may 24 , 2016 seals 6 sea turtles 8 14: 241–248...

5/24/16 Rounds Notes 14:241- 248 (2016) page of 1 8

One Step Forward, One Step . . . Forward ?

After 1 week of flushing, antibiotics and steroids, and topical treatment, there was no discharge from the right ear today and a cytology was negative for bacteria or white blood cells. We’ve been fooled by false negative

Canalography before so, this is not conclusive but good news. To see if there is any fluid in the middle ear, we ultrasound’ed the two tympanic bulla, above is the left but booth looked the same, I could not confirm fluid in the right middle ear, thus normal, still skeptical but again good news. We’ll stop flushing and wean the red

and continue topical medications this week and see where we are.

Rounds Notes is a report on the health of animals at the National Marine Life Center from Sea Rogers Williams VMD for the staff, volunteers, and community of the center including professionals involved the captive care of similar species, the views expressed are not necessarily that of NMLC. Information in Rounds Notes should be considered confidential and used solely to benefit the health of aquatic animals everywhere.

May 24 , 2016 seals 6 sea turtles 8 14: 241–248 (2016)


Harbor Seals : Onion Flake NMLC 15-034 PPv weanlingmale [admit] wt=11.8 kg, SL= 96.5 cm; [current] 33 kg BS=4/5CC: chronic otitis media (left), w/ resolved: ruptured globe (right)[post PHV1], sealpox, lungworm, and collapsed lung, post op L-TECA LBOstranded Province town 9/17/15; admit:9/17/15; last blood: 4/4/16 CBC/SCP WNLlast rads:4-16-16: DV skull canalography; complicated that contrast could not be forced into the middle ear due to material in the external ear canal.last ultrasound: 10-20-15PE: TPR 97.8, 120, 20; BAR, left eye is normal, left TECA scar is healed, all sutures removed, other PE WNL.Visual inspection [Williams 5-24-16; Right eye no change non-functional, Left ear incision completely healed.P: apply for release.Release Assessment: AC: PASS PE: PASS RADS: n/a LAB: PASS DX:/TX: PASS

Gray Seals : Seal Armstrong NMLC 16-001 PHg pupmale [admit] wt=16.2 kg, SL= 102 cm; [current] 19 kg BS=2/5CC: Not eating on his own (anorexia, failure to wean); resolved

stranded NewCastle NH 2/20/16; admit:2/21/16;last blood: 5-17-16:A: increase in WBC is likely a stress leukogram, no evidnce of infection, the mild anemia is likey due to captivity and age group, serum chemistries WNL- OK for release-CRWlast fecal: 3/1/16 single small trematode ova, 3/8/16 lice removed at exam; 4-19-16 NPFBite Quarantine: completeVisual Inspection:[Williams 5-10-16] WNL, vocal, thin.PE: pre-release [Williams 5-17-16} TPR 97.3, 120, 40, BAR BS 3/5, eyes ears nose and oral WNL mm pink and moist, ABD palpation WNL, limbs WNL, behavior normal for wild seal (will bite-caution), skin WNL A: normal PE P: release request pending CBC/SCP-CRWRelease Assessment: AC: PASS PE: PASS RADS: PASS LAB: PASS DX:/TX: PASS


Gray Seals : RusSeal Crow NMLC 16-006 PHg weanlingmale [admit] wt=17.7 kg, SL= 99 cm; [current] 20.6 kg SL= 104 cm BS=3/5CC: dehydrated, Lungworm, Lice, Tapeworm, Flukes, and woundsstranded Brewster MA 3/27/16; admit:3/31/16; released 5/20/16

Gray Seals : Shaquel O’Seal NMLC 16-007 PHg weanlingmale [admit] wt=19.7 kg, SL= 107.5 cm; [current] x kg SL= 102 cm BS=3/5CC: skin abscesses (Streptococcus), lice, LEFT (corneal scar), labored breathing (suspect lungworm), pneumonia, tapeworm/flukes

stranded 4/21/16 Hignham MA; admit: 4-24-16;last blood:4/24/16; lymphopenia, eosinophilia,last rads: 4/26/16 nmlc 16-007 PPv 4-25-16/4-28-16last fecal : 5-3-16: tramatode vs cestode ova-CRWlast UA : 4-26-16; SG 1.051, pH 7, chemistries all WNL, sediment: heavy struvite crystalsPre-release PE: [Voorhis and Berridge 5-24-16] TPR 96.7, 120, 20, old scar on left cornea, not an issue for release, all body systems examined and WNL A: OK for release-CRWRelease Assessment: AC: PASS PE: PASS RADS: FAIL/OK LAB: PASS DX:/TX: PASS

Harbor Seals : Ameilia SealHeart NMLC 16-008 PPv pupfemale [admit] wt=7.1 kg, SL= 72 cm; [current] 7.1 kg SL= 72 cm BS=2/5CC: premature, rare vomiting / regurgitation, R otitis media

stranded 4/23/16 Rye NH; admit: 4-24-16;last blood:4/24/16; leukopenia, hemoconcentration, hyperbilirubinemia, 4/26/16 Na improvedlast rads:5-10-16 (DV skull canalography: normal L, inconclusive on Rrads: 5-17-16 (DV skull canalography RIGHT only: 2 views one slightly oblique, contrast fills the distal R ear canal and pools along the tympanic membrane in a ‘hard stop’ no contrast is seen in the middle ear or nasopharynx. skull and ear structures appear normal, A: ear drum is not rupturedcytology: 5-10-16 R ear DifQuick: rod bacteria, rod bacteria in clumps, rare cocci, and rare WBCs


cytology: 5-24-16 R ear DifQuick: epitheila cells with pigment, no bacteria, no WBCsA: heavy bacterial growth from external ear.PE: [Williams 5-17-16] BAR, oral cavity normal, no aural d/c this morning, eyes and nostrils are WNL, behavior is typical, limbs WNL, ABD palp WNLPE: [Williams 5-24-16] BAR, HR 120, RR 20 lungs clear, mm pink/moist, no aural d/c (swab collected), limbs WNL, behavior WNL, other PE WNL A: possible resolving otitis media but also ear cytology may not represent the state of the bulla, but d/c flushing to allow TM to healMeds:

synotic / batril 3-4 d. R ear BID [ no flushing ]enrofloxicin 2.5 mg/kg PO BID 2-6 weeksprednisilone 5 mg EOD 5-10 tx.tramadol 50 mg 1/4 (12.5 mg) PO BID #20 (max 1/2 PO BID) PRN only

Release Assessment: AC: FAIL PE: FAIL RADS: pending LAB: FAIL DX:/TX: FAIL

Harbor Seals : LuSeal BALL NMLC 16-009 PPv pupfemale [admit] wt=x kg, SL= x cm; [current] x kg SL= x cm BS=2/5CC: abandoned pup (increased TBil, liver enzymes)


stranded 5/22/16; MOMME 5/23/16; admit: 5-24-16;last blood:4/24/16; leukopenia, hemoconcentration, hyperbilirubinemia, 4/26/16 Na improvedlast rads:5-10-16PE: [Williams 5-24-16 ] TPR= 98.4, 120, 20 BAR, vocal, eyes WNL, no aural/ nasal d/c, mm pink and moist, lungs clear, no murmur, abdomen palpates WNL, umbilicus headed, female normal, limbs normal. A: abandoned pup, fluids to formula, hydration OK no meds-CRWRelease Assessment: AC: FAIL PE: FAIL RADS: pending LAB: FAIL DX:/TX: FAIL

turtles: water temperature 77 °F pulling 48, & 51 at night if they need assistance, repeat blood gas every other morning, both are supported with oral gavage

feeding if they are not observed to eat in the pools during the day.*All turtles receive the following supplements daily [calcium 1/4 tab PO, Seatab 1/4 PO, vit B

1/4 tab PO, injectable super B complex 0.1 cc SQ q 7 days for 1 month]. *Standing medical order for 1% bw LRS SQ BID if not observed to eat.

Turtle Pre-release with anticipated release June 2nd:

Approved: Cricket NMLC 15-059; Steward NMLC 15-060; Echo NMLC 15-066; Elvis NMLC 15-075 & Franklin NMLC 15-076

Sea Turtles / Kemp’s ridley : Nicky NMLC 15-048 TLk juvenileST 2015-157, NEST 15-042Lk, 9849 no bandunknown [admit] wt=2.3 kg, SL= 25.9 cm; [current] 2.1 kg SL= 26.4 BS = 1.5/5CC: consolidated lung lobes, confirmed Osteolysis Syndrome (all limbs)assist feeding CAUTION-BITESstranded loc:Brewster date: 11/24/15; admit:12/8/15; last blood: 4/28/16 increased WBC, anemia (possible lymph contaminate)last rads: NMLC 15-048 DV, 4-22-16A: severe advanced polyarthritis with osteolysis-CRWBlood Culture: 5-10-16 no growthPE: [Williams 5-10-16] No major changes, skin may be improved, still some loss of superficial layers, swollen elbows and stifles, painful but perhaps less so. FNA site can not be detectedPE [Berridge / Williams 5-17-16] HR= 40, epithelium is improved, still agitated painful and attempts to bite, swollen elbows and stifles, red areas on ventral neck, but edema and skin integrity appear improved A: possible minor and slow progressMeds: amikacin 10 mg/kg IM q 3 days 2 mo

fluids 1% BW SQ on amikacin daystramadol 5 mg/kg PO q 48 hrstopical cream


Release Assessment: AC: FAIL PE: FAIL RADS: FAIL LAB: FAIL DX:/TX: FAIL

Sea Turtles / Kemp’s ridley : Jedi NMLC 15-051 TLk juvenileST 2015-166, NEST 15-052 Lk, 9859unknown [admit] wt=2.7 kg, SL= 28.2 cm; [current] 3.9 kg SL = 29.7 BS = 2.5/5CC: Confirmed Osteoylsis Syndrome, lung granulomasstranded loc: Brewster date; 11/24/15 admit:12/8/15; last blood: 4/28/16; watch Ca (iCa 0.8), HCT 22%, other WNL, albumin (0.9)last rads: NMLC 15-051 DV, 4-22-16A: severe advanced polyarthritis with osteolysis-CRWBlood Culture: 5-10-16 Serrate marcescens (enrofloxicin sensitive)AC- great improvement, eating well, no longer floating, swimsPE [Berridge / Williams / Voorhis 5-17-16] HR= , swelling of elbows and stifles, new finding of possible swelling of shoulders as well, no other changes, generalized edema and skin integrity is improved, body score is improved AC: better week, eating , swimming, spending time in the water column, more active but still with disability A: slow progressMeds: enrofloxicin

tramadol 5 mg/kg PO q 48 hrsRelease Assessment: AC: FAIL PE: FAIL RADS: FAIL LAB: FAIL DX:/TX: FAIL

Sea Turtles / Kemp’s ridley : Gunst NMLC 15-056 TLk juvenileST 2015-142, NEST 15-37 Lk, 9844 bandunknown [admit] wt=2.0 kg, SL= 24.2 cm; [current] 3.4 kg SL = 27.7 BS = 3/5CC: F.B. ingestion (screw) Eats > 100 g /daystranded Brewster on date: 11/24/15, admit:12/14/15; last blood: 12/14/15; increased ALKP 2038, AST 1410, CK 63k, LDH 25919, Alb low 0.7, low pro tine 2.3, elevated CHOL 456, UA 5.2 to 1.5 HCT 24%last rads: 5-17-16 DV screw is still present in the mid., left colic quadrent, the tip of the screw is missing, the screw does appear to be partially digested, there is a risk of heavy metal intoxication, there is not evidence of obstruction or periotionitis, lung outlines are normal. also no evidence of movement and the screw may be adhered in this location, local erosion and fatal peritonitisis could still occur.Point of screw is deteriorated, still on LEFT, no significant change.


PE [Williams 5-17-16] HR= n/a, no external wounds, BS good, oral good, activity and neurological exam is WNL A: only finding is F.B ingestion and decreased appetite this week.P: continued monitoring weekly DV radiographs are recommended.Release Assessment: AC: PASS PE: PASS RADS: FAIL LAB: PASS DX:/TX: FAIL

Sea Turtles / Kemp’s ridley : Cricket NMLC 15-059 TLk juvenileST 2015-225, NEST 15-94 Lk, 9906 bandunknown [admit] wt=2.2 kg, SL= 25.9 cm; [current] 4.4 kg SL = 30.1 BS = 3/5CC: shell woundstranded Eastham on date: 12/5/15, admit:12/14/15; last blood: 12/15/15 CG8 iCa=0.69 O, blood collected (lymph contaminated, no CBC)full CBC/SCP 12-29-15: 3-6-16- approved-CRWlast rads: 15-059 3/3/16 A: reasonable-CRWPE [Berridge / Williams 5-17-16] HR= 32,this turtle has a wound caused by bites from the other turtles in the RIGHT marginal scutes 10-13 with peripheral but exposed dermal bone, no active bleeding at this time, all other external systems examined and no lesions, this turtle passes and external exam for wild release-CRWRelease Assessment: AC: pass PE: PASS RADS: pass LAB: pass DX:/TX: pass

Sea Turtles / Kemp’s ridley : Steward NMLC 15-060 TLk juvenileST 2015-228, NEST 15-97 Lk, 9909 bandunknown [admit] wt=1.8 kg, SL= 24.5 cm; [current] 3.1 kg SL = 26.3 BS = 3/5CC: cold stun, linear carapacial excoriations, anemic 25%, UA 2.5, suspect pneumonia-resolved ?stranded Eastham on date: 12/5/15, admit:12/14/15;last blood: 12/14/15, increased ALKP (2142), CK (22k), GLU (175), UA (2.5), WBC (12k heterophilic); decreased ALB (0.8), HCT 25%)12-29-15 GLU and iCa OK 2/24/16 increase LDH CBC oklast rads: rads 3-28-16; 3 viewsPE [Berridge / Williams 5-17-16] HR= 48, all external systems examined and no lesions, this turtle passes and external exam for wild release-CRWRelease Assessment: AC: pass PE: pass RADS: FAIL LAB: LDH DX:/TX: pass

Sea Turtles / Kemp’s ridley : Echo NMLC 15-066 TLk juvenileST 2015-235, NEST 15-105 Lk, 9917 bandunknown [admit] wt=2.7 kg, SL= 26.5 cm; [current] 3.7 kg SL = 28.2 BS = 2.5/5CC: cold stun, left hind inguinal rash, UA over 12 !, now 3.2 (assoc 50% mort.), LDH>36000, AST 938, severe pneumoniastranded Eastham on date: 12/5/15, admit:12/14/15;last blood: 4/27/16 mild elevations of ASL, CK and LDH, non severe and all improving; CBC WNLlast rads:CT CCVS free gas in body cavity suspected, consolidation of left lung tissue near midline and generalized patchy increase in edicular pattern and focal consolidations on the RIGHT lung { note the nice comparison between the CT and AP radiograph R /L swap}4-27-16 lateral lungs WNL-CRW


PE [Berridge / Williams 5-17-16] HR= 52 all external systems examined and no lesions, this turtle passes and external exam for wild release-CRWRelease Assessment: AC: PASS PE: PASS RADS: PASS LAB: PASS DX:/TX: PASS

Sea Turtles / Kemp’s ridley : Elvis NMLC 15-075 TLk juvenileST 2015-195, NEST 15-155 Lk, 9972 bandunknown [admit] wt=2.6 kg, SL= 26.1 cm; [current] 4.0 kg SL=29.3 BS = 3/5CC: cold stun, old jaw injury, elevated LDH, skin lesions, LDH increase (9081), metabolic disturbances, lethargic, suspect pneumonia and GI gas distention or free colic gas, low iCa, granulomatous pneumoniastranded Turo on date: 12/12/15, admit:12/21/15; last blood: 2/16/16 WNL- approved CRWlast rads: CT-CCVS granuloma in the RIGHT dorsal lung field.4-30-16 A: lung pathology is still present on radiographscomparison to Feb radiograph the lung fields are not improved but clear progression or active disease can not be confirmed.PE [Berridge / Williams 5-17-16] HR= 48 all external systems examined and no lesions, this turtle passes and external exam for wild release-CRWRelease Assessment: AC: PASS PE: PASS RADS: FAIL LAB: PASS DX:/TX: PASS

Sea Turtles / Kemp’s ridley : Franklin NMLC 15-076 TLk juvenileST 2015-299, NEST 15-156 Lk, 9973 bandunknown [admit] wt=2.3 kg, SL= 25.4 cm; [current] 3.9 kg SCL = 29.4 BS = 3/5CC: cold stun, elevated LDH and UA, lethargic, possible pneumonia, GI foreign material, GI distention or free colic gas, severe consolidation of RIGHT lung, with extensive granulomasstranded Turo on date: 12/12/15, admit:12/21/15; last blood: 3/23/16 WNL approved-CRWlast rads: CT CCVS- severe Right sided lung consolidation and granuloma formation, with effacement of normal lung tissue.4-27-16 AP views may be normal- CRWPE [Berridge / Williams 5-17-16] HR= 48 RR = 12 all external systems examined and no lesions, this turtle passes and external exam for wild release-CRWRelease Assessment: AC: PASS PE: PASS RADS: PASS LAB: PASS DX:/TX: PASS

Sea Rogers Williams VMD attending veterinarian and director of science

STAFF: Kathy Zagzebski, Kate Shaffer, and Margo Madden@Rounds: Dr. Andrew Voorhis and Dr. Bruce Berridge

may 24 , 2016 seals 6 sea turtles 8 14: 241–248...

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