In 2002, a 5-year-old, 169 kg, male Atlantic bottlenose dolphin (Tursiops truncatus) contracted a peracute septicemic Erysipelothrix rhusiopathiae infection, which was confirmed via blood culture. Though this form is nearly always fatal to cetaceans, this particular animal survived, despite the development of a severe uremia, anemia, and thrombocytopenia. This triad of findings very closely resembles a clinical condition known in humans as hemolytic uremic syndrome (HUS).
The patient presented with a sudden onset of depression and inappetance. A profound leukopenia and thrombocytopenia was detected on initial blood work. An intensive course of injectable antibiotics and corticosteroids was begun, as well as oral and subcutaneous fluid therapy. A progressive deterioration in clinical condition and worsening uremia and thrombocytopenia necessitated the addition of phosphate binders, calcium supplementation, diuretics, and nutritional support. Gradually the animal recovered, with the improvement in BUN, creatinine, and hematocrit following the steady increase in platelet numbers.
HUS is the most common cause of acute renal failure in young children.1 This syndrome is characterized by progressive renal insufficiency and failure and may be caused by a myriad of agents which can affect the integrity of the microvasculature of the kidneys. These factors may include bacterial, viral, rickettsial, or fungal infections; chemotherapeutic agents; or autoimmune complexes, among others. However, the most common etiology is a Shiga toxin-producing E. coli O:157:H7.
1. Razzaq S. Hemolytic uremic syndrome: an emerging health risk. Am Family Physician. 2006.74(6):991–996.