Abstract

A 17-year-old primaparous African elephant (Loxodonta africana) gave birth to a live female calf following a 642-day gestation. The fetus passed 22 minutes after the amniotic sac and 5.5 hours after the mucus plug. The placenta did not pass. Lethargy, persistent vulvar discharge, decreased appetite, weight loss, and agalactia ensued over the next several weeks. Hematologic changes included leukocytosis, hyperfibrinogenemia, and anemia. Dam was anesthetized on day 23, 36, 42, 56, and 71 postpartum for endoscopic exam and uterine lavage. Endoscopic uterine biopsies were obtained, and endometritis confirmed. During the fourth anesthetic procedure, a 4-kg piece of placenta was removed using a modified shop vacuum. A vestibulotomy was performed on the same day to facilitate inserting a tube through the vulva and into the cervix. This allowed for the infusion of 210 mil IU penicillin G potassium (Pfizerpen, Pfizer/Roerig, NY, NY) and 12 g gentamicin sulfate (GentaVed™ 100, Vedco, Inc., St. Joseph, MO) in 3 L saline (0.9% NaCl Injection USP, Baxter Health Care Corp., Deerfield, IL) into the uterus while the animal stood in an elephant restraint device on days 62–69 postpartum. Serial endoscopic uterine evaluations before and after treatment confirmed improvement. A final piece of placenta weighing 2.6 kg passed 87 days postpartum. Decrease in white blood cell count, resolution of anemia, cessation of vaginal discharge, surgical wound healing, and increase in body weight were used to monitor improvement and determine resolution.