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Integument (skin)

(The following additional keywords have been used to categorize articles within this section and may assist your search.)

abscess, burn wound, hernia, honey, integument, snake bite, sunburn, wounds,

Elephant Bibliographic Database
www.elephantcare.org

References updated October 2009 by date of publication, most recent first.

Banerjee, A., 2008. Lucky escape after elephant gore injury of the chest. Emerg. Med. J. 25, 828.

Fowler, M.E. Wound healing in elephants. Proc American Associaton of Zoo Veterinarians and Assoc of Reptile and Amphibian Veterinarians.  143-144. 2008. 11-10-2008.
Ref Type: Conference Proceeding
Abstract:
Basic Wound Healing
A wound into the subcutaneous tissue follows sequential stages of healing, namely inflammation, débridement, proliferation, epithelization and contraction (scarring). Elephant wounds go through the same sequences if allowed to do so. Basic mammalian wound healing involves the epidermis, germinal epithelium, dermis and subcutaneous tissue. In the elephant foot the
epidermis becomes the cornified sole, pad or nail, which is produced by the germinal epithelium.The dermis becomes the corium (vascularized fibrous tissue connecting the cornified shell to the digits). The healing process may take weeks, months and even years. Particular emphasis will be given to anatomy as it relates to foot infections, basic principles of wound healing in mammals as applied to elephants, predisposing factors and factors that inhibit wound healing. Predisposing Factors of Foot Infections
Genetics (conformation defects), malnutrition (rickets), abnormal behavior (stereotypy, pawing, resting with pressure on a specific area of the foot, excessive pressure to compensate for pain in another limb), degenerative joint disease, poor sanitation, no variation in the enclosure substrate, and minimal opportunity to exercise are such factors.
Cardinal Rules Governing Wound Management, Specifically Foot Infections
 1. Elephants should be trained to allow foot inspection of all feet on a daily basis.
2. Minimize or eliminate predisposing factors.
3. Remove all necrotic material, dirt, feces, urine and debris from the wound cavity.
4. Obtain adequate drainage for an exudate to exit the cavity.
5. Prevent recontamination of the clean wound either by packing the wound cavity with
disinfectant soaked gauze or by applying a protective boot.

Meyers, D.A., Isaza, R., MacNeill, A. Evaluation of acute phase proteins for diagnosis of inflammation in Asian elephants ( Elephas maximus). Proc American Associaton of Zoo Veterinarians and Assoc of Reptile and Amphibian Veterinarians.  128. 2008. 11-10-2008.
Ref Type: Conference Proceeding
Abstract:
In many domestic species, routine hematology assays are useful diagnostic tools to diagnose inflammatory conditions. Unlike other species, these hematologic tests apparently are insensitive indicators of inflammation in elephants.1 We studied a novel group of blood proteins, called acute phase proteins, which increase during inflammatory conditions, for their usefulness in diagnosing elephants with inflammatory diseases. Although these proteins currently are useful in humans and domestic animals, each species has a different set of important proteins that must be individually investigated.2 We tested several acute phase proteins (C-reactive protein, alpha-1 glycoprotein, alpha-1 antitrypsin, serum amyloid A, haptoglobin, fibrinogen, ceruloplasmin, and albumin) as well as complete blood counts, chemistry panels, serum protein electrophoresis, and 3-D gel electrophoresis to determine their usefulness for diagnosing different types of inflammatory conditions in Asian elephants (Elephas maximus). Animals with inflammatory conditions were classified as those individuals with known illnesses such as mycobacteriosis, arthritis, nail bed abscesses, and malignant tumors. Control animals were thoseanimals that were suspected to not have any inflammation and be healthy at the time of testing as determined by physical examination and obtaining a thorough medical history.
LITERATURE CITED
1. Lyashchenko, K., R. Greenwald, J. Esfandiari, J. Olsen, R. Ball, G. Dumonceaux, F. Dunker, C. Buckley, M.
Richard, S. Murray, J.B. Payeur, P. Anderson, J.M. Pollock, S. Mikota, M. Miller, D. Sofranko, and W.R.
Waters. 2006. Tuberculosis in Elephants: Antibody responses to defined antigens of Mycobacterium
tuberculosis
, potential for early diagnosis, and monitoring of treatment. Clin. Vacc. Immunol. 13: 722-732.
2. Murata H., N. Shimada, M. Yoshioka. 2004. Current research on acute phase proteins in veterinary diagnosis:
an overview. Vet J. 168: 28-40.

Miller, J., McClean, M. Pharmacokinetics of enrofloxacin in African elephants (Loxodonta africana) after a single rectal dose. Proc American Associaton of Zoo Veterinarians and Assoc of Reptile and Amphibian Veterinarians.  224-225. 2008. 11-10-2008.
Ref Type: Conference Proceeding
Abstract:
Captive African elephants (Loxodonta Africana) are susceptible to many types of gram negative bacterial infections such as Escherichia coli, Mycoplasma  spp., Salmonella spp., Klebsiella spp., Pseudomonas spp., and Proteus spp. Enrofloxacin (Baytril®, Bayer Health Care, Animal Health Division, P.O. Box 390, Shawnee Mission, KS 66201) is a potentially effective antibiotic for
treatment of these bacterial infections in elephants. Very limited data exists on the pharmacokinetics of enrofloxacin in elephants2 and most of the dosage regimes for gastrointestinal absorption are based on horse dosages since they share a similar  gastrointestinal tract. Three African elephants from Wildlife Safari in Winston, Oregon, two females both 37-yr-old and one male 26-yr-old, were used to determine whether therapeutic levels of enrofloxacin could be achieved thru rectal administration of liquid injectable enrofloxacin (Baytril 100®, 100 mg/ml, Bayer Health Care, Animal Health Division, P.O. Box 390, Shawnee Mission, KS 66201) at a dosage of 2.5 mg/kg. A pretreatment baseline blood sample was collected. Following administration, blood samples were collected at 45 min, 1.5hr, 2.5hr, 5hr, 9hr, 23hr, 36hr to determine plasma enrofloxacin levels. Plasma enrofloxacin levels were measured at North Carolina State University, College of Veterinary Medicine using high performance liquid chromatography (HPLC) analysis. Plasma ciprofloxacin levels were measured concurrently. Results indicate plasma concentrations of enrofloxacin did not reach adequate bacteriocidal levels for any of the the following common bacterial isolates in captive elephants: Mycoplasma
spp., Escherichia coli, Salmonella spp., Klebsiella spp., Pseudomonas spp., and Proteus spp. The study determined that a rectally administered dosage of 2.5 mg/kg of liquid injectable enrofloxacin was insufficient to obtain therapeutic levels in African elephants. The low plasma levels of enrofloxacin in all three elephants may be a result of poor absorption in the distal large intestine. A future study will determine if oral administration will provide a more efficient mode of drug delivery and absorption in African elephants. It is also possible that the current dosage of 2.5 mg/kg is too low to achieve adequate therapeutic levels.
ACKNOWLEDGMENTS
I would like to thank the elephant and veterinary staff at Wildlife Safari for their participation in conducting this study. Thanks to Doctors: Modesto McClean, Jason Bennett, Andi Chariffe, Tessa Lohe, Benji Alacantar. Also thanks to Dinah Wilson, Carol Matthews, Anthony Karels, Mary Iida, Shawn Finnell, Patches Stroud, Katie Alayan.
LITERATURE CITED
1. Haines, G.R., et. al. 2000. Serum concentrations and pharmacokinetics of enrofloxacin after intravenous and intragastric administration to mares. Can. J.Vet. Res. 64(3):171-177.
2. Sanchez, C.R., et. al. 2005. Pharmacokinetics of a single dose of enrofloxacin administered orally to captive Asian elephants (Elephas maximus). Am. J. Vet. Res. 66:1948-1953.

Ramanathan, A., Mallapur, A., 2008. A visual health assessment of captive Asian elephants (Elephas maximus) housed in India. J. Zoo. Wildl. Med. 39, 148-154.
Abstract: A visual health assessment and survey questionnaire was conducted on 81 Asian elephants (Elephas maximus) housed in 10 animal facilities throughout India between November 2004 and February 2005. The survey questionnaire consisted of 10 questions that evaluated the health of the elephants, and they were completed after visually assessing each individual elephant. The information collected was ranked on a scale that was used to statistically compare the health among the study subjects. This study documented that 43.21% of the captive elephants surveyed exhibited hyperkeratosis. A significant proportion of the elephants owned by tourist camps had poor skin condition when compared with elephants from zoos and at a forest camp. Similarly, captive-born individuals were found to have better skin condition than animals that were caught from the wild. Sixty (74.1%) of the captive elephants that were observed during this study had fissures in their footpads, 20% of which were severe. The prevalence of foot fissures was significantly higher in females. A greater proportion of elephants owned by tourist camps displayed vertical and horizontal toenail cracks in comparison with the forest camp and zoo elephants. It was noted that 76.9% of the wounded animals and 80% of those having abscesses were housed at temples and tourist camps. Also, approximately 8.5% of the captive elephant population observed during this study had eye-related problems, and they were all housed at temples and tourist camps. In conclusion, it was evident that elephants housed at temples or tourist camps exhibited poor skin condition with wounds and abscesses. These findings suggest that the overall condition of the elephants housed at tourist camps was poor compared with elephants housed at zoos and at the forest camp

Schmitt, D., Charmason, S., Wiedner, E. Use of luteinizing hormone ELISAs  in breeding elephants. Proc American Associaton of Zoo Veterinarians and Assoc of Reptile and Amphibian Veterinarians.  120-121. 2008. 11-10-2008.
Ref Type: Conference Proceeding
Abstract: Successful artificial insemination (AI) of elephants depends heavily on determining the unique luteinizing hormone (LH) surges that occur during the follicular phase of the elephant's estrous cycle. Natural breeding of elephants also can benefit from a rapid and accurate determination of the two LH surges found in elephants. There are three ELISAs available for determining the LH
surge; two are commercially-available assays and one is a laboratory in-house assay. Each vary in their cost, time to complete the assay, and ease of performing the procedures. Detection of the initial non-ovulatory peak in luteinizing hormone (LH1) is best accomplished by use of an in house LH assay, or use of the LH assay available from Dr. Nancy Dahl (UC-Davis, Davis, CA
95616 USA), both of which are quantitative assays for detection of LH. For cow-side use during estrus, the qualitative ELISA Witness® LH Ovulation Timing Test Kit (Symbiotics Corporation, Kansas City, MO 64163 USA) detects LH in elephants within 20 min. This assay requires a minimum of laboratory precision to detect the ovulatory LH peak (LH2).
Introduction
Elephants are the only species known to exhibit a double LH peak during a single estrous cycle.2,4 Increased success of artificial insemination in elephants occurred partly in response to the ability to detect the LH1 surge about 21 days prior to the ovulatory LH2 surge that occurs at the end of a two to three day estrus.1 The first reports regarding detection of the double LH
surges were performed in laboratories using custom ELISA technology that require exacting procedures and two days to complete the quantitative assays.2,4 A semi-quantitative elephant LH ELISA that can be performed in the field in about 2.5 hr was developed at UC-Davis.3 A qualitative LH assay was developed for use in dogs and cats that uses a latex strip ELISA. The time for development of the test is 20 min and detects a LH surge greater than 1 ng/ml using serum. Elephants have LH1 and LH2 surges in the 4-16 ng/ml range,2,4 well within the detectable range for all of the assays described. The detection of the LH1 peak usually is from daily samples submitted weekly; this allows some efficiency of assay resources and provides at least a two-wk notice of LH2. However, accurate and timely detection of LH2 is needed at least daily and at times twice daily during estrus. The use of an LH assay which can be performed 'cow-side' and accurately detect LH2 is essential for successful AI and can be helpful in determining estrus status for natural breeding. The Witness® LH Ovulation Timing Test Kit from Symbiotics was developed for use in dogs and cats, but is effective in other species, including elephants, and meets these requirements.
Discussion
Detection of LH1 provides information for predicting the LH2 surge and performance of assays that require more laboratory time and precision are useful since detection of LH1 is not as timesensitive as LH2 detection. Both of the quantitative assays have unique advantages. An inhouse assay can be set up, but requires greater preparation time, precision of laboratory procedures is more demanding, often takes two days to perform, and is more susceptible to environmental variables. The assay developed by UC-Davis costs about $5.00 per well, takes about 2.5 hr to perform and is more stable. However, for quantitative results the overhead costs of the standard curve requires about 16 wells ($90), plus two wells for each unknown sample. The UC-Davis assay can be set up as a qualitative test with high and low controls and no standard curve. This requires from three to six wells for a single sample. The Witness® LH Ovulation Timing Test Kit has a control built into each test strip and costs about $25.00 per sample. Because 'cow-side' testing possible using the Witness® LH Ovulation Timing Test Kit, I recommend its use for detection of LH2, although the UC-Davis Elephant ELISA is competitively priced and can be performed in a nearby temporary laboratory. Because timing is
critical in detecting LH2 and performing subsequent AI, I recommend using the Witness® LH Ovulation Timing Test Kit at the time of estrus, preceded by either one of the other assays for detecting LH1, depending on availability of laboratory labor and equipment.
LITERATURE CITED
1. Brown, J. L., F. Goritz, N. Pratt-Hawkes, R. Hermes, M. Galloway, L. H. Graham, C. Gray, S. L. Walker, A. Gomez, R. Moreland, S. Murray, D. L. Schmitt, J. G. Howard, J. Lehnhardt, B. Beck, A. Bellem, R. Montali, and T. B. Hildebrandt. 2004. Successful artificial insemination of an Asian elephant at the National Zoological Park. Zoo Biol. 23: 45-63.
2. Brown, J. L., D. L. Schmitt, A. Bellem, L. H. Graham, and J. Lehnhardt. 1999. Hormone secretion in the Asian elephant (
Elephas maximus): Characterization of ovulatory and anovulatory luteinizing hormone surges. Biol. Reprod. 61: 1294-1299.
3. Dahl, N. J., D. Olson, D. L. Schmitt, D. R. Blasko, R. S. Kristipati, and J. F. Roser. 2004. Development of an enzyme-linked immunosorbent assay (ELISA) in the elephant (
Loxodonta africana and Elephas maximus). Zoo Biol. 23: 65-78.
4. Kapustin, N., J. K. Critser, D. Olson, and P. V. Malven. 1996. Nonluteal estrous cycles of 3-week duration are initiated by anovulatory luteinizing hormone peaks in African elephants. Biol. Reprod. 55:1147-1154.

Steinmetz, H.W., Eulenberger, U., Hatt, J.M. Daily clinical examinations in a herd of captive asian elephants. Proc American Associaton of Zoo Veterinarians and Assoc of Reptile and Amphibian Veterinarians.  124. 2008. 11-10-2008.
Ref Type: Conference Proceeding
Abstract:
The captive population of Asian elephants (Elephas maximus) is not self-sustaining.2 Poor reproduction and high juvenile mortality are key factors in the decreasing population. Infection with endotheliotropic elephant herpes virus (EEHV) is one of the major causes of death in the captive population, and has resulted in the loss of at least 40 captive animals.1 EEHV has been
responsible for the peracute death of two juvenile males at Zurich Zoo, Switzerland. Mortality due to peracute infection with EEHV mainly is seen in juveniles. Early detection of characteristic clinical signs of EEHV and immediate initiation of therapy are of crucial
importance due to its rapid progression. Based on past fatal EEHV experiences, Zurich Zoo modified its daily clinical health monitoring program to increase staff awareness of EEHV infection. Examinations have been incorporated into the daily routine and include daily evaluation of behaviour, appetite, colour of mucosal membranes and the measurement of body temperature; these examinations are performed by keepers. In our experiences, characteristic signs of acute EEHV infection are lethargy, anorexia, mild
colic, and cyanosis of the mucosal membranes. Results of temperature measurements have shown that best estimations of body temperature are done by measurement of the temperature in the centre of a fecal ball 5-9 min after defecation. Mean values of 36.5°C (± 0.2°C SD) are within published reference values, although adult elephants have shown significantly lower body temperature than juveniles. Establishment of individual reference values for each elephant is essential to detect unusual temperature peaks that may indicate possible EEHV viremia. The present study has shown that daily health examinations increase the awareness of keepers for
early signs of EEHV infection (e.g., peaks in body temperature and cyanotic mucosal membranes).
ACKNOWLEDGMENTS
The authors thank B. Aeschbach and all elephant keepers for taking special care of our elephants. The work and organization of Ms. G. Hürlimann is gratefully appreciated.
LITERATURE CITED
1. Mikota, S. 2007. Endotheliotropic Herpesvirus (EEHV). http://www.elephantcare.org/herpes.htm. cited: 10.04.2008:
2. Wiese, R. J. 2000. Asian elephants are not self-sustaining in North America. Zoo Biol. 19: 299-309.

Wiedner, E.B., Gray, C., Rich, P., Jacobson, G.L., Isaza, R., Schmitt, D., Lindsay, W.A., 2008. Nonsurgical repair of an umbilical hernia in two Asian elephant calves (Elephas maximus). J. Zoo. Wildl. Med. 39, 248-251.
Abstract: Umbilical hernias were diagnosed in two captive-born, female Asian elephant (Elephas maximus) calves several weeks after birth. Daily manual reduction of the hernias for 5 wk in the first case and for 5 mo in the second resulted in complete closure of the defects. Nonsurgical repair of uncomplicated, fully reducible umbilical hernias in Asian elephants can be an alternative to surgery

Woolley, L.A., Millspaugh, J.J., Woods, R.J., van Rensburg, S.J., Mackey, R.L., Page, B., Slotow, R., 2008. Population and individual elephant response to a catastrophic fire in Pilanesberg National Park. PLoS. One. 3, e3233.
Abstract: In predator-free large herbivore populations, where density-dependent feedbacks occur at the limit where forage resources can no longer support the population, environmental catastrophes may play a significant role in population regulation. The potential role of fire as a stochastic mass-mortality event limiting these populations is poorly understood, so too the behavioural and physiological responses of the affected animals to this type of large disturbance event. During September 2005, a wildfire resulted in mortality of 29 (18% population mortality) and injury to 18, African elephants in Pilanesberg National Park, South Africa. We examined movement and herd association patterns of six GPS-collared breeding herds, and evaluated population physiological response through faecal glucocorticoid metabolite (stress) levels. We investigated population size, structure and projected growth rates using a simulation model. After an initial flight response post-fire, severely injured breeding herds reduced daily displacement with increased daily variability, reduced home range size, spent more time in non-tourist areas and associated less with other herds. Uninjured, or less severely injured, breeding herds also shifted into non-tourist areas post-fire, but in contrast, increased displacement rate (both mean and variability), did not adjust home range size and formed larger herds post-fire. Adult cow stress hormone levels increased significantly post-fire, whereas juvenile and adult bull stress levels did not change significantly. Most mortality occurred to the juvenile age class causing a change in post-fire population age structure. Projected population growth rate remained unchanged at 6.5% p.a., and at current fecundity levels, the population would reach its previous level three to four years post-fire. The natural mortality patterns seen in elephant populations during stochastic events, such as droughts, follows that of the classic mortality pattern seen in predator-free large ungulate populations, i.e. mainly involving juveniles. Fire therefore functions in a similar manner to other environmental catastrophes and may be a natural mechanism contributing to population limitation. Welfare concerns of arson fires, burning during "hot-fire" conditions and the conservation implications of fire suppression (i.e. removal of a potential contributing factor to natural population regulation) should be integrated into fire management strategies for conservation areas

Bouley, D.M., Alarcón, C.N., Hildebrandt, T., O'connell-Rodwell, C.E., ., 2007. The distribution, density and three-dimensional histomorphology of Pacinian corpuscles in the foot of the Asian elephant (Elephas maximus) and their potential role in seismic communication. J Anat 211, 428-435.
Abstract: Both Asian (Elephas maximus) and African (Loxodonta africana) elephants produce low-frequency, high-amplitude rumbles that travel well through the ground as seismic waves, and field studies have shown that elephants may utilize these seismic signals as one form of communication. Unique elephant postures observed in field studies suggest that the elephants use their feet to 'listen' to these seismic signals, but the exact sensory mechanisms used by the elephant have never been characterized. The distribution, morphology and tissue density of Pacinian corpuscles, specialized mechanoreceptors, were studied in a forefoot and hindfoot of Asian elephants. Pacinian corpuscles were located in the dermis and distal digital cushion and were most densely localized to the anterior, posterior, medial and lateral region of each foot, with the highest numbers in the anterior region of the forefoot (52.19%) and the posterior region of the hindfoot (47.09%). Pacinian corpuscles were encapsulated, had a typical lamellar structure and were most often observed in large clusters. Three-dimensional reconstruction through serial sections of the dermis revealed that individual Pacinian corpuscles may be part of a cluster. By studying the distribution and density of these mechanoreceptors, we propose that Pacinian corpuscles are one possible anatomic mechanism used by elephants to detect seismic waves.

Sarma, K.K. Occupational injuries and work related diseases in the working elephants in India´s north east. Proceedings International Elephant Conservation & Research Symposium.  164-169. 2006. 2006.
Ref Type: Conference Proceeding

Shakespeare, A., Strydom, S., 2006. A method for determining the extent of thermal burns in elephants. J S Afr Vet Assoc 77, 70-74.
Abstract: A practical method was developed to assess the extent of burns suffered by elephants caught in bush fires. In developing this method, the surface areas of the different body parts of juvenile, subadult and adult elephants were first determined using standard equations, and then expressed as a percentage of the total body surface area. When viewed from a distance, the burnt proportion of all body segments is estimated, converted to percentages of total body surface area, and then summed to determine the extent of burns suffered.Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort 0110, South Africa. tony.shakespeare@up.ac.za

Shakespeare, A., Strydom, S., 2006. A method for determining the extent of thermal burns in elephants
379. J. S. Afr. Vet. Assoc. 77, 70-74.
Abstract: A practical method was developed to assess the extent of burns suffered by elephants caught in bush fires. In developing this method, the surface areas of the different body parts of juvenile, subadult and adult elephants were first determined using standard equations, and then expressed as a percentage of the total body surface area. When viewed from a distance, the burnt proportion of all body segments is estimated, converted to percentages of total body surface area, and then summed to determine the extent of burns suffered

Shakespeare, A., Steyl, J., Strydom, S., 2006. Investigating the depth of thermal burns in elephants
375. J. S. Afr. Vet. Assoc. 77, 134-140.
Abstract: Histological examination of burn injuries in elephants revealed that the depth was not as severe as expected from clinical observation. Although the actual burn depth was deep, the thickness of elephant skin, especially the dermis, resulted in the lesions being classified as less severe than expected. Examination of skin samples from selected areas showed that most lesions were either superficial (1st degree) or superficial partial-thickness (superficial 2nd degree) burns with the occasional deep partial thickness (deep 2nd degree) wound. These lesions however, resulted in severe complications that eventually led to the death of a number of the elephants

Stremme, C., Lubis, A., Wahyu, M. Veterinary care for elephants used for clearings works in the devastated areas after the tsunami in Banda Aceh. Proceedings International Elephant Conservation & Research Symposium.  271-272. 2006. 2006.
Ref Type: Conference Proceeding

Weidner, E.B., Isaza, R., Galle, L.E., Barrie, K., Lindsay, W.A., 2006. Medical management of a corneal stromal abscess in a female Asisan elephant (Elephas maximus). Journal of Zoo and Wildlife Medicine 37, 397-400.

Wiedner, E.B., Isaza, R., Galle, L.E., Barrie, K., Lindsay, W.A., 2006. Medical management of a corneal stromal abscess in a female Asian elephant (Elephas maximus). Journal of Zoo and Wildlife Medicine 37, 397-400.
Abstract: A 47-yr-old female Asian elephant (Elephas maximus) developed a corneal stromal abscess in her right eye. The elephant was trained to open her eye for topical ophthalmic therapy, and was treated six times daily with antibiotics and an antifungal solution for almost 2 mo. Nonsteroidal anti-inflammatory drugs were used to control pain, and atropine was applied topically to dilate the pupil and provide additional comfort. Vascularization of the abscess began shortly after initiating therapy, and complete resolution was obtained by 7 wk.

Wiedner, E.B., Isaza, R., Galle, L.E., Barrie, K., Lindsay, W.A., 2006. Medical management of a corneal stromal abscess in a female Asian elephant (Elephas maximus). J. Zoo. Wildl. Med. 37, 397-400.
Abstract: A 47-yr-old female Asian elephant (Elephas maximus) developed a corneal stromal abscess in her right eye. The elephant was trained to open her eye for topical ophthalmic therapy, and was treated six times daily with antibiotics and an antifungal solution for almost 2 mo. Nonsteroidal anti-inflammatory drugs were used to control pain, and atropine was applied topically to dilate the pupil and provide additional comfort. Vascularization of the abscess began shortly after initiating therapy, and complete resolution was obtained by 7 wk

Zuba, J.R., Oosterhuis, J.E., Pessier, A.P. The toenail "abscess" in elephants: treatment options including cryotherapy and pathologic similarities with equine proliferative pododermatitis (canker).  2006 Proceedings American Association of Zoo Veterinarians.  187-190. 2006.
Ref Type: Conference Proceeding
Abstract: Foot problems potentially represent the single most important clinical disease of captive elephants.  Predisposing factors include obesity, lack of exercise, nail or sole overgrowth, improper foot care, poor hygiene, inappropriate enclosure surfaces, poor conformation, malnutrition and secondary skeletal disorders such as degenerative joint disease.  Furthermore, factors such as elephant management philosophy, disposition of elephants, facilities and competency of staff in caring for elephant feet will contribute significantly to the foot health of captive animals.  It is important to note that these conditions are rarely reported in free-ranging elephants. The elephant toenail abscess is characterized grossly by proliferative outgrowth of "crab meat-like" tissue that may acutely rupture through the surface of the nail wall and/or adjacent cuticle or sole. True abscess formation with localized collections of suppurative material is not a consistent clinical feature.  In most cases, the inciting cause of these lesions are typically not found and are likely due to one or more of the predisposing factors listed above.  Once established, these frustrating lesions require extensive, intensive and prolonged medical attention.  If not cared for properly, these wounds may progress to phalangeal osteomyelitis and the need for surgical intervention.  Sole abscesses are equally frustrating and difficult to manage with proposed etiologies similar to toenail lesions. There are no reports in the literature describing the pathology of the classic proliferative abscess tissue of the elephant nail abscess.  Although variously interpreted as fibrous or granulation tissue, the authors are unaware of previous histologic descriptions of this tissue.  Biopsy samples of toenail abscess tissue from two Asian elephants (Elephas maximus) at the San Diego Wild Animal Park (SDWAP) consisted of stratified squamous epithelium arranged in columns resembling horn tubules.  The predominant histologic finding was marked, near diffuse, hydropic degeneration of keratinocytes.  There were multifocal areas of suppurative inflammation with admixed bacterial colonies.  Inflammatory foci comprised only a small portion of the lesion and were interpreted as the external surfaces of the biopsy with likely secondary bacterial colonization. Because descriptions of the normal histology of the elephant toenail could not be located, a grossly normal toenail from a different Asian elephant was obtained to compare histologic features with those of the toenail abscesses.  Sections demonstrated formation of the toenail in a manner similar to that of the hoof of the horse and cattle with tubular, intertubular and laminar horn.  Primary and secondary epidermal laminae were identified.  Proliferative lesions of horn-producing epithelium associated with ballooning degeneration and inadequate keratinization of keratinocytes, have been described in horses as equine "canker" and coronary band dystrophy.  Equine canker is most commonly observed in the hind feet of draft horses and begins in the frog sometimes with extension to the sole and hoof wall.  Grossly, lesions are characterized by soft white papillary to "cauliflower-like" tissue associated with a foul odor. Similar to what is noted in elephant foot problems, predisposing factors for the development of equine canker include poor hygiene or wet environmental conditions. There is a lack of gross and histologic description of the normal nail and sole tissue of the elephant and further investigations are warranted.  A review of the anatomy and histology of the normal equine hoof may provide a basic understanding of the elephant nail until more specific and detailed elephant information is available.  From our investigation, the authors offer that a more accurate description of the elephant toenail abscess would be proliferative pododermatitis, the term synonymous with equine canker.  A more colloquial term such as "elephant canker" may be appropriate, as well. Canker in the horse is an uncommon but difficult to treat disease of the hoof.  Historically, treatment options for elephant toenail abscesses include corrective trimming, superficial debridement and application of topical disinfectants or antibiotics. Others have constructed innovative sandals to treat and protect the affected sole or nail with success. The use of regional intravenous perfusion of the affected limb with antibiotics has also been successful. Since the elephant nail abscess now appears to be histologically and clinically comparable to equine canker, this novel characterization of an old disease may offer unique insight for treatment.  In the least, it has provided our practice with a new list of treatment options and experienced equine clinicians for consultation who have been managing patients with a similar disease for many years. One of the Asian elephants at the SDWAP has had chronic toenail abscesses for over 2 yr. Radiographs of the affected digits, as reported by others to assess degree of involvement, have fortunately been negative for evidence of osteomyelitis.  Several bacterial and fungal cultures of deep tissue biopsies and swabs of affected lesions have resulted in a mixture of organisms with no consistent single etiologic agent.  Biopsies were found negative for presence of viral DNA (elephant papillomavirus and herpesvirus) by PCR.  Typical elephant foot care at the SDWAP includes trimming and debriding with hoof knives, foot soaks and topical antibiotics.  Although difficult, attempts are made in keeping the affected foot clean and dry.  Following recommendations for the treatment of equine canker, we recently implemented the routine use of cryotherapy in all elephants with proliferative pododermatitis with improved success in the control and recession of exuberant nail lesions. The proliferative tissue of the nail is first cleaned then disinfected, debrided, trimmed with hoof knives and allowed to dry. Modified brass branding tools with contact surfaces of variable size (2-5 cm diameter) and shape (round or ovoid) are placed into liquid nitrogen (-196 C) for several minutes and then placed directly on the cankerous tissue for 30-60 sec.  This process is then repeated 4-5 min later, following a complete thaw of tissue.  Within 24 hr, the cryoburned tissue becomes macerated and necrotic and is readily removed with gentle scrubbing.  Cryotherapy offers the advantage of destroying tissue to a deeper level than trimming alone and provides hemostasis, as well.  Because of decreased sensation at the cryotherapy treatment site, a memorable painful event is avoided and the elephant patient is more routinely accepting of this technique. With the use of hoof knives, we typically remove 2-3 mm of proliferative tissue before the patient refuses further treatment, presumably due to discomfort.  With cryotherapy, we are able to remove an additional 3-5 mm of tissue by cell freezing and necrosis.  The result is quicker resolution of cankerous lesions without the need for aggressive, and potentially painful, interventions. In conclusion, it appears that elephant nail abscesses can best be described as proliferative pododermatitis, or canker, as is seen in other species.  Further gross and microscopic descriptions of normal and pathologic nail or sole lesions are necessary.  Routine cryotherapy has shown promise in the treatment of these chronic, frustrating and potentially devastating lesions of our captive elephants.

Suedmeyer, W.K., Oosterhuis, J., Kollias, G., Fagan, D., Hornoff, B., Dodam, J., Shafford, H. Elephant restraint device assisted anesthesia in an African elephant (Loxodonta africana). 2005 Proceedings AAZV, AAWV, AZA Nutrition Advisory Group.  189-191. 2005.
Ref Type: Conference Proceeding
Abstract: Modern elephant management programs often include the use of protected contact. This allows improved safety for the elephant staff but may limit access to medical conditions occurring in elephants.
A 27-yr-old female African elephant (Loxodonta africana) weighing an estimated 3,700 kg was anesthetized for evaluation of a chronic, progressive, fistulous tract of the left ventral mandible. The mandible was routinely cultured, flushed with diluted peroxide, chlorhexidine, betadine solution, or alternating antibiotics, based on microbial sensitivities. To properly assess the left mandible, the elephant had to be placed in right lateral recumbency, which was accomplished with the use of a commercially available rotational elephant restraint device (ERD). Because of the protected contact management program, right lateral recumbency could not be guaranteed at the time of immobilization. Malpositioning, tusk fracture and/or related injury could occur upon recumbency without the additional control afforded by the ERD. The ERD is a hydraulically operated unit that comfortably restrains an elephant, minimizing safety risks to the animal and staff. The ERD consists of one solid wall, three side panels, and hinged floor. The ends of the restraint are closed with moveable shift doors. The three side panels can be moved independently depending upon the size of the animal and are further subdivided with moveable "subpanels" to allow direct access to various areas of the animal. In addition, support straps help gently stabilize limbs when performing medical procedures. The unit is positioned within the elephant holding facility at the Kansas City Zoo. The unit was installed in 1994 during renovation of the elephant exhibit, whereupon the elephant management program was changed from free-contact to protected contact. The ERD is utilized for reproductive assessments, semen collection, transabdominal ultrasound, evaluation of integumentary wounds, ophthalmic and aural examination, and administration of injectable medications. However, no elephant had been anesthetized and rotated in the restraint. The affected animal could not be guaranteed to re-enter the ERD once rotated, but would enter and station in the ERD on a daily basis. Because of this, a conspecific was conditioned to allow rotation without the use of sedatives or tranquilizers, to prepare for the actual immobilization. Adjustments in strap placement, cushioning, critical evaluation of mechanical stability, and placement of hydraulic panels allowed staff to prepare for the actual immobilization, minimizing complications. The elephant was conditioned to enter and station in the ERD. After strapping the distal limbs, thorax and caudal abdomen for support, the elephant was immobilized with a combination of 3,000 IU of hyaluronidase (O'Brien Pharmacy, Kansas City, MO USA), 10 mg acepromazine maleate, and 7 mg etorphine hydrochloride (Wildlife Pharmaceuticals Inc., Fort Collins, CO USA) via pole syringe. Close monitoring of induction was performed and when stage III anesthetic plane was achieved, the elephant was rotated into right lateral recumbency, elevating the elephant 6 feet above the floor. No voluntary movement of the animal was noted while the restraint was in motion. Direct arterial blood pressure, indirect oscillometric blood pressure, blood gases, respiratory rate, excursion characteristics, cardiac rate and rhythm, and pulse oximetry was routinely monitored during the procedure. Anesthesia was maintained with intermittent boluses of etorphine hydrochloride. Intravenous physiologic fluids (lactated Ringers solution) were maintained via an i.v. aural catheter, and insufflation with oxygen was provided on a continual basis. Oral examination and palpation demonstrated an incomplete transverse fissure of the left mandibular molar, intact gingival, and proper dental occlusion with the upper arcade.  Digital radiographs of the left mandible were performed based on exposures obtained with a set of skeletonized jaws. Advantages of this diagnostic modality are the immediate imaging results, portability, and digital imaging and storage, and does not require a developer or fixative. Adjustments in radiographic angle and technique were made to obtain the best diagnostic image. Radiographic imaging demonstrated a sequestrum consisting of a fractured enamel plate  2of the mandibular molar with a fistulous tract that coursed ventrally to communicate through the skin. The elephant was elevated 6 feet above the ground, which presented unique challenges. Because of the relatively small operating space, intubation was not possible, but insufflation was readily achieved and successful based on pulse oximetry trends. A commercial lift was utilized to elevate two large-animal circle anesthetic units to the level of the elephant's head. During immobilization the legs were cushioned and restraint straps removed to lessen the potential for occlusive damage to the tissues. The ERD allows an elephant to be positioned in either right or left lateral recumbency.
Upon completion of diagnostic procedures, the narcotic agent was reversed with 1,400 mg naltrexone hydrochloride (Zoopharm, Laramie, WY USA) administered 25% intravenously and 75% subcutaneously. The elephant awoke within 90 sec and was rotated to a standing position within the restraint. Thereafter, the elephant was confined in the restraint for approximately 45 min, until no untoward effects were likely to occur. The elephant was released from the restraint and resumed normal eating and drinking within 8 hr, and voluntarily entered the restraint within 2 wk following the procedure. The elephant was stable throughout the procedure; however, a predetermined objective for mean arterial blood pressures (<200 MAP) was not achieved. Hyaluronidase was utilized to promote rapid absorption of the narcotic and neuroleptic agents.3 Acetylpromazine was used to maintain peripheral perfusion by reducing the hypertensive effects of etorphine,1 which has been documented in previous immobilizations of African elephants.3-5 Etorphine hydrochloride, a powerful narcotic agent, has been successfully used as an immobilizing agent in both wild and captive African elephants.3-5 Use of an ERD allowed full control of the immobilization, increasing safety for personnel, preventing injury to the elephant, and positioning the left mandible on the dorsal plane. Disadvantages are the elevated height of the elephant, relatively small operating space, and disrupted line of sight communication. A second procedure will be performed in the near future to address the fracture and subsequent sequestrum diagnosed during the first immobilization. The elephant is currently being conditioned to allow restraint in a holding stall that will allow greater access to the oral cavity and surgical manipulation of the affected mandible.
ACKNOWLEDGMENTS
We thank the staff of the Kansas City Zoological Park for their care, concern, and expertise in helping make this procedure a success.
LITERATURE CITED
1 Booth, N.H. Psychotropic agents. In: Booth, N.H., and R.E. McDonald (eds.). Veterinary Pharmacology and Therapeutics.  W.B. Saunders, Co., Philadelphia, PA. P. 329.
2 Fagan, V.D.A., J.E. Oosterhuis, and A. Roocraft. 2001. Captivity disorders in elephants: impacted molars and broken tusks. Der Zoologische Garten 71:281-303.
3 Honeymoon, V.L., G.R. Pettifer, and D.H. Dyson. 1992. Arterial blood pressure and blood gas values in normal standing and laterally recumbent African (Loxodonta africana) and Asian (Elephas maximus)    elephants. J. Zoo Wildl. Med. 23:205-210.
4. Kock, R.A., P. Morkel, and M.D. Kock. 1993. Current immobilization procedures used in elephants. In: Fowler,
M.E. (ed.).  Zoo and Wild Animal Medicine: Current Therapy 3. W.B. Saunders Co., Philadelphia, PA.  Pp. 436-441.
5 Raath, J.P. 1999. Relocation of African elephants. In: Fowler, M.E., and R.E. Miller (eds.). Zoo and Wild Animal Medicine: Current Therapy 4. W.B. Saunders, Co., Philadelphia, PA.  Pp. 525-533.

Abou-Madi, N., Kollias, G.V., Hackett, R.P., Ducharme, N.G., Gleed, R.D., Moakler, J.P., 2004. Umbilical herniorrhaphy in a juvenile Asian elephant (Elephas maximus)
696. J. Zoo. Wildl. Med. 35, 221-225.
Abstract: An umbilical hernia was diagnosed in a 2-wk-old Asian elephant (Elephas maximus) by physical and ultrasonographic examinations. Umbilical herniorrhaphy was elected because the defect was large (approximately 7 cm long and 10 cm deep) and could potentially lead to incarceration of an intestinal loop. General anesthesia was induced with a combination of ketamine, xylazine, and diazepam and maintained with isoflurane in oxygen. The hernial sac was explored and contained fibrous tissue, fat, and an intestinal loop but no adhesions. The hernial sac was resected and the body wall closed using the technique of simple apposition. Following a superficial wound infection, the surgical site healed with no further complications.

Lamps, L.W., Smoller, B.R., Goodwin, T.E., Rasmussen, L.E.L., 2004. Hormone receptor expression in interdigital glands of the Asian elephant (Elephas maximus). Zoo Biology 23, 463-469.
Abstract: Recently, our group performed the first histologic, histochemical, and immunohistochemical analysis of eccrine-type interdigital glands in the Asian elephant (Elephas maximus) (Lamps et al. [2001] Res Vet Sci 71:197-200). Since morphologically similar human eccrine glands express reproductive hormone receptors (including androgen, estrogen, and progesterone receptors), the purpose of the current study was to determine whether interdigital eccrine glands in the Asian elephant contain these same hormone receptors. Necropsy samples of interdigital areas from two adult Asian elephants (one male and one female) were obtained.  Immunohistochemical staining was performed for estrogen, progesterone, and androgen receptor proteins. Immunoreactivity to all three receptor proteins was seen in a nuclear distribution in eccrine glands from both samples. This staining pattern is similar to that seen in human eccrine glands and tumors of eccrine derivation, although the significance of the receptor protein expression is unknown. The immunoreactivity of elephant interdigital glandular epithelium with monoclonal antibodies raised to human receptor proteins also suggests a high degree of phylogenetic conservation of these proteins between Asian elephants and humans. Despite detailed morphologic characterization, the function of these glands remains unclear. Further studies are needed to elucidate the function of these glands, the possible relationship between hormone receptor expression and circulating hormone levels, and the potential role of these glands in chemical communication in Asian elephants.

Singleton, C., Ramer, J., Proudfoot, J. Use of unpasteurized honey for treatment of a deeply infected wound in an African elephant   ( Loxodonta africana). 2004 PROCEEDINGS AAZV, AAWV, WDA JOINT CONFERENCE.  622-624. 2004.
Ref Type: Conference Proceeding
Abstract: Case Report
A 26-yr-old female African elephant (Loxodonta africana) received a deep laceration to the neck from the tusk of another elephant. The wound originated approximately 10 cm caudal to the middle of the right pinna, extended ventromedially, and penetrated multiple muscle layers. The wound was approximately 10-12 cm wide and 25-30 cm deep.

Initial treatment involved wound lavage with sterile saline twice daily, sulfadimethoxine/ormetoprim (Primor®, Pfizer Animal Health, Exton, Pennsylvania 19341, USA; 8.5 mg/kg p.o., b.i.d.), and ibuprofen (Pharmacia and Upjohn, Kalamazoo, Michigan 49001, USA; 2 mg/kg p.o., b.i.d. as needed). There was purulent discharge from the wound on day 5, therefore topical wound dressing was initiated. After wound lavage, the wound cavity was packed with laparotomy sponges coated with a 1:1 mixture of 1% silver sulfadiazine cream (BASF Corporation, Mount Olive, New Jersey 07828, USA) and an anti-inflammatory ointment (hemorrhoidal ointment, CVS Pharmacy Inc., Woonsocket, Rhode Island 02895, USA). Despite aggressive topical and systemic therapy, the wound became progressively more purulent, necrotic, and malodorous. On day 11, the wound dressing was changed from silversulfadiazine cream / hemorrhoidal ointment to laparotomy sponges coated with unpasteurized honey (Eisele's Raw Honey, Westfield, Indiana 46074, USA). On day 16, oral antibiotics were changed from sulfadimethoxine / ormetoprim to enrofloxacin (Baytril®, Bayer Corporation, Shawnee Mission, Kansas 66201, USA; 1.5 mg/kg p.o., s.i.d.) based on culture and sensitivity results. After 5 wk of therapy (day 51), enrofloxacin was discontinued due to poor patient compliance. Wound care from day 52 until completion of healing (12 additional weeks) consisted of twice daily wound lavage and dressing with unpasteurized honey. By day 101, wound care was decreased to once daily. On day 138 wound care was discontinued, and on day 143 the wound was considered healed.

Within 4 days of beginning topical treatment with honey, subjective scores of purulent exudate, necrotic tissue, and malodor began to improve. By day 29, the wound was no longer malodorous. Minimal necrotic tissue remained in the wound on day 37, and purulent discharge had resolved by day 90.

A single-dose oral enrofloxacin pharmacokinetic study was performed to evaluate serum and milk levels of the drug. Following oral administration of enrofloxacin at 1.5 mg/kg, serum levels were subtherapeutic at all time points over 24 hr.

Discussion
Unpasteurized, or raw, honey has been used as a medicine for centuries. Many ancient cultures used honey to treat skin wounds, gastric ulcers, diarrhea, eye disorders, and cough.7 There are many reports in the human medical literature of wound dressing with unpasteurized honey, but there are very few reports of its use in clinical veterinary medicine.4,5

The success of unpasteurized honey as a wound dressing is due to its antibacterial, antiinflammatory, immune-stimulating, tissue-debriding, and tissue-nourishing properties. High osmolality, phytochemicals, production of hydrogen peroxide, and stimulation of leukocyte activity contribute to the overall antibacterial activity of honey. Raw honey reduces inflammation by eliminating bacterial production of pro-inflammatory antigens and cytotoxins,8
reducing local edema by osmosis,6 and contributing antioxidants that scavenge free radicals.2 Immune system stimulation includes activation of neutrophils, stimulation of lymphocyte proliferation,1 and release of immune-mediator compounds by monocytes.11 Dressing wounds with raw honey often eliminates the need for surgical debridement.10 Honey improves tissue regeneration by stimulating the development of new capillary beds, thereby increasing nutrient delivery and oxygen supply to tissues.3,6 Raw honey also provides the moist environment necessary for proliferation of epithelial cells and fibroblasts.8

Honey is easy to use as a wound dressing. It can be spread directly onto wounds, soaked into gauze, or used to fill cavities. It generally causes no pain upon application.7 Plasma or lymph is drawn out of tissues by osmosis, creating a layer of dilute honey in contact with the wound surface; there is minimal adhesion of bandage materials to cause pain or tissue damage when dressings are changed.6 Honey dressings can be changed daily, but can be changed more frequently if the wound is infected or contaminated; bandages can be changed less frequently if the wound is clean and dry.6 Any residual honey is easily removed with warm water. Solidified honey can be returned to the liquid form by warming to 37°C. Honey should not be heated excessively because the enzyme that produces hydrogen peroxide is easily inactivated by heat.6 Although honey may contain clostridial spores, there are no published reports of wound botulism.

In this case, no adverse effects resulted from using unpasteurized honey as a wound dressing. Necrosis and malodor were greatly decreased within 16 days and purulent discharge was drastically reduced within 23 days of beginning treatment with honey. Subjectively, the wound healed faster and with less scar tissue than expected for this elephant as well as in comparison to wounds in other elephants. Raw honey likely provided the primary antibacterial activity during wound healing since enrofloxacin serum levels were subtherapeutic. Unpasteurized honey should be considered for topical treatment of deep, infected wounds in elephants.

ACKNOWLEDGMENTS
The authors thank Ellen Clark, RVT, Jennifer Niederlander, RVT, David Hagan, Barre Fields, Don Nevitt, Jill Sampson, Leslie Mackie, Adam Cheek, Niki Jordan, and Shea Earley for assistance with wound management, and Susan Mikota, DVM for consultation regarding the case.

LITERATURE CITED
1. Abuharfeil, N., R. Al-Oran, and M. Abo-Shehada. 1999. The effect of bee honey on the proliferative activity of human B- and T-lympocytes and the activity of phagocytes. Food Agric. Immunol. 11: 169-177.
2. Frankel, S., G.E. Robinson, and M.R. Berenbaum. 1998. Antioxidant capacity and correlated characteristics of 14 unifloral honeys. J. Apicultural Res. 37(1): 27-31.
3. Gupta, S.K., H. Singh, A.C. Varshney, and P. Prakash. 1992. Therapeutic efficacy of honey in infected wounds in buffaloes. Indian J. of Ani. Sci. 62(6): 521-523.
4. Harcourt-Brown, F.M. 2002. Honey to treat rabbit abscesses. Exotic DVM 3(6): 13-14.
5. Mathews, K.A. and A.G. Binnington. 2002. Wound management using honey. Compend. Contin. Educ. Pract. Vet. 24(1): 53-60.
6. Molan, P.C. 1998. A brief review of the use of honey as a clinical dressing. Primary Intention (Aust. J. Wound Manage.) 6(4): 148-158.
7. Molan, P.C. 1999. Why honey is effective as a medicine. 1. Its use in modern medicine. Bee World 80(2): 80-92.
8. Molan, P.C. 2001a. Why honey is effective as a medicine. 2. The scientific explanation of its effects. Bee World 82(1): 22-40.
9. Molan, P.C. 2001b. Honey as a topical antibacterial agent for treatment of infected wounds. World Wide Wounds. Http://www.worldwidewounds.com.
10. Subrahmanyam, M. 1993. Topical application of honey in treatment of burns. Br. J. Surg. 78(4): 497-498.
11. Tonks, A., R.A. Cooper, A.J. Price, P.C. Molan, and K.P. Jones. 2001. Stimulation of TNF-α release in monocytes by honey. Cytokine 14(4): 240-242.

Taranov, O., Ryabchikova, E., Tikhonov, A., Pugachev, V., Repin, V., 2004. Sebaceous glands of woolly mammoth (the histological evidence). Proceedings of the Russian Academy of Sciences, ser. biol. , 398, 139-141.

Clausen, B., 2003. Elephant clinic. A mobile elephant clinic in Thailand. Experiences in the first two years. Dansk Veterinaertidsskrift 86, 20-25.
Abstract: From the most recent figures available (1998), it appears that there are probably more tame elephants (2257) than wild elephants(1300-3000) in Thailand. In August 1999 a mobile elephant clinic was set up using local and Danish personnel; the clinic was financed by the RSPCA and is based in Lampang, northern Thailand, and provides free medical care, medication and advice for the tame elephants in the country. The age of the treated animals ranged from below 1 year to over 56 years, with most being 36-40. The treatments given to 164 elephants during the 2-year period are tabulated; 53% were male, 60% were involved in the tourist industry and 37% in forestry. Most treatments (151, 32.5%) were for routine care of hooves and skin, poor condition (107, 23.1%), chronic wounds (42, 9.1%), digestive problems (26, 5.6%), and acute eye problems (25, 5.4%). Details of the treatments and the drugs used are given. The place of tame elephants in the economy of the country is discussed.

Mikota, S.K., Hammatt, H., Finnegan, M. Occurrence and prevention of capture wounds in Sumatran elephants (Elephas maximus sumatranus). Proc Amer Assoc Zoo Vet.  291-293. 2003.
Ref Type: Conference Proceeding
Abstract: The capturing of elephants in Indonesia began in 1986 as an attempted solution to human-elephant conflict.  The intent was to train "problem" elephants for use in agriculture, logging and tourism.  The initial captures were conducted under the guidance of Thai mahouts and Thai koonkie elephants (trained elephants used for capture).  A number of the Indonesians that were originally trained in capture techniques still work for the government forestry department (KSDA).  The younger pawangs (elephant handlers) that participate in captures have learned from their peers.  There is no formal training program. The actual mortality rate associated with elephant captures in Sumatra is unknown as official reports are lacking.  The age structure of the existing ~ 400 captive elephants is young (most under 25) which suggests that smaller, younger elephants are preferentially captured and / or that adult elephants do not survive the capture and training processes.  Our personal experiences (Mikota and Hammatt) in Sumatra show that mortality in newly captured elephants is high.In 2001, with endorsement from the World Wide Fund for Nature-Indonesia (WWF), the Wildlife Conservation Society (WCS), Fauna and Flora International (FFI), and the International Elephant Foundation (IEF), we requested a two-year Moratorium on elephant captures during which time capture techniques would be improved and alternative conflict mediation techniques evaluated.
A Moratorium against placing additional elephants into the Elephant Training Centers has been issued by the central government, however capture for translocation is still sanctioned.  Unfortunately, the provincial governments have increasingly acted in their own interests since the government of Indonesia began a de-centralization process a few years ago. Riau Province is thought to have the largest remaining populations of wild Sumatran elephants.Fifty-seven, human-elephant conflicts occurred in Riau between 1997-2000.  Although Riau is a hotbed of conflict, problems are occurring throughout Sumatra and we are aware of conflicts and captures in Bengkulu and North Sumatra. In October 2002, we were invited by KSDA (the provincial forestry department) to accompany their team into the field as they attempted to capture a large bull that had been raiding a palm oil plantation.  This opportunity was invaluable as we were able to observe first hand the techniques being used and where improvements were needed.  As a result of this and other experiences with newly captured elephants we observed:
·Equipment (Palmer) is old, poorly maintained, and used improperly. · Essential supplies are lacking or homemade substitutes are used.
·The dose of xylazine is very high compared to wild elephant capture doses used in India and Malaysia.  The same dose is often used regardless of the size of the elephant. ·The needles are too short to reach muscle; open-ended needles are used which can become plugged with tissue, thus preventing injection. ·Neither the correct charge nor the correct load is selected.  We observed that many darts bounced making it difficult to ascertain the amount of drug injected or its depth of penetration.  Selection of an inappropriate charge results in unnecessary trauma. ·The preparation and use of darts, needles, and syringes lacks basic hygiene. ·Dart wounds are not treated and antibiotics are not administered.  · There is no understanding of stress or capture myopathy. ·The capture team was not aware that sternal recumbency severely compromises respiration in elephants and that they can quickly die in this position. ·It is believed that elephant restraints must inflict pain to prevent wild elephants from escaping once captured.  ·There is no veterinarian on the capture team. The current capture techniques result in leg wounds from unprotected chains, neck wounds from "kahs" (neck yokes made of wood and wire), and abscesses from inappropriately administered darts.  Leg and neck wounds often become maggot infested.  Infections from dart wounds are, however, the primary cause of capture-related mortality.  These abscesses can drain for several months, even with treatment, and often progress to a necrotizing fasciitis, acute sepsis, and death. The Riau Province KSDA Team has been receptive to suggested changes to minimize wounds. Provision of heavier chains has alleviated the fear that elephants will escape.  Covering the chains with fire hose or heavy plastic minimizes injuries to legs and use of the kah has been discontinued.  A basic dart wound treatment protocol has been established. In June 2003, a comprehensive Elephant Immobilization and Translocation Workshop for Sumatra is planned to retrain all of Sumatra's field teams and to upgrade equipment. Sumatra's wild elephant population probably numbers fewer than 3000 and is under continued threat.  With so few elephants left, the preservation of as many viable herds as possible takes on increased urgency.  The Moratorium achieved in 2001 has set the groundwork for KSDA to choose translocation of wild elephants rather than capture and placement into already over-crowded and under-resourced Elephant Training Centers.  We cannot guarantee that Sumatra will capture elephants only for translocation, and it is inevitable that many more elephants will end up in captivity.  Regardless, all of the elephants that must suffer the interruption of their lives at the hand of man deserve, at the very least, humane treatment.  Translocations are neither simple nor a complete panacea.  Identifying suitable translocation areas and insuring that elephants remain there are significant challenges.  WWF-Indonesia is continuing its efforts to secure the lowland forest of Tesso Nilo in Riau Province as a "safe haven" for at least some of Sumatra's wild elephants (see WWF AREAS Program – Riau, Sumatra: http://www.worldwildlife.org/species/attachments/riau_profile.pdf).  The identification of interim release sites, together with improved capture techniques, offers the hope that fewer elephants will be removed from the wild.   ACKNOWLEDGMENTS: Our work in Sumatra has been supported by the Guggenheim Foundation, a CEF grant from the American Zoo and Aquarium Association, the International Elephant Foundation, Oregon Zoo, Columbus Zoo, Disney, Peace River Refuge, the Elephant Managers Association, the Riddles Elephant and Wildlife Sanctuary, Tulsa Zoo, Toronto Zoo, Niabi Zoo, San Antonio Zoo, Denver Zoo (AAZK Chapter), Milwaukee Zoo (AAZK Chapter), the Audubon Nature Institute (Youth Volunteers), Buttonwood Park Zoo, Melbourne Zoo, and private donors.  Special thanks to Harry Peachey, John Lehnhardt, Holly Reed, Kay Backues, Mike Keele, Steve Osofsky, and Heidi and Scott Riddle.

Nath, I., Bose, V.S.C., Panda, S.K., Das, B.C., Singh, L.A.K., 2003. A case of multiple abscesses in a baby elephant. Zoos' Print Journal 18, 1270.

Sleeman, J.M., Clyde, V.L., Finnegan, M.V., Ramsay, E.C., Shires, M.G., 2003. Mammary botryomycosis and mastectomy in an African elephant (Loxodonta africana). Vet Rec 152, 54-55.

Vodicka, R., Kral, J., 2003. Purulent trunk dermatitis in a male Ceylon elephant (Elephas maximus). Verh. ber. Erkrg. Zootiere 41, 151-153.
Abstract: A report in given on the therapy of purulent trunk dermatitis in an aggressive male Ceylon elephant. Despite the non-standard steps we took (repeated anaesthesias during a short time, non-compliance with the recommendations as to the application of some drugs, etc.) and the difficult handling (an aggressive; incontrollable elephant, no restraint chute), it is possible even to treat a case like this.

 2002. Large Animal Internal Medicine. Mosby, St.Louis.

Cheeran, J.V., 2002. Elephant facts. Journal of Indian Veterinary Association Kerala 7, 12-14.

Clausen, B., 2002. An assessment of the work of the mobile elephant clinic based in Lampang, Thailand. In: Baker, I., Kashio, M. (Eds.), Giants on Our Hands: Proceedings of the International Workshop on the Domesticated Asian Elephant, Bangkok, Thailand, 5-10 February 2001. FAO Regional Office for Asia and the Pacific (RAPA), Bangkok; Thailand, pp. 239-240.
Abstract: For copies write to: Forest Resources Officer, FAO Regional Office for Asia and the Pacific, Maliwan Mansion, Phra Atit Road, Bangkok 10200, Thailand; Email: masakazukashio@fao.org

Murata, K., 2002. The louse, Haematomyzus elephantis Piaget, 1869, (Mallophaga: Haematomyzidae) infection of captive Asian elephants and its treatment. Japanese Journal of Zoo and Wildlife Medicine 7, 145-148.
Abstract: A louse (Haematomyzus elephantis) infection was found on the epidermis of 3 Asian elephants (Elephas maximus) in captivity. Although each elephant showed heavy itching sensation with scratching of bodies on the wall or ground in the facility, no bruises or papules on their bodies were observed. The local treatment by dipping using a synthetic pyrethroid liquid was ineffective. Good expulsion was attained with the treatment with a carbaryl-based shampoo 5 to 7 times during more than 2 months. It is necessary to inspect for louse infections of imported elephants in zoos at the time of quarantine.

Nayar, K.N.M., Chandrasekharan, K., Radhakrishnan, K., 2002. Management of surgical affections in captive elephants. Journal of Indian Veterinary Association Kerala 7, 55-59.

Rees, P.A., 2002. Asian elephants (Elephas maximus) dust bathe in response to an increase in environmental temperature. Journal of Thermal Biology 27, 353-358.
Abstract: (1) A captive herd of Asian elephants (Elephas maximus) exhibited dusting  behaviour when the maximum daily temperature exceeded approximately 13°C, and dusting frequency increased directly with the environmental   temperature. (2) Individual animals showed variation in dusting frequency but this was not related to body mass, suggesting that the function of   dusting is not primarily thermoregulatory. (3) Synchronisation in the   timing of dusting behaviour within the herd suggests that it may have a function in the maintenance of social cohesion. (4) The function of  dusting behaviour could not be determined from the data presented, but it  may be involved in skin care, protection from insects or other parasites, temperature control, protection from radiation or some combination of  these.

Welsch, U., Unterberger, P., Hofter, E., Cuttitta, F., Martinez, A., 2002. Adrenomedullin in mammalian and human skin glands including the mammary gland. Acta Histochem 104, 65-72.
Abstract: Adrenomedullin is a peptide that has been ascribed numerous functions. In the present paper, adrenomedullin has been localized immunhistochemically in a variety of skin glands of humans, elephants and impalas: apocrine scent glands, eccrine sweat glands, holocrine glands and mammary glands. In the apocrine glands expression of adrenomedullin varied with respect to staining intensity and intracellular localization. In general, glands which appeared to be actively secreting were more strongly stained than quiescent glands. However, within a single glandular tubule, individual cells differed considerably in the staining intensity of adrenomedullin. Adrenomedullin was present in both non-lactating and lactating mammary secretory epithelia, both ducts and alveoli reacted positively. In human mammary glands displaying apocrine metaplasia, the apical protrusions were strongly positive. Furthermore, positive immunostaining was found in endothelium and often in smooth muscle cells of small arteries and veins and in mast cells as well. Many of the adrenomedullin-positive epithelial cells were most strongly stained in the area of the Golgi apparatus, the cellular apex and particularly close to the basal side of the cell membrane.This pattern suggests packaging of adrenomedullin into secretory granules and secretion both at the apex of cells and at their basis. The first form of secretion suggests exocrine secretion, the latter form endocrine secretion of adrenomedullin. A possible hormonal function is in line with basally located electron dense small secretory granules, which have been found by electron microscopy in the glandular epithelia studied.

Sarma, K.K., Sarma, M., Ramanathan, A., Kheria, T., 2001. Peribursal haematoma in a working elephant of Kaziranga National Park. Intas Polivet 2, 206-207.

Mooring, M.S., Benjamin, J.E., Harte, C.R., Herzog, N.B., 2000. Testing the interspecific body size principle in ungulates: the smaller they come, the harder they groom. Animal Behaviour 60, 35-45.
Abstract: Tick removal grooming may be centrally regulated by an internal timing mechanism operating to remove ticks before they attach and engorge (programmed grooming model) and/or evoked by cutaneous stimulation from tick bites (stimulus-driven model). The programmed grooming model predicts that organismic and environmental factors that impact the cost-benefit ratio of grooming (e.g. body size and habitat) will influence the rate of tick removal grooming. The body size principle predicts that smaller-sized animals, because of their greater surface-to-mass ratio, should engage in more frequent tick removal grooming than larger-bodied animals in order to compensate for higher costs of tick infestation. The body size principle may be tested intraspecifically between young and adult animals, or interspecifically among species of contrasting body sizes. To rigorously test the interspecific body size prediction, we observed the programmed grooming (oral and scratch grooming) of 25 species (or subspecies) of bovids at a tick-free zoological park in which stimulus-driven grooming was ruled out. Multiple correlation analysis revealed highly significant negative correlations between species-typical mass and mean species grooming rates when habitat was controlled for in the model. Species-typical habitat type (classified along a gradient from most open to most closed) was positively correlated with mean oral grooming rate, indicating that species tended to groom at a higher rate in woodland and forest habitats (where typical tick density would be high) compared with more open environments. Species mass accounted for up to two-thirds of the variation in grooming rate across species, whereas habitat accounted for ca. 20% of variation in oral grooming. Similar results were obtained when the analysis was expanded to include 36 species/subspecies of six different families. The body size principle can therefore account for a large proportion of species-typical differences in programmed grooming rate among ungulates. However, to understand the tick defense adaptations of very large mammals that rarely or never engage in oral or scratch grooming (e.g. elephants, giraffes, rhinoceros), alternative tick defense strategies must be considered, such as thick skin, wallowing, rubbing and tolerance of oxpeckers and other tick-eating birds.

Pandey, S.K., 2000. Management of sinus due to necrosis of right transverse process of second lumbar vertebra in an elephant. Zoos' Print Journal 15, 328.

Richman, L.K., Montali, R.J., Hayward, G.S., 2000. Review of a newly recognized disease of elephants caused by endotheliotropic herpesviruses. Zoo Biology 19, 383-392.
Abstract: There are two newly recognized herpesviruses that cause a fatal disease syndrome in elephants. They are known as the elephant endotheliotropic herpesviruses, of which one is fatal for Asian elephants (Elephas maximus) and the other for African elephants (Loxodonta africana) The disease syndrome affects predominantly young elephants and has been described in North America, Europe, and Israel. The predominant clinical signs for both species include lethargy, oedematous swellings of the head, neck, and thoracic limbs, oral ulceration, cyanosis of the tongue, and death of most elephants in 1-7 days. Three affected young Asian elephants recovered after a 3-4-week course of therapy with the anti-herpesvirus drug famciclovir. Additional reported herpesvirus-associated lesions in otherwise healthy elephants include localized skin papillomas in African elephants, proliferative vulval lymphoid patches in African elephants, and pulmonary nodules in African elephants. Recent findings suggest that these localized herpesvirus-associated lesions in healthy African elephants may be one source of the herpesvirus that causes disseminated disease and death in the Asian species and the African species. These findings have implications for management practices in facilities keeping both African and Asian elephants and in protecting natural elephant habitats from virulent forms of the virus.

Ronald, B.S.M., Sukumar, K., Meenachiselvan, M.S., Dorairajan, N., 2000. Isolation of Actinomyces pyogenes [Arcanobacterium pyogenes] from fistula in an elephant. Zoos' Print Journal 15, 306.

 1999. Equine Medicine and Surgery. Mosby, St. Louis MO USA.

Cooper, R.A., Molan, P.C., 1999. Minimum inhibitory concentration of honey for 20 strains of Pseudomonas isolated from infected wounds. Journal of Wound Care 8, 161-164.

Cooper, R.A., Molan, P.C., Harding, K.G., 1999. Minimum inhibitory concentration of honey for 58 strains of coagulase -positive Staphylococcus aureus isolated from infected wounds. Journal of the Royal Society of Medicine 92, 283-285.

Godagama, W.K., Wemmer, C., Rathnasooriya, W.D., 1999. Prevalence and distribution of body injuries of domesticated Sri Lankan elephants (Elephas maximus maximus). Ceylon Journal of Science, Biological Sciences 27, 47-59.
Abstract: The prevalence and distribution of injuries was studied in 140 domesticated Sri Lankan elephants between April 1993 and April 1994. Five types of injuries were recorded including abscesses, punctures, wounds, spilt toe nails and ulcerated feet. The prevalence (%), number of injuries, range and site with highest frequency were as follows: abscesses, 17%, 0.3±0.05, 0-4, temporal region of head; wounds, 49%, 3.0±0.4, 0-29, lower region of the hind limb; punctures, 54%, 4.6±0.5,0-28, upper region of the fore limb; split toe nails, 54%, 1.0±0.2, 0-8, both fore and hind limbs; and ulcerated feet, 69%, 2.0±0.1, 0-4, feet. Five types of minor injuries were also observed: callouses (36%; 1.0±0.1; 0-6; temporal region of the head and scapula region of the shoulder), skin growths (38%; lower distal region of the hind limbs), small lumps (41%; upper proximal region of the fore limb), broken ear edges (27% both ears) and twisted tails (22%). The number of abscesses and wounds was significantly higher in males than in females. The number of elephants with abscesses, wounds, punctures, callouses, skin growths and broken ear edges was significantly higher in older age group (41-75 years) than in younger elephants.

Green, E.M., 1999. Thermography. In: Colahan, P.T., Merritt, A.M., Moore, J.N., Mayhew, I.G. (Eds.), Equine Medicine and Surgery. Mosby, St. Louis MO USA, pp. 1333-1340.

Jeffery, J., Vellayan, S., Sulaiman, S., Oothuman, P., Zahedi, M., Krishnasamy, M., 1999. On the occurrence of Haematomyzus elephantis Piaget (Mallophaga: Haematomyzidae) on the elephant, Elephas maximus indicus Cuvier -- a new record for peninsular Malaysia. Tropical Biomedicine 16, 51-52.
Abstract: The elephant lice, H. elephantis, is reported from peninsular Malaysia for the first time. The report is based on 4 males and 2 females collected from a 10 month old elephant, E. maximus indicus, kept in the Kuala Krai Mini Zoo in the state of Kelantan, peninsular Malaysia.English

Kuntze, A., 1999. Poxvirus infections in elephants. In: Fowler, M.E., Miller, R.E. (Eds.), Zoo and Wild Animal Medicine: Current Therapy 4. W.B. Saunders, Philadelphia, PA, USA, pp. 547-550.

Mills, N.J., 1999. The importance of wound lavage. International Veterinary Wound Management Forum 1, 2-4.

Abou-Madi, N., Kollias, G.V., Sturmer, A.T., Hackett, R.P. Umbilical herniorrhaphy in a juvenile Asian elephant (Elephas maximus). Proceedings AAZV and AAWV Joint Conference.  212-216. 1998.
Ref Type: Conference Proceeding

Burks, R.I., 1998. Povidone-iodine solution in wound treatment. Physical Therapy 78, 212-218.

Matsuo, K., Hayashi, S., Kamiya, M., 1998. Parasitic infections of Sumatran elephant in the Way Kambas National Park, Indonesia. Japanese Journal of Zoo and Wildlife Medicine 3, 95-100.
Abstract: In 1995, 3 Sumatran elephants (Elephas maximus sumatranus) died suddenly of clostridial infection in the Way Kambas National Park, Lampung province, Indonesia. Postmortem examination revealed that the gastrointestinal tracts of all 3 animals were also infected with Murshidia falcifera (Nematoda), Hawkesius hawkesi and Pfenderius papillatus (Digenea) and Cobboldia elephantis (Diptera). The elephant louse, Haematomyzus elephantis, was a common cause of dermatopathy in elephants kept in the national park.

Molan, P.C., 1998. A brief review of the use of honey as a clinical dressing. Primary Intention (The Australian Journal of Wound Management) 6, 148-158.

Brogan, T.V., Nizet, V., 1997. A clinical approach to differentiating necrotizing fasciitis from simple cellulitis. Infections in Medicine September, 734-738.

Gage, L.J., Blasko, D., Caton, D. The use of direct contact infrared irradiation to aid the healing of pressure sores in elephants (Elephas maximus). Proceedings American Association of Zoo Veterinarians.  187-189. 1997.
Ref Type: Conference Proceeding

Gage, L.J., Fowler, M.E., Pascoe, J.R., Blasko, D., 1997. Surgical removal of infected phalanges from an Asian elephant (Elephas maximus). Journal of Zoo and Wildlife Medicine 28, 208-211.
Abstract:  A 40-yr-old female Asian elephant (Elephas maximus) developed cellulitis in her left front leg.  A draining tract behind the lateral nail of her left front foot was discovered.  This lesion was treated by aggressive irrigation using a variety of disinfectant solutions.  Radiographically, there was degeneration and fragmentation of the distal phalanx of the fifth digit and patterns suggestive of osteomyelitis of the second (middle) phalanx.  The fragments of the distal phalanx and the affected portion of the second phalanx were removed surgically.  Six months after surgery the incision had healed but  fistulous tract remained on the palmar surface of the foot.  The tract extended to the second phalanx, and there was radiographic evidence of osteomyelitis in the second phalanx and the distal portion of the proximal phalanx.  The remainder of the second phalanx and the distal potion of the proximal phalanx were surgically removed. Aggressive aftercare allowed complete wound closure by second intention.

Liptak, J., 1997. An overview of the topical management of wounds. Australian Veterinary Journal 75, 408-413.

Sharma S.P., 1997. Surgical treatment of gunshot wounds under xylazine and ketamine anaesthesia in an elephant: clinical case report. Indian Veterinary Journal 74, 973-974.

Rasmussen, L.E.L., Munger, B.L., 1996. The sensorineural specializations of the trunk tip (finger) of the Asian elephant, Elephas maximus. Anatomical Record 246, 127-134.
Abstract: BACKGROUND: The dorsal extension of the tip of the trunk of Asian elephants (Elephas maximus), often referred to as "the finger," possesses remarkable mechanical dexterity and is used for a variety of special behaviors including grasping food and tactile and ultimately chemosensory recognition via the vomeronasal organ. The present study describes a unique sensory innervation of this specialized region of the trunk. METHODS: The tip of the dorsal aspect of the trunk is referred to as the trunk tip finger and has been studied grossly in 13 living elephants. One tip from a male Asian elephant was obtained for histologic study when it was accidentally severed. The tissue was fixed in 10% neutral buffered formalin, and portions were either sectioned frozen or embedded in paraffin and serial sectioned. Sections were stained with silver in both cases. RESULTS: The skin of the trunk tip finger differs from that of the surrounding areas; it contains a high density of free nerve endings, numerous convoluted branched small corpuscles, and vellus vibrissae that resemble vellus hairs, which do not protrude beyond the skin surface. The finger is thus densely innervated with three distinctive types of sensory terminals. Corpuscular receptors consist of small Pacinian corpuscles and convoluted branched simple corpuscles. Both are present in the superficial dermis. Abundant regular vibrissae are present in the skin surrounding the trunk tip finger. Short vibrissae that do not protrude from the skin surface, referred to as vellus vibrissae, are abundant in the finger tip. Both types of vibrissae are innervated by hundreds of axons resembling the mystacial vibrissae of rodents. Free nerve endings are numerous in the superficial dermis, often making intimate contact with the basal cells of rete pegs. CONCLUSIONS: The dorsal finger of the trunk tip of Asian elephants has a unique sensory innervation that resembles aspects of sensory innervation of mystacial skin of rodents or lip tissue of monkeys. This dense sensory innervation can be correlated with the tactile ability of these animals to use the trunk finger to grasp small objects for feeding and to insert chemically active samples into the ductal orifices of the vomeronasal organ for subsequent chemosensory processing.

Singhal, N., 1996. Treatment of an injured wild elephant in north Bengal forests. Indian Forester, Special issue: wildlife management. 122, 969-970.
Abstract: A note is given on the treatment of a solitary male wild elephant found in Panighata Resume land forest with a badly injured foreleg knee joint, possibly caused by a gunshot wound. The elephant was immobilized with a dart of Immobilon, and the wound cleaned and washed with iodine solution, and treated with 500 g of povidine iodine ointment and a fly repellent (surgicare). The animal was also given dexa-methazone (5 ml) intravenously, and Decadron (12 ml), Oxy-Vet (30 ml) and tetanus toxoid intramuscularly. The operation lasted 54 minutes, after which the animal was revived with Revivon, and later offered bananas and banana culms. The animal has made a full recovery.

Boomker, J., Bain, O., Chabaud, A., Kriek, N.P.J., 1995. Stephanofilaria thelazioides n. sp. (Nematoda: Filariidae) from a hippopotamus and its affinities with the species parasitic in the African black rhinoceros. Systematic Parasitology 32, 205-210.
Abstract: Stephanofilaria thelazioides sp. nov. is described and figured from an ulcerated skin lesion on a hippopotamus Hippopotamus amphibius from the Kruger National Park, South Africa. This nematode is closely related to S. dinniki, a parasite of the black rhinoceros Diceros bicornis in Africa, but differs from it in the number of cuticular spines surrounding the mouth, the arrangement of the cloacal papillae and the measurements of the spicules, gubernaculum and microfilariae. Species of the genus Stephanofilaria possess spines on the head which have been derived by modification of the sensory papillae. S. thelazioides is the most primitive species of the genus and has the least modified arrangement of these papillae, with 6 bifid internal labial spines, 4 bifid external labial spines and 4 cephalic papillae. The genus appears to have diversified in various mammals which have in common a thick skin, such as rhinoceroses, elephants, buffaloes and now the hippopotamus. It appears to have become adapted secondarily to domestic bovines, initially in Asia and subsequently in North America.

Brook, I., Frazier, E.H., 1995. Clinical and microbiological features of necrotizing fasciitis. J. Clin. Microbiol. Sept., 2382-2387.

Chandrasekharan, K., Radhakrishnan, K., Cheeran, J.V., Nair, K.N.M., Prabhakaran, T., 1995. Review of the Incidence, Etiology and Control of Common Diseases of Asian Elephants with Special Reference to Kerala. In: Daniel, J.C. (Ed.), A Week with Elephants; Proceedings of the International Seminar on Asian Elephants. Bombay Natural History Society; Oxford University Press, Bombay, India, pp. 439-449.
Abstract: Incidence, etiology, symptoms and control of specific and non-specific diseases of captive and wild elephants have been reviewed. Asian elephants have been observed to be susceptible to various parasitic diseases such as helminthiasis, trypanosomiasis and ectoparasitic infestations, bacterial diseases such as tetanus, tuberculosis, haemorrhagic septicemia, salmonellosis and anthrax, viral diseases such as foot and mouth disease, pox and rabies and non-specific diseases like impaction of colon, foot rot and corneal opacity. A detailed study extending over two decades on captive and wild elephants in Kerala, revealed high incidence of helminthiasis (285), ectoparasitic infestation (235), impaction of colon (169) and foot rot (125). Diseases such as trypanosomiasis (21), tetanus (8), tuberculosis (5) pox (2) and anthrax (1) were also encountered. The line of treatment against the diseases mentioned, have been discussed in detail.

Raubenheimer, E.J., van Heerden, W.F., van Niekerk, P.J., de Vos, V., Turner, M.J., 1995. Morphology of the deciduous tusk (tush) of the African elephant (Loxodonta africana). Arch Oral Biol 40, 571-576.
Abstract: The tusk of the African elephant is preceded by a deciduous tooth generally known as the tush. Tushes from nine elephant fetuses and six calves younger than 1 year were exposed by dissection and described morphologically. All tushes consisted of a crown, root and pulpal cavity, the formation of which is completed soon after birth. They reached a maximum length of 5 cm, appeared not to erupt through the skin and were pushed aside and resorbed during enlargement of the distally located primordium of the tusk. Dental enamel, which covered the crown, could easily be removed and consisted of rods with an interwoven arrangement; the dentine-enamel junction was flat. Cellular cementum extended for variable distances over the crown and the dentine was tubular in nature. Although the tush apparently has no function, it provides the anlage and orientation for the development of its permanent successor.

Guillot, J., Chermette, R., Gueho, E., 1994. Prevalence of the genus Malassezia in the Mammalia. Journal de Mycologie Medicale 4, 72-79.
Abstract: The carriage of Malassezia on the skin of 271 domestic and 85 wild mammals was investigated. Ear samples and skin samples were collected, and Sabouraud's glucose agar with 0.05% chloramphenicol and 0.05% cycloheximide and the same medium with 1% olive oil were used for cultures. The plates were incubated for 1 wk at 32 and 37°C, respectively. Of the 356 animals examined, representative of 40 different species, 122 (34%) had Malassezia on the skin, especially in the external ear canal (27%). Lipophilic yeasts were particularly prevalent in some animal species (29% of cattle, 36% of cats, 57% of pigs, 66% of dogs and 75% of pachyderms). For these species, the presence of yeasts correlated with the amount of lipids on the skin. No Malassezia yeasts were recovered from rodents, lagomorphs and insectivores. Most strains isolated from domestic and wild carnivores (33 dogs, 18 cats, 2 bears, 2 foxes and 2 ferrets) were the non-lipid dependent species M. pachydermatis. The lipid dependent strain M. furfur was recovered from 23 pigs, 7 elephants, 3 chimpanzees, 2 rhinoceros, 2 sheep, 1 cow, 1 cheetah and 1 okapi. Except for 18 dogs, 12 cats, 2 foxes, 2 ferrets and 1 okapi suffering from otitis externa, no dermatological lesions were observed at the time of sampling. The possible aetiological role of Malassezia yeasts in animal cutaneous diseases is discussed.

Kjolseth, D., Frank, J.M., Barker, J.H., Anderson, G.L., Rosenthal, A.I., Acland, R.D., Schuschke, D., Campbell, F.R., Tobin, G.R., Weiner, L.J., 1994. Comparison of the effects of commonly used wound agents on epithelialization and neovasularization. J. Amer. College of Surgeons 179, 305-312.

Goldenheim, P.D., 1993. An appraisal of povidone-iodine and wound healing. Postgrad. Med. J. 69, S97-S105.

Lloyd, M., Goddard, M., Zeinowicz, R., Harper, J.S., III, 1993. One approach to the removal of an aural rhabdomyoma in a 7 year old african elephant. Proceedings American Association of Zoo Veterinarians 115-119.

Baker, G.T., Chandrapatya, A., 1992. Sensilla on the mouthparts and antennae of the elephant louse, Haematomyzus elephantis Piaget (Phthiraptera: Haematomyzidae). Journal of Morphology 214, 333-340.
Abstract: The labial palpus of H. elephantis has 6 sensilla that represent 3 different types: trichoid, basiconic and styloconic. Two rows of basiconic sensilla are situated on the dorsal and central surfaces of the rostrum, and each row consists of 3 sensilla. Male and female antennae have 15-17 trichoid sensilla situated on the scape, pedicel and 3 antennal annuli. Both sexes have 2 sensilla basiconica on the dorsal surface of the pedicel near the junction of the scape and pedicel. Two coeloconic sensilla are situated on the antenna of both sexes, one sensillum on each of the last 2 annuli. There are 3 plate organs, 2 on the last annulus and 1 on the penultimate annulus of the male and female antennae. Sexual dimorphism is exhibited in the male and female antennae, in that the male has about twice as many sensilla basiconica on the apex of the last annulus as does the female. The total number of sensilla basiconica on the apex of the male antennae is at least 2 times the number that is known to be present in any other species of lice.

George, P.O., 1992. Some common surgical conditions encountered in elephants. In: Silas, E.G., Nair, M.K., Nirmalan, G. (Eds.), The Asian Elephant: Ecology, Biology, Diseases, Conservation and Management (Proceedings of the National Symposium on the Asian Elephant held at the Kerala Agricultural University, Trichur, India, January 1989). Kerala Agricultural University, Trichur, India, pp. 173.

Islam, S., Lahkar, B.C., Barman, N.N., Das, M., 1992. Isolation of Trichosporiella species from a fungal lesion of an Indian elephant (Elephas maximus) and its successful treatment. Journal of the Assam Veterinary Council 2, 68-69.
Abstract: Skin lesions (approx. 5 cm in size) were found on the left and right thoracic and abdominal regions along the linea alba of a working bull elephant. Some lesions showed scab-like thickening. A fungal isolate identified as Trichosporiella was cultured from skin scrapings of the lesions. The lesions resolved after 5 months of topical application of iodine and an ointment of salicylic, benzoic and chrysophanic acids.

Meiswinkel, R., 1992. Afrotropical Culicoides: C. (Avaritia) loxodontis sp. nov., a new member of the Imicola group (Diptera: Ceratopogonidae) associated with the African elephant in the Kruger National Park, South Africa. Onderstepoort Journal of Veterinary Research 59, 145-159.
Abstract: Culicoides (Avaritia) loxodontis sp. nov., is described and illustrated from both sexes collected in South Africa. It is the 5th species of the Imicola group of the subgenus Avaritia to be described from the Afrotropical Region, and is presently known only from the Kruger National Park where it has been collected in light-traps and reared from the dung of the African elephant (Loxodonta africana) on various occasions. A number of character states, and statistical analyses of antennal and palpal measurements, are used to separate the new species from its taxonomic congeners C. imicola Kieffer, 1913, C. pseudopallidipennis Clastrier, 1958, C. bolitinos Meiswinkel, 1989 and C. miombo Meiswinkel, 1991. It is suggested that the occurrence of the African elephant is the primary factor that determines the distribution of Culicoides loxodontis sp. nov., and that this close association, coupled with the fact that C. loxodontis sp. nov. can be locally abundant, may result in the cycling of certain arboviruses between this biting midge and the elephant

Pandey, S.K., Bandopaphyay, A.C., 1992. A fibroma in the trunk of an Indian elephant. Indian Veterinary Journal 69, 847.

Tripathy, S.B., Das, P.K., 1992. Treatment of Stephanofilarial dermatitis in an Asian elephant (Elephas maximus): a case report. In: Silas, E.G., Nair, M.K., Nirmalan, G. (Eds.), The Asian Elephant: Ecology, Biology, Diseases, Conservation and Management (Proceedings of the National Symposium on the Asian Elephant held at the Kerala Agricultural University, Trichur, India, January 1989). Kerala Agricultural University, Trichur, India, pp. 162-163.
Abstract: Chronic progressive dermatitis to be due to Stephanofilaria in an Asian elephant has been discussed.  The lesions were detected on the toes and heels of both hind feet and on the right abdominal wall. Examination of the skin scrapings and oozing blood over the lesion area revealed presence of microfilarae. Histopathological examination of affected skin revealed hyperkeratosis parakeratosis, acnathosis, granulomatous reactions and perivascular cuffings. Application of 8% metrifonate ointment on Vaseline and Himax base brought clinical cure in 22 and 15 days post treatment, respectively.

von Solodkoff, M., 1992. An elephant tusk with a spear injury. Tierarztl. Prax. 20, 102-109.
Abstract: This tusk specimen contains a metal spear with a wooden component, which is surrounded by a quiver-like osseous encasement. The injury was probably caused by a drop-spear trap. The spear entered the tusk through the base of the pulp. The osseous encasement is constructed by pulpocytes which turned to odontoblasts after stimulation and are responsible for the development of secondary dentine. Secondary dentine is characterized by its irregular arrangement of dentine tubules, in contrast to those of true ivory.

Willix, D.J., Molan, P.C., Harfoot, C.J., 1992. Minimum concentration of honey (%, v/v) in the growth medium needed to completely inhibit the growth of various species of wound-infecting bacteria. Journal of Applied Bacteriology 73, 388-394.

Anderson, W.I., Scott, D.W., 1991. Epidermoid cysts in the skin of an Asian elephant (Elephas maximus). Veterinary Dermatology 2, 171-172.

Brahmasa, A., 1991. Cryosurgery of cutaneous papilloma in two Asian elephants: a case report. Thai Journal of Veterinary Medicine 21, 151-159.

Hirokawa, M., Manabe, T., Takasu, N., 1991. Necrotizing fasciitis rapidly diagnosed by aspiration cytology. The Japanese Society of Pathology 567-572.

Jarjour, W.N., Jeffries, B.D., Davis, J.S., Welch, W.J., Mimura, T., Winfield, J.B., 1991. Autoantibodies to human stress proteins. Arthritis and Rheumatism 34, 1133-1138.
Abstract: Unselected sera from patients with various rheumatic, inflammatory bowel, and autoimmune skin diseases (n=268) were examined against human cell lysate by immunoblotting procedures, to determine the prevalence of autoantibodies to stress proteins (heat-shock proteins) hsp60 (homolog of Escherichia coli groEL and Mycobacterial 65K antigens), hsp73, and hsp90.  Using standard, sensitive and specific assay conditions, IgG and IgM autoantibodies to these stress proteins were not demonstrable, or were detected infrequently, in sera from control subjects (n=36) and from patients with rheumatoid arthritis, Sjogren's syndrome, ankylosing spondylitis, Reiter's syndrome, systemic lupis erythematosus, and systemic sclerosis.  Autoantibodies to hsp60 were relatively more common (>= 20% of sera) in patients with mixed connective tissue disease, polymyositis/dermatomyositis, psoriatic arthritis, inflammatory bowel disease, epidermolysis bullosa acquista, and bullous pemphigoid.  Anti-hsp73 autoantibodies were detected in 20% or more of the sera from patients were Lyme disease and ulcerative colitis.  Taken together, these data extend the spectrum of autoimmune and inflammatory diseases in which humoral anti-stress protein reactivity develops.  However, the paucity of humoral autoreactivity to stress proteins in patients with systemic lupis erythematosus and rheumatoid arthritis argues against a direct role of anti-stress protein autoantibodies in the pathogenesis of these disorders.

Nanjappa, K.A., 1991. Anaesthesia and treatment of a wounded wild Makana elephant (Elephas maximus). Indian Veterinary Journal 68, 360.

Jeu, M.H., Fan, P.F., Jiang, F.M., 1990. Morphological study of the adult stage of the elephant louse Haematomyzus elephantis with light and scanning electron microscopy (Insecta: Rhynchophthiraptera). Journal of Shanghai Agricultural College 8, 9-19.
Abstract: Certain features of the morphology of adult males and females of H. elephantis are figured in 20 SEM micrographs, and described. The specimens were from an Asian elephant (Elephas maximus) from Burma in Chongqing Zoo. The distribution of the sensory setae and campaniform organs on the legs, the existence of sexual dimorphism of the sensory pegs on the apical part of the 5th antennal segment, the abdominal scales with a serrated edge, and the phallic sac of the male with 2 types of sensory pores are all described for the first time. Several errors in the literature are corrected, especially concerning the mouthparts and antennal sensilla. The mouthparts of H. elephantis differ from those of either the Anoplura (described functionally as piercing) or Mallophaga (chewing). It is suggested that the mouthparts of H. elephantis are not homologous with those of Mallophaga (the suborder in which H. elephantis is placed by some authorities) but instead that they represented a unique piercing type. Arguments are put forward to raise the suborder Rhynchophthirina (represented by this single species, according to other authorities) to ordinal rank, for which the name Rhynchophthiraptera is proposed.

Ossent, P., Guscetti, F., Metzler, A.E., Lang, E.M., Rubel, A., Hauser, B., 1990. Acute and fatal herpesvirus infection in a young Asian elephant (Elephas maximus). Vet. Pathol. 27, 131-133.
Abstract: Infections with herpesvirus may cause papillomatous lesions in the Asian and African elephant.  In both species, the virus has been reported to localize only in the skin.  Disseminated nodules of epithelial cells were found in the lungs of a high percentage of wild African elephants.  In these cases, the proliferated cells contained intranuclear inclusion bodies in which herpesvirus particles were observed by electron microscopy.  The virus in those cases caused no illness.  This report documents the necropsy findings of a juvenile Asian elephant dying peracutely from massive generalized hemorrhage due to lesisons in the endothelial cells of the capillaries.  The cell nuclei frequently contained inclusion bodies in which herpesvirus particles were demonstrated.  This has not been described in elephants before.

Pathak, S.C., Saikia, J., Lahon, D.K., Deka, K.N., Barua, S.K., Dewan, J.N., Vety, A.H., 1990. Attempted ventral herniorrhaphy in an Asian elephant (Elephas maximus) using xylazine sedation. Journal of Zoo and Wildlife Medicine 21, 234-235.
Abstract: Ventral herniorrhaphy in a female Asian elephant (Elephas maximus) under xylazine hydrochloride sedation was attempted.  A dose of 0.16 mg/kg body weight was adequate to produce sedation, analgesia, and muscle relaxation for the procedure.  The postoperative management of the surgical wound was difficult and resulted in the failure of the surgery.

Rasmussen, L.E.L., Munger, B. Micro-anatomy of the trunk tip of Elephas maximus. Chemical Senses 15, 629. 1990.
Ref Type: Abstract
Abstract: Full-text:  This study documents the characteristics of the sensory innervation and cutaneous receptors in the dermal and epidermal skin of the extreme trunk tip (finger) and adjacent skin of the Asian elephant Elephas maximus by light microscopy.  During the flehmen response the elephant moistens the trunk tip with liquids of interest and apparently uses this tip for transport of such substances to the mucous-filled openings of the incisive ducts, which lead to the vomeronasal organ.  We expected to find this region of the trunk tip richly innervated, perhaps with specialized nerve endings, especially in the epidermis.  Unexpectedly, our light microscopic examinations demonstrated three distinctive features.  First, a uniquely high density of free nerve endings are apparent in the superficial layers of the trunk tip skin.  Second, in the skin closely associated with the trunk tip unusual tiny short vibrissal hairs surrounded by hundreds of axons were interspersed with more conventional vibrissal hairs.  Third, unique complex branched encapsulated corpuscles were abundant in the superficial layer of the dermis in the area of the tip and in the closely associated skin. This study provides basic histological information about the trunk tip region as the initial part of our investigation of the innervation, cutaneous sensory receptors, especially possible chemosensory receptors of the trunk and its orifices.

Sironi, G., Caniatti, M., Caniatti, M., 1990. Immunohistochemical detection of papillomavirus structural antigens in animal hyperplastic and neoplastic epithelial lesions. Journal of Veterinary Medicine Series A 37 , 760-770.
Abstract: One hundred and seventy two hyperplastic and neoplastic epithelial lesions from 8 different mammalian and 1 avian species were tested with an immunohistochemical technique to detect papillomavirus structural antigens. Selected lesions were diagnosed histologically as papilloma, fibropapilloma, equine sarcoid, squamous cell carcinoma, basalioma, epulis, keratoacanthoma, trichoepithelioma, pilomatrixoma, epidermal inclusion cyst, and hyperkeratotic or acanthotic epidermal lesions. Positive nuclear staining was detected in 14 out of 23 papillomas, 8 out of 32 fibropapillomas and in 1 out of 3 hyperplastic epidermal lesions. Positive samples were found in 5 of 8 mammalian species. Selected samples were also examined by transmission electron microscopy. In 4 samples papillomavirus was seen. In two other samples, negative with immunoperoxidase technique, papovavirus-like particles were observed.

Swaim, S.F., Henderson, R.A., 1990. Small Animal Wound Management. Lea and Febriger.

Williams, T.M., 1990. Heat transfer in elephants: thermal partitioning based on skin temperature profiles. Journal of Zoology (Lond) 222, 235-245.
Abstract: The elephant with its low surface-to-volume ratio presents an interesting problem concerning heat dissipation.  To understand how such large mammals remain in thermal balance, we determined the major avenues of heat loss for an adult African elephant and an immature Indian elephant.  Because conventional physiological measurements are difficult for these animals, the present study used a non-invasive technique, infrared thermography, to measure skin temperatures of each elephant. Detailed surface temperature profiles and surface area measurements of each elephant were used in standard equations for convective, conductive and radiant heat transfer.  Results demonstrated that heat transfer by free convection and radiation accounted for 86% of the total heat loss for the elephants at Ta = 12.6 degrees C.  Heat transfer across the ears, an important thermal window at high ambient temperatures, represented less than 8% of the total heat loss.  Surface area of the animals, and metabolic heat production calculated from total heat loss  of the African elephant, scaled predictably with body mass.  In contrast, the thermal conductance of the elephants (71.6 W/degree C, African; 84.5 W/degree C, Indian) was three to five times higher than predicted from an allometric relationship for smaller mammals.  The high thermal conductance of elephants is attributed to the absence of fur and appears to counteract reduced heat transfer associated with a low surface-to-volume ratio.

George, P.O., Cheeran, J.V., Menon, C.P.G., George, T.J., 1989. Treatment of a wound on the trunk of an Indian elephant (Elephas maximus): a case report. Indian Journal of Veterinary Surgery 10, 76-78.

Hegel, G.V., Hanichen, T., Mahnel, H., Wiesner, H., 1989. Warts (papilloma/sarcoid) in elephant. Erkrankungen der Zootiere 31, 201-205.
Abstract: Warts ( Papilloma, Sarcoid) in  Elephants  ( Hegel,G.)1989; translated from German by Gerda Martin. Papilloma virus - from the group Papova virus - is considered  an etiological agents of wart- like skin changes in cattle, sheep, mountain goat, and rabbit. (ROSENBERGER,1970; ROLLE and MAYR, 1984). Equine sarcoid (PALMER. 1985) found in horses is most likely caused by bovine papilloma virus. The alternate name is based on clinical and morphological differences in the actual papilloma. In the initial stage, the sarcoid is similar to that of the papilloma; however in later stages, tumorous decay on the surface of the epidermis, and proliferation of the mesenchymal part of the tumor in the subcutis dominate (DIET and WIESNER, 1982). Wart- like changes in the skin of elephants as described by PILASKI et al (1987, 1988), proved to be caused by Herpes virus.  Such skin changes in elephants are not rare and require treatment since size and volume of the excrescences  may cause functional disturbances in the patient. Even if the animal's  general   well being  is not impaired, the importance of esthetics and hygiene should not be disregarded in a place where there are spectators and visitors (zoo, circus). The following paper reports findings of wart- like skin changes in elephants. Observations and Therapy In the elephants  kept in the Hellabrunn  Zoo, no case of papilloma or similar skin tumors had occurred since 1972. First case: In 5-28 - 1987, a ca. 18 month old female L.a. named " Sabi" arrived In Hellabrunn. This animal had a wart- like thickening of 1 cm at the dorsal end of the trunk. After 8 weeks, more of those such skin changes appeared on trunk and lower lip without  impairment in general well being. Treatment consisted of  one daily, subcutaneous injection of 1 amp. Chelidonium D7 (DHU Chelidonium majus L.), and application of fresh ??Schoellkraut  juice dabbed onto the warts but was unsuccessful.  After a change of treatment was made: 10 drops of Thuja D4 (DHU Thuja occidentalis L) and 20 drops Acidum nitricum D12 (DHU Acidum nitricum), orally, once a day, at separate times of the day, there remained, after 2 weeks, a wart on the lower lip the size of a cherry pit, and the before mentioned  wart on the dorsal end of  the trunk had now grown to the size of a cherry. Even the strength of Thuja LM 6 (DHU Thuja occidentalis L.)  20 drops, oral, the growth of the wart on the dorsal end of the trunk, now with a diameter of 5 cm, could not be stopped: Exstirpation had to be performed. Frequent  sucking had promoted strong ulceration.  A secondary infection  had set in,  the surface showed granular  tissue exuding blood and pus.

On 10 -  6 -  1987 the growth was exstirpated and tissue was sent for virolog. and histolog. examination. In addition, tissue was removed from a fresh small wart for vaccine. During the operation the animal was immobilized (anesthetic: 0.3 ml Immobilon* (large animal Immobilon Rc* - Vet. Ltd.),  10mg Xylacin, 150 IE Hyaluronidase i. m.). There were no complications during recovery. Two  weeks post op., the first vaccination was given, followed by a second vacc. four weeks there after, of 5.0 ml, subcut.., of an auto vaccine developed by the Institute for Medical Microbiology, Dept. of Infectious and Epidemic Medicine. In February 1988, there occurred another bout with wart- like growth on the ventral part of the trunk, lower jaw, shoulders and feet, some with a diameter of 15 mm.  From the sedated young animal tissue was taken from several newly grown warts for the manufacture of auto vaccine (sedation: "Hellabrunner Mischung" / 150 IE Hyaluronidase). After 10 days, the first vaccination was given, and by the time of the second vacc." Sabi" was free of externally visible skin changes.

On 6. 6. 1988, "Sabi" fell ill again. Over night she was covered with 48 warts,  with  diameters from 2mm - 15 mm on trunk and head, and 10 more on the chest.The attempt to "ice"  the warts with liquid nitrogen was not successful. Instead, coagulation of ca. 20 of the larger warts was used. The monopolar coagulation electrode of the Erbotom F 2 (Erbe Elektromedizin) coagulates reaching deeply  into the healthy zone of the surrounding tissue. As before, tissue for the manufacture of the auto vaccine was taken, as well as  0.5 ml of blood from the ear vein for the manufacture of a "own- blood"  nosode. (Large animal, premedication: 20 mg Xylazin i.m., 20 minutes later : 0.5 ml Immobilon R (large animal Immobilon R c - Vet Ltd.) and 150 IE Hyaluronidase i.m. The following day, "Sabi" was given the "own- blood" nosode at a strength of C5 (20 drops daily).In addition, she was vacc. once again. Since "Sabi" was free of warts at the time of the second vaccination -   given 4 weeks after the first - the "own- blood" treatment was discontinued. Shortly there after, however, several new warts cropped up (diameter ca. 1 cm), so that the "own- blood"  treatments were continued. Since that time "Sabi" has had no recurrences.Second case : The Indian elephant cow (E. maximus) , named "Dirndl" , age ca. 22 years, had been kept in the box next to "Sabi" since "Sabi's" arrival. They kept trunk contact. On 5-2-1988, "Dirndl" showed on the distal trunk a substantially increased raised area ca. 2 x 2 cm oozing blood. It seemed to be an injury from a metal rope used in off limiting. The wound was disinfected and treated twice a day with chloromycetin spray with Gentian violetR (Parke Davis).  After  one week  the growth had increased substantially  and on the surface,  it had a cauliflower-like ulcerated  appearance.Upon light touch or movement of the dorsal  trunk, blood appeard spontaneously.   Four days later, the growth was exstirpated, while the animal was standing. (Sedation: 2.2 ml Hellabrunn mixture / 150 Hyaluronidase i. m.) . The attempt to close the skin of the trunk over the wound failed because the tension in that area was too great.  The surface of the wound was cauterized and treated with ChloromycetinSpray with Gentian violet R (Parke Davis). Tissue for pathological and histological examination was sent out.  One week after the operation,  the area of the wound was  highly swollem and the wound was infected. Treatment: Several times a day, an  ablution with a 0.1 % Rivanol solutionnR (Asid - 2 Aethoxy-6.9-diamin  acridinlactat)  and application of Sulfonamid-Codliver oil salve (WDT = Sulfadimidin- Sodium- cod liver oil).  In addition, analogous to "Sabi" , once daily 20 drops of "own-blood" nosode,  potency C 5  given orally. Three weeks post. op., there could be clearly distinguished a limited relapse, an area of  6 x 9 cm rising  ca. 2 cm  above the healthy skin of the trunk. The surface looked like the first growth.  It was extirpated under general anesthetic  (Premed.:80 mg Xylazin i. m., 20 min. later: 1.8 ml ImmobilionR and 150 IE Hyaluronidase). In addition, the whole wound was coagulated  by monopolar coagulation electrode as above. Daily for 4 weeks, the wound  was brushed with a 1:5 wood tar -alcohol - solution.There were no complications during recovery. After 5 weeks , all that could be seen was a ca. 1.5 cm long small scar on the skin of the trunk.

Histomorphological Findings:  Fixation with formalin, embedding in paraffin; stain: Hemalaun-Eosin, connective tissue stain  in the manner of Masson. The histomorphological  findings based on the tissue samples of "Sabi" and "Dirndl"  are the  same, and agree  with the findings of 3 other skin tumor tissue taken from elephants of different origin (tab. 1). The tumors  consist mainly of fibroplastic cells  with more or less  abundant collagen fibers and blood vessels. The boundaries from the adjacent corium and lower skin is largely indistinct.  In all larger neoplasties , the covering epidermis has been preserved  at margins only due to superficial ulceration.  Here the P. acuta aseptica diffusa borders  are irregular and strongly profiled, the epithelium is acanthoid and hyperkeratotic. The nuclei of tumor cells  are considerably anisomorphic, some have gigantic nuclei. Mitosis is frequent. Due to the ulcerated epidermis , there is deep infiltration with infectious cells. Virological findings: From the extirpated tissue taken from the African Elephant "Sabi" ca. 3 g was homogenated, in addition, the cells were "opened" by defrosting and ultrasound, and the "cleared" tissue suspension was analyzed  for free virus particles after concentration and negative-contrasting with  electron microscopy .  At the same time, small tissue samples of 2 mm  from deeper epidermis layers  were fixed as usual for the ultrahistological exam , embedded in epoxy  resin, and ultra thin slices were scanned by the electron microscope. No papilloma virus was found  in the concentrated, cell free tissue extract or  the ultrathin slices of tissue samples .No virus particle of  any kind was found.

Discussion
To  show papilloma by culturing cannot be done since  no species of this genus can  be propagated  in cell cultures  with the exception of its original host. The failed  attempt to prove their presence with the electronmicroscope does not exclude a papilloma virus etiology in tumors. When virus particles are viewed in higher concentrations, the electron microscopic  proof is successful. Using ultrahistologyical methods the particles in cell nuclei can only be found when the few cells  of specific skin cells  are in the virus propagation stage. In the case of virally induced papilloma however, a true virus propagation is not necessary. In the last few years, it was found that equine sarcoid  can be caused  by bovine papilloma virus. But it was only the genome of the virus which could be isolated by means of gene technology (ALTMANN, 1980; HAUSEN, 1980); the virus itself could not.  The oncogenetic potency of the virus in heterologic hosts , without true virus production, has been established.  A broader spectrum of hosts  for , at least , the papilloma virus in cattle seems to be the case.  And a bovine papilloma induced skin fibromatose in  (a) horse has been reported (LANCASTER, 1979). This virus can also appear in wild 'cud chewers, perhaps even carnivores. It is in part also related to the human papilloma virus. The possibility of transfer to humans (LANCASTER 1982) as well as other mammals such as elephants  has not been proved but is probable. In comparing the histological findings of the 5 skin growths with those of the viral fibropapilloma in cattle and horse (called equine sarcoid here), the relative immaturity of the tumorous tissue is evident. It compares to the so- called sarcoid in horses. The sarcoid-like structure and the indistinct  separation from healthy tissue  speaks for a virus etiology and  morphologically a relapse can be expected. This occurred in both of the clinically described cases.

A differential diagnosis excludes a Herpes virus infection, as described by PILASKI et al. (1987, 1988) in elephants on the basis of different histological findings. Inclusions could not be found in any of the cases. The warts on the elephants were clinically similar to the well known sarcoids in horses (DIETZ and WIESNER, 1982). The two sick animals were in "trunk contact" occupying adjacent boxes. Almost one year after the arrival of  "Sabi" who had warts, "Dirndl" fell sick. That points to the infectious nature of warts. The relapse after the first operation on "Dirndl" suggests that the extirpation of the growths was not complete. This may be related to the fact that the animal was standing  and only sedated. In contrast , the extirpation of the "relapse" was carried out on a fully immobilized animal and with the use of the Erbotom F 2  for coagulation including the adjacent tissue.  We know of various 'wart therapies' in human medicine with differing success. The various treatments employed in the one and one half years of "Sabi's" illness can be labled neither successful, nor unsuccessful. The use of auto vaccine which is analogous  to a "stable specific " vaccine in the treatment of papilloma in cattle, could  perhaps have triggered the recurrence of warts at the  conclusion of the vaccination treatments. That would favor the etiology of a virus 'picture.' The influence of the 'burn' or extirpation of a single or more growths which returned, in the surrounding growths cannot be determined. It remains inconclusive if the use of the "own- blood" nosode C 5 aided the successful therapy , since the necessity  to fight a recurrence had not yet occurred.

Kuntze, A. Disorders of performing elephants: perineal hernia, prepatellar bursitis and olecranal tyloma. Erkrankungen der Zootiere. Verhandlungsbericht des 31. Internationalen Symposiums uber die Erkrankungen der Zoo und Wildtiere, Dortmund 1989.  185-187. 1989. Berlin, German Democratic Republic, Akademie Verlag.
Ref Type: Conference Proceeding

Kuntze, A., 1989. Dermatopathies in elephants and their treatment. Kleintierpraxis 34, 405-415.

Muller, M., Rytz, U. Dermatomycosis in two African elephants. Erkrankungen der Zootiere. Verhandlungsbericht des 31. Internationalen Symposiums uber die Erkrankungen der Zoo- und Wildtiere, Dortmund 1989.  207-209. 1989. Berlin, German Democratic Republic, Akademie Verlag.
Ref Type: Conference Proceeding
Abstract: Cases of dermatomycosis are reported in 2 adult African elephants in the Zoological Garden in Basle. Trichothecium, Scopulariopsis and Aspergillus spp. were isolated from skin biopsies.

Schmidt, M.J. Zinc deficiency, presumptive secondary immune deficiency and hyperkeratosis in an Asian elephant: A case report. Proc.Am.Assoc.Zoo Vet.  23-31. 1989.
Ref Type: Conference Proceeding
Abstract: Zinc deficiency in an Asian elephant caused a secondary immune deficiency, and skin lesions which included superinfected vesiculobullae above the toenails and hyperkeratosis on the extensor surfaces of both elbows and on the tail.  The elephant responded to therapy with an immune stimulant drug, but the chronic recurring skin lesions did not heal until after zinc supplementation was added to the diet. Additional excerpt: Dramatic improvement was noted within two weeks after the elephant was started on 2 g zinc carbonate per day. Lesions resolved by eight weeks. Subsequently, the dietary zinc level was adjusted from 21.56 mg/kg of feed to 53.6 mg/kg of feed on a dry matter basis.

Tripathy, S.B., Das, P.K., Acharjya, L.N., 1989. Treatment of microfilarial dermatitis in an Asian elephant (Elephas maximus): a case report. Indian Journal of Indigenous Medicines 31-33.
Abstract: Clinical and laboratory findings are presented for a case of chronic dermatitis in a 32-year-old female Asian elephant in Nandan Biological Park, Barang. Lesions were observed on the toes and heels of the hind feet and right abdominal wall, and microfilariae resembling Stephanofilaria were present in skin scrapings and blood from the lesions. Application of 8% metrifonate [trichlorfon] ointment in Himax (right food and abdomen) or vaseline (left foot) daily resulted in clinical cure after 15 days in lesions treated with Himax-based metrifonate and 22 days with vaseline-based metrifonate.

Umbert, I.J., Winkelmann, R.K., 1989. Necrotizing fasciitis: a clinical, microbiological, and histopathologic study of 14 patients. J. of the Amer. Acad. Of Dermatology 20, 774-781.

von Hegel, G., Hanichen, T., Mahnel, H., Wiesner, H. Warts (papilloma/sarcoid) in two elephants. Erkrankungen der Zootiere. Verhandlungsbericht des 31. Internationalen Symposiums uber die Erkrankungen der Zoo- und Wildtiere, Dortmund 1989.  201-205. 1989. Berlin, German Democratic Republic, Akademie-Verlag.
Ref Type: Conference Proceeding

Bettenbender, R. Foot care and skin care: Vital components of the elephant management program at Lincoln Park Zoo. AAZPA Reg.Conf.Proc.  545-549. 1988.
Ref Type: Conference Proceeding

von Solodkoff, M., 1988. Two cases of bullet injuries in elephant tusks. Tierarztl. Prax. 16, 201-203.
Abstract: Rifle bullets in the pulp of elephant tusks cause different excrescences, which are determined by the various materials of bullets, the point of entry and seriousness of inflammation. In two present cases so-called bridges are built by contre-coup effect after bullet penetration into the pulp of the tusk. The material of the bridges contains secondary ivory which differs completely from the characteristic criss-cross patterns of ivory.

Karesh, W.B., Smith, F., Frazier-Taylor, H., 1987. A remote method for obtaining skin biopsy samples. Conservation Biology 1, 261-262.

Lillywhite, H.B., Stein, B.R., 1987. Surface sculpturing and water retention of elephant skin. Journal of Zoology (Lond) 211, 727-734.

Pilaski, J., Rosenbruch, M., Gelderblom, H., Olberding, P., Hagenbeck, C., 1987. Herpes virus infectionin an Asian elephant (Elephas maximus). Erkrankungen der Zootiere 29, 179-184.

Rogers, P. Unhealed pressure sores in an Asian cow. Proc.Ann.Elephant Workshop. 8, 35-38. 1987.
Ref Type: Conference Proceeding

Swaim, S.F., Lee, A.H., 1987. Topical wound medications: a review. Journal of the American Veterinary Medical Association 190, 1588-1593.

Jacobson, E.R., Sundberg, J.P., Gaskin, J.M., Kollias, G.V., O'Banion, M.K., 1986. Cutaneous papillomas associated with a herpesvirus-like infection in a herd of captive African elephants. Journal of the American Veterinary Medical Association 189, 1075-1078.
Abstract: Proliferative cutaneous lesions developed in a herd of captive African elephants (33 from an animal importer in Texas, and 63 young elephants collected in Zimbabwe). Group-1 elephants were purchased 8 months before the arrival of the group-2 elephants. On arrival, 7 group-1 elephants had raised nodular fibrous growths, located predominantly on their trunks. Lesions were not observed in the group-2 elephants until approximately 3 months after they were acquired. Lesions on group-2 elephants began as small focal proliferative growths that regressed or that progressed into large nodular fibrous growths that were similar in appearance to those seen in the group-1 elephants. Lesions at various stages of development were biopsied and examined. Histologically, early lesions were inverted papillomas, with hyperplastic and hypertrophic epithelial cells containing amphoteric intranuclear inclusions in the lesion center. Older, large, nodular fibrous growths were ulcerated and were composed predominantly of a thickened dermis containing fibroblasts, collagen, and a mixed inflammatory cell infiltrate; inclusions were not observed in adjacent epidermal cells. Using a peroxidase- antiperoxidase technique, we did not detect group-specific papillomavirus antigens. Southern blot hybridization analysis of DNA from lesion specimens did not indicate papillomavirus- specific genomes. Electron-microscopically, inclusions consisted of aggregates of virus particles. The particles had electron- dense and electron-lucent cores and were 95 to 103 nm in diameter. Virions developed envelopes from nuclear membranes. Mature particles were seen within the cytoplasm and filled the intercellular spaces. On the basis of size, location, conformation, and envelopment, the particles most closely resembled those of herpesviruses.

Merkt, H., Ahlers, D., Bader, H., Rath, D., Brandt, H.P., Boer, M., Dittrich, L., 1986. Aftercare and recovery of a female Indian elephant after delivery of a dead fetus by episiotomy. Berl. Munch. Tierarztl. Wochenschr. 99, 329-333.

Ritchie, B.W., Thomas-Baker, B., Latimer, K.S., 1986. Dermoid cyst in an African elephant. Journal of the American Veterinary Medical Association 189, 1192.

Wallace, K. Elephant skin maintenance through exhibit modification. Proc.Ann.Elephant Workshop 7.  59-60. 1986.
Ref Type: Conference Proceeding

Jacobson, E.R., Sundberg, J.P. Cutaneous fibrous polyps in a captive herd of african elephants. Proc. Amer. Assoc. Zoo Vet.  71. 1985.
Ref Type: Conference Proceeding

Karesh, W.B., Robinson, P.T., 1985. Ivermectin treatment of lice infestations in two elephant species. Journal of the American Veterinary Medical Association 187, 1235-1236.

Velez, H., Diaz, F., 1985. Onychomycosis due to saprophytic fungi (human). Mycopathologia 91, 87-92.

Agrawal, M.C., Shah, H.L., 1984. Stephanofilarial dermatitis in India. Vet. Res. Commun. 8, 93-102.
Abstract: Four species of Stephanofilaria have been reported from India causing various forms of dermatitis in cattle, buffalo, goat and elephant. However, additional work is needed to establish their identity as separate species. The lesions appear to flare up following reinfection, while the application of a petroleum jelly alone reduces them. In vitro tests have shown organophosphorous compounds to possess stephanofilaricidal action in addition to their insecticidal activity. Aspects where further work is needed are indicated.

Braack, L.E.O., 1984. A note on the presence of the louse Haematomyzus elephantis Piaget (Mallophaga:Rhychophthirina) in the Kruger National Park. Koedoe 27, 139-140.

Buys, D., Keogh, H.J., 1984. Notes on the microstructure of hair of the Orycteropodidae, Elephantidae, Equidae, Suidae and Giraffidae. South African Journal of Wildlife Research 14, 111-119.
Abstract: The microstructure of hair of seven species of African mammals is described.  Distribution notes and micrographs are presented to assist in hair identification.

Chatterjee, A., 1984. Association of a Stephanofilaria indistinguishable form S. assamensis with lesions on the feet of Indian elephant (Elephas maximus). Indian Journal of Animal Health 23, 29-35.

Wright, P.G., Luck, C.P., 1984. Do elephants need to sweat? South African Journal of Zoology 19, 270-274.

Valente, A., 1983. Hair structure of the woolly mammoth, Mammuthus primigenius and the modern elephants, Elephas maximus and Loxodonta africanus. Journal of Zoology (Lond) 199, 271-274.
Abstract: The structure of overhairs from a Wooly mammoth, Mammuthus primigenius, 10-13 thousand years old,is compared with that of its living relatives, Elephas maximus and Loxodonta africana.  The hair profile, cross-sectional appearance, wholemount and cuticular scale cast of the hairs of the three species were examined and a selected array of photographs representing the hair structure of each species is presented.  In general there is little variation between the three species in the gross structure of the overhairs.

Sundberg, J.P., Russell, W.C., Lancaster, W., 1981. Papillomatosis in Indian elephants. Journal of the American Veterinary Medical Association 179, 1247-1249.

Brown, T.M., Clark, H.W., Bailey, J.S., 1980. Rheumatoid arthritis in the gorilla: A study of mycoplasma-host interaction in pathogenesis and treatment. Proceedings of the Symposium on the Comparative Pathology of Zoo Animals. Smithsonian Institution, Washington,D.C., pp. 259-265.
Abstract: Rheumatoid arthritis in a gorilla was first observed at the National Zoo in 1969.  As the result of our preliminary report, several other gorillas were recognized to have similar symptoms.  These true animal models have been observed for seven to nine years with highly successful therapeutic results based upon a pathogenetic concept developed over a 30-year period in a study of the disease in humans.  The seriousness of arthritis in the gorilla is reflected by the reports we have received in the past few years of a total of 26 additional captive gorillas variously affected.  The systemic aspects of rheumatoid arthritis, such as failure to gain weight and grow normally, hot and swollen joints, migratory arthritis, severe localized muscular atrophy, generalized weakness and depression, presented classical evidence of the rheumatoid disease pattern.  Remission occurred in one pregnant gorilla, and a flare reaction followed delivery, which is characteristic of the disease pattern in the human counterpart.      Laboratory studies were in support of rheumatoid disease. Immunoglobulin alterations were noted with reversed A/G ratios and elevations of IgC and IgM.  Positive bentonite flocculation rheumatoid factor tests were observed, and a positive lupus erythematosus (LE) test was noted in one animal.  Abnormal hematologic findings were frequent, with increased sedimentation rates and lymphocytosis.      Evidence of mycoplasma association was indicated by complement-fixing antibody response, positive cultures, and demonstration of the mycoplasma antigen in the tissue.  Of greatest significance were the induced rise and subsequent fall of mycoplasma antibodies resulting from the challenge to the host with antimycoplasma medication and the production of the Jarisch-Herxheimer flare response.  All these mycoplasma relationships have been found in man with the additional demonstration of delayed-type skin reaction with mycoplasma antigen.      It has been stressed that in infectious hypersensitivity, the microbial source is obscured, yet it must be defined and the proper therapy planned on an individualized basis.  The medication must be given in relatively small, intermittent dosage to avoid the development of delayed hypersensitivity which negates the drug effect.  Until more effective medications are developed, the treatment must also be administered over an extended period of time to achieve permanent control of the disease.  The demonstration of the importance of the pathogenesis concept speaks for itself in the final analysis with the recovery of severely disabled gorillas.      In conclusion, it would appear that a study of rheumatoid arthritis in the gorilla and man, approached from the point of view of comparative pathology and medicine, has opened a new direction for an understanding of the pathogenesis of this complex disease.  From these studies, one can now visualize for the first time that rheumatoid arthritis in the gorilla and in man is a controllable and potentially curable disease.  It seems that new thinking in regard to further demonstrations of etiologic associations must be given to all species where tissue hypersensitivity to microbial agents is basic.  It is suggested that Koch's postulates were not designed to include this area of pathogenesis where the role of the host is as significant as that of the parasite--an omission which has delayed the development of new knowledge in this area for a half a century. Is not the time at hand to revise our concepts and move in a new direction?

Stehlik, M., 1980. Skin myiasis due to Ruttenia loxodontis Rodhain in an African elephant. Vet Rec 107, 227.

Swaim, S.F., 1980. Management of contaminated and infected wounds. Surgery of Traumatized Skin. W.B. Saunders, Philadelphia, pp. 119-213.

George, P.O. Common surgical conditions in elephants. State Level Workshop on Elephants.  63-67. 1979. India, College of Veterinary and Animal Sicences, Kerala Agricultural University.
Ref Type: Conference Proceeding

Gruenberg, K., Jarofke, D., 1978. Surgical removal of excessive callous growth from the vulva of an Indian elephant (Elephas maximus). Erkrankungen der Zootiere 14, 301-304.

Obi, T.U., 1978. Traumatic granuloma in an African elephant, Loxodonta africana, and its treatment with yatren-casein. East African Wildlife Journal 16, 69-71.

Marennikova, S.S., Maltseva, N.N., Korneeva, V.I., Garanina, N., 1977. Outbreak of pox disease among carnivora (felidae) and edentata. J Infect Dis 135, 358-366.
Abstract: An outbreak of pox disease in Carnivora of the family Felidae occurred in the Moscow Zoo. Two forms of the disease were found: (1) fatal, fulminant pulmonary without skin lesions and (2) dermal with rash. The severity of the dermal form varied from subclinical to lethal. The pulmonary form was characterized by pneumonia and exudative pleuritis, and large concentrations of virus were observed in the lungs and exudate. In addition to Carnivora of the family Felidae, two giant anteaters had a severe form of the disease (dermal with hemorrhages) and died. The agent of the outbreak appeared to be very closely related to cowpox virus; however, pocks developed at a lower temperature than do those that result from infection with cowpox virus. Strains isolated from sick animals were identical to the virus previously isolated from an outbreak of pox among elephants and okapi. The most probable sources of infection were rats that were fed to some of the animals. During the outbreak, a female attendant at the zoo became infected.

Miller, R.M., 1977. Segmental gangrene and sloughing of elephants' ears after intravenous injection of phenylbutazone. Veterinary Medicine Small Animal Clinician 72, 633-637.

Dipeolu, O.O., 1976. The occurrence of ticks on a baby African elephant in Nigeria. East African Wildlife Journal 14, 227.

Kane, K.K., Corwin, R.M., Boever, W.J., 1976. Louse infestation of Asian elephants. Journal of the American Veterinary Medical Association 169, 906-908.

Hattingh, J., 1972. A comparative study of transepidermal water loss through the skin of various animals. Comp Biochem Physiol A 43, 715-718.

Basson, P.A., McCully, R.M., de Vos, V., Young, E., Kruger, S.P., 1971. Some parasitic and other natural diseases of the African elephant in the Kruger National Park. Onderstepoort Journal of Veterinary Research 38 , 239-254.

McCully, R.M., Basson, P.A., Pienaar, J.G., Erasmus, B.J., Young, E., 1971. Herpes nodules in the lung of the African elephant [Loxodonta africana (Blumenbach, 1797)]. Onderstepoort Journal of Veterinary Research 38, 225-236.
Abstract: Lymphoid nodules associated with Cowdry Type A intranuclear inclusions in epithelial and syncytial cells were found in the lungs of 74% of 50 African elephants in the Kruger National Park.  Subsequent studies proved these were caused by a herpes virus (Erasmus,McCully,Pienaar,Young, Pieterse & Els, 1971).  The disease appears to be subclinical or latent.  This virus, in common with other herpes viruses, might be more pathogenic in some other host.  The pathogenesis of the lymphoid nodules and the various stages of their formation are given and the detailed characteristics are illustrated.

Montagna, W., 1971. Cutaneous comparative biology. Archives of Dermatology 104, 577-591.
Abstract: This article reports the biological properties and adaptive patterns of structure and function of mammalian skin. There is an inverse relation between the richness of pelage and the thickness and complexity of epidermal undersurface of the epidermis.  Active melanocytes are numerous in the viscera and must have other functions than making melanin.  The dermis follows a stereotypical structural pattern, but shows many species differences; no animal has the amounts of elastic tissue, vascularity, and nerves as does the human.  Hair follicles differ in different species and in various parts of the body, and are parts of the cutaneous sensory system. Sebaceous and apocrine glands secrete pheromones.  Except for horses, only man sweats in response to heat stimulation. Thermal sweating, therefore, can be studied only in man.

Seetharam, S.B., 1971. Umbilical hernia in an elephant calf. Ceylon Veterinary Journal 48, 533-536.

Singh, B.S., 1971. Umbilical hernia in an elephant calf. Indian Veterinary Journal 48, 533-536.

Bhattacharjee, M.L., 1970. A note on stephanofilarial dermatitis among elephants in Assam. Science and Culture 36, 600-601.

Fain, A., 1970. A new anoetid living in the ear wax of an elephant (Acarina: Sarcoptiformes). Acta Zool Pathol Antverp 50, 173-177.

Rao, A.T., Acharjya, L.N., 1970. A case of fibrosarcoma in a baby elephant. Indian Veterinary Journal 47, 593.

Spearman, R.I.C., 1970. The epidermis and its keratinization in the African elephant (Loxodonta africana). Zoologica Africana 5, 327-338.

Raghavan, R.S., Reddy, K.R., Khan, G.A., 1968. Dermatitis in elephants caused by the louse Haematomycus elephantis (Piagot 1869). Indian Veterinary Journal 45, 700-701.

Feriz, H., 1967. Projectiles in elephant tusks. Zahnarztl Rundsch 76, 221-222.

Horstmann, E., 1966. The epidermis of the elephant. Z. Zellforsch. Mikrosk. Anat. 75, 146-59.

Fernando, S.D.A., Jayasinghe, J.B., Panabokke, R.G., 1963. A study of the temporal gland in an Asiatic elephant (Elephas maximus). Ceylon Veterinary Journal 11, 108-111.

McGaughey, C.A., 1962. Diseases of elephants. Part 4. Ceylon Veterinary Journal 10, 3-9.

Alwar, V.S., Seneviratna, P., Gopal, S., 1959. Indofilaria pattabiramani n.g.n. sp., a filaria from the Indian elephant (Elephas maximus) causing haemorrhagic dermatitis. Indian Veterinary Journal 36, 408-414.

Attwell, R.I.G., 1954. A note on wounds in elephants. African Wild Life 8, 204-205.

Ferrier, A.J., 1947. The care and management of elephants in Burma. Steel Brothers, London.

Goss, L.J., 1946. Hospital and laboratory. 51st Annual Report,New York Zoological Society 22-25.

Ramiah, B., 1942. An obscure abscess in an elephant. Indian Veterinary Journal 29, 200.

Pfaff, G., 1940. Diseases of Elephants. Superintendent, Govt. Printing and Stationary, Burma, Rangoon.

Austen, E.E., 1936. Exhibition of the ears of African elephants showing evidence of attack by larvae of a warble-fly. Procedings of the Zoological Society of London 1936, 1189.

Ferris, G.F., 1931. The louse of elephants. Haematomyzus elephantis Piaget (Mallophaga: Haematomyzidae). Parasitology 23, 112-127.

Austen, E.E., 1930. On a new dipterous parasite (family Calliphoridae, subfamily Calliphorinae) of the Indian elephant with notes on other dipterous parasites of elephants. Procedings of the Zoological Society of London 1930, 677.

Bequaert, J.C., 1916. Parasitic muscid larvae collected from the African elephant and the white rhinocerous by the Congo expedition. Bull. Amer. Mus. Nat. Hist. 35, 377-387.

Smith, F., 1890. The histology of the skin of the elephant. Journal of Anatomy and Physiology 24, 493-503.

Freeman, H.E., 1886. Parasites of elephant. J. Micr. and Nat. Sci. 5, 187.

 

 

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