Abstract

In 2006, an adult female bottlenose dolphin (Tursiops truncatus) was diagnosed with a ventral cervical abscess caused by Candida glabrata, as previously described.¹ The abscess was medically managed with intermittent ultrasound-guided fluid aspiration, lavage, intralesional antifungals such as caspofungin, and systemic oral voriconazole for 6 years. In 2012, the animal developed a significant inflammatory hemogram and inspiratory stridor. A secondary, multilobulated abscess was identified with ultrasound caudal to the previous lesion. A computed tomography (CT) scan with contrast revealed significant soft tissue swelling with multiple non-enhancing foci and patchy mineralization, dorsal and caudal to the hyoid, as well as dorsal displacement and reduced air space surrounding the larynx. Surgery was performed under general anesthesia. The dolphin was positioned in dorsal recumbency to facilitate a 12-cm longitudinal ventral midline incision. Intraoperative ultrasound aided identification of surgical landmarks and the abscess cavity. Debridement of all necrotic tissue to healthy margins was completed. A round Jackson-Pratt drain was placed with an external drain bulb secured to a pectoral fin strap. Tension-relieving stents and simple interrupted sutures were used to close the incision. The drain was removed five days later, and the skin sutures were gradually removed over the next five weeks. A 5-month postoperative contrast CT scan revealed a static degree of soft tissue thickening and dorsal larynx displacement. There was progressive dystrophic mineralization but no convincing evidence of non-enhancing foci (i.e., fluid). At 1 year post-surgery, the animal is clinically normal. Routine monitoring includes monthly CBC and chemistry panels with intermittent ultrasonographic reassessment of the lesion. Although a multilobulated mass is still present, there has been no recurrence of fluid accumulation and additional aspirations have not been required.

Acknowledgements

The authors wish to thank the US Naval Medical Center San Diego for their ongoing medical and diagnostic support that aids in the excellent veterinary care of our patients. Finally, the authors thank all of the veterinarians, technicians, trainers, and records office personnel that were instrumental in facilitating the care of this animal.

* Presenting author

Literature Cited

1.  Lutmerding BA, Johnson SP, Ferrara S, Hill LD, Ruiz CL, Emory-Gomez FM, Jensen EJ. Techniques in interventional radiology: case studies in marine mammal medicine. In: Proceedings from the IAAAM 41st Annual Conference, Vancouver, British Columbia, Canada; 2010: 74–76.