DISEASE SUMMARY PAGE

Sole Abscess in Elephants

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Summary Information
DiseasesList of Miscellaneous / Metabolic / Multifactorial Diseases / Disease summary
Alternative Names See also:
Disease Agents
  • Predisposing factors that may lead to foot diseases in captive elephants include lack of exercise, lack of regular foot care and inspection, nail and sole overgrowth and lack of trimming, inappropriate enclosure surfaces (hard unyielding substrates contribute to the development of foot problems, for example by trauma and by lack of opportunity for digging), constant direct contact with dirty and wet surfaces in which pathogens can proliferate, malnutrition, excess feeding/insufficient exercise leading to overweight elephants which put more stress on their feet, arthritis and inherited poor foot structure. (B22.34.w12, B454.1.w1, B454.16.w16)
  • Sole abscesses may occur following penetration or bruising of the sole. (B212.w27)
  • Sole abscesses may be related to disruption of the internal blood supply of the foot. (B454.5.w5)
  • Sole abscesses may occur following puncture of the sole by a foreign body; this is probably less common than abscessation related to improper trimming of the sole or insults such as a "stone bruise". (B454.5.w5)
  • Sterile abscesses which develop within the sole will become infected when they rupture. (B454.5.w5)
  • Mixed infections have been documented, such as Staphylococcus, Streptococcus, Klebsiella, Fusobacterium, Bacteroides and Pseudomonas from one sole abscess complicated by phalangeal osteomyelitis. (P30.1.w9)

Further information on Disease Agents has only been incorporated for agents recorded in species for which a full Wildpro "Health and Management" module has been completed (i.e. for which a comprehensive literature review has been undertaken). Only those agents with further information available are linked below:

Infectious Agent(s) --
Non-infectious Agent(s) --
Physical Agent(s)
General Description

In Elephants:

  • The elephant sole is a broad and relatively flat surface.(B22.34.w12)
  • Penetrating wounds in elephants often occur on the soles from stepping on foreign bodies such as stones, nails or wires that may cause a sole abscess. (B22.34.w12, P5.39.w1)
  • In captivity, cases of abscesses have been associated with an internal blood supply dysfunction. (B454.5.w5)
  • Sole abscess may complicate into a phalangeal osteomyelitis, in these cases 

Clinical signs:

  • Acute lameness. (B64.27.w4, B212.w27, J2.34.w2)
  • Reluctance to move. (B22.34.w12)
  • Resting of the affected foot. (B212.w27)
  • Pain, particularly when the affected area is pressed. (B212.w27)
  • Discomfort on palpation of the affected area. (B22.34.w12)
  • Swelling. (B22.34.w12, B64.27.w4)
    • Swelling may not be obvious. (B212.w27)
  • Area affected may be hot. (B22.34.w12, B64.27.w4)
    • Heat and swelling may extend to the skin of the foot around the edges of the sole, and even above the nails, if there is extensive inflammation. (B212.w27)
  • Presence of exudates, in some cases purulent. (B22.34.w12, J2.28.w2, P9.1.w7)
    • Exudate may escape from the edges of the foot, or above a nail. (B212.w27)
  • Presence of granulation tissue. (B22.34.w12)
  • Swollen limb. (J2.28.w2, P9.1.w7)
  • Untreated cases may cause sloughing of the nails and in some cases the full sole. (B64.27.w4)
  • If osteomyelitis of the phalanges is present signs of poor general health have been reported. (P30.1.w9)
  • Fever. (B64.27.w4, B212.w27)
Further Information Investigation/ Diagnosis:
  • Clinical signs and physical examination are characteristic. (B64.27.w4, B212.w27)
  • Haematology and biochemistry may be unremarkable. (J2.34.w2)
  • Culture of infected penetrating wound commonly reveal a mixed growth of  bacteria, such as Staphylococcus, Streptococcus, Pseudomonas, Proteus, Escherichia coli and Enterobacter. (P5.39.w1)
  • Culture of sole abscess that complicated into osteomyelitis a number of microorganisms have been isolated from the draining tract, such as Staphylococcus, Streptococcus, Klebsiella, Fusobacterium, Bacteroides and Pseudomonas. (P30.1.w9)
  • Radiography of the foot using a portable equine radiographic unit. (P1.1997.w6)
    • A series of radiographs may produce diagnostic images of the digits. Different time settings are required for different views of the foot. (P1.1997.w6)
      • Using a 400 speed film/screen combination, a portable x-ray unit at 80 kVP and 15 mA, the elephant standing with its foot flat on the film cassette and the x-ray unit held with the tube head 55 cm from the surface of the foot, at a 45 degree angle, the following times were required for adult elephants: (P1.1997.w6)
        • Distal phalanges: 0.25 - 0.4 s. (P1.1997.w6)
        • Proximal and middle phalanges: 0.4 - 0.7 s. (P1.1997.w6)
        • Distal portion of the metacarpals: 0.6 - 0.9 s. (P1.1997.w6)
        • Proximal edge of the metacarpals: 0.75 - 1.25 s. (P1.1997.w6)
      • For lateral views of the metacarpals and metatarsals: 3.0 - 4.0 s (tube head 45 cm from the surface of the leg). (P1.1997.w6)
      • For lateral or antero-posterior views of the carpus: 4.0 s (tube head 45 cm from the surface of the leg). Note: This requires the elephant to be trained to accept the film cassette being taped to the leg. (P1.1997.w6)
    • To visualise and evaluate chronic draining tracts, a radiopaque dye can be instilled deep into the tract, the opening plugged with cotton wool and a radiograph of the area taken immediately. (P1.1997.w6)
    • Radiography may show:
      • If a foreign body has penetrated the foot. (J4.171.w5)
      • Signs of osteomyelitis. (J2.34.w2)
Treatment:
  • Aggressive therapy is required. This may include daily debridement, foot lavage or foot soaking, topical and parenteral treatment with antibiotics. Use of Regional Digital Intravenous Perfusion in Elephants (RDIP) may allow more rapid resolution of deep infections. (J2.34.w2)
  • Conservative treatment, such as flushing, may have to be carried out over prolonged periods. (J2.34.w2, P20.1998.w7)
  • Sedation may be required in order to carry out painful or invasive treatments (e.g. removal of excessive granulation tissue). (P20.1998.w7)
  • The sole over the abscess should be pared down and the abscess opened with a knife. (B212.w27)
  • The abscess should be drained, daily if necessary, all the devitalised tissue should be debrided. Any necrotic debris is flushed out with saline or saline/hydrogen peroxide solution, followed by a topical treatment with an iodine solution. Antibiotic or antiseptic ointment is used twice daily to prevent further infection and allow the normal growth of the sole. A wide variety of chemical agents have used to treat the affected area, such as Hexol, hydrogen peroxide, Poviderm solution or Novalsan. In cases where the infected area cannot be fully opened, soaking the foot in a tub with hot Epsom salts may soften the tissues and make treatment possible. (B454.5.w5, B454.13.w13, J2.34.w2, J4.171.w5, P1.1996.w2)
  • If a visible foreign body is present, it can be removed with a vice-grip pliers. (J4.171.w5)
  • If a penetrating foreign body has been diagnosed from radiography, an opening must be made with a hoof knife under sedation to remove the foreign body and drain the wound. In such cases,1,500 IU of tetanus antitoxin subcutaneously should be given for short-term protection. (J4.171.w5)
  • Systemic antibiotic and topical antibiotic preparations should be selected based on culture and sensitivity. (B64.27.w4, P30.1.w9)
  • If the abscess cannot be fully drained, flushed and exposed, then systemic antibiotics are indicated. (P1.1996.w2)
  • Daily lavage or foot soaks after drainage of the abscess and in combination with antibiotics, such as ampicillin. (B64.27.w4, J2.34.w2)
  • Note: Considerable time is required for granulation/healing by second intention. (J4.171.w5)
  • Regional Digital Intravenous Perfusion in Elephants (RDIP) of the affected foot, with or without anaesthesia, depending upon the management setting, has been described in elephants. (J2.34.w2, P30.1.w9)
    • An Elephas maximus - Asian Elephant with a sole abscess of the right hind foot was treated by Regional Digital Intravenous Perfusion in Elephants (RDIP)
      • Haemostatic and bactericidal gauzes were to packed into the fistula to avoid excessive bleeding during the procedure and a protective and compressive bandage was applied (removed 24 hours later). The elephant improved dramatically within two days from the procedure. (J2.34.w2) Following the procedure:
        • Twice daily foot baths were given in a concrete pool using a Dakin solution of monosodium carbonate (15 g) and active chlorine, and potassium permanganate in one liter of water; (J2.34.w2)
        • Sulfamethoxazole-trimethoprim, 48 g orally twice daily was administered for four weeks; (J2.34.w2)
        • Phenylbutazone was given, 5 g twice daily orally for one week. (J2.34.w2)
      • The RDIP was repeated after 15 days to ensure total recovery. (J2.34.w2)
    • An Loxodonta africana - African Elephant with a fore foot sole abscess complicated by osteomyelitis of the second phalange was treated by Regional Digital Intravenous Perfusion in Elephants (RDIP). (P30.1.w9)
  • Surgical removal of all or part of an infected phalange has been described, however, post-operative complications, such as secondary infections and contralateral limb problems have commonly been reported. (J2.28.w2, P9.1.w7, P20.1998.w7 P30.1.w9)
  • Analgesics are indicated: phenylbutazone, 9 g daily was given prior to treatment and 5 g twice daily orally for one week after RDIP of the affected foot. (J2.34.w2)
  • In some cases, protection of the foot from environmental contamination is needed. Specially constructed boots, made of canvas or leather, are fitted to keep the foot dry and clean. (B64.27.w4, J4.171.w5, P1.1996.w2, P20.1998.w7)

Prevention:

  • Adequate regular foot trimming. (P5.39.w1)
  • Provision of appropriate, clean and dry, substrates. (B10.49.w21, B214.3.7.w3, B336.53.w53)
    • The substrate should not be too rough. (B336.53.w53)
    • Rubber mats on concrete sleeping areas may be beneficial. (B454.5.w5)
    • A lightly brushed concrete floor is recommended, as it provides an adequate surface. Deep brushed concrete should be avoided since this tends to accumulate faeces and urine, on which bacteria can grow. (J4.171.w5)
  • Regular exercise, preferably on natural substrates. (B454.5.w5)
  • Adequate hygiene. (B454.5.w5)
  • Provision of access to uncontaminated moist substrates and water is beneficial to foot health. (B454.6.w6)
  • Adequate nutrition is recommended to maintain foot health. Biotin, protein and trace elements, such as zinc, selenium and arsenic are some of the nutrients to consider. (B454.3.w3)
  • Reduce of elephant's weight. (B454.5.w5)
  • Correction of certain repetitive abnormal behaviours. (B454.5.w5)
Associated Techniques
Host taxa groups /species Further information on Host species has only been incorporated for species groups for which a full Wildpro "Health and Management" module has been completed (i.e. for which a comprehensive literature review has been undertaken).

(List does not contain all other species groups affected by this disease)

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