On March 6, 1989, a 6 week old elephant seal pup was rescued from Bean Hollow Beach in San Mateo County, California. "Hercules" presented with swelling from the suborbital area to the end of the nose. The swelling caused the face to distort to the left. Initial debriding removed enough tissue to reveal several cm of maxillary bone and expose the fascia of the orbit of the left eye. Although we routinely see lacerations on our orphaned pups at CMMC, this was by far, the worst injury we have treated. After initial debriding, the animal was placed on antibiotics and the wound was cleansed daily. He was tube fed elephant seal pup formula Q4H until he was able to eat on his own. In June of 1989 he was released at Point Reyes National Seashore and in July he was resighted with other weaners at Ano Nuevo State Reserve.

In March of 1989, the California Marine Mammal Center admitted an elephant seal pup with the most severe facial wounds the Center has ever successfully treated. On admission, the animal's face was swollen to the point of being distorted toward the right. However he appeared alert and active to the point of being aggressive.

Initial physical examination revealed three long, deep lacerations traversing the face across the bridge of the nose, with areas of wound penetration into the left maxillary sinus. The animal was emaciated, lung sounds on auscultation were strong, although harsh, and initial blood parameters were within normal ranges with the exception of the sodium and phosphorus levels being slightly elevated. This was most likely attributable to moderate dehydration. The white cell count was low normal, causing concern that the body was not responding to the infection. The animal was treated with Keflex at 30mg/lb divided QID and started on gastric gavage of elephant seal pup formula Q4H after several initial gavages of a rehydrating solution. A simethicone solution was added to each tubing for several days to prevent any secondary problems of gastrointestinal irritation that might be caused by the constant purulent drainage postnasally. He was given subcutaneous Lactated Ringers solution at 500ml BID for the first 48 hours to help alleviate the dehydration. The wounds were flushed Q4H with sterile saline solution for the first three days. Because of the proximity of the wound to the eye, the eyes were flushed with sterile saline after each treatment.

On day two, during routine gastric gavage, a piece of bone came out of the mouth on withdrawal of the gavage tube. Inspection of the mouth revealed a three inch section of the upper jaw was broken and had been dislodged, leading to concern that osteomyelitis might develop. Flushing of the lesion in the mouth with a dilute chlorhexidine solution was initiated thereafter until evidence of clean wound closure was noted.

After four days of treatment, the animal was judged stable enough to have much of the infected tissue removed. Over one third of the animal's face had to be debrided. Areas of the left maxilla and the fascia of the left orbit were exposed during debriding. The area over the nose was also debrided but some questionable tissue was left on the right side of the face because of concern that too much bone might be exposed. The other area of major concern was the presence of a 1-2cm fissure into the maxillary sinus.

Daily treatments now included cleaning the debrided areas with a gauze pad soaked in dilute betadine solution, applying Chloramphenicol opthalmic ointment bilaterally, and covering any exposed bone with sulfadene cream twice daily. By this time Hercules had learned to open his mouth when the feeding tube was presented, eliminating the need to touch his face for gavaging. Thereby preventing any accidental damage to the face during the healing process.

After two weeks the blood panel was repeated and the white cell count had increased to thirty thousand, ending any concern about Hercules' immune response. This, coupled with the sodium and phosphorus being back in normal range, improved his prognosis significantly. In addition, the exposed sinus in the oral cavity was closing with no evidence of infection and granulation tissue was beginning to cover most of the face. Since the amount of purulent matter he was producing had decreased dramatically. Hercules was introduced to a pool with water levels kept low enough to allow him to keep his head above water.

At one month, the only areas of exposed bone were on the bridge of the nose and just below the eye. One small piece of cartilage that had not reattached had to be removed but the rest of the face was essentially healed. To make the rehabilitation nearly complete, Hercules began to free feed, ending the necessity of daily restraint. Oral antibiotic therapy was discontinued at this time but opthalmic antibiotics continued to be administered after feeds in the pool because a large portion of the eye was still exposed and tended to redden with repeated exposure to water.

A routine blood check at almost two months revealed a white cell count of forty thousand with no clinical signs. A two week course of oral chloramphenicol at 10mg/lb TID was initiated. Appetite, weight gain, and activity remained normal throughout the course of antibiotics. A post treatment blood sample showed a white cell count of twenty eight thousand, an acceptable level for an elephant seal pup. At this time we were also able to discontinue the opthalmic ointment treatments. In two more weeks, the white cell count was down to twenty- one thousand.

The remainder of Hercules' rehabilitation at CMMC was uneventful, resulting in his release in June of 1989. Our efforts were rewarded in July and again in October with resightings at Ano Nuevo State Reserve. The one negative aspect was that at the fall resighting it appeared that the eye was no longer present. We are hopeful of a repeat resighting when the yearlings return to Ano Nuevo in 1990 as a one year survival places the animal on an even footing with animals never treated at a rehabilitation facility.

Whether Hercules is ever resighted again we are encouraged by the natural healing ability we observed in this case. If at any point, this animal had become depressed or showed evidence of severe pain we would have euthanatized him. Our recommendation to any rehabilitators would be to give an animal every chance possible as long as there is no major suffering evident.