A 3.5 m, approximately 550 kg, female sub adult long finned pilot whale (Globicephala melaena) was observed swimming abnormally in the shallow waters of Long Island Sound. On 5 Aug 1993, after several days of observation, the whale's condition was considered critical and she was transported to the Aquarium for Wildlife Conservation for medical care and rehabilitation.

Diagnostic procedures performed during the whale's clinical course included physical examination; abdominal and thoracic ultrasonography; thoracic radiography; rhinoscopy; bronchoscopy; hematology; serum biochemical, hormonal, mineral, and toxicologic assays; influenza and morbillivirus serology; bacterial and fungal culture of blood, gastrointestinal, and respiratory tracts; and cytology of the gastrointestinal and respiratory tracts. Significant findings included a pronounced list, thin body condition, weakness, anorexia, lethargy, tachypnea, and a mucopurulent blowhole discharge. Laboratory abnormalities included elevations of erythrocyte sedimentation rate, fibrinogen, creatinine and cytologic evidence of an acute inflammatory blowhole exudate. The whale was seronegative for human and whale influenza viruses and had a low stable morbillivirus titer throughout her clinical course. An Escherichia cold exhibiting multiple drug resistance (including enrofloxacin, ciprofloxacin, ampicillin, cephalothin, and tylosin) was isolated from the respiratory tract.

Treatment included oral fluids, force feeding, antibiotics (oral and intramuscular), antifungal drugs, anthelmintics, anti-ulcer drugs, anti-inflammatory agents, anabolic steroids, a decongestant, and an expectorant (Table 1). During two months of antibiotic treatment (amikacin, penicillin and trimethoprim/sulfadiazine) the whale demonstrated marked clinical improvement and laboratory abnormalities resolved. Clinical relapse occurred associated with the development by the E. cold of progressive antibiotic resistance (including trimethoprim/sulfa, chloramphenicol, doxycycline, and neomycin). The isolate was quite susceptible to loracarbef (Lorabid, Eli Lilly, Co., Indianapolis, IN) and oral therapy was begun, with dose adjustments based on blood concentrations, to achieve levels considered therapeutic for man (Table 2). Loracarbef treatment was continued for four months.

Despite normalization of the whale's condition persistent respiratory tract discharge and E. cold isolation occurred. Respiratory exudate eventually resolved following decongestant and expectorant treatment. It was believed the E. cold had colonized the nasal mucosa and the loracarbef treatment was preventing the development of normal commensal bacterial flora. Loracarbef was discontinued and within one month cultures became negative for E. coli. The whale was released six weeks after antibiotic therapy was discontinued and eight months after arrival at the aquarium.

Acknowledgments

The authors thank the Eli Lilly Company for determination of loracarbef blood levels; Dr. Patrick McDonough and Valerie Patten, Diagnostic Laboratory, Cornell College of Veterinary Medicine and Dr. Balakrishnan, Barbara Abbott, and Selma Richman, Coney Island Hospital, for bacterial sensitivity testing; Dr. Robert Webster, St. Jude Children's Research Hospital for influenza serology; Drs. Carol House and Alfonso Torres, USDA, APHIS, NVSL, Foreign Animal Disease Diagnostic Laboratory, for morbillivirus serology; Drs. Tracey S. McNamara and James Walberg for cytological evaluation; and the staffs of the Aquarium for Wildlife Conservation and the Okeanos Ocean Research Foundation for animal handling and care.