Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
ISSN:
0003-1488
Publication Date:
15 Jul 2009
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Use of phlebotomy treatment in Atlantic bottlenose dolphins with iron overload

Shawn P. Johnson DVM, MPVM1, Stephanie K. Venn-Watson DVM, MPH2, Stephen E. Cassle DVM3, Cynthia R. Smith DVM4, Eric D. Jensen DVM5, and Sam H. Ridgway DVM, PhD, DACZM6
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  • 1 United States Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, 53560 Hull St, San Diego, CA 92152.
  • | 2 United States Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, 53560 Hull St, San Diego, CA 92152.
  • | 3 United States Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, 53560 Hull St, San Diego, CA 92152.
  • | 4 United States Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, 53560 Hull St, San Diego, CA 92152.
  • | 5 United States Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, 53560 Hull St, San Diego, CA 92152.
  • | 6 Department of Pathology, School of Medicine, University of California, San Diego, La Jolla, CA 92093.
DOI:
https://doi.org/10.2460/javma.235.2.194
Volume/Issue:
Volume 235: Issue 2
Online Publication Date:
15 Jul 2009
Restricted access
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Abstract

Case Description—3 adult (24- to 43-year-old) Atlantic bottlenose dolphins (Tursiops truncatus) with chronic episodic malaise and inappetence associated with high serum aminotransferase (alanine aminotransferase and aspartate aminotransferase) activities, high serum iron concentration, and serum transferrin saturation > 80% were evaluated.

Clinical Findings—Results of histologic examination of liver biopsy specimens revealed hemosiderosis in all 3 dolphins. Except for chronic lymphocytosis in 1 dolphin, results of extensive diagnostic testing revealed no other abnormalities. For each dolphin, a diagnosis of iron overload of unknown origin was made.

Treatment and Outcome—Phlebotomy treatment was implemented to reduce body stores of iron. Each phlebotomy procedure removed 7% to 17% (1 to 3 L) of estimated blood volume. Treatment consisted of an induction phase of weekly phlebotomy procedures for 22 to 30 weeks, which was complete when serum iron concentration and aminotransferase activities were within reference ranges and serum transferrin saturation was ≤ 20% or Hct was ≤ 30%. Total amount of iron removed from each dolphin was 53 to 111 mg/kg (24.1 to 50.5 mg/lb) of body weight. One dolphin required maintenance procedures at 8- to 12-week intervals when high serum iron concentration was detected.

Clinical Relevance—Although the cause of the iron overload and high serum aminotransferase activities remained unknown, phlebotomy treatment successfully resolved the clinicopathologic abnormalities, supporting a role of iron overload in the hepatopathy of the 3 dolphins.

Abstract

Case Description—3 adult (24- to 43-year-old) Atlantic bottlenose dolphins (Tursiops truncatus) with chronic episodic malaise and inappetence associated with high serum aminotransferase (alanine aminotransferase and aspartate aminotransferase) activities, high serum iron concentration, and serum transferrin saturation > 80% were evaluated.

Clinical Findings—Results of histologic examination of liver biopsy specimens revealed hemosiderosis in all 3 dolphins. Except for chronic lymphocytosis in 1 dolphin, results of extensive diagnostic testing revealed no other abnormalities. For each dolphin, a diagnosis of iron overload of unknown origin was made.

Treatment and Outcome—Phlebotomy treatment was implemented to reduce body stores of iron. Each phlebotomy procedure removed 7% to 17% (1 to 3 L) of estimated blood volume. Treatment consisted of an induction phase of weekly phlebotomy procedures for 22 to 30 weeks, which was complete when serum iron concentration and aminotransferase activities were within reference ranges and serum transferrin saturation was ≤ 20% or Hct was ≤ 30%. Total amount of iron removed from each dolphin was 53 to 111 mg/kg (24.1 to 50.5 mg/lb) of body weight. One dolphin required maintenance procedures at 8- to 12-week intervals when high serum iron concentration was detected.

Clinical Relevance—Although the cause of the iron overload and high serum aminotransferase activities remained unknown, phlebotomy treatment successfully resolved the clinicopathologic abnormalities, supporting a role of iron overload in the hepatopathy of the 3 dolphins.

Contributor Notes

Presented in part at the 39th Annual Meeting of the International Association of Aquatic Animal Medicine, Pomezia, Italy, May 2008.

The authors thank Atwell Cersley, Eric Alford, and Drs. Nate Daughenbaugh and Christopher Dold for technical assistance and Kevin Carlin and Risa Daniels for data assistance.

Address correspondence to Dr. Johnson.