Candida spp. in Cetaceans: Neglected Emerging Challenges in Marine Ecosystems

Cetaceans, which are crucial in marine ecosystems, act as sentinels for ecosystem and human-environmental health. However, emerging fungal infections, particularly by Candida spp., pose a growing concern in these marine mammals. This review consolidates current knowledge on the prevalence, clinical manifestations, species distribution, and antifungal resistance of Candida infections in cetaceans. We detail the diverse pathogenic impacts of Candida, including respiratory, dermal, and systemic afflictions, underscoring diagnostic and treatment challenges amid rising antifungal resistance. Our analysis extends beyond health concerns in captive cetaceans, where confinement stress heightens vulnerability, to encompass substantial ecological risks in wild populations. The review emphasizes the One Health perspective, linking cetacean health with broader environmental and human public health issues. We particularly focus on the potential zoonotic transmission of emerging fungal pathogens such as Candida auris and the role of environmental changes in fostering antifungal resistance. The study underscores the need for concerted, interdisciplinary efforts in veterinary, medical, and environmental sciences to enhance understanding and management of Candida infections in cetaceans. We advocate for comprehensive monitoring and collaborative research initiatives to mitigate the rising challenge of these infections. Addressing Candida spp. in cetaceans is not just a conservation priority but a critical step in safeguarding overall marine health and, by extension, human health in the context of evolving infectious diseases.

Apneustic anesthesia ventilation improves pulmonary function in anesthetized bottlenose dolphins (Tursiops truncatus)

Introduction

Use of mechanical ventilation during general anesthesia is a necessary practice in the anesthetization of small cetaceans as spontaneous ventilation fails to provide adequate gas exchange. Currently available methods of ventilation do not account for the intermittent breathing strategy of representative species within this infraorder of fully aquatic mammals and may have a significant effect on cardiac and respiratory physiology.

Methods

To understand the impact of mechanical ventilation on cardiopulmonary function in one small species of cetacean, the bottlenose dolphin (Tursiops truncatus), we compared controlled mechanical ventilation (CMV) to a novel ventilation method known as apneustic anesthesia ventilation (AAV). AAV simulates the normal inspiratory breath-hold pattern of dolphins. Ten anesthetic procedures (dental procedure, n = 9; bronchoscopy, n = 2) were performed on nine dolphins (age range: 10-42 years; mean = 32 years; median = 37 years; female = 3, 40%; male = 6, 60%). In a cross-over study design, dolphins were instrumented and randomly assigned to AAV or CMV as the initial mode of ventilation, then switched to the alternate mode. Baseline cardiopulmonary data were collected and again after 30 min on each mode of ventilation. Cardiac index, stroke volume index, systemic vascular resistance, alveolar dead space, alveolar-arterial oxygen tension gradient, arterial oxygen content, oxygen delivery index, and dynamic respiratory system compliance index were calculated at each of the four time points.

Results

During AAV, dolphins had higher arterial oxygen tension, higher mean airway pressure, reduced alveolar dead space ventilation and lower alveolar-arterial oxygen difference. Cardiovascular performance was not statistically different between the two modes.

Discussion

Our study suggests AAV, which more closely resembles the conscious intermittent respiratory pattern phenotype of dolphins, improves ventilation and pulmonary function in the anesthetized dolphin. Future studies should evaluate the cardiopulmonary effects of neutral buoyancy and cardiopulmonary sparing drug protocols to reduce the need for hemodynamic support of current protocols.

Return of Sound Production as a Biomarker of Bottlenose Dolphin Emergence from Anesthesia

(1) Background: When a human or animal is recovering from general anesthesia, their medical team uses several behavioral and physiological parameters to assess their emergence from the unconscious state to complete wakefulness. However, the return of auditory and acoustic behaviors indicative of the complete return of consciousness in humans can be difficult to assess in a completely aquatic non-human mammal. Dolphins produce sound using the nasal system while using both passive auditory and active biological sonar (echolocation) to navigate and interrogate their environment. The sounds generated by dolphins, such as whistles and clicks, however, can be difficult to hear when the animal is submerged. (2) Methods: We implemented a system to audibly and visually (i.e., using spectrograms) monitor the underwater acoustic behavior of dolphins recovering from anesthesia. (3) Results: Eleven of the twelve recorded dolphins began echolocating within 92 min (Mean = 00:43:41 HH:MM:SS) following spontaneous respirations. In all cases, the dolphins echolocated prior to whistling (Mean = 04:57:47). The return of echolocation was significantly correlated to the return of the righting reflex (Mean = 1:13:44), a commonly used behavioral indicator of dolphin emergence. (4) Conclusions: We suggest that acoustic monitoring for the onset of click production may be a useful supplement to the established medical and behavioral biomarkers of restoring consciousness following anesthesia in bottlenose dolphins.

SUPERFICIAL CERVICAL LYMPHADENITIS ASSOCIATED WITH STREPTOCOCCUS PHOCAE IN FIVE COMMON BOTTLENOSE DOLPHINS (TURSIOPS TRUNCATUS): A CASE SERIES

Between 2009 and 2018, five common bottlenose dolphins (Tursiops truncatus) at the US Navy Marine Mammal Program presented with superficial cervical lymphadenitis. Clinical findings included ultrasonographic evidence of cervical lymph node enlargement, severe leukocytosis, elevated erythrocyte sedimentation rates, and reduced serum iron. Three of the dolphins presented with clinicopathologic changes without presence of clinical signs, and the other two cases additionally presented with partial to complete anorexia, lethargy, and refusal to participate in training sessions. Ultrasound-guided fine needle aspiration or biopsy of the affected lymph nodes yielded Streptococcus phocae by PCR in all cases, and the organism was cultured in one of five cases. Animals were treated with a combination of enteral, parenteral, intralesional antimicrobial, or a combination of those therapies and supportive care. Time to resolution of clinical disease ranged between 62 and 188 days. To the authors' knowledge, this is the first report of Streptococcus phocae cervical lymphadenitis in cetaceans. Streptococcus phocae lymphadenitis should be a differential for cervical lymphadenopathy in this species, especially when associated with pronounced systemic inflammation and a history of potential exposure.

In vitro evaluation and in vivo use of a novel surgical stent to minimize suture pressure necrosis

OBJECTIVE

To evaluate the efficacy of stents to distribute pressure when incorporated into tension-relieving sutures.

STUDY DESIGN

An in vitro study and case report.

ANIMAL

One common bottlenose dolphin (Tursiops truncates).

METHODS

Three novel silicone stents, a traditional stent, and a control were tested in vitro by using a suture simulator. Stent surface area was measured by using a pressure mapping sensor. Pressure was derived from the measured surface area and the downward force of the suture simulator. Novel silicone stents were also used in the closure of an incision in a bottlenose dolphin.

RESULTS

No difference was found in surface area or pressure among the three silicone stents (adjusted P > .05). Silicone stents yielded an average, 2.69 cm² more surface area and 842.37 kPa less pressure compared with the control as well as 1.67 cm² more surface area and 110.67 kPa less pressure compared with the traditional stent. The traditional stent yielded 1.02 cm² more surface area and 731.7 kPa less pressure compared with the control. Incision site and silicone stent assessment performed postoperatively revealed no obvious pressure necrosis.

CONCLUSION

Stents improved distribution of suture pressure, and novel silicone stents were more effective compared with traditional stents. Novel silicone stents appear to have preliminary clinical success in vivo.

CLINICAL SIGNIFICANCE

Our study provides evidence that stents effectively help distribute suture pressure, and their incorporation might minimize the risk of suture pressure necrosis. Novel silicone stents should be integrated into tension-relieving suture patterns when closing wounds and incisions, particularly in aquatic animals.