DIAGNOSIS AND MANAGEMENT OF SUSPECTED CONGESTIVE HEART FAILURE SECONDARY TO DILATED CARDIOMYOPATHY IN A SAND TIGER SHARK (CARCHARIAS TAURUS) WITH ESTABLISHMENT OF PRELIMINARY NORMAL ECHOCARDIOGRAPHIC INDICES.

Elasmobranch cardiac anatomy and physiology has been well described; however, there is a dearth of information regarding cardiac disease. In support of a clinical case of suspected congestive heart failure in a 22-yr-old male sand tiger shark (Carcharias taurus), a study was undertaken to identify feasible echocardiographic imaging planes and preliminary indices for this species. Eleven echocardiograms were performed on six apparently healthy sand tiger sharks. Echocardiographic parameters are presented using descriptive statistics, including mean, median, standard deviation (SD), minimum and maximum values. These data were utilized for the diagnosis and clinical management of the affected shark. The shark initially presented with increased respiratory effort, dependent, peripheral edema, and anemia. Echocardiography revealed atrial, ventricular, and sinus venosus dilation. As congestive heart failure secondary to dilated cardiomyopathy was strongly suspected, therapy was initiated with oral benazepril and torsemide, and later pimobendan. After a year of therapy, clinical signs resolved. Cardiac size and function improved on echocardiography with a reduction in sinus venosus dilation, maximum and minimum atrial and ventricular inner diameters, and an increase in atrial and ventricular fractional shortening. Cardiac disease in elasmobranchs may be underdiagnosed, so it may be necessary to develop standardized ultrasound techniques and cardiac measurements for each species of elasmobranch managed within zoos and aquaria.

Identifying coagulopathies in the pathophysiology of cold stress syndrome in the Florida manatee Trichechus manatus latirostris.

Cold stress syndrome (CSS) in the Florida manatee Trichechus manatus latirostris has been defined as morbidity and mortality resulting from prolonged exposure to water temperatures <20°C. The pathophysiology is described as multifactorial, involving nutritional, immunological and metabolic disturbances; however, the exact mechanisms are unknown. We hypothesized that thromboembolic complications contribute to the pathophysiology of CSS in addition to the previously described factors. During the winter of 2014-2015, 10 Florida manatees with clinical signs of CSS were presented to Lowry Park Zoo, Tampa, FL, USA. Thromboelastography (TEG) and coagulation panels were performed at admission. In addition, coagulation panel data from 23 retrospective CSS cases were included in the analyses. There were numerous differences between mean values of TEG and coagulation parameters for healthy manatees and those for CSS cases. Among TEG parameters, reaction time (R), clot formation time (K) and percentage of clot lysed after 30 min (LY30) values were significantly different (p < 0.05) between the 2 groups. CSS cases also had significantly higher mean D-dimer concentration and coagulation factor XI activity, prolonged mean activated partial thromboplastin time (aPTT) and significantly decreased mean antithrombin activity. These combined abnormalities include clinicopathologic criteria of disseminated intravascular coagulation, indicating an increased risk of thromboembolic disease associated with manatee CSS.

COAGULATION ASSESSMENT: UNDERUTILIZED DIAGNOSTIC TOOLS IN ZOO AND AQUATIC ANIMAL MEDICINE.

Veterinarians specializing in nondomestic species are faced with unique challenges regarding research and diagnostic capabilities given the wild and frequently dangerous nature of their patients. Standard diagnostic techniques used in small or large animal practice are not always possible due to anatomical constraints, size, tractability, or the inherent risk of anesthesia in highly valued, rare species. Diagnostic modalities that utilize simple, relatively noninvasive techniques show promise in evaluating nondomestic species and elucidating the pathophysiology behind poorly characterized disease processes in both wild and captive populations. Coagulation profiles, which may include prothrombin time (PT), partial thromboplastin time (PTT), D-dimer concentration, platelet count, and thromboelastography (TEG) are frequently used in domestic species but often overlooked in exotic medicine due to lack of normal reference values and/or availability. Whenever possible, coagulation profiles should be utilized in the evaluation of various disease processes including neoplasia, sepsis, trauma, inflammation, toxin exposure, and envenomation. There are several reports of coagulopathies in both wild and captive species; however, few studies on coagulation profiles have been published on nondomestic species. Clinicians should consider coagulation testing as part of the diagnostic work-up in nondomestic species. A review of available coagulation diagnostic tests is provided here in addition to summarizing the pertinent coagulation disorders currently established in the literature.

ESTABLISHMENT OF ECHOCARDIOGRAPHIC PARAMETERS OF CLINICALLY HEALTHY FLORIDA MANATEES (TRICHECHUS MANATUS LATIROSTRIS).

A standardized echocardiographic technique was recently established for the Florida manatee (Trichechus manatus latirostris). There are no available published data on normal echocardiographic parameters in any Sirenian species. The purpose of this study was to report reference parameters for various echocardiographic measurements. These parameters are intended to serve as a comparison for future research into the prevalence of cardiac diseases in the manatee and to aid in diagnosing animals with suspected cardiac disease in rehabilitation facilities. Annual health assessments of free-ranging manatees in Crystal River National Wildlife Refuge, Florida, and pre-release health assessments of rehabilitated manatees at Tampa's Lowry Park Zoo permitted comparison of echocardiographic measurements in adult (n=14), subadult (n=7), and calf (n=8) animals under manual restraint.

REPRODUCTIVE NEOPLASMS IN WILD AND LONG-TERM CAPTIVE FEMALE FLORIDA MANATEES (TRICHECHUS MANATUS LATIROSTRIS).

Few reports of neoplastic diseases in manatees exist in the veterinary literature. This case series presents reproductive neoplasia noted in eight wild and long-term captive female Florida manatees (Trichechus manatus latirostris) obtained through carcass recovery and animal rehabilitation programs between April 2009 and May 2014. All cases were evaluated histologically, and diagnoses of uterine carcinoma (n = 1), granulosa cell tumor (n = 2), ovarian adnexal tumor (n = 1), and leiomyoma (n = 5) were made. The underlying cause of tumor development and effects on reproductive success is currently unknown, but possible asymmetric reproductive aging and/or a correlation between obesity and reproductive disorder in long-term nonreproductive female manatees are of interest and warrant further investigation.

Identification of Francisella noatunensis in novel host species French grunt (Haemulon flavolineatum) and Caesar grunt (Haemulon carbonarium).

Francisella noatunensis is an emerging pathogen of fish that has been isolated from several cultured species worldwide. Here presented is a case involving several hundred marine grunts that were caught near the Florida Keys for display in public aquaria. These fish were maintained in a recirculating system where they began to experience mortalities approximately two weeks post-stocking. Postmortem examination revealed disseminated systemic granulomatous disease most severely affecting spleen and kidney. Splenic and renal tissue homogenates inoculated in modified Thayer Martin agar media yielded colonies consistent with F. noatunensis 4 days post inoculation. Bacterial colonies and tissues were confirmed positive after real-time PCR amplification of the intracellular growth loci gene (iglC) specific for F. noatunensis subspecies orientalis. Consequently, multiple novel host species for this pathogen were identified, including the French grunt (Haemulon flavolineatum) and the Caesar grunt (Haemulon carbonarium).

Conservative management of pneumothorax and pneumoperitoneum in two Florida manatees (Trichechus manatus latirostris).

Two distressed Florida manatees (Trichechus manatus latirostris) were reported to the Florida Fish and Wildlife Conservation Commission. The first animal was determined to be an abandoned, emaciated calf. The second animal was a nursing calf that had sustained watercraft-related trauma. Both animals were captured and transported to Tampa's Lowry Park Zoo, where diagnostic evaluations, including physical examinations, blood work, computed tomography (CT), and radiographs were performed. Radiograph and CT scans identified the presence of free air within the pleural and abdominal cavities of both animals. Based on the lack of substantial findings in the first animal and a rapid resolution of clinical signs in the second animal, both animals were managed conservatively. This report documents simultaneous pneumothorax and pneumoperitoneum, the associated clinical and diagnostic findings, and conservative medical management of these conditions in the Florida manatee.

Echocardiographic evaluation of clinically healthy Florida manatees (Trichechus manatus latirostris).

Antemortem studies pertaining to the manatee cardiovascular and cardiopulmonary systems are limited despite reports of cardiac disease in postmortem specimens. The objective of this project was to develop a technique for echocardiography in the Florida manatee (Trichechus manatus latirostris). Because of their unique anatomy, a ventral approach was employed by use of an echocardiography table designed specifically for this study. Fourteen clinically healthy, free-ranging and captive Florida manatees underwent echocardiography between the fall of 2011 and winter of 2012. Eight females and six males of various age categories were included in the study. Clear visualization of all valves and chambers was accomplished, and length and width measurements of the left atrium, peak aortic flow velocity, and ejection fraction percentage were calculated in most animals. Abnormalities observed during the study included atrioventricular regurgitation and severe right-atrial enlargement. Based on the results of this study, echocardiography in the Florida manatee is possible, which has both clinical and research implications in larger epidemiologic studies evaluating diseases of the cardiopulmonary and cardiovascular systems.

Establishment of a 2-dimensional echocardiographic protocol and reference parameters for clinically healthy southern stingrays (Hypanus americanus).

OBJECTIVE: To establish an echocardiographic technique and 2-dimensional reference parameters for southern stingrays (Hypanus americanus). A second objective was to compare echocardiographic measurements obtained from animals of different sex, size, environment, handling technique, and position. ANIMALS: 84 presumed healthy, wild, semiwild, and aquarium-housed southern stingrays. PROCEDURES: Animals, anesthetized and manually restrained, were positioned in dorsal recumbency, and echocardiography was performed. A subset of this population was also imaged in ventral recumbency for comparison. RESULTS: Echocardiography was feasible, and reference parameters were established for this species. While some standard measurements could not be assessed due to body habitus, all valves, chambers, and the conus were clearly visualized in the majority of animals. Statistical significance was reached for some variables when comparing animals from different environments and handling methods, but these differences were not considered clinically relevant. The data were therefore separated into 2 subsets of echocardiographic reference parameters based on disc width since some of the measurements were dependent on body size. This approach mostly separated the sexes due to strong sexual dimorphism. CLINICAL RELEVANCE: Limited information is available regarding cardiac disease in elasmobranchs; most of the available information on cardiac physiology focuses on a few shark species. Two-dimensional echocardiography is a noninvasive tool utilized to evaluate cardiac structure and functionality. Southern stingrays are one of the most commonly displayed elasmobranchs in public aquaria. This article expands on the growing body of information regarding veterinary care in elasmobranchs and provides clinicians and researchers with another diagnostic modality to utilize in screening for health/disease.

Cardiac evaluation of clinically healthy captive maned wolves (Chrysocyon brachyurus).

The objective of this project was to determine radiographic vertebral heart sizes and electrocardiographic (ECG) and echocardiographic measurements in healthy anesthetized maned wolves (Chrysocyon brachyurus). The wolves, housed at the White Oak Conservation and Smithsonian National Zoo Conservation and Research Centers, were being anesthetized for annual examinations. Cardiac auscultation, thoracic radiographs, a standard 6-lead ECG, and echocardiography were performed on the wolves while they were under general anesthesia. Thirteen maned wolves were evaluated: five males and eight females. Mean age was 6.4 +/- 4.4 years (range, 2-13 years). Mean weight was 26 +/- 2.95 kg (range, 22-32 kg). Low-grade systolic murmurs were auscultated in three of 13 maned wolves. Evaluation of ECGs revealed a sinus rhythm, with a QRS morphology, and mean electrical axis similar to domestic canines. Radiographic evaluation revealed a mean vertebral heart size of 8.27 +/- 0.48 (range, 7.9-8.6). In addition, the cardiac silhouette was seen to elongate, with an increase in sternal contact in older wolves. Echocardiography showed that mitral valve degenerative changes and insufficiency is likely common in older wolves. Visualization of physiologic regurgitation across the mitral and pulmonary valves was common in wolves of all ages. Left ventricular measurements were similar to those reported for healthy dogs, and several variables correlated well with body weight. Two wolves were found to have one to three heartworms in the right pulmonary artery, and degenerative mitral valve disease was determined in maned wolves older than 6 years of age. All of the wolves in this study were on heartworm preventative and tested negative for heartworm antigen at their annual examinations. The results of this study provide reference information for use in the cardiac evaluation of anesthetized maned wolves.

Establishment of reference values for various coagulation tests in healthy Florida manatees (Trichechus manatus latirostris) and evaluation of coagulation in debilitated manatees during rehabilitation.

OBJECTIVE: To establish reference ranges for coagulation parameters in healthy Florida manatees (Trichechus manatus latirostris) and compare results with those for debilitated manatees undergoing treatment at a rehabilitation facility. DESIGN: Prospective study. ANIMALS: 29 healthy manatees and 45 debilitated manatees with various diseases. PROCEDURES: Manatees considered healthy on the basis of results of physical examination, CBC, and serum biochemical analysis underwent coagulation testing including measurement of prothrombin time, partial thromboplastin time, D-dimer concentration, platelet count, and fibrinogen concentration to establish reference ranges. For comparison, a group of manatees undergoing rehabilitation was also tested, and the results were compared. Thromboelastography was also performed on some animals. RESULTS: Values for D-dimer concentration were significantly higher in debilitated versus healthy animals. There was no significant difference for prothrombin time, partial thromboplastin time, platelet count, or fibrinogen concentration between groups. Thromboelastography was performed on 8 healthy animals. CONCLUSIONS AND CLINICAL RELEVANCE: Reference ranges were established for various tests of coagulation that may assist clinicians during the initial evaluation and rehabilitation of Florida manatees. Future research to evaluate the effect of specific disease processes on the coagulation cascade is recommended.

Diaphragmatic hernia and right-sided heart enlargement in a Florida manatee (Trichechus manatus latirostris).

Postmortem evaluation of a Florida manatee (Trichechus manatus latirostris) revealed cold stress lesions and previous watercraft trauma that included broken ribs, a diaphragmatic hernia, an enlarged vena cava, and right-sided cardiomegaly. We discuss these findings and present a possible pathogenesis for the cardiomegaly.