veterinary/nutrition roundtable discussion...determination post-surgical wound care anemic animal...
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Veterinary/Nutrition
Roundtable Discussion Nancy Lung, VMD; SSP Veterinary Advisor
Deb Schmidt, PhD; SSP Nutrition Advisor
Joe Smith, DVM; SSP Veterinary Advisor
Low starch biscuits
Current pain relief
strategies
Quality of life
determination
Post-surgical wound care
Anemic animal diet
Animal protein
requirements
Abnormal
menses/menopause
Thyroid problems
Firm stools
Biscuit choices
Dividing diet in the day
Vitamin regimens
Activity range targets
Physical development
milestones
Fiber in the diet
Constipation
Deworming strategies
Social issues
Dry skin
Inappropriate lactation
Inappropriate copulation
Heart/renal diet
General Respiratory
General Cardiac
Chronic Diarrhea
General Reproductive
Low starch biscuits
“We have had great success with our
orangutans losing weight with Mazuri low starch
biscuits. Is anyone else using this? We also had
to modify our other starchy items in their diet.”
Nutrition – Low starch biscuits
oAnyone using low starch biscuits? oSaint Louis – in rotation, exclusively for a diabetic
animal we had
oDr. Valdes – DAK
oDrs. Dennis & Less – Cleveland Metroparks Zoo
orangutan & chimpanzee serum
o insulin
o cholesterol
o glucose
o triglycerides
Nutrition – Low starch biscuits
Browse Low
Biscuit Starch
Protein 18% 20 %
Fat 5.2% 6.2%
ND Fiber 26% 34 %
Starch 19% 5%
Energy 3.185 kcal/g 3.2 kcal/g
Reminder; better to NOT cook items for
animals routinely
Current pain relief strategies
“Current pain-relief strategies for arthritis,
cancer, etc. How to determine if your animal is
in pain. How far to go with treatment of pain.”
Signs of pain
Could be NONE!
Decrease in appetite
Decrease in activity
Changes in behavior
Holding/pointing to painful area
Sensitive to touch
Lameness/decrease use of limb
Radiographic changes?
If it would cause pain in a person, assume it also causes pain in primates
Analgesia/pain management
Opioids (sensitive!)
Steroids (side effects)
Non-steroidal anti-inflammatories (NSAIDS)
Tramadol
Gabapentin/pregabalin (neuropathic pain)
Nutraceuticals (for OA)
Physical therapy/exercise
Environmental modifications
Acupuncture
Laser therapy
How far to go?
Differing philosophies
Is the treatment/management working?
What is the animal’s quality of life?
Are there other reasonable treatment options?
Do the good days outnumber the bad?
Does the animal do the things it used to enjoy doing?
No single answer
Quality of life determination
“Quality of life determination; when to euthanize and
how to decide.”
Post-surgical wound care
“Post-surgical wound care”
Anemic animal diet
“Diet for anemic animal”
Nutrition – Anemic Animal
oWhat recommendations are for an anemic animal?
oIs animal consuming primate biscuits?
oAre there any medical problems causing anemia?
oWith veterinary approval, supplement with iron tablets
or multi vit/min tablet.
Nutrition – Geriatric Diets
oChanges associated with geriatric diets? oFemales – stop Fe supplementation when they stop menstruating
oSofter foods - severe dental issues
oMonitor weights
o Excessive fat stores?
o Muscle wasting due to inactivity
oOther medical issues easily complicate the issue
Animal protein requirements
“Do Orangutans require animal protein as part of a
daily, balanced captive diet. If not, what ways other
than formulated biscuits, can we increase their protein
intake.”
Nutrition – Protein
oDo orangutans require animal protein as
part of a daily, balanced captive diet?
oAmino acid profiles – plant vs animal
oAll have same AAs
oDifferent proportions of AAs
oPlants limited in lysine, methionine,
threonine, & tryptophan
oDifferent rate of absorption
oDifferent rate of use
Abnormal menses/menopause
“We have an older female orangutan who has
gradually been getting heavier and longer menses. We
were wondering if anyone knows if this might be normal,
possibly menopausal? We are just wondering if we
should be concerned or if anyone has experienced this
with their older female primates?”
Menopause
Post-reproductive, infertile
Humans: 12 consecutive months of acyclicity
Not a light-switch—slow and gradual
Prolonged menses
Irregular intervals
Extra or skipped cycles
Irregular bleeding patterns
Not well documented in orangutans
What are you all seeing?
Maybe not menopause?
Reproductive Tract Diseases # of Institutions % of Institutions
Dysmenorrhea 5 11.1% Endometriosis 4 8.9%
Uterine Leiomyoma 3 6.7% Infertility 2 4.4%
Menopause 2 4.4% Vaginitis 2 4.4% Endometritis 2 4.4%
Mammary Neoplasia 1 2.2% Ovarian Cyst 1 2.2%
Uterine Cyst 1 2.2% Uterine Neoplasia 1 2.2%
Benign Prostatic Hypertrophy 0 0.0% Cervical Neoplasia 0 0.0% Mastitis 0 0.0%
Ovarian Neoplasia 0 0.0% Prostatic Neoplasia 0 0.0%
Prostatitis 0 0.0% Testicular Infection 0 0.0% Testicular Neoplasia 0 0.0%
Other Reproductive Diseases 4 8.9%
Diagnostics to rule out problems
Monitor cycling
Hemastix in urine
Fecal hormones
Thorough exam
Vaginal exam
Rectal exam
Abdominal palpation
Imaging of repro tract
Ultrasound
CT
Contrast radiographs
Serum hormones (validation issues)
Endoscopy
Thyroid problems
“I have a question regarding zoos who treat orangutans
for thyroid issues. How often do their meds get
changed? Are there thyroid values they go by for
altering medications? Will thyroid conditions prevent
females from becoming pregnant? Will taking thyroxine
have any effect on carrying a pregnancy to full term?”
Thyroid testing
Validation issues with great apes
Difficulty in interpreting results
Better to evaluate clinical signs
Current research—updates?
Clinical signs
Hypothyroidism
Rough, dry skin
Pallor
Coarse hair
Hoarse voice
Slow thought/action
Fatigue
Weight gain
Cold intolerance
Hair loss
Bradycardia
Muscle cramps
Constipation
Amenorrhea
Hyperthyroidism
Nervousness
Goiter
Palpitations
Poor concentration
Fatigue
Weight loss
Heat intolerance
Bloating
Tachycardia
Muscle cramps
Changing meds
As needed
May need multiple alterations over time
Base on clinical signs
Effects on reproduction
Hypothyroidism is associated with infertility in females
Levothyroxine considered safe during pregnancy and
lactation
Drugs may be required to control disease well enough to
allow pregnancy
Firm stools
“We have several orangutans with extra firm stool. We
have tried a number of remedies for this with varied
success. My question is, what do they consider to be a
stool condition that needs to be treated and what has
worked well with orangutans to soften hard stool? In
other words, how do you know if the stool condition you
see is normal for that individual or if it needs treatment?”
Orangutan Stool Assessment FORT WORTH ZOO
Nutritional Services Department in Cooperation with the World of Primates Exhibit
SCORE 1: Very loose, runny, liquid, no form
SCORE 4: Well formed feces, drier, but not hard
SCORE 2: Mix of formed and unformed, loose, some runny liquid
SCORE 5: Formed feces, but very hard
SCORE 3: Formed feces, but very soft
Score 6: Separated hard feces, hard to pass
June Stool Chart S S M T W T F S S M T W T F S S M T W T F S S M T W T F S S
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Chantek 2 2 2 2 3 1 1 1 1 1 1 1 1 2 2 1 1 2 1 1 1 1 1 1 2 1 2 1 1 1
Ramses 4 4 4 3 4 4 4 4 4 4 4 4 4 3 3 4 4 4 4 4 4 3 3 3 4 4 4 4 4 4
Nick 2 2 2 1 1 1 2 2 2 2 3 3 3 3 3 2 2 2 1 2 1 2 2 2 2 2 2 2 2 2
Mekong 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
PT 3 3 3 ns ns 3 3 ns 3 3 ns ns ns 4 3 3 3 4 4 4 4 ns 4 5 4 ns 4 4 3 NS
1 - Very Loose Liquid Spatter * Stool was seen but could not determine from which animal
2 - Mixture of Formed and Unformed
3 - Formed but Very Soft
4 - Well Formed Drier but not Hard
Daily tracking of stool quality
“Chantek” “PT”
Biscuit choices
“When choosing biscuits, which criteria are most
important? What are the benefits of low starch? How
much fiber is a good amount? Do you worry about
factors like gluten? Are there any other
qualities/nutrients of high priority? Is there such a thing
as "too much" variety if your orangutans will consume
five different types?”
Nutrition – Biscuits
oWhich criteria are most important?
oHow much fiber is a good amount?
o Any other high priority nutrients?
Nutrition – Biscuits
Marion
Leafeater
Mazuri
Low
Starch
Mazuri
Browse
Biscuit
ZuPreem
Primate
Diet Dry
Protein % 23 21 18 21
Fat % 6.5 5 3 6
Neutral Detergent
Fiber %
21 33 26 2
Ca % 1 1 1.3 0.6
P % 0.7 0.7 0.7 0.4
Vit D3 IU/kg 3500 4270 3325 2076
Sugar % 14 5 13 ?
Starch % 12 7 19 ?
Nutrition – Biscuits
oDo you worry about gluten?
oAllergic response
o Is there a thing as “too much” variety if your
orangutans will consume five different types of
biscuits?
Dividing diet in the day
“When determining how to feed out diets, should you
consider spacing carbs vs sugars at certain times of the
day or is it sufficient to simply divide the diet in half for
morning/evening or throughout the day?”
Nutrition – Feeding
oWhen feeding diets, should you consider
spacing carbs vs sugars at certain time of the
day?
oOr is it sufficient to simply divide the diet in half
or feed throughout the day?
oMultiple feedings are always beneficial
oMay need to target feed high calorie items
and scatter feed low calorie items
Vitamin regimens
“Discuss the pros and cons of vitamin regimens for
growing youngsters, adults, pregnant/nursing moms.”
Nutrition – Supplements
oDiscuss the pros and cons of vitamin regimens
for growing youngsters, adults,
pregnant/lactating moms.
oGreatest benefit to poor eaters
o Supplement with multi vitamin/mineral unless
you know specifically what is lacking
Activity range targets
“Is there a target range of activity for adults as they age
to help combat the health issues associated with a more
sedentary lifestyle?”
Physical development milestones
“Human babies have three - six month check ups to
assess growth and development. Are we, as the SSP,
gathering data to have physical developmental
milestones (not Carol's behavioral ones) as a reference
base? What would you most need from trainers to help
establish these?”
Fiber in the diet
“What percentage of the orangutan diet is fiber? Do
you routinely use some kind of fiber supplement like
FiberCon, Miralax, etc.”
Nutrition – Fiber
oWhat percentage of the orangutan diet is fiber?
o Knott (1999)
o 20-60% NDF, most above 50% NDF
o biscuits average 25-33% NDF
o produce NDF o fruit: raspberries 25%
o greens: alfalfa sprouts 28%
o vegetables: whole ear of corn 44%
Nutrition – Fiber
o Do you routinely use some kind of fiber supplement
like FiberCon, Miralax, etc.?
oLaxatives
oFiber
o Soluble fiber – psyllium (Metamucil), pectin, guar gum
o Insoluble fiber – neutral detergent fiber
oCrude Fiber - used in human diet analyses
Constipation
“Do your orangutans have problems with constipation?”
Chronic Constipation
• ???????
• Inadequate dietary fiber
• Inadequate hydration
• Long retention time in the colon
• Treat any identified cause
• “Tweak” the protocol to the individual and follow daily fecal scoring
• Mineral oil
• Pumpkin
• Prunes
• Miralax
• Other laxatives
• Combinations of the above
• May be needed for life
Possible causes Possible therapies
(Diagrams from Wrong, Edmonds and Chadwick, 1981)
Managing Chronic GI Disease
Chronic Cases % of reporting institutions
Yes 42.2%
No 40%
No answer 18.8%
Symptoms/Diagnoses % of reporting institutions
Acute diarrhea 57.8%
Chronic Constipation 35.6%
Chronic diarrhea 28.9%
Chronic regurgitation 17.8%
Other GI – (FB, hemorrhoids, etc.) 6.7%
Appendicitis 4.4%
Abdominal abscess 2.2%
Constipation and Diarrhea
These conditions are multifactorial and
challenging to tease out and manage.
Orangutan Stool Assessment FORT WORTH ZOO
Nutritional Services Department in Cooperation with the World of Primates Exhibit
SCORE 1: Very loose, runny, liquid, no form
SCORE 4: Well formed feces, drier, but not hard
SCORE 2: Mix of formed and unformed, loose, some runny liquid
SCORE 5: Formed feces, but very hard
SCORE 3: Formed feces, but very soft
Score 6: Separated hard feces, hard to pass
June Stool Chart S S M T W T F S S M T W T F S S M T W T F S S M T W T F S S
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Chantek 2 2 2 2 3 1 1 1 1 1 1 1 1 2 2 1 1 2 1 1 1 1 1 1 2 1 2 1 1 1
Ramses 4 4 4 3 4 4 4 4 4 4 4 4 4 3 3 4 4 4 4 4 4 3 3 3 4 4 4 4 4 4
Nick 2 2 2 1 1 1 2 2 2 2 3 3 3 3 3 2 2 2 1 2 1 2 2 2 2 2 2 2 2 2
Mekong 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
PT 3 3 3 ns ns 3 3 ns 3 3 ns ns ns 4 3 3 3 4 4 4 4 ns 4 5 4 ns 4 4 3 NS
1 - Very Loose Liquid Spatter * Stool was seen but could not determine from which animal
2 - Mixture of Formed and Unformed
3 - Formed but Very Soft
4 - Well Formed Drier but not Hard
Daily tracking of stool quality
“Chantek” “PT”
Deworming strategies
“What are the current tests/drugs used for deworming?
Any prophylactic dosage or only treatment as needed?
What parasites are being found? How frequently do you
examine samples?”
How often are routine fecal exams conducted?
Fecal Frequency # of Institutions % of Institutions
Annual 7 15.56%
2x/year 27 60.00%
3x/year 2 4.44%
4x/year 6 13.33%
Opportunistically 2 4.44%
Did not answer 1 2.22%
Which of the following methods are used?
Methods Used # of Institutions % of Institutions
Direct 41 91.11% Flotation 36 80.00%
Centrifugation 17 37.78%
Sedimentation 4 8.89%
Special Stains 6 13.33%
Other 3 6.67%
Special Stains: Iodine (4), Acid Fast (2), Diff Kwik (2), Gram’s (1),
Trichrome (1)
Other tests: Baermann’s (1)
Which of the following parasites have been identified in the past 10 years?
Which parasites do you believe contribute to clinical disease in your
orangutans?
Parasite Identified % Identified Clinical % Clinical % Clinical of
Identified
Balantidium coli 32 71.11% 14 31.11% 43.75% Strongyloides sp. 12 26.67% 4 8.89% 33.33% Entamoeba coli 10 22.22% 3 6.67% 30.00% Giardia sp. 7 15.56% 4 8.89% 57.14% Coccidia 4 8.89% 0 0.00% 0.00% Oxyurids 2 4.44% 0 0.00% 0.00% Cryptosporidium sp. 0 0.00% 0 0.00% 0.00% Other 21 46.67% 5 11.11% 23.81%
Other Parasites: Trichomonas 7 (1); Flagellates 3 (0); Amoeba 1 (0);
Baylisascaris 1 (1); Blastocystis 1 (0); Capillaria 1 (0); E. hartmanii 1 (0); Strongyle 1
(0); Trichuris 1 (1)
Do you perform routine parasite prophylaxis in your orangutan
collection?
Answer # Institutions % of Institutions
Yes 14 31.11%
No 29 64.44%
Did not answer 2 4.44%
Prophylactic Treatments:
Albendazole annually: 1
Albendazole q3wks: 1
Fenbendazole q3mo: 1
Ivermectin during exams: 1
Ivermectin q1mo: 6
Ivermectin
quarterly/metronidazole q6mo:
1
Ivermectin/Strongid/Fenbendaz
ole rotated monthly: 1
Pyrantel q2mo: 1
Pyrantel q3mo: 1
Social issues
“Social issues between female Orangutans - aging,
maturity, breeding related?”
Dry skin
“How humidity and/or temperature affects skin and hair
- dry skin and hair loss remedies. We have one of our
three Orangutans that have seasonal dry skin problems.
She is on fish oil capsules, but we didn't see a great help
in the Winter.”
Inappropriate lactation
“Lactation in animals that are not pregnant and have
never been pregnant or ever had a baby”
Normal lactation
Two phases
Lactogenesis
Controlled by prolactin, growth hormone, and
glucocorticoids
Synthesis of milk fat, protein, etc in mammary tissues
Milk ejection
Controlled by oxytocin from pituitary
Mechanical stimulation of nipple evokes oxytocin release
Ejection stimulates prolactin release which triggers additional
milk synthesis
What can go wrong?
Galactorrhea
Excessive or inappropriate production of milk
Prolactin
Pituitary adenomas—very common in people
Physical stimulation
May trigger oxytocin/prolactin cycle
May cause discharge that is not milk
Hypothyroidism
Side effects of drugs
H2 blockers (cimetidine)
Antidepressants (MAOI, SSRI)
Antihypertensives
Contraceptives
Herbs (anise)
Inappropriate copulation
“Our male really enjoys the company of our young
female (16years), but he does not breed her often,
maybe two or three times a year. They often engage in
presexual behavior, and we often will find what appears
to be dried semen on the floor. We would like ideas on
increasing copulation.”
Heart/renal diet
“With the rising concerns of renal and age related heart
issues, is there any plan to come up with a diet that
caters to address these issues? It would be nice to have
lists of foods to avoid and foods to help with these issues
that are quite prevalent. I know that kidney problems
are related to high potassium levels and we have cut
out certain food items to hopefully help slow down renal
problems. I’m also curious if the panel could touch on
geriatric diet changes that should occur.”
General Respiratory
Condition Score
Respiratory Infections 83
Heart Disease 41
Obesity 41
GI Conditions 11
Repro disease/complications 7
Renal Disease 5
Trauma 5
Dental Disease 4
Husbandry 3
Osteoarthritis 2
Anesthesia 2
Diabetes 2
Neoplasia 2
Allergies 1
Geriatric Disease 1
Strongyloides 1
COD >15yr
Heart Disease 28.9%
Respiratory Infections
15.7%
Renal Disease 14.5%
GI Conditions 6%
Repro Disease 4.8%
Neoplasia 4.8%
Anesthesia 3.6% (obesity)
2012 Health Survey
Clinician’s Opinion 2008 Mortality Survey
COD <15yr
Strongyloides #1
Respiratory Infections
#2
GI Conditions #3
Condition % institutions *
Respiratory Infections >50
Repro Disease/complications >50
Obesity 47
Chronic GI Conditions 42
Strongyloides 27
Osteoarthritis 27
Renal Disease 17
Heart Disease 16
Maternal Neglect 13
Diabetes 2
2012 Health Survey
*have diagnosed and/or managed in the
past 10 years
Respiratory Disease
• #1 Cause of Death in Orangutans 9-40yrs
• 38% North American institutions managing chronic respiratory disease
• 20.4% of all captive orangs in the European Union have had chronic URTD or air sacculitis – (2009 EU Orang health survey)
Respiratory Disease Respiratory
Disease
%
Institutions
Air sac infection 42
Sinusitis 31
Pneumonia 31
Bronchiectasis /
Chronic bronchitis
24
Allergies 16
COPD 9
Other
2
Seasonal colds 2
Anatomy
• Main anatomic differences across ape species occur in the upper respiratory tract
• Orangutan Sinuses – Large maxillary sinuses
– Lack frontal sinuses and ethmoid air cells
• Extensive laryngeal air sacs
• Identical lower respiratory anatomy identical to humans and gorillas
Sinusitis—Pay attention to it!
• Physical Traits – fluid accumulation
– mucosal membrane thickening or atrophy
– airway obstruction
– sclerosis of adjacent bone
• Chronic sinusitis is undiagnosed in many cases
• *Likely precursor to development of air sacculitis and pneumonia*
• CT necessary for determination of extent of sinusitis
Normal Mild Moderate/Severe
Air sacculitis • Most commonly reported
respiratory disease
• Large volumes of purulent fluid
• Secondary aspiration pneumonia
• Don’t let the big bag of pus cloud your judgement
• Paired laryngeal ostia--just below the
vocal cords
• Variable shape
• Passes under pectoral muscles and clavicles
• Increases in size and complexity as animal matures
• Very extensive in adult male
• Function unknown
Laryngeal Air Sac
Anatomy
Adult female
Air Sacculitis
• Pus varies from liquid to “peanut butter”
• Mixed bacterial infection,
mainly enteric Gram negative, kitchen sink stuff
• Fibrous bands in chronically
infected air sacs may form compartments, complicating the drainage process
Peanut butter looks
“normal” on CT
Not so normal on CT
Air Sacculitis Management • Persistent / recurrent infections common. Don’t expect a cure. • It’s important to manage it to reduce the morbidity
from secondary pneumonia and bacteremia. • Most cases require drainage. Antibiotics alone
cannot penetrate. • Closed drainage and lavage • Marsupialization • Closure of laryngeal ostia • Complete or partial air sac resection
Marsupialization
Ostia closure
Throat sac
resection Surgical drainage through operant
conditioning
Lower Respiratory Tract Pneumonia: The under-appreciated culprit
• Pneumonia: 31% • Bronchiectasis: 24% (why?) • Undiagnosed: Many more
Lower Respiratory Tract
• The similarities to cystic fibrosis are striking
– Genetic/ultrastructural explanation?
– The high incidence of bronchiectasis
• Medical management of chronic respiratory patients is similar to cystic fibrosis management – Control the bacterial load, improve mucous clearance,
maintain pulmonary function
Invest in Operant Conditioning
• Nebulization
• Intramuscular injection
• Throat sac manipulation, ultrasound, treatment
• Postural drainage
• Blood collection
• Thoracic radiography
General Cardiac
Condition Score
Respiratory Infections 83
Heart Disease 41
Obesity 41
GI Conditions 11
Repro disease/complications 7
Renal Disease 5
Trauma 5
Dental Disease 4
Husbandry 3
Osteoarthritis 2
Anesthesia 2
Diabetes 2
Neoplasia 2
Allergies 1
Geriatric Disease 1
Strongyloides 1
COD >15yr
Heart Disease 28.9%
Respiratory Infections
15.7%
Renal Disease 14.5%
GI Conditions 6%
Repro Disease 4.8%
Neoplasia 4.8%
Anesthesia 3.6% (obesity)
2012 Health Survey
Clinician’s Opinion 2008 Mortality Survey
COD <15yr
Strongyloides #1
Respiratory Infections
#2
GI Conditions #3
Condition % institutions *
Respiratory Infections >50
Repro Disease/complications >50
Obesity 47
Chronic GI Conditions 42
Strongyloides 27
Osteoarthritis 27
Renal Disease 17
Heart Disease 16
Maternal Neglect 13
Diabetes 2
2012 Health Survey
*have diagnosed and/or managed in the
past 10 years
Orangutan Cardiac Disease
• Orangutan cardiac knowledge lags behind that for chimps and gorillas
• In the literature: – 1991: sudden death
– 1995: successful treatment
– 1999: Coxsackie myocarditis
– 2009: pericardial effusion / heart failure
Acknowledgement for this section: Dr. Lauren Howard, Dr. Rita McManamon, Dr. Linda Lowenstine
• 20% of adult deaths due to heart disease
– Additional 12% contributory
• Myocardial fibrosis predominant
• One recent aortic dissection
• Infective myocarditis in literature
• More aortic atherosclerosis seen in orangutans compared to other apes
What we know so far…
UCD VMTH Linda J. Lowenstine
The main lesion in all the apes
in zoos is myocardial fibrosis
And arteriosclerosis
Atherosclerosis: orangutans in aorta and
internal iliac arteries, rarely in coronary
arteries
Linda J. Lowenstine
Linda J. Lowenstine
What are we doing?
• 68% of institutions are performing heart ultrasounds on routine exams
Great Ape Heart Project
• More orangutan studies needed!!!
Chronic Diarrhea
Chronic Diarrhea
• chronic stress
• Parasitism
• Dysbiosis
• Inflammatory bowel disease
• Food allergy/celiac
• Chronic enteritis
• Treat any identified cause
• Gluten-free diet
• Stress management trials
• Pharmaceuticals (budesonide,
metronidazol, immodium, etc)
• Pro-biotics
• Voodoo (forever flagyl)
Possible causes Potentially useful therapies
Chronic Diarrhea
• Easy to ignore
• Can persists for decades
• Can lead to life-threatening protein loss and electyrolyte imbalance.
• Monitor your animal regularly (training for blood collection)
General Reproductive
Orangutan Reproductive Health
• This is a very broad category! – Fertility
– Contraception
– Perinatal care
– Pediatrics (handrearing, surrogacy, vaccines)
– Reproductive pathology
Acknowledgements for this section: Dr. AJ Marlar, Dr. Linda Lowenstine
Normal Captive Parameters • Age of puberty : Female 7-12 Y Male 7-14
– Menarche: approx 7 Y
– Menstrual cycle length 23-33 days (6 animals, 35 cycles)
– Estrogen peak: approx mid-way through cycle
– Pregnancy: 227-275 D, Avg 245 D
– Labial Swelling- usually starts 2-4 weeks into pregnancy
Pregnancy Related Disease 2012 Health Survey
Condition # institut % institut
Maternal Neglect
6 13.3
Dystocia 6 13.3
Other 4 8.9
Birth Defects
3 6.7
ParturitionMortality
2 4.4
Premature 2 4.4
Stillbirth
2 4.4
Condition #institut % institut
Abortion 1 2.2
Placentitis 1 2.2
Placenta abrupta
0 0
Placenta previa 0 0
Pregnancy toxemia
0 0
Pregnancy Diabetes
0 0
Reproductive Tract Diseases 2012 Health Survey
Condition #institut %institut
Dysmenorrhea 5 11.1
Endometriosis 4 8.9
Uterine leiomyoma 3 6.7
Infertility 2 4.4
Menopause 2 4.4
Other 4 8.9
Vaginitis 2 4.4
Endometritis 2 4.4
Mammary neoplasia
1 (MALE) 2.2
Ovarian Cyst 1 2.2
Condition #institut
%institut
Uterine cyst 1 2.2
Uterine neoplasia 1 2.2
Prostatic hyperplasia 0 0
Cervical neoplasia 0 0
Mastitis 0 0
Ovarian neoplasia 0 0
Prostatic neoplasia 0 0
Prostatitis 0 0
Testicular Infection 0 0
Testicular neoplasia 0 0
Perinatal
Causes of
Death
Fetus – Day 1
• Placentitis; placental infarction • Umbilical strangulation • Congenital malformation • Maternal pre-eclampsia
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