004 Weight: 4265 Kg (9403 Lb) Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Blood drawn for Vitamin E levels and an ESR. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 102 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed) Rx: TOCOPHEROL, ALPHA 50 ml PO SID until further notice. (CST) 7.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined on exhibit. Nail abscess on the middle nail of the left front foot. Keepers have carved it out and are continuing to work on it. 3 cm dorsoventral defect over most of front aspect of front nail. (CST) 10.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Per kpr abscess is improving. They are working on it daily and she is doing a 15 minute soak in Nolvasan. (ARM) 12.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) radiographs taken of abscess foot (ARM) 16.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Radiographs of abscess toe taken. (ARM) 17.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Kpr reports that abscess is getting bigger. Per AED start on Naxcel and DMSO cocktail. Due to time restraints kprs are unable to saok the toe, cut on it and do Wandas physical therapy. They will be combining soaking her toe and a warm water soak for her joint. A large rubber container was made to accomodate her leg. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 103 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Abscess looks the same. Kprs are cutting it back everyday. Radiographs taken of toe. (ARM) 18.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: CEFTIOFUR SODIUM mg topically SID for 7 days. (CST) 19.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Went up to examine Wanda's abscess. There is a great deal of exposed soft tissue, but she does not seem as tender as expected. The abscessed area is large. Keepers have done good, aggressive trimming. Rads show lucency only in area you can see is affected, but will retake films with more exposure and see if a track can be seen. (AED) 19.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined abscess. Appears to be extending up into the nail on the cranial aspect of the nail as well as caudally in the ventral aspect. Keepers are trimming the affected areas out. (CST) 20.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: TOCOPHEROL, ALPHA 8800 iu PO SID until further notice. (CST) 21.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Reexamined foot. Mass of granulation tissue in rostral aspect was rubbed off. Keepers are doing a good job of exposing the affected areas ventrally as well as on the rostral nail. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 104 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 24.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Reexamined foot. Continues to look ugly but improving. Swelling in rostral nail extends dorsally but need to be careful about coring it out lest the entire nail crack due to this being a weight bearing limb/toe. (CST) 26.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined foot and was present for trimming. The bubble that was on the front of the nail is almost completely trimmed off today during session revealing a bruise under the hard outer layer. No necrotic material seen in this area. Along bottom of nail (plantar surface) the crevase is widening with trimming efforts, and more necrotic tissue is exposed. Used the available forceps to pull out necrotic tissue, foul smelling. Plan: 1. Will locate other forcep options to remove larger pieces of tissue. 2. Three new photos taken to share with Allan Roocroft, to get new input. His email response of 2 days ago now seems N/A d.t. discovery that the tissue behind the bubble is not abscessed. Will see what he says now. 3. Focus on removal of necrotic tissue in crevase, with the goal to allow drainage. (AED) 28.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Rostral portion of nail is clean and looks good. Underlying nail is firming up. Keepers are still working on ventral region. (CST) 31.Oct.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Somewhat sensitive over the lateral portion of the rostral aspect of the nail. Keepers to try again today to trim that out. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 105 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Phone conversation with Laura Richman re Herpes virus testing. Emailed Erin Latimer to get actual results sent. Wanda's test is not negative for herpes virus. Her titer is reported to be .550. A positive control has a titer of 1.615 and a negative 0.2. Her result is in the grey zone and the lab is not able to make an interpretation. They have not yet tested enough samples. A synopsis of this was emailed two days ago to elephant staff, HW, MS, RK, SC. Will be sending additional samples to the lab. (AED) 6.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Visual exam of toe. Kprs have removed almost all of nail. There are two regions of soft, necrotic tissue exposed, and the bulging area below when viewed from the front. They still get pus when approaching from the plantar surface. Wanda is mucho cranky today after a day of television filming. No attempt made to touch abscessed area. Allan Roocroft has not responded since the last email photos were sent by Rick. (AED) 8.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined toe. Much of the rostral portion of the nail has now been removed. Discussed elephant herpes with the keepers. (CST) 9.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: DIMETHYLSULFOXIDE 90% ml topically SID for 10 days. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 106 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Kpr reports that animal has had debris in her ear right flap the last couple of days. Requested swab of debris for cytology. (ARM) 18.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: SILVER SULFADIAZINE/Protect-a-pad (50/50) topically SID for 14 days. (CST) 21.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined toenail where it has been carved away. Area looks very good. No sign of infection and tissue is now hardened. (CST) 22.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Faxed herpes results to Dr. Barrie at Columbus Zoo per his request. (CST) 23.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Faxed herpes results to Dr. Rob Coke of San Antonio Zoo. (CST) 27.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Toe nail is growing in very nicely. There remains a fissure behind the nail on the plantar surface that is cleaned and picked open during treatment. This tissue continues to bleed when manipulated. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 107 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 28.Nov.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Same observations as Ann made in note yesterday. (CST) 6.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Blood draw attempted for Vitamin E levels. Wanda did well, but walked away during the draw. There was not enough serum for submittal will redraw . (ARM) 8.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Blood collected for CBC/chemistries/vitamin E levels. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 108 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 14.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) <<< Microbiology >>> Sample Source: Stool Laboratory: Accession #: [ ] Antech Collection Date: 11 DEC 04 [ ] AHDL Submission Date: 12 DEC 04 [X] PetLabs, Inc. Report Date: 14 DEC 04 Submission type: [X] enteric pathogen screen Comments: Moderate growth of normal enteric flora. No Salmonella, Shigella, or Campylobacter isolated. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 109 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Per kpr Wanda is stiff on right front leg today. Per CST - giving extra 1/2 syringe of Ketoprofen at 11:30am, and another extra 1/2 syringe if necessary this evening. AED to look at tomorrow. (ADD) 18.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wanda continues to be stiff, and today was hard to get up and did not want to leave her sand stall. On visual exam she is holding right front foot up off the ground some. She is leaning trunk on bars to take weight off the foot. When she places weight on right foot the ankle settles with a shifting motion. Ketoprofen plan is to give 1 syringe in am, 1 in pm. Gave 15ml equine adequan IM today. She did not react badly to the injection. Will order more to give as soon as it arrives. (AED) 19.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Per kpr animal looks a little better this afternnon, but still needs to rest during foot checks. Per CST give 1/2 syringe of Ketoprofen (ARM) 19.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in stall in am. Standing with right front leg elevated and held off to side. Occasionally placing it and noted once swinging it into front left limb. Able to ambulate well when asked to come to bars. Just appears a bit stiff and painful. Not leaning on anything this morning and did not note ankle settling. Looking into IV hyaluronate solution. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 110 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 20.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Attempted blood draw on Wanda today. She did not cooperate. Will try again tomorrow. (ARM) 20.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in am. Approximately 1 degree Fahrenheit outside right now. Wanda is standing with right front limb off ground most of the time. Displaying occasional rocking stereotypical behavior- unsure if this is due to being kept up at night (to start recording again tonight), pain, or boredom due to not being let outside. Frigidly cold which is likely exacerbating Wanda's condition. Concerned that while we got through the mild winter last winter with occasional hiccups with Wanda that we could be in trouble if she stays here this winter. Discussed concerns with Scott Carter. This afternoon, she is to be bled for CBC/chemistries/fibrinogen/bile acids to assess her overall condition as it relates to the long term NSAID usage as well as the higher recent dosaging. (CST) 21.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in stall. She is standing with her right front leg elevated again. More alert. Weather has eased up as well (30 degrees or so now compared to yesterday's 1 degree). Talked with keeper. She feels Wanda is more alert, she is eating everything offered to her, ate her morning ketoprofen (did not eat it yesterday afternoon), and in general looking better. Two elephant meetings today. Am with Ron/Scott/Ann. Pm with keepers/Scott/Harry. PM: Keepers report she is doing much better this afternoon. Better overall attitude as well as spirits. Rx: SILVER SULFADIAZINE/Skin so soft/Nolvasan ointment topically SID f (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 111 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 22.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Doing much much better. Taking medication. Alert. May be at least partially due to being able to get outside yesterday. (CST) 23.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Kpr report small swelling on lateral aspect of front left foot. On exam area is smooth, raised and leaking a small amount of fluid. Animalreacts when the area is probed. This is the same foot that has the large nail abscess on a medial digit. Doctor to exam. (ARM) 24.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Swelling examined on lateral aspect of left front foot. Mildly to moderately locally swollen. Skin has died over the surface of the apparent abscess. Area prepped. Incised with hemostats. Culture taken. Unable to flush at this time. Keepers to soak and flush with nolvasan. (CST) 25.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Removed dead skin and tissue, cleaned with nolvasan and applied ointment. (ARM) 26.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Area is opened. Edematous tissue present still where the dead skin was peeled away. Applied betadine solution. Plan: Soak with 1/4 cup epson salts and 100 mls concentrated nolvasan in 15-20 gallon container for minimum 10 minutes twice a day. Apply concentrated betadine solution to area. Let sit for 30 seconds or so to dry. Apply ointment. Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 112 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 26.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Diet... Wanda is excessively obese which will make her travel that much more difficult. Need the following asap: 1. Three days straight of EVERYTHING that this animal is fed and amounts. Popcorn, bagels, regular diet etc. Everything. 2. Her current weight. 3. A plan. (CST) 27.Dec.2004 Weight: 4288 Kg (9453 Lb) Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wt increased by 10lbs (ARM) 27.Dec.2004 Weight: 4288 Kg (9453 Lb) Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: DMSO, Silvadene, Nolvasan ointment (CST) 28.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. "Meaty" moist appearance to the exuberant tissue. Continuing to treat with betadine solution to dry it out/antibacterial properties then topical antibiotic ointment. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 113 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 29.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) <<< Microbiology >>> Sample Source: wound Laboratory: Accession #: [ ] Antech Collection Date: 26 DEC 04 [ ] AHDL Submission Date: 27 DEC 04 [X] PetLabs, Inc. Report Date: 29 DEC 04 Submission type: [X] aerobic bacteriology Organism: Growth: heavy moderate light 1. Escherichia coli [X] [ ] [ ] 2. Streptococcus Group G. Beta-heamolytic [X] [ ] [ ] Sensitivity: 1 | 2 | 3 | Amikacin: S | | | Amoxicillin/Clavulanate: R | | | Ampicillin: R | | | Carbenicillin: S | | | Ceftazidime: S | | | Ceftiofur: R | | | Cephalothin: R | | | Ciprofloxacin: S | | | Chloramphenicol: R | | | Enrofloxacin: I | | | Gentamicin: S | | | Nitrofurantoin: R | | | Piperacillin: S | | | Tetracycline: R | | | Ticarcillin: S | | | Tobramycin: S | | | Trimethoprim/Sulfa: R | | | Comments: Streptococcus are predictably sensitive to penicillin and its derivatives. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 114 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 31.Dec.2004 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined protuberant tissue. Kprs under impression soaks are helping to draw out the abnormal tissue. They are using nolvasan DMSO soaks twice daily. Have not debrided, as CT has said he will do the debriding. (AED) .....2005... 2.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) There is a hole on the bottom aspect of the abscess that extends approximately 1 inch behind absces material. Kprs are not to flush this until there is clearance from a vet. There is dead tissue that needs to be debrided. Digital images taken and will be sent to Alan. PM- kprs requested extra dose of ketoprofen due to increased pain after exercising. Radiographs taken. Exposure need to be adjusted. (ARM) 3.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Kpr reports that Wanda is very painful. She is swinging her front right foot almost constantly when at rest. She is reluctant to step foward on that leg. Public is now commenting about it. Video taped small portion of her swinging. Kpr also reports that she is sleeping longer in the morning and reluctant to move once she gets up. Gave 15mls of Adequan IM in the left rear. Doctor to exam. RW talked to Alan Roocroft who advised coring out pad, he feels that the abscess needs to drain out the bottom of Wandas foot. Kprs began coring out the pad and found track between pad and abscess. Radiograph taken again. need to adjust exposure. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 115 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 3.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in stall. Holding right foot up. Resting some weight on trunk tip. Examined 'abscess' but unable to get good look/touch due to reticence on her part. Instructed keepers to carve it out in order to get betadine/ointment down to the affected tissue. Possibility of a foreign body in it due to the appearance. Cultures taken of sand in exhibit to match with cultures from Winky's and Wanda's recent abscesses. Worried about retention of fecal matter/urine/microorganisms in the soil. Rx: POLYSULFATED GLYCOSAMINOGLYCAN 7500.0 mg (CST) 5.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) <<< Microbiology >>> Sample Source: exhibit substrate - sand Laboratory: Accession #: [ ] Antech Collection Date: 03 JAN 05 [ ] AHDL Submission Date: [X] PetLabs, Inc. Report Date: 05 JAN 05 Submission type: [X] aerobic bacteriology Comments: Heavy growth of mixed normal environmental flora. Growth included coagulase negative Staphylococcus, alpha-heamolytic Streptococcus and Bacillus species, all of which is considered normal flora. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 116 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 5.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Visual exam of Wanda. She is more uncomfortable. She takes very frequent breaks while trimming left front foot. The lesion on her left front foot has not changed that much since last exam. The tissue at the top of the protuberance is protruding a bit more. The kprs have removed nail below the protuberance in an effort to allow drainage, but have not found a track yet. There is a white area that appears to be the draining tract and will likely be the port of exit. This area is very sensitive, and the kprs trimmed it heavily yesterday. Allan Roocroft will be here in 3 days to assess and trim. BID soaks continue. Kpr reports that success when trying to give half dose of ketoprofen at days end is not always good. Will give 9000mg in the am for one week and see how she does. Looking back in the record, the original Rx was 6000mg bid. Angel will try to confirm that we originally gave this dose bid as per syracuse. (AED) 5.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Radiographs taken of abscess. PEr MM the biofreeze seems to offer some short term relief. Per CST apply 3 times a day (ARM) 5.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Culture results came back as heavy growth of Strep Group G, a beta hemolytic Strep and also E. coli. Substrate grew mixed normal environmental flora including coag neg staph, alpha hemolytic strep, and bacillus. Winky and Wanda grew the same bugs out of their abscesses but it may not be due to contamination from the dirt floor. Late pm: Still very painful. With negative hemoccult fecal test this morning and normal bloodwork the last time she was bled, prescribed second tube of ketofen to be given this afternoon. Rx: TOCOPHEROL, ALPHA 8800 iu PO SID until further notice. Rx: SILVER SULFADIAZINE gm topically SID for 10 days. Rx: KETOPROFEN PASTE 6000 mg PO BID for 1 day. Rx: BIOFREEZE mg topically TID until further notice. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 117 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 6.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: KETOPROFEN PASTE 9000 mg PO SID for 7 days. (AED) 6.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) IM treatment with adequan given today. Rx: POLYSULFATED GLYCOSAMINOGLYCAN 25000 mg IM q4day for 20 days. (CST) 8.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wanda's feet inspected and trimmed slightly by Allan Roocroft. His assessment is that there is an abscess present, and that we should treat so that drainage can occur from two directions. He says every day we should use forceps to remove necrotic debris from abscess as it protrudes laterally. We should also continue to thin out the pad in an area 3 inches in diameter to allow ample room for necrotic tissue to grow down. He said there's no way to know how large the necrosis is above this, so provide lots of room. He said this abscess should not provide too much of a problem as long as it does not migrate medially over the pad. We discussed substrate, and eh likes sand more than dirt, for hygiene reasons especially. He said you can see right were the urine and feces are and clean better. He is not concerned about the abrasive nature of sand. He said to hose sand twice weekly to keep it cleaner. He siad the 2nd nail is walled off and its hard to say whether there will be further problems with this down the way. He suggests exercising her by having her lift both feet high up on supports. His assessment is that This abscess is d.t. her nonweight bearing in the right front, as suspected. Asked his twice if he would use topicals and he said no. (AED) 9.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Able to give 25cc's of adequan. Will try full dose on Thursday. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 118 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 10.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Desens for blood draw today. Will attempt again later this week. Wanda has knots on her shoulders where the Adequan injections were given. Rx per CST of panalog for 10 days. (ARM) 10.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: PANALOG topically SID for 10 days. (CST) 14.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Checked foot and watched during trim. The abscess is growing out thru the bottom of the pad more, as hoped. The abscess is not protruding out as much as before. Kpr able remove a nice chunk of this two days ago. Today Patty used blade to remove more of the pad below the abscess. Can see a black ring around the abscess there. She is still very tender when you actually try to touch the abscess, and she was cranky today when kpr got to that part. Overall good steady progress toward resolution. (AED) 16.Jan.2005 Weight: 4206 Kg (9273 Lb) Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Went to elephant building to examine. Animals in process of getting weighed. Wanda tipped the scales at 9270 pounds! Excellent progress by the elephant keeper staff in terms of scaling back on treats, dietary revisions, and increasing exercise. Discussed with SC. (CST) 17.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Worked with Mary for about 45 minutes in a training session. Able to get 15 mls of adequan into her during a foot presentation process. She keeps leaning away during her injections which requires the 'injector' to lean fully into the stall. Would like to see operant conditioning behavior bring her up against the stall door in order for drugs to be given for fear of injury to vet staff leaning in too far. Discussed with Mary. Will try smaller injections more frequently starting tomorrow to get them into her. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 119 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 18.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wanad was perfect for her injection today. first lean in and first stick got 17ml's IM. Decided to end on a positive note and will increase amount to two injections at next session. Blood draw desens went well today. (ARM) 19.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Partial radiographs taken today. Wanda was very crabby and took a swipe at a kpr and after the second xray she charged everyone. Stopped at that time due to safety concerns. Will try again next week when she is in a better mood. (ARM) 22.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wanda went back to original ketofen dose 4 days ago, and required a tube and a half again yesterday. Keepers say she is uncomfortable again today. I advised them to give a tube and a half today, and continue with this elevated dose UFN. A tube and a half is 9000mg, which is only slightly above the 2mg/kg dose. (2.135mg/kg). (AED) 23.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Abscess on left front foot continues to improve slowly. Draining out the bottom and continuing to move down the foot slowly. Treated with two separate injections of 17 mls of adequan IM in right biceps. She was exceptionally good for this and maintained nicely. Jackpot rewards given for her excellent behavior. (CST) 25.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) glucose noted on urine analysis; consulted w/ Drs Wiedner/Isaza; glucose had been reportedly found in ~60% normal, healthy asians; plan is to monitor urine every 2 weeks ufn. (ALC) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 120 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 25.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: CARRAVET GEL gm (CST) 26.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Blood draw desens. (ARM) 26.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in stall in am. She is placing a lot more weight on her front right limb than she has recently when I have observed her. Her attitude is generally good as well at the moment. Discussion at elephant meeting to put sand down in stall 4 in addition to stalls 1 and 2. (CST) 27.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined Wanda today. Kprs able to trim foot aggressively yesterday and today is her day off. She is still holding right foot up, and is walking slowly. Her mood/aggressiveness seems improved. Gave 45cc adequan IM via hand injection. (AED) 28.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed); tuberculin testing - trunk wash Collected trunk wash #1 for tb culture series. Wanda continues to take weight off right front carpus frequently but otherwise seemed subjectively bright and cooperative. (ALC) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 121 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 30.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Blood collected for ESR study. She was very good for the procedure. Kprs feel that she has been in better spirits the last couple of days. (ARM) 30.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in stall. Reweighed yesterday. She is indeed down almost 200# from her prior weight. Keepers are doing a good job in cutting back on her calories/exercising her. She appears bright and alert. Not standing on three limbs when examined. (CST) 31.Jan.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Treated with 3 injections of adequan (17 mls each roughly) IM in various places in left shoulder musculature. Wanda did extremely well with the injection series. Rx: POLYSULFATED GLYCOSAMINOGLYCAN 25000 mg IM q4day until further notice. (CST) 1.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed); tuberculin testing - trunk wash Second trunk wash of three in series done successfully today. Both elephants did a great job. (AED) 1.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed); tuberculin testing - trunk wash Adequan treatment modified to once weekly per AED discussion with Kathryn Gamble. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 122 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 4.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed); tuberculin testing - trunk wash Collected trunk wash #3 for tb culture series. (ALC) 7.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Treated with 50 mls (3 injections) of adequan IM in right front shoulder. She behaved perfectly. (CST) 9.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined. Abscess on lateral aspect of left front leg is resolving nicely in terms of moving distally down the limb. Area is slightly swollen today, possibly because of a lack of drainage. Keepers emailed pictures to Alan Roocroft for trimming advice. (CST) 10.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) observed in stall; keepers report hearing a clicking sound when she walks; this is new for her but not uncommon amoung arthritic elephants; examined right cheek pressure sore; mentioned that I have seen very good success using humilac spray on cheek sores; will discuss with vet staff (ALC) 11.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) participated in trimming of NBA tissue - LF #5; there is "crab meat" visible just caudal to toe 5 (LF) at the edge of the nail; trimmed away as much as she would allow; today she had exudate working out of a crack in the skin also caudal to the #5 nail; most came out from the pressure of walking but Rick was also able to push some out; continue current foot soak therapy; will check again tomorrow and trim/remove any tissue possible. observed trailer training; she made her way to the entrance twice, then backed away. (ALC) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 123 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 12.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) more exudate expelled from swelling caudal to LF toe 5; walking up and down the trailer ramp seems to encourage expulsion; able to push more out by hand after foot soak; continue current tx and asked keepers to continue to try to work out exudate from opening in swelling (ALC) 13.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in am. 5-7 cm vertical 'split' present along front of abscess. Mild to moderate amount of cheesy abscess material present and draining. Aerobic/anaerobic culture taken for submittal. Expressed small amount of the material. She is moderately sensitive there this morning. (CST) 14.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) 50ml's of Adequan given. 2 injections were given in her left shoulder and one in her right. Blood draw attempted, did not go well. Will desens and try again. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 124 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) <<< Microbiology >>> Sample Source: foot Laboratory: Accession #: [ ] Antech Collection Date: [ ] AHDL Submission Date: [X] PetLabs, Inc. Report Date: 17 Feb. 2005 Submission type: [X] aerobic bacteriology Organism: Growth: heavy moderate light 1. Escherichia coli [X] [ ] [ ] 2. Klebsiella pneumoniae [X] [ ] [ ] Sensitivity: 1 | 2 | 3 | Amikacin: S | S | | Amoxicillin/Clavulanate: R | S | | Ampicillin: I | R | | Carbenicillin: S | R | | Ceftazidime: S | S | | Ceftiofur: S | S | | Cephalothin: R | S | | Ciprofloxacin: S | S | | Chloramphenicol: S | S | | Enrofloxacin: S | S | | Gentamicin: S | S | | Nitrofurantoin: S | S | | Piperacillin: S | S | | Tetracycline: S | S | | Ticarcillin: S | R | | Tobramycin: S | S | | Trimethoprim/Sulfa: S | S | | Comments: Please see anaerobic report below. (ADD) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 125 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 17.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) <<< Microbiology >>> Sample Source: foot Laboratory: Accession #: [ ] Antech Collection Date: [ ] AHDL Submission Date: [X] PetLabs, Inc. Report Date: 17 Feb. 2005 Submission type: [X] anaerobic bacteriology Organism: Growth: heavy moderate light 1. Streptococcus intermedius [X] [ ] [ ] Comments: Sensitivities routinely not performed on anaerobes, this per NCCLS guidelines. Antibiotics routinely suggested include: *Penicillin *Broad-spectrum penicillins *Metronidazole *Chloramphenicol *Clindamycin =============================Page Break============================= (ADD) 17.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Culture from abscess in her left front foot came back with heavy E. coli and K. pneumonia. Both are sensitive to gentamicin. Will mix a flush solution to have some local affect on the abscess site. (CST) 18.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) using a topical mixture of benzoyl peroxide and metronidazole on Winky's abscess tissue; will try same product topically on Wandas lesion caudal to #5 left. Rx: METRONIDAZOLE/benzol peroxide topically BID for 10 days. (ALC) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 126 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 19.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Anaerobic culture of abscess grew Streptococcus intermedius. Aerobic culture grew E.coli and Klebsiella. Both are susceptible to gentamicin. (CST) 20.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Fecal hemoccult test negative. (RAJ) (ADD) 21.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: HUMILAC SPRAY topically SID until further notice. (ALC) 21.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wanda is extremely aggressive lately. Has made numerous attempts to punch kprs while working on her front abscess. Gave 50ml's of Adequan IM in 3 locations. Also did blood draw desens. Kprs report that Wanda is weight shifting in her back legs. (ARM) 22.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined her foot today. Although the surface looks like it is progressing, it worries me that she remains so tender. Will continue to monitor. (AED) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 127 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 27.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed); ultrasound - left front foot; visual inspection - RECHECK attempted to ultrasound wanda's left front nba. she was not very patient. this is a sensitive area. applied dmso/gent combination. this will be used once daily with the bezoyl peroxide used once daily during opposite time. (ALC) 28.Feb.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Treated with 50 ml in three different injections in the right front limb musculature. Wanda behaved wonderfully for the injections. Rx: GENTAMICIN AND DMSO topically to abscess SID for 10 days. (CST) 1.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Negative hemoccult on feces. (ADD) 2.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Kprs report that Wanda had abnormal behavior yesterday. At 1:45 in the afternoon, she went down on her right knee and held left front up for a few minutes, tremoring as she held it up. She then layed down inside, and slept for 1.5 hours. Kprs do not recall her sleeping like this inside before. While laying her left front foot tremored, until she fell asleep. (AED) 2.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Wanda fell asleep in the stall while ass. curator was observing her yesterday. Observed swinging her right front foot at her sides today. Discussions about usage of etogesic amongst vet staff. Obscene amount of bagels and chow in large 5 gallon bucket at the exhibit which is not contributing to the weight loss program in this animal. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 128 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 8.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined feet today. The lesion on the lateral aspect of the left front foot is healing over. There is much less swelling than on prior exams, and the tissue is firmer. The skin on the surface is grey and smooth- no visible crab meat. KUO. (AED) 14.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) GAve adequan via hand injection (ARM) 16.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Decided to try apple cider vinegar soaks for 2 weeks instead of nolvasan/ epsom salts to see if abscesses improve with this therapy. (AED) 17.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: ETODOLAC 21000 mg PO SID for 28 days. Rx: APPLE CIDER VINEGAR 64-150 oz topically BID for 14 days. (AED) 20.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Keeper reports that Wanda is putting weight on all four limbs more often now. (CST) 21.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Keeper reports that Wanda is holding right front limb up a fair amount today. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 129 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 22.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined in morning around 9:30 am. Wanda laid down in the squeeze stall this am. This is very abnormal for her to lie down in the middle of the day (only done so 4 times that keepers are aware of). Upon standing, she stood with her right front leg held off the ground bumping it repeatedly against her left front limb. Appears to be in some discomfort. Will attempt blood draw/ erythrocyte sedimentation rate. PM: Unable to obtain blood. Discussed etogesic dosage with Dr. Case. Will increase it to 6 mg/kg at this time and monitor for improvement. 25,320 mg SID. (CST) 23.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Evaluated Wanda's comfort today. She has been holding right front foot up and swinging it almost constantly over the last 4 days, since just after changing pain relief to etogesic. She appears bright, and her mood is good, which is odd. She usually has a worse mood when appearing more uncomfortable. She appears to be moving faster- her movements in general are more rapid. She is swinging right front foot and banging it against left. She laid down yesterday and trembled as seen about 4 times in the last 6 weeks. We will try increased dose of etogesic (6mg/kg started today) for one more day and increase dose friday am if needed. We will err on the side of pain relief and increase dose if there is not significant improvement. (AED) 23.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Blood drawn for CBC/chemitries and ESR. (ARM) 24.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Vaccinated with 1ml of Imrab and 1ml of Tetanus toxoid IM via hand syringe. Wanda was observed walking around the yard and she was flexing both front legs quite well. (ARM) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 130 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 24.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) ESR value is down compared to last time. Bloodwork results look good at this point. Today, Wanda is holding her right front leg up less than she has been of late according to keepers. Appears to be doing better in terms of her overall attitude as well. Visual exam: Observed holding right front limb off ground and swinging it about once a minute for 5 minutes of observation. (CST) 25.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) examined in stall eating in early morning. she is lifting her right front less and less. the current dose of 7 mg/kg seems to be effective at this time. EDDU WNL. keeper is pleased with behaviour and results at this time. (ALC) 26.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Examined Wanda today. She is more comfortable. She is placing full weight on the right front foot at times, and is not holding it up or banging it against other leg. She is rocking a lot today, and kprs not sure why. Plan is to continue to monitor and maintain dose of 7mg/kg, (29,400mg) and then increase dose to 8mg/kg on the 3rd of April. She is getting every other day or every day foot soaks d.t. trailor training. Plan is to increase frequency next week. (AED) 30.Mar.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) keepers report Wanda to be laying down more than usual this morning. they also report a quivering in her left front leg. observed in stall sleeping. respirations and heart rate WNL. at times sleeping soundly. mouth visible and color WNL. did not see any quivering at the time. keepers report EDDU WNL. suspect nice, warm weather and access overnight may have contributed to her being tired. observed later to be up and behaving normally. KUO. (ALC) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a - page 131 - Clinical Notes - Individual Specimen Report DETROIT ZOOLOGICAL PARKS =============================================================================== Scientific Name: ELEPHAS MAXIMUS (no subsp) Accession #: 4468 Common Name: Asiatic elephant Female Name: WANDA Birth: 18.Nov.1958 (Estimated) =============================================================================== 3.Apr.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Rx: ETODOLAC 33760 mg PO SID for 6 days. (AED) 3.Apr.2005 Problem: abscess - right rear limb (Confirmed); lameness - right front limb (Confirmed); obesity (Confirmed); skin mass (Confirmed); arthritis (Confirmed); abscess - left front hoof (Confirmed) Treated with adequan IM. (CST) Printed on: 27.Jul.2006 /ISIS/MedARKS/5.40a