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CASE DESCRIPTION A 19-year-old male bottlenose dolphin (Tursiops truncatus) presented with inappetence and avoidant behavior. CLINICAL FINDINGS Ultrasound revealed a large-volume left-sided pleural effusion, which was consistent with chronic nonchylous lymphatic effusion and mild chronic hemorrhage by cytology. Computed tomography identified ipsilateral rib fractures, atelectasis, nodular pleuritis, marginal lymph node enlargement, and suspected dilation of the thoracic duct and internal thoracic veins. Fifteen lipids were significantly higher in serum of the dolphin as compared with controls (n = 3) using nontargeted lipidomics. TREATMENT AND OUTCOME A series of thoracentesis procedures were performed. Follow-up CT demonstrated marked reduction in pleural effusion with persistence of thoracic duct dilation and mass-like areas of pleural thickening. Ultrasonographic resolution of pleural effusion occurred 14 months after presentation; however, recrudescence was noted 5 months later. Over a total of 24 months, 21.52 L of pleural effusion was removed. Despite the presence of pleural effusion, the patient was clinically stable during this time and quality of life was considered good on the basis of continuous animal welfare evaluations. Humane euthanasia was elected following acute clinical decline 27 months after initial diagnosis. Necropsy confirmed severe pleural effusion, chronic severe pleural fibrosis with chronic hemorrhage, and mediastinal fibrosis with entrapped lymph nodes and thymic tissue. CLINICAL RELEVANCE Pleuritis and effusion were suspected sequelae of previous rib fractures. To our knowledge, this is the first report of nonchylous lymphatic pleural effusion with repeated pleural drainage and diagnostic imaging for clinical management in a bottlenose dolphin.

A 7‐year‐old female ostrich (Struthio camelus) presented with lameness, left intertarsal joint swelling and a healing wound on the caudomedial aspect of the joint. Synovial culture revealed Corynebacterium species and radiographs were consistent with progressive septic arthritis. Multiple treatments were attempted including through‐and‐through joint lavage, intra‐articular antibiotics, caudomedial arthrotomy, and regional limb perfusion in conjunction with systemic antibiotics and analgesia. Euthanasia was ultimately performed due to prolonged recumbency and poor prognosis. This report describes novel therapies and a surgical approach utilized for treatment of intertarsal septic arthritis in an ostrich and exemplifies the poor prognosis described in other species presenting with non‐responsive septic arthritis of critical joints., A female ostrich (Struthio camelus) presented with left intertarsal septic arthritis that was culture positive for Corynebacterium. This report describes novel therapies and a surgical approach utilized for attempted treatment of intertarsal septic arthritis in an ostrich and exemplifies the poor prognosis described in other species presenting with non‐responsive septic arthritis of critical joints.

Reproductive success is vital in sustaining free‐ranging and managed bottlenose dolphin (Tursiops truncatus) populations. Ultrasonography is an invaluable, non‐invasive tool in assessing the fetomaternal unit in humans and animals, including dolphins and horses. The purpose of this prospective longitudinal cohort study was to develop a protocol for fetomaternal ultrasonographic monitoring in dolphins and to report normal measurements and descriptive findings correlated with a positive outcome. From 2010 to 2017, serial ultrasonographic evaluations of 12 healthy dolphins were performed over the course of 16 pregnancies. A total of 203 ultrasound examinations were included in the study. Several metrics were accurate in predicting fetal age. Fetal biparietal diameter (BPD), thoracic width in dorsal and transverse planes, thoracic height in a sagittal plane, aortic diameter, and blubber thickness all demonstrated high correlation with gestational age (r > 0.94, P

Surgical intervention on cetaceans is rarely performed due to challenges including general anesthesia and post-operative wound healing. This report describes the evaluation and treatment of an adult female bottlenose dolphin (Tursiops truncatus) with the US Navy Marine Mammal Program, with a chronic ventral cervical abscess caused by Candida glabrata. Despite aspiration and lavage along with multiple antifungal drugs, the patient developed inspiratory stridor with decreased performance level and surgical treatment was pursued. Under general anesthesia with the dolphin in dorsal recumbency position a 12-cm longitudinal ventral midline neck incision was used for exploration. Intraoperative ultrasound aided the identification of surgical landmarks and the abscess cavity. After adequate drainage and curettage, a closed-suction drain was placed in the surgical site. Retention sutures were used to close the incision and the external drain bulb was secured to a pectoral fin strap. One-year post-op, the dolphin was clinically normal and follow-up imaging showed no significant recurrence of the abscess. This case demonstrates a novel surgical approach of managing abscesses in dolphins, including placement and management of a negative suction drain in a submerged patient. The successful collaboration between veterinary anesthesiology, veterinary medicine, radiology, and general surgery allowed the patient to continue her normal activities as a full-duty service member.

Lung function (breath duration, respiratory flow [], and tidal volume [VT]), and end-expiratory O2 were measured in 19 adult bottlenose dolphins (Tursiops spp.) while at rest in water or beached for up to 10 min. The results show that inspiratory VT, expiratory VT, or inspiratory did not differ on land or in water. The average expiratory for all dolphins on land decreased by 16%, and the expiratory and total breath durations increased by 5% and 4%, respectively, compared with in water. There were temporal changes observed during beaching, where expired and inspired VT and inspired decreased by 13%, 16%, and 9%, respectively, after 10 min on land. These data suggest that dolphins compensate for the effect of gravity by adjusting respiration to maintain alveolar ventilation and gas exchange, but during extended durations, the increased work of breathing may impede ventilation and gas exchange. Continuous monitoring of lung function and gas exchange may help prevent long-term damage during out-of-water medical procedures, optimize animal transport conditions, and improve survival during stranding events.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged as the cause of a global pandemic in 2019-2020. In March 2020, New York City became the epicenter in the United States for the pandemic. On 27 March 2020, a Malayan tiger (Panthera tigris jacksoni) at the Bronx Zoo in New York City developed a cough and wheezing with subsequent inappetence. Over the next week, an additional Malayan tiger and two Amur tigers (Panthera tigris altaica) in the same building and three lions (Panthera leo krugeri) in a separate building also became ill. The index case was anesthetized for diagnostic workup. Physical examination and bloodwork results were unremarkable. Thoracic radiography and ultrasonography revealed a bronchial pattern with peribronchial cuffing and mild lung consolidation with alveolar-interstitial syndrome, respectively. SARS-CoV-2 RNA was identified by real-time, reverse transcriptase PCR (rRT-PCR) on oropharyngeal and nasal swabs and tracheal wash fluid. Cytologic examination of tracheal wash fluid revealed necrosis, and viral RNA was detected in necrotic cells by in situ hybridization, confirming virus-associated tissue damage. SARS-CoV-2 was isolated from the tracheal wash fluid of the index case, as well as the feces from one Amur tiger and one lion. Fecal viral RNA shedding was confirmed in all seven clinical cases and an asymptomatic Amur tiger. Respiratory signs abated within 1-5 days for most animals, although they persisted intermittently for 16 days in the index case. Fecal RNA shedding persisted for as long as 35 days beyond cessation of respiratory signs. This case series describes the clinical presentation, diagnostic evaluation, and management of tigers and lions infected with SARS-CoV-2 and describes the duration of viral RNA fecal shedding in these cases. This report documents the first known natural transmission of SARS-CoV-2 from humans to nondomestic felids.

Despite numerous barriers to transmission, zoonoses are the major cause of emerging infectious diseases in humans. Among these, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and ebolaviruses have killed thousands; the human immunodeficiency virus (HIV) has killed millions. Zoonoses and human-to-animal cross-species transmission are driven by human actions and have important management, conservation, and public health implications. The current SARS-CoV-2 pandemic, which presumably originated from an animal reservoir, has killed more than half a million people around the world and cases continue to rise. In March 2020, New York City was a global epicenter for SARS-CoV-2 infections. During this time, four tigers and three lions at the Bronx Zoo, NY, developed mild, abnormal respiratory signs. We detected SARS-CoV-2 RNA in respiratory secretions and/or feces from all seven animals, live virus in three, and colocalized viral RNA with cellular damage in one. We produced nine whole SARS-CoV-2 genomes from the animals and keepers and identified different SARS-CoV-2 genotypes in the tigers and lions. Epidemiologic and genomic data indicated human-to-tiger transmission. These were the first confirmed cases of natural SARS-CoV-2 animal infections in the United States and the first in nondomestic species in the world. We highlight disease transmission at a nontraditional interface and provide information that contributes to understanding SARS-CoV-2 transmission across species. IMPORTANCE The human-animal-environment interface of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important aspect of the coronavirus disease 2019 (COVID-19) pandemic that requires robust One Health-based investigations. Despite this, few reports describe natural infections in animals or directly link them to human infections using genomic data. In the present study, we describe the first cases of natural SARS-CoV-2 infection in tigers and lions in the United States and provide epidemiological and genetic evidence for human-to-animal transmission of the virus. Our data show that tigers and lions were infected with different genotypes of SARS-CoV-2, indicating two independent transmission events to the animals. Importantly, infected animals shed infectious virus in respiratory secretions and feces. A better understanding of the susceptibility of animal species to SARS-CoV-2 may help to elucidate transmission mechanisms and identify potential reservoirs and sources of infection that are important in both animal and human health.

The human-animal-environment interface of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important aspect of the coronavirus disease 2019 (COVID-19) pandemic that requires robust One Health-based investigations. Despite this, few reports describe natural infections in animals or directly link them to human infections using genomic data. In the present study, we describe the first cases of natural SARS-CoV-2 infection in tigers and lions in the United States and provide epidemiological and genetic evidence for human-to-animal transmission of the virus. Our data show that tigers and lions were infected with different genotypes of SARS-CoV-2, indicating two independent transmission events to the animals. Importantly, infected animals shed infectious virus in respiratory secretions and feces. A better understanding of the susceptibility of animal species to SARS-CoV-2 may help to elucidate transmission mechanisms and identify potential reservoirs and sources of infection that are important in both animal and human health., Despite numerous barriers to transmission, zoonoses are the major cause of emerging infectious diseases in humans. Among these, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and ebolaviruses have killed thousands; the human immunodeficiency virus (HIV) has killed millions. Zoonoses and human-to-animal cross-species transmission are driven by human actions and have important management, conservation, and public health implications. The current SARS-CoV-2 pandemic, which presumably originated from an animal reservoir, has killed more than half a million people around the world and cases continue to rise. In March 2020, New York City was a global epicenter for SARS-CoV-2 infections. During this time, four tigers and three lions at the Bronx Zoo, NY, developed mild, abnormal respiratory signs. We detected SARS-CoV-2 RNA in respiratory secretions and/or feces from all seven animals, live virus in three, and colocalized viral RNA with cellular damage in one. We produced nine whole SARS-CoV-2 genomes from the animals and keepers and identified different SARS-CoV-2 genotypes in the tigers and lions. Epidemiologic and genomic data indicated human-to-tiger transmission. These were the first confirmed cases of natural SARS-CoV-2 animal infections in the United States and the first in nondomestic species in the world. We highlight disease transmission at a nontraditional interface and provide information that contributes to understanding SARS-CoV-2 transmission across species.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged as the cause of a global pandemic in 2019-2020. In March 2020, New York City became the epicenter in the United States for the pandemic. On 27 March 2020, a Malayan tiger (

Lung function (breath duration, respiratory flow [

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged as the cause of a global pandemic in 2019-2020. In March 2020 New York City became the USA epicenter for the pandemic. On March 27, 2020 a Malayan tiger (Panthera tigris jacksoni) at the Bronx Zoo in New York City developed a cough and wheezing with subsequent inappetence. Over the next week, an additional Malayan tiger and two Amur tigers (P. t. altaica) in the same building and three lions (Panthera leo krugeri) in a separate building also became ill. The index case was immobilized, and physical examination and bloodwork results were unremarkable. Thoracic radiography and ultrasonography revealed peribronchial cuffing with bronchiectasis, and mild lung consolidation with alveolar-interstitial syndrome, respectively. SARS-CoV-2 RNA was identified by real-time, reverse transcriptase PCR (rRT-PCR) on oropharyngeal and nasal swabs and tracheal wash fluid. Cytologic examination of tracheal wash fluid revealed necrosis, and viral RNA was detected in necrotic cells by in situ hybridization, confirming virus-associated tissue damage. SARS-CoV-2 was isolated from the tracheal wash fluid of the index case, as well as the feces from one Amur tiger and one lion. Fecal viral RNA shedding was confirmed in all seven clinical cases and an asymptomatic Amur tiger. Respiratory signs abated within 1-5 days for most animals, though persisted intermittently for 16 days in the index case. Fecal RNA shedding persisted for as long as 35 days beyond cessation of respiratory signs. This case series describes the clinical presentation, diagnostic evaluation, and management of tigers and lions infected with SARS-CoV-2, and describes the duration of viral RNA fecal shedding in these cases. This report documents the first known natural transmission of SARS-CoV-2 from humans to animals in the USA, and is the first report of SARS-CoV-2 in non-domestic felids.

The objective of this study was to establish a comprehensive technique for ultrasound examination of the dolphin hepatobiliary system and apply this technique to 30 dolphins to determine what, if any, sonographic changes are associated with blood-based indicators of metabolic syndrome (insulin greater than 14 μIU/ml or glucose greater than 112 mg/dl) and iron overload (transferrin saturation greater than 65%). A prospective study of individuals in a cross-sectional population with and without elevated postprandial insulin levels was performed. Twenty-nine bottlenose dolphins ( Tursiops truncatus ) in a managed collection were included in the final data analysis. An in-water ultrasound technique was developed that included detailed analysis of the liver and pancreas. Dolphins with hyperinsulinemia concentrations had larger livers compared with dolphins with nonelevated concentrations. Using stepwise, multivariate regression including blood-based indicators of metabolic syndrome in dolphins, glucose was the best predictor of and had a positive linear association with liver size (P = 0.007, R

This prospective study characterizes the impact of positioning on the pulmonary volume and pulmonary atelectasis in Egyptian fruit bats (

We measured respiratory flow ( V ), breathing frequency ( f R ), tidal volume ( V T ), breath duration and end-expired O 2 content in bottlenose dolphins ( Tursiops truncatus ) before and after static surface breath-holds ranging from 34 to 292 s. There was considerable variation in the end-expired O 2 , V T and f R following a breath-hold. The analysis suggests that the dolphins attempt to minimize recovery following a dive by altering V T and f R to rapidly replenish the O 2 stores. For the first breath following a surface breath-hold, the end-expired O 2 decreased with dive duration, while V T and f R increased. Throughout the recovery period, end-expired O 2 increased while the respiratory effort ( V T , f R ) decreased. We propose that the dolphins alter respiratory effort following a breath-hold according to the reduction in end-expired O 2 levels, allowing almost complete recovery after 1.2 min.

This prospective study characterizes the impact of positioning on the pulmonary volume and pulmonary atelectasis in Egyptian fruit bats (Rousettus aegyptiacus). The soft tissue appearance of atelectactic pulmonary parenchyma can obscure or mask pulmonary pathology. Soft tissue within healthy lung parenchyma caused by atelectasis can efface the margins of pathology, such as pulmonary metastasis or pneumonia, due to overlapping attenuation profiles. Pulmonary atelectasis is an unwanted side effect of anesthesia resulting from muscle relaxation and is exacerbated by high (80-100%) inspired oxygen supplementation during general anesthesia. Positioning can help minimize pulmonary atelectasis. Seven R. aegyptiacus received computed tomography imaging in suspended vertical (head-up) and inverted (head-down) positions that generated images in the dorsoventral plane. Vertically positioned bats had a significantly greater lung volume compared to inverted positioning (P = 0.0053). The nondependent portion of the lung apices in the vertically positioned bats had significantly more negative Hounsfield units (i.e. less dense tissue) than the dependent portions of the lung and was also less dense than both portions of the lungs in inverted positioned bats. Although not an intuitive positioning for bats, a vertical orientation generates less pulmonary atelectasis and a greater lung volume compared to bats positioned in a more natural inverted position. Despite physiologic adaptations to hang in an inverted position when not in flight, avoidance of inverted positioning during anesthesia and anesthetic recovery is recommended based on these findings.

We measured respiratory flow (

Two related female snow leopards ( Panthera uncia) were diagnosed with osteochondritis dissecans of the lateral femoral condyle via radiographs and computed tomography. Lesions were either bilateral (Patient 1) or unilateral (Patient 2). Surgical treatment was performed using an osteochondral autograft transfer system following cartilage flap removal. After a 6-wk recovery period, both animals had a markedly improved gait with mild pelvic limb stiffness. Patient 1 developed intermittent lameness 9 mo postsurgery and Patient 2 had mild lameness 3 yr postsurgery. Because of recurrent lameness, both animals were treated with platelet-rich plasma intra-articular injections and oral gabapentin (Patient 1) or oral meloxicam (Patient 2). Full incorporation of autografts was confirmed with computed tomography (both patients) and arthroscopy (Patient 1 only). Osteochondritis dissecans has been previously reported in snow leopards and these cases represent the first reported use of osteochondral autograft repair and platelet-rich plasma to treat the condition.

Pulmonary disease has been well documented in wild and managed dolphin populations. The marginal lymph nodes of the dolphin thorax provide lymphatic drainage to the lungs and can indicate pulmonary disease. This study standardized a technique for rapid, efficient, and thorough ultrasonographic evaluation of the marginal lymph nodes in bottlenose dolphins ( Tursiops truncatus). Thoracic ultrasonography was performed on 29 clinically healthy adult bottlenose dolphins. Reference intervals for lymph node dimensions and ultrasonographic characteristics of marginal lymph nodes were determined from four transducer orientations: longitudinal, transverse, oblique, and an orientation optimized to the ultrasonographer's eye. The relationship between lymph node dimensions and dolphin age, sex, length, weight, origin, and management setting (pool versus ocean enclosure) were also evaluated. The mean marginal lymph nodes measured 5.26 cm in length (SD = 1.10 cm, minimum = 3.04 cm, maximum = 7.61 cm, reference interval [10th to 90th percentiles per node dimension] 3.78-6.55 cm) and 3.72 cm in depth (SD = 0.59 cm, minimum = 2.64, maximum = 5.38 cm, reference interval 2.98-4.50 cm). Sex, dolphin length, weight, and management setting had no effect on lymph node dimensions. Dolphins30 yr of age had longer node lengths than dolphins 5-10 yr old. Node dimensions did differ between dolphins from various origins. Most commonly, the lymph node was found to be hyperechoic relative to surrounding soft tissues (98%) and to have irregular caudal borders (84%), ill-defined deep borders (83%), flat superficial border (67%), triangular or rounded triangle shape (59%), irregular cranial border (55%), and moderate heterogeneity (34%). The data reported in this study serve as a baseline reference that may contribute to earlier detection of pleural and pulmonary disease of managed and wild cetacean populations.

Anesthesia and surgery in cetaceans have inherent risks and have rarely been utilized as viable treatment options. This report represents the first known multidisciplinary team approach to emergency laparotomy in a compromised, 22-yr-old, female Pacific white-sided dolphin ( Lagenorhynchus obliquidens ). The inciting clinical signs and ancillary diagnostics were consistent with a mechanical ileus. Although no torsion or obstruction was apparent during surgery, severe enteritis and peritonitis were noted. Postoperatively, the animal was maintained on aggressive medical management with continuous supportive care until succumbing 3 days later with clinical pathology indicative of terminal sepsis and profound inflammation. Postmortem findings included generalized vascular stasis and segmental intestinal volvulus with infarction. To the authors' knowledge, this is one of the most-complex surgical and anesthetic procedures performed in a cetacean. Though the outcome was unsuccessful, this case represents the aquatic veterinary community's collective advances in the ability to treat cetaceans under human care.

Pulmonary disease is one of the leading causes of cetacean morbidity and mortality in the wild and in managed collections. The purpose of this study was to present the computed tomographic (CT) appearance of the thorax of the live bottlenose dolphin (Tursiops truncatus) out-of-water and to describe the technical and logistical parameters involved in CT image acquisition in this species. Six thoracic CT evaluations of four conscious adult bottlenose dolphins were performed between April 2007 and May 2012. Animals were trained to slide out of the water onto foam pads and were transported in covered trucks to a human CT facility. Under light sedation, animals were secured in sternal recumbency for acquisition of CT data. Non-contrast helical images were obtained during an end-inspiratory breath hold. Diagnostic, high quality images were obtained in all cases. Respiratory motion was largely insignificant due to the species' apneustic respiratory pattern. CT findings characteristic of this species include the presence of a bronchus trachealis, absence of lung lobation, cranial cervical extension of the lung, lack of conspicuity of intrathoracic lymph nodes, and presence of retia mirabilia. Dorsoventral narrowing of the heart relative to the thorax was seen in all animals and is suspected to be an artifact of gravity loading. Diagnostic thoracic computed tomography of live cetaceans is feasible and likely to prove clinically valuable. A detailed series of cross-sectional reference images is provided.

Health assessment of free-ranging populations requires an integrated approach, often incorporating a method to measure mass as a representation of the animals' ability to utilize environmental resources. In chelonians, direct measurements of mass have historically served as a corollary for body condition. However, this method may not accurately represent the true fat volume (FV) and may be skewed by the presence of eggs, shell size, or muscle mass. The objective of this study was to use computed tomography (CT) to develop a model for determining body condition index (BCI) in free-ranging Blanding's turtles (Emydoidea blandingii). Mass, shell measurements, and FV were measured by CT in 65 free-ranging Blanding's turtles from Lake and DuPage counties in Illinois. Twenty-one different models were built for BCI using both FV and fat percentage (FP) as dependent variables. The best fit model for FP included the relationship between mass and carapace length with nearly 60% model support. The model for FV demonstrated a similar relationship but had only 18% support. Linear models with BCI as the dependent variable showed that juveniles had a higher FP than adults and females with more eggs had a lower FP. FP can be calculated in the field with nearly 60% accuracy compared to CT-assessed FP as a component of a physical exam and population health survey to assess the effectiveness of conservation efforts for the endangered Blanding's turtle.

Too Narrow to Swim? Andrew R. Haas, Marina Ivancic, Kassem Harris, and Michael Renner University of Pennsylvania Medical Center, Section of Interventional Pulmonary and Thoracic Oncology, Philadelphia, Pennsylvania; National Marine Mammal Foundation, San Diego, California; Roswell Park Cancer Center, Section of Interventional Pulmonology, Buffalo, New York; Doctor of Veterinary Medicine, Key Largo, Florida

Pulmonary disease is one of the leading causes of cetacean morbidity and mortality in the wild and in managed collections. The purpose of this study was to present the computed tomographic (CT) appearance of the thorax of the live bottlenose dolphin (Tursiops truncatus) out-of-water and to describe the technical and logistical parameters involved in CT image acquisition in this species. Six thoracic CT evaluations of four conscious adult bottlenose dolphins were performed between April 2007 and May 2012. Animals were trained to slide out of the water onto foam pads and were transported in covered trucks to a human CT facility. Under light sedation, animals were secured in sternal recumbency for acquisition of CT data. Non-contrast helical images were obtained during an end-inspiratory breath hold. Diagnostic, high quality images were obtained in all cases. Respiratory motion was largely insignificant due to the species' apneustic respiratory pattern. CT findings characteristic of this species include the presence of a bronchus trachealis, absence of lung lobation, cranial cervical extension of the lung, lack of conspicuity of intrathoracic lymph nodes, and presence of retia mirabilia. Dorsoventral narrowing of the heart relative to the thorax was seen in all animals and is suspected to be an artifact of gravity loading. Diagnostic thoracic computed tomography of live cetaceans is feasible and likely to prove clinically valuable. A detailed series of cross-sectional reference images is provided.