Clara Lee, MD1, Eric D Jensen, DVM2, Jennifer Meegan, DVM2, Marina Ivancic, DVM2, James Bailey, DVM3, Dean Hendrickson, DVM4, Jeffrey Weiss, MD1, Gordon Wisbach, MD, MBA1. 1Naval Medical Center San Diego, 2US Navy Marine Mammal Program, 3Veterinary Medicince, University of Florida, 4Veterinary Medicine, Colorado State University
Successful major surgery on marine mammals is rare world-wide and has not been published in the modern literature. This report describes the evaluation and treatment of a 22 year-old female US Navy-trained bottlenose dolphin with a chronic ventral cervical mass. Ultrasound and contrast radiography showed a discrete fluid-filled mass caudodorsal to the hyoid apparatus. Fluid culture from needle aspiration grew Candida glabrata. Over several years the abscess was managed with serial needle aspirations and multiple antifungals. In 2012 further growth of the abscess was noted that caused inspiratory stridor and decreased performance level.
After failed medical management, surgical treatment was pursued in 2014. Under general endotracheal anesthesia, surgery was performed with the patient supine on a specially designed operative table. Through a neck incision the abscess was located and image-guided drainage was performed. After adequate drainage and curettage, a 10Fr Blake drain was placed in the surgical site. The ventral cervical muscles and incision were closed with sutures. The drain was secured to the dolphin with a bridle and the external drain bulb was secured to a pectoral fin strap. The drain was removed 5 days later and the skin sutures gradually removed over 5 weeks. Three years after the surgery, the dolphin was clinically normal and follow-up imaging showed no significant recurrence of the abscess. This case demonstrates a novel surgical approach of managing abscesses in marine mammals, including placement and management of a negative suction drain in a submerged patient. The successful collaboration between veterinary anesthesiology, veterinary medicine, radiology, and general surgery allowed the patient to continue her normal activities as a full-duty service member.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86355
Program Number: MSSP04
Presentation Session: Military iPoster (Non CME)
Presentation Type: MSSPoster