TECHNIQUE

Rectal Administration in Elephants  (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords
  • Use of suppositories in elephants
Description Administration of tablets/suppositories:
  • Insert the required quantity of tablets or suppositories into the rectum. (J3.120.w3)

Preparation of the medication as a fluid:

  • Place the required medication (powdered drug or tablets) in about 60 ml of hot water in a container with a lid. (W580.Aug2005.w1)
  • Leave to dissolve for about one hour. (W580.Aug2005.w1)

Administration of fluid/dissolved :

  • Put on a full length disposable protective glove.
  • Lubricate the glove thoroughly.
  • Insert the gloved hand and arm into the elephant's rectum and remove all reachable faecal balls.
  • Add a further 40 to 60 ml of hot water to the medication in the container, close the lid and shake well.
  • Draw the dissolved medication into a large catheter syringe.
  • Check the temperature of the medication (it should be warm but not uncomfortably hot).
  • Attach flexible tubing to the end of the syringe.
  • Hold the other end of the tubing in the gloved, lubricated hand and pass this into the rectum.
  • Pass the tubing as far as possible into the rectum.
    • If deposition of the drug is too far distal, near the anal sphincter, or is too close to faecal balls, premature expulsion of the medication is likely. (J375.1.w1)
  • Keeping the tube in place in the rectum, withdraw the hand.
  • Inject the medication from the syringe into the tube; repeat until the required dose has been injected.
  • Detach the syringe from the tube, fill the syringe with air, reattach and inject the air to flush any remaining medication from the tube into the rectum.
  • Pull the syringe and attached tubing upward to withdraw the tubing; residual medication in the tube is then likely to be emptied into the rectum as the tube is withdrawn.

(J375.1.w1, J289.28.w3, W580.Aug2005.w1)

Appropriate Use (?)
  • Useable in elephants which cooperate and accept rectal manipulation. (J375.1.w1)
  • This route is particularly useful for repeated administration of drugs, such as for elephants being treated for Mammalian Tuberculosis. (J3.120.w3, P503.1.w4, W580.Aug2005.w1)
  • This route is useful for administration of drugs to elephants in which, for whatever reason, (e.g. a mouth problem) oral  administration of a drug is not possible. (J2.31.w2)
  • The rectal mucosa is relatively efficient for absorption (J375.1.w1); it appears to provide an absorptive surface similar to that of the upper gastrointestinal tract and is therefore an appropriate alternative to oral administration of medications. (W580.Aug2005.w1)
  • A single daily rectal administration of metronidazole at 15 mg/kg bodyweight (25 1g suppositories) was shown to provide therapeutic plasma levels of the drug. (J3.120.w3)
  • It has been shown that famciclovir, given rectally at 8.0 - 15.0 mg/kg in Elephas maximus - Asian Elephant provides concentrations of the active metabolite penciclovir at concentrations which, in humans, are considered therapeutic. (J375.1.w1, P503.1.w4)
Notes
  • Care must be taken to ensure that personnel working nearby are aware that a hands-on procedure is being carried out. Both personnel directly involved with the procedure, and those working nearby, need to ensure that movements and noise (from telephones, bleepers, shutting doors, heavy machinery etc.) that might disturb the elephant, both inside and outside the elephant area, are minimized during the procedure. This includes activities at nearby enclosures that might be audible to the elephant and could startle it. (V.w6, V.w72, V.w84, V.w86, V.w88)
  • Many elephants are trained anyway to accept rectal manipulation for reproductive procedures. (J375.1.w1)
  • Working at the back of the elephant may be safer for the operator than working near the head. (J375.1.w1)
Complications/ Limitations / Risk
  • Elephants are very large, heavy and strong, highly intelligent, can move surprisingly quickly and can be highly strung at times: 
    • Depending on the management system (free contact / no contact / protected contact), and the character and training of the individual elephant, it may be necessary to carry out any hands-on procedure with the elephant under sedation and/or in an elephant restraint device.
    • There is always some risk to personnel involved when carrying out hands-on procedures on a conscious elephant.
    • There is always some risk to the elephant when sedation is used, especially if full anesthesia is required.

    (V.w6, V.w72, V.w84, V.w86, V.w88)

  • This route cannot be used if the elephant does not cooperate and accept rectal manipulation. (J375.1.w1)
  • The drug may be expelled from the rumen too soon by active contraction of the rectum by the elephant. (J375.1.w1)
    • This is most likely if deposition of the drug is too far distal, near the anal sphincter, or is too close to faecal balls. (J375.1.w1)
  • The wall of the rectum may be injured during the procedure. (J375.1.w1)
  • Some drugs are absorbed relatively poorly by this route, for example rifampin. (J375.1.w1)
Equipment / Chemicals required and Suppliers
  • Arm-length obstetric-type disposable protective gloves

  • Lubricant

  • A large dose catheter syringe (40 ml)

  • Flexible plastic tubing, about 75 cm/2.5 ft long

  • Appropriate medication

  • Hot water

  • Container with a lid, of suitable size to hold 120 ml water plus tablets or powdered medication

Expertise level / Ease of Use
  • Expertise and experience of the elephant handler(s) are critical when carrying out hands-on procedures on a conscious elephant. (V.w6, V.w72, V.w84, V.w86, V.w88)
Cost/ Availability
  • Inexpensive.
Legal and Ethical Considerations
  • When working with elephants it is important always to remember that their size and weight means that they can injure people easily, whether intentionally or unintentionally. The potential risks to all personnel involved must be considered before any hands-on procedure is initiated, and remembered during the procedure. It is critical that all personnel are highly trained and understand their respective roles and responsibilities during the procedure, that one person has overall command responsibility, and that no unnecessary people are present within the contact area. (V.w6, V.w72, V.w84, V.w86, V.w88)
  • The safety of both veterinarians and animal care staff involved in the procedure must be considered.
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee Susan K. Mikota DVM (V.w72)
References J2.31.w2, J3.120.w3, J375.1.w1, J289.28.w3, P503.1.w4, V.w6, V.w72, V.w84, V.w86, V.w88, W580.Aug2005.w1

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