EVALUATION OF THE I-STAT PORTABLE CLINICAL ANALYZER FOR MEASUREMENT OF IONIZED CALCIUM AND SELECTED BLOOD CHEMISTRY VALUES IN ASIAN ELEPHANTS ( ELEPHAS MAXIMUS )

SERUM VITAMIN D AND SELECTED BIOMARKERS OF CALCIUM HOMEOSTASIS IN ASIAN ELEPHANTS (ELEPHAS MAXIMUS) MANAGED AT A LOW LATITUDE

An understanding of species-specific vitamin D metabolism and its role in calcium homeostasis is essential for correct diet formulation and development of husbandry protocols for managed nondomestic species. This study documented serum vitamin D metabolites and other analytes involved in calcium homeostasis in Asian elephants (Elephas maximus) managed at a latitude similar to their wild natural habitat. Serum values for 33 elephants managed at a low latitude were measured in the peak of summer, revealing low vitamin D2 (25(OH)D2 2.3 ± 0.6 ng/ ml and 24,25(OH)2D2 2.17 ± 0.52 ng/ml) and nondetectable vitamin D3. Serum minerals (calcium, phosphorus, magnesium), ionized calcium, and parathyroid hormone were within normal reported ranges. In comparison with previously reported values in elephants managed at a high latitude, 25(OH)D2 (P < 0.001), 24,25(OH)2D2 (P = 0.001), and magnesium (P = 0.013) were significantly lower, and parathyroid hormone was significantly higher (P < 0.001). The lack of D3 production during ample sun exposure at a low latitude suggests that Asian elephants are incapable of cutaneous photobiosynthesis of vitamin D, and that low serum D2 is normal for this species.

Performance of a manually operated salad spinner centrifuge for serum separation in the healthy domestic horse (Equus caballus) and southern white rhinoceros (Ceratotherium simum)

BACKGROUND

Field veterinarians and researchers studying wild species, such as the southern white rhinoceros, often work in remote areas with limited access to standard laboratory equipment, hindering the ability to measure serum analytes.

OBJECTIVES

The first objective was to produce an inexpensive, manually operated centrifuge that could accept standard laboratory tubes by modifying a consumer-grade salad spinner with low-cost materials. The second objective was to compare biochemistry analysis results obtained from equine and southern white rhinoceros serum separated by traditional laboratory and manual salad spinner centrifugation.

METHODS

We optimized the design and serum separation protocol using non-anticoagulated equine blood. Equine and rhinoceros serum samples were separated by manual salad spinner or traditional laboratory centrifugation. Measured analytes included sodium, potassium, chloride, urea nitrogen, creatinine, phosphorous, total calcium, magnesium, glucose, total protein, albumin, globulin, creatinine kinase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, bicarbonate, sorbitol dehydrogenase, and triglycerides. Results obtained from serum separated by each centrifugation technique were compared by Deming regression and Bland-Altman analyses.

RESULTS

A tube adaptor insert modeled after a swing angle rotor and a two-step salad spinner centrifugation yielded serum comparable to traditional laboratory centrifugation. For the majority of analytes, no proportional or constant biases were detected between centrifugation methods. A positive proportional bias in the measurement of ALP in serum separated by manual centrifugation was detected in both equine and rhinoceros samples.

CONCLUSIONS

Manual centrifugation with a modified salad spinner yields diagnostic quality serum suitable for the measurement of most standard biochemistry analytes.

EXPERIMENTAL CHOLECALCIFEROL SUPPLEMENTATION IN A HERD OF MANAGED ASIAN ELEPHANTS (ELEPHAS MAXIMUS)

Vitamin D supplementation may pose a significant health risk in species where levels of deficiency, sufficiency, and toxicity have not been clearly established, and species-specific research on vitamin D supplementation should be performed. This study documented the effect of vitamin D supplementation on serum vitamin D metabolites and other analytes of Ca homeostasis in Asian elephants (Elephas maximus). Six adult Asian elephants received PO supplementation with cholecalciferol at 300 IU/kg of body weight (BW) once a week for 24 wk. Serum was analyzed every 4 wk for 25-hydroxyvitamin D₂/D₃ [25(OH)D]; 24,25-dihydroxyvitamin D₂/D₃ [24,25(OH)₂D]; 1,25-dihydroxyvitamin D [1,25(OH)₂D]; parathyroid hormone (PTH); total Ca; ionized Ca (iCa); P; and Mg. After the supplement was discontinued, serum 25(OH)D₂/D₃ was measured every 4 wk until levels returned to baseline. At the start of the study, the average serum 25(OH)D₃ was nondetectable (<1.5 ng/ml). With cholecalciferol supplementation, 25(OH)D₃ increased at an average rate of 2.26 ng/ml per month and reached an average concentration of 12.9 ± 3.46 ng/ml at 24 wk. Both 24,25(OH)₂D₃ and 1,25(OH)₂D increased over time with supplementation from an average of <1.5 to 12.9 ng/ml and from 9.67 to 36.4 pg/ml, respectively. PTH, iCa, Ca, P, and Mg remained within reported normal ranges throughout supplementation. After the supplement was discontinued, serum 25(OH)D₃ demonstrated a slow decline to baseline, taking an average of 48 wk. Elephants demonstrated significant individual variation in response to supplementation and subsequent return to baseline. Supplementation of Asian elephants with a weekly dose of 300 IU/kg BW cholecalciferol for 24 wk appears to be effective and safe. Additional clinical studies would be necessary to investigate the safety of other routes of administration, dosages, and duration of vitamin D supplementation, as well as associated health benefits.

Comparison of ionised calcium measured using a portable analyser to a reference method in healthy dogs

OBJECTIVES

To compare the ionised calcium measured on a portable analyser (iSTAT, Abbott) to a reference method.

MATERIALS AND METHODS

Blood samples from 39 apparently healthy dogs were analysed in duplicate using a portable analyser and a reference method (Radiometer ABL800 FLEX). Bland-Altman plots and Passing-Bablok regression were used to assess constant and proportional bias between the two instruments. A within-assay percentage coefficient of variation and total error (TE) was calculated for both analysers. The reference interval was calculated for the portable analyser using the robust method with confidence interval bootstrapping.

RESULTS

The Bland-Altman plot showed a -0.036 mmol/L difference between the two instruments (95% confidence limit -0.08 to 0.01 mmol/L; limits of agreement -0.07 to 0.006 mmol/L). Neither the Bland-Altman plot nor the Passing-Bablock regression (slope -0.03; 95% confidence interval -0.08 to 0.19 and intercept 1; 95% confidence interval 0.83 to 1.2) showed significant proportional bias. The coefficient of variation for the portable analyser was 1.08%, compared to 0.78% for the reference method with a total error of 3.5% for the portable analyser. The estimated population-based reference interval for ionised calcium using the portable analyser is 1.23 to 1.42 mmol/L.

CLINICAL SIGNIFICANCE

For the healthy dogs in this study, compared to the reference method, the portable analyser showed no significant bias for measurement of ionised calcium. Further studies including hyper and hypocalcaemic dogs are required to determine clinical impact of the use of this analyser.

EVALUATION OF PLASMA CARDIAC TROPONIN I IN ASIAN ELEPHANTS (ELEPHAS MAXIMUS) USING TWO CLINICAL ANALYZERS

Cardiac troponin I (cTnI) is specific to myocardial tissue, highly conserved across taxa, and a reliable indicator of myocardial disease in human and veterinary medicine. Biomarkers, like cTnI, may be useful for cardiac evaluation of elephants because the application of other modalities is complicated by the size of the animal. The goal of this study was to establish observed ranges for plasma cTnI in Asian elephants (Elephas maximus) measured by two point-of-care analyzers. Blood was collected from captive juvenile (≤15 yr; n = 9), adult (16-50 yr; n = 42), and geriatric (>50 yr; n = 16) elephants. Following centrifugation, heparinized plasma was stored at 5°C prior to and in between analyses on iSTAT (Abbott Point of Care Inc, Princeton, NJ 08540, USA) and HUBI-QUANpro (Humiasis Co, Ltd, Anyang-si 14042, South Korea) analyzers. With the exception of two results, plasma concentrations of cTnI were below the limit of quantification (LOQ < 0.05 ng/ml) for the HUBI-QUANpro (n = 64), which prohibited comparison between the two analyzers. Observed ranges were determined for plasma cTnI concentrations reported by the iSTAT for the entire population sampled (n = 58; mean 0.011 ng/ml; SD ± 0.013 ng/ml; range 0.00-0.07 ng/ml; 95% CI 0.008-0.015 ng/ml; median 0.01 ng/ml) and with outliers excluded (n = 50; mean 0.007 ng/ml; SD ± 0.007 ng/ml; range 0.00-0.02 ng/ml; 95% CI 0.005-0.009 ng/ml; median 0.01 ng/ml). No significant differences were observed between age classes (P = 0.70) or sexes (P = 0.34). Higher cTnI concentrations were significantly correlated with increasing age (Pearson's r = 0.426; P = 0.002). Future studies are warranted to investigate the diagnostic potential of plasma cTnI in Asian elephants.

Comparison of Hematocrit and Biochemical Analytes among Two Point-of-Care Analyzers (EPOC and i-STAT Alinity v) and a Veterinary Diagnostic Laboratory in the African Savanna Elephant (Loxodonta africana) and the Southern White Rhinoceros (Ceratotherium simum simum)

This study compared hematocrit measured with the EPOC and i-STAT Alinity v point-of-care analyzers and manual measurement of packed cell volume in managed African savanna elephants (Loxodonta africana) and southern white rhinoceros (Ceratotherium simum simum). Biochemical analytes were also measured with the EPOC, i-STAT Alinity v, and a veterinary diagnostic laboratory in the same animals. Analytes assessed included blood urea nitrogen, chloride, creatinine, glucose, ionized calcium, potassium, and sodium. There were no differences for hematocrit values for African savanna elephants or southern white rhinoceros (p ≤ 0.05). In African savanna elephants, there were no differences between the EPOC and i-STAT Alinity v analyzers for any measured analytes except ionized calcium. When compared to a veterinary diagnostic laboratory, there were differences for a majority of the biochemical analytes measured on the EPOC and i-STAT Alinity v analyzers in African savanna elephants. In southern white rhinoceros, there were differences for a majority of analytes among all three analyzers. While differences existed among the portable analyzers and a veterinary diagnostic laboratory for biochemical analytes in both species, these numerically small differences are unlikely to be clinically significant. For routine health care of African savanna elephants and southern white rhinoceros, these point-of-care analyzers may be a useful alternative to commercial analyzers for the parameters evaluated.

Age related variation of health markers in Asian elephants

Although senescence is often observed in the wild, its underlying mechanistic causes can rarely be studied alongside its consequences, because data on health, molecular and physiological measures of senescence are rare. Documenting how different age-related changes in health accelerate ageing at a mechanistic level is key if we are to better understand the ageing process. Nevertheless, very few studies, particularly on natural populations of long-lived animals, have investigated age-related variation in biological markers of health and sex differences therein. Using blood samples collected from semi-captive Asian elephants, we show that pronounced differences in haematology, blood chemistry, immune, and liver functions among age classes are also evident under natural conditions in this extremely long-lived mammal. We provide strong support that overall health declined with age, with progressive declines in immune and liver functions similarly in both males and females. These changes parallel those mainly observed to-date in humans and laboratory mammals, and suggest a certain ubiquity in the ageing patterns.

Stability of Whole Blood Electrolyte Specimens at Room Temperature vs. Slushed Ice Conditions

BACKGROUND

Data on the stability of whole blood electrolytes is limited to small sample sizes. We sought to determine the stability of whole blood electrolytes under room temperature and slushed iced conditions in human patients at a major hospital center.

METHODS

Whole blood samples were obtained from 203 patients hospitalized for various pathophysiological conditions. Electrolyte concentrations of sodium, potassium [K+], ionized calcium, and chloride were measured at 5 different timepoints spanning 3 h. Samples were stored at room temperature (22-24 °C) or under slushed ice conditions (0.1-0.2 °C) before analysis.

RESULTS

Under both conditions, sodium, ionized calcium, and chloride did not show a measurable change up to 109 min compared to baseline; however, the mean increase in [K+] over 138 min of storage in slushed ice was 0.0032 (0.0021 [5th percentile] to 0.0047 [95th percentile]) mmol/L/min (adjusted R2 = 0.62, P < 0.001). Five percent of the specimens demonstrated a ≥0.3 mmol/L change in [K+] from baseline after 67 min of storage in slushed ice. In contrast, 1% of the specimens stored at room temperature showed the same change at the same timepoint.

CONCLUSIONS

Whole blood sodium, [K+], ionized calcium, and chloride concentrations remain stable for at least 109 min at room temperature. However, whole blood specimens stored in slushed ice for not more than 67 min exhibit a 5% probability that the [K+] concentration will increase by at least 0.3 mmol/L compared to baseline. The other analytes do not destabilize for up to 178 min of slushed ice storage.

Whole blood gas and biochemical reference intervals for Lohmann Silver layers

The blood gas and biochemical reference range established with i-STAT clinical analyzer in avian has become common, however, the reference value for various laying hen lines is limited. Therefore, blood gas and biochemical reference intervals will be established for Lohmann Silver layers in the pre- and post-laying periods. The blood sample was collected at a 4-wk interval. A total of 230 Lohmann Silver layers including 80 pullets (5–17 wk) and 150 laying hens (21–37 wk) were collected for whole blood measurement with the i-STAT clinical analyzer. The CG8+ cartridge provides values of the following 13 parameters: sodium (Na mmol/L), potassium (K mmol/L), ionized calcium (iCa mmol/L), glucose (Glu mg/dL), hematocrit (Hct% Packed Cell Volume [PCV]), pH, partial pressure carbon dioxide (PCO₂ mm Hg), partial pressure oxygen (PO₂ mm Hg), total concentration carbon dioxide (TCO₂ mmol/L), bicarbonate (HCO₃ mmol/L), base excess (BE mmol/L), oxygen saturation (sO₂%), and hemoglobin (Hb g/dL). The correlation of these parameters and the effect of physiological status were investigated. The reference value interval was established with a reference value advisor for pre-laying and post-laying birds. Correlations were found to be statistically significant, especially between BE and HCO₃ and TCO₂. Besides, values in Na, iCa, K, Hct, Hb, sO₂ differed significantly between the pre- and post-laying periods. Data in this study might serve as important information for facilitating the genetic selection and assessing the health of Lohmann Silver laying hens.

STANDING SEDATION WITH XYLAZINE AND REVERSAL WITH YOHIMBINE IN JUVENILE ASIAN ELEPHANTS (ELEPHAS MAXIMUS)

Evaluation and improvement of immobilization methods are important for wildlife welfare and biodiversity conservation. The sedative and physiological effects of xylazine (50-110 mg per elephant; 0.09-0.15 mg/kg IM) were evaluated in 15 juvenile Asian elephants (Elephas maximus) in Sri Lanka. The time from xylazine injection until first sign of sedation, handling, and reversal with yohimbine (0.009-0.03 mg/kg IV) were recorded. Behavioral signs, level of sedation (no effect, light, moderate, or deep) and response to handling were assessed. Rectal temperature, pulse, and respiratory rates were recorded and arterial blood samples were analyzed 30 and 45 min after xylazine injection. The first sign of sedation occurred within 5-18 min. Standing sedation was induced in all elephants, but the level of sedation varied differently over time for each elephant. Twelve elephants remained standing throughout the sedation period, while 3 elephants became laterally recumbent. Sedative effects included lowered head and trunk, droopy ears, snoring, and penis protrusion. Pulse rate, respiratory rate, and rectal temperature ranged between 30-45 beats/min, 4-12 breaths/min, and 35.6-37.2°C, respectively, at 30 min after xylazine injection, and there were no changes over time. Pulmonary function and acid-base balance were adequate (range partial pressures of arterial oxygen 73-123 mmHg and carbon dioxide 33-52 mmHg, arterial hemoglobin oxygen saturation 96-99%, pH 7.34-7.54, lactate 0.9-2.5 mmol/L). Yohimbine was administered 46-110 min after the injection of xylazine, and the first sign of recovery occurred within 1-4 min. Resedation after reversal with yohimbine was observed in two elephants. In conclusion, xylazine at the doses used induced light to deep sedation with stable physiology and most elephants remained standing.

Evaluation of the i-STAT Alinity v in a veterinary clinical setting

Many point-of-care (POC) analyzers are available for the measurement of electrolytes and acid-base status in animals. We assessed the precision of the i-STAT Alinity v, a recently introduced POC analyzer, and compared it to 2 commonly used and previously validated POC analyzers (i-STAT 1, Stat Profile pHOx Ultra). Precision was evaluated by performing multiple analyses of whole blood samples from healthy dogs, cats, and horses on multiple i-STAT Alinity v analyzers. For comparison between analyzers, whole blood samples from dogs and cats presented to the emergency room were run concurrently on all 3 POC instruments. Reported values were compared by species (dogs and cats only) using Pearson correlation, and all values from all species were analyzed together for the Bland-Altman analysis. Results suggested that the i-STAT Alinity v precision was very good, with median coefficients of variability <2.5% for all measured parameters (except the anion gap), with variable ranges of coefficients of variation. In addition, good-to-excellent correlation was observed between the i-STAT Alinity v and i-STAT 1, and between the i-STAT Alinity v and Stat Profile pHOx Ultra for all parameters in both cats and dogs, respectively. In this cohort, the i-STAT Alinity v had clinically acceptable bias compared to the currently marketed analyzers and can be used for monitoring measured analytes in cats and dogs, although serial measurements in a single animal should be performed on the same analyzer whenever possible.

Seasonal variation of health in Asian elephants

Long-lived species are often predicted to be buffered against seasonal variation: longevity means low annual mortality and reproductive rates and annual variability in climate may therefore have a smaller impact on population growth rates of long-lived species in comparison to short-lived ones. However, little is known of the physiological mechanisms underlying such patterns in long-lived species. In this study, we investigated seasonal variation in the health of Asian elephants living in a seasonal monsoon climate. We used two complementary methods: (i) global and (ii) trait-by-trait analyses of seasonal effects on 23 health parameters of 225 individually marked elephants with known age and reproductive and health history, with repeated measures per individual over a 26-month period. The global analysis highlighted the biggest differences in health between the hot and monsoon seasons. Our trait-specific analyses identified the physiological functions underlying such health variation in different ecological settings, including haematological, immunological, muscular, kidney and liver functions, as well as protein balance and electrolytes. Overall, the results suggest that even long-lived, large mammals may experience physiological changes in response to seasonal variation that in extreme circumstances can pose a significant health risk.

THE VITAMIN D STATUS OF ASIAN ELEPHANTS (ELEPHAS MAXIMUS) MANAGED IN A NORTHERN TEMPERATE CLIMATE

Knowledge about the normal metabolism and involvement of vitamin D in elephant calcium homeostasis is essential to understanding the possible role of vitamin D in Asian elephant (Elephas maximus) health, as well as to informing accurate diet formulation. This study provides an evaluation of analytes involved in vitamin D metabolism, in conjunction with dietary intake and ultraviolet light (UV) exposure, in Asian elephants managed in a northern temperate climate. Once monthly, for a total of 12 mo, serum from six adult Asian elephants was analyzed for 25-hydroxyvitamin D [25(OH)D], 24,25-dihydroxyvitamin D [24,25(OH)₂D], 1,25-dihydroxyvitamin D [1,25(OH)₂D], parathyroid hormone (PTH), total calcium (Ca), ionized calcium (iCa), phosphorus (P), and magnesium (Mg). The diet was analyzed monthly for vitamin D, Ca, and P. Monthly average vitamin D-weighted UV daily sums were determined to gauge average UV light exposure within the vitamin D action spectrum. No serum or diet parameters were affected by time or season. Average serum 25(OH)D₂ was 7.02 ± 0.85 ng/ml. 25(OH)D₃ levels were nondetectable in all samples despite supplementation of the diet with recommended levels of vitamin D₃, and UV exposure was at sufficient levels for cutaneous vitamin D synthesis for 6 mo of the year. Levels of 24,25(OH)₂D averaged 31.7% higher than 25(OH)D, and average 1,25(OH)₂D₂ was 11.24 ± 1.04 pg/ml. Values for PTH, Ca, iCa, P, and Mg were within expected ranges for Asian elephants. The information gained from this research expands the knowledge base for these analytes, evaluates 24,25-dihydroxyvitamin D for the first time, and provides new information regarding vitamin D metabolism and test interpretation in the Asian elephant.