A Balanced Approach to Meeting the Nutritional Needs of the Critically Ill Neonatal Tursiops truncatus
Aggressive nutritional support is paramount to success in the therapy of a critically ill dolphin calf. For an optimal outcome, it is also essential to maintain and promote the mother/calf relationship while treating the sick calf. This case report will utilize the case study of "Liko" to describe an effective balanced approach to the medical and nutritional management of a sick neonatal dolphin calf.
In September 2000 Dolphin Quest Hawaii had two healthy calves (Tursiops truncatus) born and one stillborn to three pregnant females. All three females were kept together and shared responsibilities of caring for and nursing both calves (Liko and Keo).
In the first 2 months of life, it was noted that Liko (the male calf) was not thriving and was noticeably smaller size as compared to Keo (the female calf). At 2 1/2 months of age concern for his slow development prompted close monitoring of his respiratory rate and nursing time. He was observed to have a decreased nursing time and a higher respiratory rate then the female calf. In a short time the problem intensified with Liko's respiratory rate increasing to 41/5 minutes and nursing time decreasing to about 7 seconds per hour. At this time a deliberate decision was made to initiate aggressive diagnostic studies and therapy.
Physical Examination and Diagnostic Information
On physical exam Liko was weak and thin. His eyes were glazed, and his odor. Harsh lung sounds were noted bilaterally on auscultation. Breath had a sour odor. Harsh lung sounds were noted bilaterally on auscultation.
Hematology revealed a severe microcytic non-regenerative anemia, inflammatory leukogram, lymphopenia, monocytosis, and elevated sedimentation rate. Decreased serum iron and alkaline phosphatase with an elevated total CO2 were noted on serum chemistry (Table 3). Thoracic ultrasound suggested a consolidated right lung lobe, nodular appearing pleura, and loss of the pleural space.
Medical treatment initiated immediately for a respiratory infection of unknown etiology and anemia included" injectable enrofloxacin (Baytril), oral amoxicillin, oral itraconazole, oral ferrous sulfate, folic acid, vitamin B-12 supplements, and a one-time injection of Nandrolone Decorate to stimulate erythropoiesis.
All three females were kept together in the nursing pool with the two calves. During treatment, Liko and his mother were separated into a shallow portion of the pool. Both mom and calf were held under gentle restraint in shallow water for the duration of the procedures, and released together simultaneously at the end of the procedure. Within a few treatments, the mother did not need to be restrained during treatments.
The plan was to allow Liko to nurse from his mother, begin regular tube feedings of formula, attempt to teach suckling from a bottle, and offer pieces of fish. The mothers were all trained for voluntary milk collection utilizing a modified breast pump, it was decided to supplement Liko's formula with as much mother's milk as possible. Proximate analysis was done on the milk to determine it's the caloric content (Table 1).
The formula contained:
1 herring fillet (222 calories/100g)
45g Zoologic powdered formula 30/55
30g Zoologic powdered formula 33/40
5ml salmon oil (menhaden)
10ml heavy whipping cream
1 L water/pedialyte
1.5 ml lecithin
50 mg Taurine
½ tab lactobacillus
7.5 g dicalcium phosphate
30-60 mls of fresh mother's milk added directly to the formula to be fed. Dependent on the quantity of mother's milk utilized, the formula had 1.5 to 1.6 kcal/ml.
Previous reports on sick/orphaned Tursiops calves indicate that they can require up to 150 kcal/kg body weight/day to attain positive weight gain. This intense nutritional demand has been met through frequent small feeds (up to one feed per hour). With Liko at 29 kg, his nutritional requirement per day was estimated at 4,350 kcal/day. This would require the delivery of over 3 liters of formula/day if Liko did not have the opportunity to nurse.
The nutritional management approach of supplementing nursing with tube feedings made accurate daily caloric intake impossible. However, careful monitoring guided decisions to manipulate his daily caloric supplementation plan to meet his needs for daily positive weight gain.
Tables 2 and 3 demonstrate how the observed clinical parameters helped dictate the daily decisions for nutritional management.
After one month of complete treatment and monitoring, Liko's medical problem had entirely resolved. All medications were discontinued and he resumed his busy job as a dolphin calf playing with his friend Keo and nursing from both mothers.
Table 1. Milk composition of two dolphins.
Table 2. Clinical observations and nutritional supplementation.