Physical Examination

Physical examination

An onsite physical examination is necessary, and can be challenging due to a variety of factors. Smaller animals will be easier to examine simply because they are easier to handle and restrain when conducting the examination. An animal that is still partially in the water is easier to turn onto its side to examine the underside, listen to heart and lungs, etc. An animal completely out of the water, unless very small, will be more difficult to manipulate. With a large whale that cannot be physically manipulated at all, the physical examination will be limited to those body parts that are exposed.

Skin condition and hydration

Evaluate the skin condition of the animal. Normally, it should be wet and smooth like rubber. If the animal has been out of the water for sometime and the skin has been exposed to the air, wind, and heat of the sun, it may begin to look dry and wrinkled. With extended exposure it may begin to peel. It is therefore important to keep the skin wet and protected from the elements. It is also important to look closely at any sunburn patterns. For example, if the animal has sunburned skin only on the right side, this indicates the animal was floating right side up, which may be indicative of problems associated with the right lung.

Push down on the skin with fingers or hand to roughly check the animal’s current state of hydration. The skin of a well hydrated animal is firm to the touch, while those with possible dehydration are “squishy”. A more objective way of determining the state of hydration is through a blood profile. This takes time as a blood sample must be drawn and analyzed for the results, but it will give you precise information as to the degree the animal is dehydrated. Animals that are emaciated, have not been eating normally for some time, and/or are suffering from illness are likely to be dehydrated. Those that have stranded for other reasons (i.e. followed prey to shore, got ‘lost’, etc.) or have recent injuries that are not life threatening are usually well hydrated.

Physical Examination:

Body Temperature

- Along with blood samples, body temperature is also only taken by a qualified veterinarian. - The normal temperature range can be from 36.5 ̊- 38 ̊C. A temperature over 40 ̊ is considered critical. A note of caution, however, as an elevated temperature of a struggling animal may not reflect infection or inflammation but just body heat from exertion. So, body temperature of a stranded marine mammal must be carefully evaluated in relation to other factors, and is often not useful. - Exact age estimation of a stranded animal is difficult to ascertain unless it is obviously a stillborn or neonate. Cetaceans and dugongs are generally classified as calf, subadult or adult. Very young calves, or neonates, can be fairly easily determined by size, clean unscratched skin, and the lack of teeth. The fleshy umbilicus may be present as well. If a young calf strands, there is always a small possibility that the mother may still be offshore, so ask the First Responders and recruit community members to look for sightings of another animal in the area likely to be the mother. Neonates require very specialised around the clock care and will need to be fed a specially designed formula instead of whole fish. - As much morphometric information as possible should be collected. This includes length and width or girth. The size and shape of all fins (dorsal, pectoral, and tail fluke) and location of blowhole are also helpful to note. Check the teeth, if possible, for overall condition and amount of wear (minimal to maximum wear). With morphometrics and this other information, as well as an identification of the species of the stranded animal, it is possible to estimate age classification of the animal. - If at all possible, diagnostic sampling should be done at the stranding site. This provides much more detailed information on the health status of the animal which is important in deciding whether to release, rehabilitate, or euthanise the animal. Complete diagnostics will be necessary to develop a medical management plan if rehabilitation is pursued. - Blood is the most important biological sample that a medical practitioner uses to assess, diagnose, and medically manage the animal. When there is an opportunity to collect more samples, blowhole and faecal samples are next in importance. Test results from these samples can provide information on more specific illnesses like respiratory infections, diarrhoea, and gastrointestinal parasitism.

Physical Examination:

Determine State of Nutrition: check the profile of muscle mass below the dorsal fin. Body condition scoring (BCS) is an important subjective and semi-quantitative tool used to assess and make recommendations relating to nutritional status and overall health in a wide range of species.

A scale of 1-to-4 - used to assess body fat and muscle, with a lower score indicating emaciation and a higher score indicating obesity.

Studies have shown a significant relationship between body condition and survivability in marine mammals, with failed animals showing a poorer body condition than those that survived. A lower body condition score may indicate poor nutrition and underlying chronic illness, which may be correlated with decreased delphinid survival rates post-release.

Body Condition of cetaceans - assessed by analysing morphometric data (i.e. relationship between girth, length and weight, as well as by using Body Mass Index (BMI) or ultrasound measurements of blubber thickness as a determinant of body fat condition.

Emaciated animals have a visible ‘dipping’ of the muscle masses or a sunken look with a visible ‘neck’. This is described by some as the animal having the profile of a “peanut – head’ rounder and neck thinner and then body angling out again It is also important to listen to the quality and sound of the breaths. Normally, the breaths should be clear, strong and quick. 38

Physical Examination:

Bleeding

● Excessive bleeding from the blowhole, mouth and anus are poor prognostic signs, unless due to superficial cuts occurring at the time of stranding. ● Bleeding from injuries may occur and depending on area of injury it may be disinfected and wrapped temporarily.

Reflexes and muscle tone;

● Assessment of key reflexes and muscle tone may give an indication of the level of consciousness in animals showing little evidence of movement, vocalisation, etc.. Those that can be assessed include: ● Palpebral reflex- should close eyelids on touching. ● Blowhole reflex - normally held closed and should tighten on touching its edge. ● Jaw tone - should resist attempts to open its mouth. ● Tongue and flipper tone - gentle tugging on the tongue or flipper should be met with strong resistance.