Introduction The Tsavo mobile veterinary unit has attended to quite a number of cases this month. Cases continue to remain high in the region. Rain is expected soon but recent showers have done little to help the situation. Cases continue to remain high especially in elephants. Cases handled in the month carried out by the resident vet, skyvet and another vet who stood in for the resident vet while he was away. Treatment of a huge tusker (Jacob) near Sala gate 11th October The huge elephant bull christened Jacob was treated in September for an arrow wound near the rear leg. An arrow and huge dead flesh was removed from the wound. He was again given a repeat treatment after the wound showed signs of oozing pus. He was immobilized using 18mgs of etorphine in a dan-inject dart system. Pus was drained and the wound cleaned using water mixed with hydrogen peroxide. Tinture of iodine was splashed in the wound and a final cover of clay used to cover the wound.  Anti-inflammatory and antibiotics were injected parenterally. Prognosis is now good and recovery expected in a month.

Euthanasia of a zebra with a fractured limb, Aruba. 11th July The female zebra reported by nearby lodge of unable to stand was attended to found with a complete fracture of front limb. Due to poor prognosis of healing she was euthanized by use of 20 cc euthatol rapid intravenous injection through the jugular vein. Treatment of an injured elephant bull in Amboseli national park, 12th October The elephant bull was seen oozing pus from around the left flank. The elephant was darted using 18 mgs of etorphine propelled in dan inject dart system. The deep arrow wound was washed using water mixed with hydrogen peroxide, dead tissues debrided and splashed with tincture of iodine. A final spray of oxytetracycline spray was sprayed and covered with green clay. Prognosis given was good. Treatment of orphan (Shimba) in Voi stockade, 15th October After being attacked by lions earlier in the year, the elephant orphan recovered from its injuries but started losing condition slowly and become so thin standing became a problem.  Despite continued treatment and intravenous glucose infusion he finally succumbed. Autopsy was carried out and revealed a lung infection resembling chronic bacterial infection. Samples were taken and will be sent to laboratory for analysis. Treatment of an elephant bull at Rukinga ranch, 23rd Oct Case History  This case was reported by the security officer in charge of the Rukinga ranch. While on patrol they came across an elephant bull with a swollen fore limb around Rukinga dam. The elephant was on sight and was attended to under the Sky-Vet program from the veterinary headquarters in Nairobi. On arrival at the site, the elephant could barely move as it was evidently in pain and listless. General observation revealed an emaciated bull with protruding bony prominences. He was hesitant to move and thus preferred being near the water pool, standing under a tree while resting the left forelimb. Immobilisation and Physical examination To ascertain the extent of the injuries, the elephant was immobilised using 18mg Etorphine Hcl with a combination of 1500 IU Hyaluronidase in a 3ml dart. Darting was done from a car using the Dan inject® system. It took 10 minutes for the drug to take effect and the Elephant went on a left lateral recumbency. On closer examination, multiple penetrating (gunshot) wounds could be seen on the axillar aspects of the left forelimb, another one anteriorly through the thoracic wall and another one lodged laterally on the left knee joint. The wounds were oozing purulent discharge. Treatment The wounds were probed with a long haemostatic forceps to ascertain the depth and determine if the projectile heads were retrievable. All the wounds were cleaned with copious volumes of water and the pus drained.10% Hydrogen peroxide was also flushed in to remove dead tissue and Lugol’s iodine used to irrigate the wounds. Topical antibiotic spray ( Oxytetracycline) and green clay was also applied in the wounds. Systemic administration of 15 000mg amoxicillin was done via intramuscular injection. Revival 48 mgs of Diprenorphine hydrochloride was administered through the ear vein. The elephant attempted to rise up but was overwhelmed. The veterinary team tried assisting it up through roping and pulling it up but the attempts were unsuccessful. After several hours of attempted efforts, a consultative decision was made to euthanize the bull so as to get rid of pain and suffering. Both tusks were retrieved and handed over to KWS security team at Rukinga ranch for safe custody. Treatment of a Lion with bite wounds, 26th Oct Case History While on routine patrol, the DSWT- Bura desnaring team came across  a Lion that got injured while fighting for a mating partner near Aruba dam On general examination, the lion axhibited a leg carrying lameness and was walking with difficulty. Immobilization and physical examination The lion was remotely darted with a combination of 4mg medetomidine Hcl and 290mg of Ketamine Hcl. The drug took 10minutes for full effect. On physical examination, the Lion was in good body condition and the bite wounds were clearly visible, laterally on the left foreleg around the carpus, elbow and shoulder region. Palpation revealed intact bones with soft tissue swelling distally around the carpus. The bite wounds were discharging pus. Further examination revealed a laceration at the mucosa of the lower lip. Treatment The pus was expressed and the wounds flushed with 10% Hydrogen peroxide. Lugol’s iodine was used to clean the wounds before topical treatment with antibiotics and Alamycin® spray. Parenteral treatment was done with Intramuscular injection of 3000mg Amoxicillin and 20mg dexamethasone . Revival 15mg Atipamizole Hcl was injected intramuscularly about one hour after the last Ketamine dose. There was a smooth recovery from anaesthesia. Rescue of a waterbuck from a Man hole at Voi Safari Lodge, 26th Oct We received a call that a water buck had been stuck in a manhole after a fierce fight with a male counterpart. The veterinary and the stockade rescue team rushed to the site which was just near the unit. The waterbuck was still strong as the case was reported in time. He was restrained physically and pulled out of the manhole successfully. Treatment of a speared elephant Bull , 30th Oct The speared elephant was a member of a herd of eight adult bulls sited at the watering point just by the Ngutuni Lodge. The manager of the lodge reported the cases in time and the veterinary team responded appropriately. On general examination, this particular bull had an obvious protruding mass at the lateral aspect of the right thigh. This swelling had an opening that was discharging pus. Immobilization and physical examination The elephant was darted using the Dan inject® remote darting system with 18mg Etorphine Hcl combined with 1500IU Hyaluronidase. Effective anaesthesia was achieved within 12 minutes and the animal adopted a right lateral recumbency. We noticed some mild wounds which were cleaned with water and treated with Lugol’s iodine before it was roped over to a left lateral recumbency to expose the swollen side. Large volumes of pus was drained from a pus filled pocket which had formed subcutaneously.  Treatment The swelling was lanced to enhance drainage and to facilitate access to the underlying necrotic fibrous tissue which had plugged the point of entry of the arrow. The plug was removed and large volumes of pus oozed out from within the thigh muscle tissue. An arrow head was recovered while probing the wound within the muscles. The wound was cleaned with copious amount of water and 10% used to clean the necrotic tissue. Lugol’s iodine was also irrigated on the wound and topical antibiotics applied together with a plug of green clay to facilitate healing. Revival Reversal of anaesthesia was done using 48mg Diprenorphine Hcl and the elephant recovered in 2 minutes. The prognosis of the case is good as the insult was lodged out. Treatment of a speared elephant Bull , 30th Oct This case was reported by the manager of Ngutuni Lodge and the bull was among a herd of 8 bulls. It was seen to have a hanging mass of flesh protruding from an abdominal wound. Immobilization and physical examination The elephant was darted remotely from a vehicle using 18mg Etorphine Hcl together with 1500IU Hyaluronidase enzyme. The drug took 10 minutes to effect and  the animal assumed a sternal recumbency before being roped over into a left lateral recumbency so as to expose the wound. On close examination, the wound was oozing pus and there was a penetrating wound seen through the abdominal wall. Probing did not reveal any foreign object within the wound. Treatment The wound was washed clean with plenty of water and the necrotic debris removed using 10%hydrogen peroxide. Cleaning was enhanced with Lugol’s iodine before topical antibiotic spray and Green clay was used to treat the wound. Parenteral administration of Amoxicillin trihydrate and Flunixin meglumine was done intramuscularly. Reversal The elephant was revived with 48mg Diprenorphine hydrochloride injected through the ear vein. Recovery from anaesthesia was smooth and took about 2 minutes. The prognosis of the case is good. Examination of a sub adult female elephant with a fractured right hind limb   Case history A tourist reported a lame elephant just by the roadside near the voi safari lodge. The mobile veterinary unit responded in time to confirm and attend to the case. On general observation, the elephant was very weak and emaciated. It was dragging its right hind limb which was swollen distally. Immobilisation and physical examination The elephant was darted on foot using 15mg Etorphine Hcl together with 1500 IU Hyaluronidase   combined in a 3 ml dart since the terrain was not reachable by a vehicle. It took 10 minutes for the drug to take effect and the elephant adapted a left lateral recumbency. On physical examination the right limb was swollen distally at the level of the tarsus. Pus was discharging from a wound that penetrated through to the tarsal joint. Probing revealed loose irregular bone fragments that were confirmed to be tarsal bones. On palpation through the wound, a fractured end of the distal tibia could be felt. The wound was septic and the chances of recovery were negligible. Diagnosis Complete open fracture at the tibia-tarsal joint and secondary septic osteoarthritis. Recommendation The prognosis for this case is poor due to the complexity of the tarsal joint and the resultant infection. For welfare reasons, animals should be free from pain and suffering and hence euthanasia is best for this case. Conclusion The elephant was euthanized to relieve it from pain and suffering Conclusion and acknowledgement Tsavo ecosystem has begun to receive some showers and case load is expected to reduce due to reduced human/wildlife conflict and poaching incidences occasioned by enhanced security. The unit will continue to respond immediately to all cases reported to the unit. We also like to thank our sponsors ViER PFOTEN through the David Sheldrick wildlife Trust (DSWT) for their support to the unit. We return our gratitude to them. We also want to recognise the support of Kenya Wildlife Service in its steadfast vision of securing Kenya’s wildlife heritage.

Report by: Drs Poghon, Olianga and Njoroge