Abstract

In February 2011, an adult female Atlantic bottlenose dolphin (Tursiops truncatus) was found stranded in Turner Sound in west Andros, Bahamas. The Atlantis Marine Mammal Stranding Rescue team responded and transported in a very dehydrated, emaciated older dolphin with a mild C-shaped spinal curvature to the right and severe sunburn to Atlantis Dolphin Cay. "Miss Turner" was kept in a quarantine facility with med pool in order to aggressively treat her illnesses. The initial response and treatment to her mild but progressive C shaped spinal deformity was to perform radiographs, electrotherapy and temporary physical therapy that instituted stretching and straightening techniques, as well as counteractive pressure against the convex aspect of her curvature. Her spinal deformity became more progressive and she began to bend in the mid lumbar area and curve to the left as well, forming more of an "S" shape. In October of 2012, a CT scan was performed in order to assess her severe scoliosis. Then an ultrasound was performed for various reasons which included assessment of epaxial muscle fibrosis and revealed evidence of left-sided mineralization. In May 2012, discussions and plans were put in place to initiate a specific physiotherapy technique that was used in adult human scoliosis and has proven to be an effective treatment in spinal deformities in humans. Our goals were to increase flexibility, increase swimming behavior and movement, decrease pain and increase overall quality of life. This technique involves spinal segmental isolation, rotations and glides. Continued assessment of the dolphin's spine was performed in order to direct specific therapy. These included segmental tissue-specific examination, segmental traction and rotation tests and palpation of tissue and pain perception points. A "no go zone" area was established due to the spinal deformity in the cranial lumbar area consisting of likely fused and contact points of the lumbar transverse spinous processes and also fractured and subsequent bridging of the transverse spinous processes on the contralateral side.

The physiotherapy treatment plan was instituted and consisted of:
3 sets 3x weekly

1.  30 thoracic spinal segmental rotations (blocks of 2–3 three vertebrae)

2.  30 mid to caudal lumbar segmental rotations (blocks of 2–3 vertebrae)

3.  30 thoracic spinal segmental side glides (blocks of 2–3 three vertebrae)

4.  30 mid to caudal spinal segmental side glides (blocks of 2–3 three vertebrae)

5.  2 slow straightening peduncle stretches at the end of each session

Standardized pictures were taken of Miss Turner at rest with light support next to a fixed 90° angle 1x weekly. Pain was assessed by her heart rate squinting of eyes. Primary and secondary reinforcement was utilized throughout the sessions.

Assessment of change in the dolphin's function, condition, conformation and swimming behavior was looked at both objectively and subjectively over a 5 month time period. Subjective assessment included documented reports of new and increased swimming behavior such as increased swimming to the right, diving down with head first, increased activity, increased movement of the caudal aspect of her body and increased play with the young dolphins. Objective assessment included measured overlays (Cobb's angles) from a standard baseline (the cranial insertion of the dorsal fin) to the dorsal fluke notch on standardized pictures. The overlays and angle measurements indicate a fairly progressive, positive change in the position of the caudal aspect of her body from her dorsal fin to her fluke.

Preliminary and initial assessments of spinal segmental isolation and rotation physiotherapy support the treatment of scoliosis or spinal deformities in small cetaceans by increasing flexibility, suppleness, overall swimming activity and body confirmation. This treatment could be implemented in various known situations of vertebrate animal spinal disease caused by trauma, idiopathic scoliosis, loss of limbs and other spinal illnesses.

Acknowledgements

I would like to thank my co-authors on this project. We also need to recognize the Atlantis marine mammal specialists and lab assistants for their enormous effort and diligence in implementing the physiotherapy, behavior logs, photos and as well as their overall dedication and effort towards increasing the quality of life for this animal. I would also like to recognize our Vice President, Teri Corbett, for the means to fund the training needed to implement our treatments.

* Presenting author

Literature Cited

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3.  Weiss, Hans-Rudolf. 2012. Physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria. Scoliosis 7:4–7