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BDMLR - Marine Mammal Medic Handbook
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APPENDIX VI – VETERINARY SECTION- SEALS

PLEASE MAKE THE ATTENDING VET AWARE THAT YOU ARE CARRYING THIS INFORMATION, SO HE / SHE CAN REFER TO IT, AS WELL AS TO THE INFORMATION IN THE MAIN TEXT OF THE HANDBOOK.
Please note that this section is intended for the use of vets. The exception to this is the section on fluid therapy, for the use of those with experience in stomach tubing.

Additional information on assessment…

Malnutrition

Pale mucous membranes are often associated with anaemia in malnourished pups or, less frequently, with internal haemorrhage. They may be associated also with peripheral vasoconstriction, a physiological change associated with diving which may be triggered when stressed pups are handled. Severely malnourished pups may be hypoglycaemic, exhibiting muscle tremors and twitching, and blood glucose levels of less than 2 mmol/litre.

Respiratory conditions

Bacterial infections confined to the upper respiratory tract are associated with a mucoid or mucopurulent nasal and, sometimes, ocular discharge, sneezing, coughing, dyspnoea and tachypnoea. Pups with pneumonia are also dull, pyrexic (over 37.2 oC/ 99 oF) and have audible lung sounds, particularly rales, on auscultation. Nasal swabs can be useful in diagnosis, although cases of pneumonia may require a laryngeal swab to reveal the underlying pathogen.

Two species of lungworm, Parafilaroides gymnurus and Otostrongylus circumlitis, cause parasitic pneumonias in seal pups. O. circumlitis and members of the Parafilaroides genus are thought to have intermediate hosts and therefore only weaned pups are likely to become infested. P. gymnurus appears to be recorded more frequently in common seals, and infests the lung parenchyma and alveoli, causing pulmonary oedema, inflammation and excessive mucus production. Signs include tachypnoea, dyspnoea, a wet, productive cough, and, on auscultation, rales, ronchi and areas of emphysema and consolidation. Pulmonary and pleural haemorrhage also may occur, with epistaxis and hypovolaemic shock as potential sequelae. O. circumlitis infests the bronchial tree, causing physical obstruction. It may be found also in the right ventricle, pulmonary artery and blood vessels of the liver. Signs are similar to those of P. gymnurus, although milder, and adult worms may be expectorated. Bacterial pneumonia is a common sequel to lungworm infestation. Diagnosis of lungworm is based on clinical signs and the presence of larvae in the sputum and faeces. Infestations with the nasal mite, Halarachne halichoeri, may induce signs similar to those associated with upper respiratory tract infections.

Phocine herpesvirus has been observed in common seals undergoing rehabilitation in the Netherlands and U.K. Often only mild upper respiratory tract infections are seen but severe disease may occur, particularly in pups less than one month old. Initial signs include nasal discharge, inflammation of the oral mucosa, vomiting, diarrhoea and pyrexia (up to 40 oC/104 oF), with coughing, anorexia and lethargy developing later. The infection can be fatal. Diagnosis is achieved primarily by demonstrating rising antibody titres. Post mortem changes include severe hepatic necrosis and interstitial pneumonia.

Cardiovascular abnormalities

Auscultation of the heart may reveal murmurs. These may be associated with dehydration or, less frequently, with congenital abnormalities, e.g. patent ductus arteriosus. Healthy seal pups often exhibit sinus arrhythmia, but heart rates consistently above 120 beats per minute are likely to be clinically significant. Gums can be checked for prolonged capillary refill time.

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Fluid therapy

Timing

If emaciated or lethargic, or journey time over 1 hour, give fluids on the beach prior to transport. Otherwise allow the pup 30 minutes’ rest after transport before tubing.

Volume

(given every 3-4 hours)
common seal pup : 100 - 200 mls
grey seal pup : 150 - 250 mls

Fluids

Use an oral electrolyte solution, for example Lectade Plus. If suspect hypoglycaemia, add 20mls of 40% glucose/dextrose to the fluids.

If holding for any length of time, it should be remembered that seal pups may develop diarrhoea if placed on milk replacers containing lactose, as they are relatively intolerant to this sugar. Prior to weaning, pups should be fed lactose-free milk replacers, or fish liquidised in an electrolyte solution.

Technique

Use a lubricated, flexible stomach tube (approx. 1 cm external diameter). Measure off the length needed to enter the stomach (just behind the foreflipper).

First person: straddle the pup, as described under ‘Handling’; keeping the thumb wrapped over the top of the muzzle slide the fingers of one hand under the pup’s chin and lift the pups head up against your stomach; use this hand to open the jaw by pressing the forefinger into the angle of the jaw on one side (N.B. sometimes the pup will open its mouth when the tube is rubbed against its teeth). Work the tube past the animal’s teeth with your other hand, gently pushing the tube down, as you visualise it under the skin (so know it is in the oesophagus).

Second person: pour the fluids.

N.B. minimise air entering the stomach by kinking/pinching the tube as pour the first of the fluids, and avoid inhalation of fluids by kinking/pinching the tube, and pushing the pup’s head down, before removing the tube. Remember careful, controlled restraint of the animal’s head during tubing is essential to avoid getting bitten!

Debilitated pups can be given intravenous fluids via the extradural intravertebral vein (see under ‘Blood sampling’).

Tubing a seal pup
Click Photo for full-page view

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Therapeutics

The following drugs have been used in seal pups undergoing rehabilitation. Dose rates are as for dogs, except where indicated.

Antibiotics

Clamoxyl LA (amoxycillin)
Synulox (potentiated amoxycillin)
Antirobe (clindamycin) – abscesses, osteomyelitis, gum disease
Baytril (enrofloxacin) - particularly septicaemias
Marbocyl (marbofloxocin) particularly septicaemias
Pipril (piperacillin) (100 mg/kg bid; i/v, i/m) – particularly Pseudomonas septicaemias
Pangram (gentamycin) – particularly Pseudomonas infections
Duphatrim, Zaquilan (potentiated sulphonamides)
Oxytetracycline
Depomycin Forte (penicillin/streptomycin)

Anti-inflammatories

Zenecarp, Rimadyl (carprofen)
Metacam (meloxicam)
Ketofen (ketoprofen) – max. 3 days’ use, as risk of gastric ulceration
Finadyne (flunixin) - max. 3 days’ use, as risk of gastric ulceration

Mucolytics

Bisolvon (bromhexine)
Sputolosin (dembrexine) (300 mg/kg b.i.d.; oral)
Mucodyne (carbocisteine) (75-125 mg q.i.d.; oral)

Bronchodilators

Ventipulmin (clenbuterol) (1–5 mg/kg b.i.d.; oral, i/m, i/v)

Drugs acting on the gastro-intestinal tract

Buscopan (dipyrone and hyoscine)
Tagamet (cimetidine) (5-10 mg/kg q.i.d.; oral, i/m)
Zantac (ranitidine) (2-3 mg/kg b.i.d. initially, then s.i.d.; oral)
Liquid paraffin (1 ml/kg/day in divided doses; oral)
Kaogel (kaolin and pectin) (1 ml/kg/day in divided doses; oral)
Forgastrin (attapulgite and bone charcoal) (2.5-5g/feed; oral)
BCK granules (bismuth, kaolin and charcoal)

Topical eye treatments

Chloromycetin (chloramphenicol) (applied 3-6 times daily)
Fucithalmic (fusidic acid) (1-2 drops 3-6 times daily)
Orbenin (cloxacillin) (applied 3-6 times daily)
Neobiotic (neomycin) (applied 3-6 times daily) occasionally for corneal ulcers caused by
Pseudomonas aeruginosa
Genticin, Tiacil (gentamycin) (applied 4-6 times daily) particularly for melting corneal ulcers
caused by Pseudomonas aeruginosa – can enrich with injectable gentamycin (Pangram)
Exocin (ofloxacin) (1-2 drops 4-6 times daily) particularly for melting corneal ulcers caused by
Pseudomonas aeruginosa
Ciloxan (ciprofloxacin) (2-3 drops 4-6 times daily) particularly for persistent corneal ulcers
Maxitrol (dexamethasone, hypromelllose, neomycin, polymyxin B) (3-4 drops 3-6 times daily)
to reduce scarring

Vitamin supplementation

Injectable multivitamin + B complexes can be given initially
Aquavits (oral multivitamin preparations for fish eaters) (1 tablet b.i.d.; oral)
human oral multivitamin preparations alternatively can be used (twice recommended dose
rate, ensuring 50 mg/kg feed of thiamine and 100 mg/kg feed of vitamin E)

Iron supplementation

Ferrous sulphate (200 mg b.i.d.; oral) – dose can be increased in non-regenerative anaemias68

Anthelminthics

Intramuscular ivermectin (Ivomec) at 200–300 mg/kg intramuscularly appears to be effective in the elimination of lungworm and gastrointestinal nematodes in grey seal pups. Particular care is required when treating pups for lungworm infestation, because anaphylaxis and physical obstruction can occur when lungworm die off following ivermectin therapy. Therefore, it is inadvisable to initiate treatment until the pup has been stabilised for a few days. Side effects can be minimised by:

  • ensuring the pup is stabilised before treatment
  • monitoring the pup’s temperature and breathing pattern carefully after treatment
  • giving antibiotics, mucolytics and, where necessary, anti-inflammatories and oral fluids before, during and after treatment.

Common seal pups, particularly emaciated, weak individuals, appear to be at greater risk from such complications and, in this species, Ripercol (levamisole) in divided doses, according to a protocol devised by the Seal Rehabilitation and Research Centre, Pieterburen (see Appendix I) may be more appropriate. Panacur (fenbendazole), at 10mg/kg orally on three consecutive days, also appears to reduce initial lungworm burdens without a massive inflammatory response in commons. However, with both treatment regimes, a second or even third course may be necessary to totally eliminate the infestation. Panacur is also effective in eliminating gastrointestinal nematodes in both species.

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Injection sites and needle sizes

The drugs given above can be administered via routes recommended for dogs, with the exception of the subcutaneous route in any pup with a significant blubber layer.

In seal pups, intravenous injections can be given into the extradural intravertebral vein. With the pup held in sternal recumbency by an assistant, the vein is accessed via the L3-L4 intervertebral space, midway between the last rib and the iliac crests. In pups under 25kg, the space can be located easily by palpation of the adjacent spinous processes, and a 1 to 2 inch (2.5 to 5cm) 21 or 20 gauge needle can be used. In larger seals, the space is found by walking a 2.5 to 3.5 inch (6 to 9cm) 20 to 18 gauge spinal needle over the vertebrae.

Intramuscular injections are given into the lumbar muscles (the gluteals can be used in larger animals). 1 to 3.5 inch (2.5 to 9cm) 21 to 18 gauge needles may be required, depending on the size of the pup and the thickness of its blubber layer.

Grey seal pup sedated for radiography
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Wound management

Fresh wounds can be stitched but are prone to dehiscence, due to the inherent elasticity of the skin, and this may be exacerbated by postsurgical swelling of the wound. As dressings are difficult both to keep clean and to keep on, old, contaminated wounds are best left uncovered to heal by secondary intention, aided by frequent flushing and debriding. Bite wounds are invariably infected and unsuitable for stitching although, in cases involving extensive damage and infection of soft tissue and bone on the flippers, digit amputation and closure of healthy skin may be the most appropriate course of action. Liquid plastic dressings (e.g. Germolene New Skin) appear to provide additional protection for sutured wounds following surgery.

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Eye care

Topical medication is used to treat the majority of ocular conditions in seal pups undergoing rehabilitation. This often necessitates keeping pups dry for prolonged periods of time, which can be stressful, particularly for older animals. Subconjunctival injections of antibiotics, administered under sedation, have been used successfully in intractable animals. Severely traumatised and infected eyes, or those where glaucoma has developed, can be removed by enucleation. Seals with loss of sight in one, or even both eyes still appear to be viable in the wild.

James Barnett blood sampling a grey seal pup
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Oiled pups

Pups heavily oiled in an acute oil spill can be washed with detergent and thoroughly rinsed. Appropriate therapy also may be required for complications arising from the ingestion and inhalation of such oil, and its contact with mucous membranes, corneas and skin.

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Sedation

Intramuscular Domitor (medetomidine) can be used in pups free of cardiac irregularities. The following dose-related responses, with some individual variation, have been recorded:

50 - 70 g/kg - light sedation

80 - 90 g/kg - moderate sedation

100 g/kg - heavy sedation

Sedation occurs within 5 minutes, lasts up to 1 hour and can be reversed with intramuscular Antisedan (atipamezole).

Domitor (20 g/kg) in combination with Torbugesic (butorphanol) at 80 g/kg, both intramuscularly, may give a less variable response than Domitor alone.

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Anaesthesia

In animals free of cardiac irregularities, anaesthesia has been induced in seal pups with 60 g/kg Domitor and 2 mg/kg Vetalar (ketamine), both intramuscularly, generally following premedication with 20 - 50g/kg atropine, intramuscularly. General anaesthesia is achieved within 5 minutes and lasts up to 1 hour. Pups are intubated and given oxygen. Apnoea and bradycardia (as low as 2-3 beats per minute) often occur during anaesthesia, associated with seals’ physiological adaptations to diving. Thus, intermittent positive pressure ventilation is often necessary and heart rates should be monitored carefully. Anaesthesia can be prolonged with halothane or isoflurane, and any residual Domitor can be reversed with intramuscular Antisedan.

An intramuscular combination of Domitor (25 g/kg) and Torbugesic (100 g/kg), followed after 15 minutes by intramuscular Vetalar (2.0 - 2.5 mg/kg), has been used to anaesthetise grey seal pups. Rapinovet (propofol), administered at 5 - 6.5 mg/kg intravenously, shows considerable promise as a means of inducing short periods of anaesthesia, after premedication with 10 –20 g/kg atropine, intramuscularly. Anaesthesia also can be induced by masking down with isoflurane, with or without initial sedation, although breath holding may occur.

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Blood sampling

Blood samples are taken from the extradural intravertebral vein (see under ‘Injection sites and needle sizes’ above). Blood samples from seals rapidly clot and therefore should be placed immediately in blood tubes containing anticoagulant (EDTA for haematology, heparin for biochemistry).

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Euthanasia

Pups in terminal condition can be euthanased with barbiturates given intravenously (see under ‘Injection sites and needle sizes’ above) or intraperitoneally. Canine dose rates apply.

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