Abstract

Preliminary investigations involving laparoscopic techniques in cetaceans have suggested that this technology could expand our current diagnostic and treatment capabilities. In October of 1998 a 27 year old female bottlenose dolphin (Tursiops truncatus) with a history of chronic hematuria, unresponsive to conventional therapy, was anesthetized for laparoscopic exploratory and renal biopsy.

Anesthesia was induced using Propofol intravenously followed by intubation and maintenance with Isoflurane. Insufflation was achieved by introducing a Veress needle into the peritoneal cavity lateral to the rectus abdominus at the level of the umbilicus. Approximately three liters of sterile carbon dioxide were used to inflate the abdominal cavity to a maximum internal pressure of 15 mm Hg. The Veress needle was replaced with a 12 mm trocar and a 30 degree, 60 cm x 10 mm Hopkins telescope (Karl Storz Veterinary America) was inserted for visualization of the abdominal organs. Two additional 5 mm trocars were placed in the lateral abdominal wall for introduction of instruments and subsequent biopsy collection.

The left kidney capsule was incised and a single reniculus was bluntly dissected free from the parenchyma. A 2-0 vicryl Endoloop (Ethicon Endosurgical) was placed around the base of the reniculus to control hemorrhage from the biopsy site. Laparoscopic scissors were used to excise two, 1x1 cm of renal tissue from the selected reniculus. These were collected for culture and histopathology. There was minimal hemorrhage from the biopsy site and the renal capsule was not surgically closed as the incision was minimal.

The 12 mm trocar site was closed using # 1 PDS threaded on a J-needle (Synergistic) which contained the peritoneum, fascia and subcutaneous tissue within the closure, followed by closing the skin with 2-0 nylon. The 5 mm trocar sites were closed at the subcutaneous and skin levels using 2-0 nylon. All three sites were additionally secured using methylmethacrylate surgical glue.

Within one hour of endotracheal tube removal and recovery, the animal was placed into a medical pool and was released under her own control. The day following surgery, the patient appeared behaviorally normal and began to eat her normal ration.

Histopathology demonstrated glomerulonephritis consistent with immune complex deposition. While causative antigens may be exogenous (viral, bacterial, protozoal) or endogenous (neoplastic or autoimmune) special stains for renal amyloid were negative. The suspected etiology of this case is a chronic low grade endometritis, which is currently under evaluation. The animal continues to do well at this time while still under medical management.