Abstract

A 25-year-old female South African fur seal (Arctocephalus pusillus pusillus), kept under human care, presented with intermittent anorexia and progressive weight loss for a period of four months.

Several non-invasive diagnostic and therapeutic attempts were made unsuccessfully, and a medical evaluation was done under general anesthesia that included blood analysis, radiographs, and an abdominal ultrasound. While the blood results were unremarkable, the ultrasound revealed the presence of an intra-abdominal cystic structure, and the radiograph showed fecal impaction with an accumulation of dense fecal material in the distal colon. An initial approach with diet restriction, daily subcutaneous and oral hydration, laxatives, lubricants, and enemas was unsuccessful in resolving the fecal impaction.

On 20 December 2022, a contrast CT scan was performed revealing the presence of a densely mineralized fecalith measuring 5.5 cm in length, 3.0 cm in width, 3.7 cm in height lodged in the intra-pelvic colon, 1.0 cm wider than the narrowest portion of the pelvic canal; and confirmed the cystic structure measuring 10 cm in length, 8.4 cm in width, 7.1 cm in height, suspected to be of ovarian origin.

A total of six gas anesthesias were done over five weeks, with four colonoscopies using intra-fecalith Coca-Cola® instillation and manual fragmentation with forceps. The cyst was drained by percutaneous ultrasound-guided centesis, and 270 mL of serosanguineous aseptic fluid was removed. With daily voluntary enemas and adjunctive oral laxatives, the fecalith was finally successfully fragmented and intestinal transit was restored.

Fecalomas and fecal impactions are known to happen in pinnipeds, especially in older animals with co-morbidities, where intestinal transit can be compromised. Challenges in early diagnosis and intervention may arise due to limited access to animals and their colony grouping. Proactive diagnostic measures are crucial, and the use of Coca-Cola® for fecalith fragmentation, established in human literature,¹ proved effective as an adjuvant therapy in this case.

Acknowledgements

The authors wish to thank Dr. Monique Strange and Dr. Malcolm Rose for their support and contributions to this case, Dr. Marina Ivančić for her knowledge and expertise on CT scans, and the Sea Lion Point Marine Mammal Specialists for their valiant efforts towards providing voluntary access to the patient when required.

*Presenting author

Literature Cited

1.  Ferre-Aracil C, González-Haba M, Tormo-Lanseros B, Giménez-Alvira L, Jiménez- Garrido M. Distal intestinal obstruction syndrome resolved by dissolution with Coca-Cola® via colonoscopy in a cystic fibrosis patient. J Cyst Fibros. 2020;19:e43–e44.