Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology 30/01/2016 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex 776414 Elephas maximus/Asian Female elephant Date Time Note Author 30/01/2016 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Notes/Comments Birth Date Age ~ from 28/01/1978 to 28/01/1980 37Y 0M 2D ~ Keepers found Chai dead in the yard during morning head check (approximately 7:30am). She was laying on her left side under the hay feeder at the far east side of yard 3. On initial inspection, there was no external signs of trauma and no sign that she struggled to get back up. Suspect acute death. Necropsy will be performed toady. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 11M 29D Test Request Detail Sample Quality Date Requested Requested By 30/01/2016 Jennifer D'Agostino Color Color Intensity ~ ~ Laboratory Analysis Start Date Analysis Equipment National Zoo Departm 02/02/2016 ~ Clarity Consistency Additional Characteristics ~ ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Reviewed Page 1 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Sample Detail (GSN: S-WCD16-041429) Collection Date/Time 26/01/2016 00:00 Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN Collection Method Collected By Reason Phlebotomy Keeper Staff Routine Additives/Preservatives Exclude from reference intervals No EDTA Necropsy Detail Animal Type GAN Preferred ID Taxonomy Sex Birth Date Age Individual 21517980 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 37Y 0M 2D Submission Death Date 30/01/2016 00:00 Carcass Weight Date Submitted 30/01/2016 Measurement ~ Date Discovered 30/01/2016 Estimate No Submitted By Jennifer D'Agostino Exclude from reference intervals No Manner of Death Natural/Non-euthanasia Death Location Location Type Enclosure Enclosure ELEPHANT Recent History/Observations Note Elephant was found dead in exhibit yard at 7:30 am as keepers arrived to the barn. There were no previous signs of illness. She fell just under the hay feeder and there were no signs of external trauma or strugggle to get up. Special Request Case Info Death Numbers Death Number Pathology Case Number OKCZ-00117 Parties to get copy of final report ~ Responsible Pathologist Michael M. Garner DVM Responsible Resident ~ ~ Effective Date Entered By ~ ~ Workflow Notes and Additional Case Comments ~ Gross Necropsy Necropsy Info Necropsy Date 30/01/2016 Necropsy Prosector Jennifer D'Agostino Carcass Condition Code Fresh Additional Staff ~ My Institution HOSP Reference Number ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 2 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Report Report Written Date 30/01/2016 Necropsy Report/Description External exam: Animal is in good to slightly thin body condition. There are no external signs of trauma. There is a small amount of dried blood in the oral cavity which is presumed to have originated from the trachea at time of death as no oral lesions are present. There is blood congestion within the mucosa of the hard palate. There is some partially masticated hay in the oral cavity between the upper and lower left molars. The upper right front molar was shed several weeks ago and the socket remains open but clean and free of food debris. There are several (approximately 25) firm, raised nodules (abscesses) in the skin measuring 1-5 cm in diameter along the right side of the body from the submandibular area to the lateral flank. Several of the lesions are covered in scab material and contain thick, cream colored purulent debris. Lesions appeared to be associated with the incident 2 months ago when she required some keeper assistance to rise from a right lateral recumbent position. The lesions were being flushed daily by keepers and were slowly resolving. Thoracic cavity: The trachea, esophagus, heart and lungs were removed en bloc from the thoracic cavity for examination. Trachea, esophagus, and heart (including great vessels) all appear grossly normal. Overall, lungs subjectively appear to be diffusely congested with blood but are otherwise grossly normal. A single bronchial lymph node contained a white, mineralized nodule measuring approximately 5-7mm in diameter. A thyroid gland was identified and removed (presumed right gland). There was a slightly firm, tan colored nodule approximately 4 cm in diameter in the cranial portion of the thyroid gland. Abdominal cavity: The contents of the abdominal cavity were removed en bloc for examination. There was minimal abdominal fat noted throughout the body cavity. Several lymph nodes were identified in the subcutaneous tissues along the ventrum and all appeared normal. The liver and biliary ducts were grossly normal. Spleen, pancreas, stomach, small intestine, large intestine, cecum, colon, kidneys, adrenal glands and urinary bladder were all grossly normal. Stomach and intestinal tract were filled with normal feed and fecal material respectively. Both left and right ovaries contained multiple cystic structures throughout the parenchyma. The uterine endometrium was mucoid and hyperplastic in appearance and the uterus contained several firm, round masses of varying sizes (2-10cm in diameter) presumed to be leiomyomas. Vestibule and vaginal canal are grossly normal. Musculoskeletal system: The head was disarticulated from the body through C1 and it was noted that the vertebral body was anatomically displaced significantly to the right of midline. There was no hemorrhage around the vertebral body or the spinal cord and the joint with the foramen magnum appeared stable. Joint surfaces of the left distal carpal joint, right hip, left elbow and left stifle were examined. The left distal carpal joint and left elbow appeared normal. There were 3 small circular, 1 mm diameter, indentations in the cartilage in the center of the right femoral head, the acetabulum appeared normal. There was an irregularly shaped 3 cm x 2 cm indentation in the cartilage on the articular surface of the lateral side of the trochlea. There are also mild erosive lesions in the cartilage over the lateral and medial ridges (non-articular regions) of the trochlea. The articular surface of the patella appears grossly normal. Tissues submitted include: Spinal cord, thyroid gland (normal section and nodule), trachea, esophagus, right eye, tongue, lung (several sections), heart (several sections), aorta, pulmonary artery, bronchial lymph node, liver, bile duct, spleen, pancreas, kidney, adrenal gland, urinary bladder, ovary, uterus, stomach, small intestine, large intestine, ceceum, colon, lymph node (submandibular, bronchial, mesenteric), skin (abscess) Tissues submitted to NVSL for culture: bronchial lymph node and lung Tissues saved frozen for research: 1) Erin Latimer - tongue, heart, liver, spleen, lymph node 2) Gary Hayward - lung, spleen, lymph node 3) SSP - lung, liver, kidney, spleen, lymph node (store in tissue bank) 4) Northwest ZooPath - lung, liver, kidney, spleen, lymph node (store in tissue bank) Gross / Preliminary Diagnosis Diagnoses Diagnosis Standardized Diagnosis ~ ~ Initial Necropsy Comments & Interpretation ~ Samples & Tests Samples Sample Type/Anatomical Source Preservative Tissue/Eye Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/HEART Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/Skin Formalin, 10% buffered Tissue/Endocrine- Thyroid Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Evaluation Status Tissue/COLON (NOS) Laboratory Formalin, 10% buffered Test Name Printed: 05/02/2016 © 2015 International Species Information System Result Oklahoma City Zoological Park Page 3 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology ~ ~ ~ Tissue/UTERUS Report End Date 01/02/2016 ~ ~ Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/Spleen Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/Lung Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/HEART Laboratory ~ Result Evaluation Status National Zoo Departm Elephantid herpesvirus 1 (quantitative.PCR) Test Name 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 2 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 3 or 4 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 5 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 6 (quantitative.PCR) 0 ge/ml/ ~ ~ released Tissue/Spleen Laboratory ~ Result Evaluation Status National Zoo Departm Elephantid herpesvirus 1 (quantitative.PCR) Test Name 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 2 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 3 or 4 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 5 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 6 (quantitative.PCR) 0 ge/ml/ ~ ~ released Tissue/LIVER Laboratory ~ Result Evaluation Status National Zoo Departm Elephantid herpesvirus 1 (quantitative.PCR) Test Name 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 2 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 3 or 4 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 5 (quantitative.PCR) 0 ge/ml/ ~ ~ released National Zoo Departm Elephantid herpesvirus 6 (quantitative.PCR) 0 ge/ml/ ~ ~ released Tissue/BLADDER Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/ESOPHAGUS Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/STOMACH (NOS) Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/PANCREAS Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/LYMPH NODES (MESENTERIC) Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/LYMPH NODE (SUBMANDIBULAR) Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/Kidney Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/TRACHEA Printed: 05/02/2016 © 2015 International Species Information System Formalin, 10% buffered Oklahoma City Zoological Park Page 4 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/LARGE INTESTINE Formalin, 10% buffered Tissue/TONGUE Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/LIVER Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/DUCT (BILE) Formalin, 10% buffered Tissue/LYMPH NODE (HILAR) Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/OVARY (NOS) Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/SMALL INTESTINE Formalin, 10% buffered Tissue/MUSCLE Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/Adrenal Gland Formalin, 10% buffered Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Laboratory Test Name Result Evaluation Status ~ ~ ~ ~ ~ Tissue/spinal cord Formalin, 10% buffered Measurements Organ Weights & Lengths Measurement Date/Time ~ Type Measurement Item Measurement Value Measured By ~ ~ ~ ~ Histopathology Tissue Processing Histopathology Info Tissue Trim Date ~ Histopathology Report Date ~ Trimmed By ~ Histopathology Report By ~ Tissue Processing Submission Date ~ Responsible Pathologist Michael M. Garner DVM Tissue Processed Completion Date ~ My Institution ~ Histopathology Report ~ Histopathology Diagnosis Diagnosis Standardized Diagnosis ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 5 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Finalize Finalization Date ~ Relevant Death Info ~ Significant contributors to death Diagnosis Standardized Diagnosis ~ Primary Body System Affected Responsible Pathologist Michael M. Garner DVM Responsible Resident ~ ~ Final Summary ~ Necropsy Case Info for Husbandry Staff (R1 Note) ~ Addendum Date ~ Note Reported By ~ ~ Audit Trail ~ 21/01/2016 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 7M 4D Test Request Detail Sample Quality Date Requested 21/01/2016 Color ~ Requested By Laboratory Jennifer D'Agostino National Zoo Departm Color Intensity Clarity ~ ~ Analysis Start Date Analysis Equipment 22/01/2016 ~ Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes Sample Detail (GSN: S-WCD16-041436) Collection Date/Time Collection Method Phlebotomy Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN 01/09/2015 00:00 Collected By Reason Keeper Staff Routine Additives/Preservatives Exclude from reference intervals No EDTA Test & Result Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 6 of 75 Report Start Date 31/01/2015 Animal Type Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 6M 2D Test Request Detail Sample Quality Date Requested 21/01/2016 Color ~ Requested By Jennifer D'Agostino Color Intensity ~ Laboratory Analysis Start Date National Zoo Departm 22/01/2016 Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ Yes Sample Detail (GSN: S-WCD16-041435) Collection Date/Time Sample Type 30/07/2015 00:00 Whole Blood Collection Method Collected By Phlebotomy Keeper Staff Anatomical Source/Tissue EAR VEIN Reason Routine Additives/Preservatives Exclude from reference intervals No EDTA 18/01/2016 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 11M 21D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment Weight Info 17/01/2016 18/01/2016 00:00 Jennifer D'Agostino 1 animal Animal died 2016-01-30 ~ Printed: 05/02/2016 © 2015 International Species Information System Date 17/01/2016 Measurement Value Estimate 3,405 kg Yes Exclude From Reference Intervals Yes Oklahoma City Zoological Park Page 7 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Treatment Detail Treatment Item/Drug Dose Amount Dosage Amount Cosequin Equine (726.7 mg/g Solid > Powder) (Chondroitin sulfate (Nutriceutical Grade); Glucosamine Hydrochloride (Nutriceutical Grade)) (NUTRAMAX) Form Of Drug Powder 25,200 mg Frequency once a day (sid) 7.401 mg/kg Administrated Dose 34.677 g Quantity Concentration Of Drug Duration 348days Delivery Route Oral (p.o.) Loading Dose ~ 726.7 mg/g Treatment Response Clinical Response ~ Adverse Effects ~ Adverse Effects Note: ~ Staff Instructions Give 10 scoops once daily until further notice. Prescription Notes/Comments 10 scoops Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 17/01/2016 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 17/01/2016 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 11M 20D ~ Notes/Comments Elephant has completed the initial loading dose of Cosequin. Starting tomorrow will start the once daily maintenance dosing. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 07/01/2016 Prescription/Treatment Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 8 of 75 Report Start Date 31/01/2015 Animal Type Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 11M 10D Basic Info Weight Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 06/01/2016 07/01/2016 00:00 Gretchen Cole 1 animal Animal died 2016-01-30 ~ Date Measurement Value 06/01/2016 3,405 kg Estimate Yes Exclude From Reference Intervals Yes Treatment Detail Treatment Item/Drug Emcelle (500 IU/ml Liquid > Solution) (Tocopherol) Dose Amount 10,000 IU Frequency once a day (sid) Dosage Amount 2.937 IU/kg Duration 365days Administrated Dose 20 ml Quantity Delivery Route Loading Dose Form Of Drug Solution Concentration Of Drug 500 IU/ml Oral (p.o.) ~ Treatment Response Clinical Response ~ Adverse Effects Adverse Effects Note: ~ ~ Staff Instructions Give 10,000 IU [20 ml] of Emcelle, once a day (sid) for 365 days. Start treatment on 07/01/2016 Administration route: Oral (p.o.) Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 01/01/2016 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 11M 4D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 9 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Basic Info Weight Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 01/01/2016 01/01/2016 00:00 Gretchen Cole 1 animal Animal died 2016-01-30 ~ Date Measurement Value 01/01/2016 3,405 kg Estimate Exclude From Reference Intervals Yes Yes Treatment Detail Treatment Item/Drug RED CELL Dose Amount 75 g Dosage Amount 0.022 g/kg Administrated Dose 75 g Quantity Frequency once a day (sid) Duration Delivery Route 365days Oral (p.o.) Loading Dose ~ Form Of Drug ~ Concentration Of Drug ~ Treatment Response Clinical Response Adverse Effects ~ ~ Adverse Effects Note: ~ Staff Instructions Give 75 g of RED CELL, once a day (sid) for 365 days. Start treatment on 01/01/2016 Administration route: Oral (p.o.) Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 29/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 29/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 11M 1D ~ Notes/Comments Keepers report this animal has returned to normal. They have observed, through overnight video monitoring, this animal lay down on its right side twice in the past week and stand without assistance. Examination of animal in stall. It was bright, alert, and active. The swelling on the right foreleg has reduced to a small pocket on the caudal elbow. All other edema has resolved. The hindleg was not palpated due to position, but edema also appears to have resolved. Will plan to not continue firocoxib at this time. Keepers to Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 10 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology monitor. Complete blood count: Recheck slide evaluation performed and toxic changes are still reported. This animal does not have clinical illness that would be expected to cause this, will evaluate laboratory methods to ensure correct findings. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 11M 1D Test Request Detail Sample Quality Date Requested 29/12/2015 Color ~ Requested By Gretchen Cole Color Intensity ~ Analysis Start Date & Time Analysis By 29/12/2015 15:39 Julia Jones Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample VetScan HM5 No Additional Characteristics Degraded ~ No Notes/Comments Slide Evaluation: Bilobed Monocytes [m]: 31% Target Cells seen Toxic heterophils: 1+tox(6/28); 2+tox(2/28) Test Requests & Test Results Excld. from RI Reviewed ~ No No ~ No No 16.5 ~ No No 25.6 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 ~ No No ~ 28.0 40.1 ~ No No 16.9 % ~ ~ ~ ~ ~ No Platelets 156 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.11 % ~ ~ ~ ~ ~ No Mean Plate. Vol. 6.9 fL ~ ~ ~ ~ No No PDW-cv 29.6 % ~ ~ ~ ~ ~ No Neutrophil % [m] 28 % ~ ~ ~ ~ No No Lymphocyte % 12 % [m] ~ ~ ~ ~ No No Monocyte % [m] 29 % ~ ~ ~ ~ No No Anisocytosis few (2+) ~ ~ ~ ~ ~ No Poikilocytosis few (2+) ~ ~ ~ ~ ~ No Polychromasia rare (1+) ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 16.09 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.66 *10^12 cells/L ~ 2.15 3.98 HGB [a] 12.8 g/dL ~ 8.7 HCT [a] 34.17 % ~ MCV 129 fL ~ MCH [a] 48.1 pg MCHC 37.4 g/dL RDW Sample Detail (GSN: S-WCD16-040613) Collection Date/Time Sample Type 29/12/2015 00:00 Whole Blood Collection Method Collected By Phlebotomy Keeper Staff Anatomical Source/Tissue EAR VEIN Reason Recheck/Follow-up Additives/Preservatives Exclude from reference intervals No EDTA, Potassium Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 11 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology 25/12/2015 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 27D Basic Info Weight Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 24/12/2015 25/12/2015 00:00 Gretchen Cole 1 animal ~ ~ ~ Date 24/12/2015 Measurement Value Estimate 3,405 kg Yes Exclude From Reference Intervals Yes Treatment Detail Treatment Item/Drug Firocoxib (227 mg Solid > Tablet) (Firocoxib) Dose Amount Dosage Amount 454 mg 0.133 mg/kg Frequency Duration Administrated Dose 2 count Quantity Form Of Drug Tablet once a day (sid) 5doses Delivery Route Oral (p.o.) Loading Dose ~ Concentration Of Drug 227 mg Treatment Response Clinical Response ~ Adverse Effects ~ Adverse Effects Note: ~ Staff Instructions Give 454 mg [2 count] of Firocoxib, once a day (sid) for 5 doses. Start treatment on 25/12/2015 Administration route: Oral (p.o.) Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 24/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Printed: 05/02/2016 © 2015 International Species Information System Sex Oklahoma City Zoological Park Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 26D Page 12 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Date Time Note Author 24/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Notes/Comments Report End Date 01/02/2016 ~ Keepers report this animal has been doing well. Reviews of overnight video shows the animal lays down on its left side nightly and has no problems rising. There is swelling on the right fore and hindlegs over the bony prominences. It was palpated and found to be soft, fluctuant, and on the hindleg associated with increased warmth. This is not unexpected with the recent recumbency and will likely take a few weeks to resolve. Expect edema to move ventrally before resolving. Will continue firocoxib for 5 additional days. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 22/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 22/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 24D ~ Notes/Comments Keeper (KR) reported a swelling on right shoulder seen during morning bath. Animal visualized by JCJ and it was reported that there was an approximately 35cm x 15cm area of edema over the pressure point of the scapula. This is most likely due to the recumbency overnight 2 days ago. Edema will likely shift to gravity dependent area of the thorax and leg, then resolve spontaneously. Continue to monitor. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 21/12/2015 Clinical note Animal Type GAN Individual 21517980 Date Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Time Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 23D Note Author 21/12/2015 11:30 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex ~ Veterinary technician JCJ communicated with supervisor (NN) and reported that this animal was found recumbant overnight and was laying down for about 5 hours. Animal did get up in the AM (815am). Collected blood for chemistry analysis and if able will get blood for CBC in PM. Keepers to monitor Complete blood count: Normal leukogram with fewer toxic heterophils than recent samples. Chemistry: Improving elevation in creatine kinase, 710u/l, consistent with improving muscle injury after recumbency. Continue to monitor. Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 13 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 23D Test Request Detail Sample Quality Date Requested Requested By 21/12/2015 Gretchen Cole Color Color Intensity ~ ~ Analysis Start Date & Time Analysis By 21/12/2015 00:00 Julia Jones Clarity Consistency ~ ~ Analysis Equipment ~ Additional Characteristics ~ Insufficient Sample No Degraded No Notes/Comments 200 cell differential toxic heterophils: 1+ toxicity: 66% of the heterophils 2+ toxicity: 26% of the heterophils 3+ toxicity: 1.3% of the heterophils Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 14 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No ~ No No 16.5 ~ No No 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 High No No ~ 28.0 40.1 High No No 17 % ~ ~ ~ ~ ~ No Platelets 135 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.10 % ~ ~ ~ ~ ~ No Mean Plate. Vol. 7.0 fL ~ ~ ~ ~ No No PDW-cv 29.1 % ~ ~ ~ ~ ~ No Neutrophil % [m] 37.5 % ~ ~ ~ ~ No No Lymphocyte % 10.5 % [m] ~ ~ ~ ~ No No Monocyte % [m] 19.5 % ~ ~ ~ ~ No No Eosinophil % [m] 0% ~ ~ ~ ~ No No Basophil % [m] 0% ~ ~ ~ ~ No No HCT [m] 36 % ~ 25.6 47.9 ~ No No Est. Platelets adequate ~ ~ ~ ~ ~ No Anisocytosis rare (1+) ~ ~ ~ ~ ~ No Polychromasia rare (1+) ~ ~ ~ ~ ~ No Poikilocytosis rare (1+) ~ ~ ~ ~ ~ No Target Cells ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 18.34 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.58 *10^12 cells/L ~ 2.15 3.98 HGB [a] 13.8 g/dL ~ 8.7 HCT [a] 32.99 % ~ 25.6 MCV 128 fL ~ MCH [a] 53.4 pg MCHC 41.7 g/dL RDW few (2+) Sample Detail (GSN: S-WCD15-040588) Collection Date/Time Sample Type 21/12/2015 00:00 Whole Blood Anatomical Source/Tissue EAR VEIN Additives/Preservatives EDTA Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Recheck/Follow-up No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 23D Test Request Detail Sample Quality Date Requested Requested By Analysis Start Date & Time Analysis By 21/12/2015 Gretchen Cole 21/12/2015 00:00 Julia Jones Color Color Intensity Clarity Consistency Colorless ~ Clear ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 15 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No 270 Low No No 0 31 ~ No No ~ 414 7,023 ~ No No Tot. Bili. 0.3 mg/dL ~ 0.1 0.6 ~ No No BUN 11 mg/dL ~ 6.0 20.0 ~ No No Ca 9.3 mg/dL ~ 9.2 12.0 ~ No No Phos 3.6 mg/dL ~ 3.1 7.4 ~ No No Creat [a] 1.2 mg/dL ~ 0.8 2.3 ~ No No Glucose 111 mg/dL ~ 51 131 ~ No No Na 120 mmol/L ~ 123 141 Low No No K 4.5 mmol/L ~ 3.8 5.8 ~ No No Total Protein 7.6 g/dL ~ 6.5 9.6 ~ No No Globulin 4.6 g/dL ~ 3.0 6.5 ~ No No Test Primary Result Secondary Result Low RI High RI Evaluation Albumin 3.0 g/dL ~ 2.3 4.2 Alk. Phos. [a] 37 U/L ~ 44 ALT 9 U/L ~ Amylase 5,500 U/L [a] Sample Detail (GSN: S-WCD15-040587) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 21/12/2015 00:00 Serum EAR VEIN ~ Collection Method Collected By Reason Exclude from reference intervals Phlebotomy Keeper Staff Recheck/Follow-up No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 23D Test Request Detail Sample Quality Date Requested Requested By 21/12/2015 Gretchen Cole Color Color Intensity Colorless ~ Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample 21/12/2015 00:00 Julia Jones ~ No Clarity Consistency Additional Characteristics Degraded Clear ~ ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 16 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Albumin 4.7 g/dL ~ 2.3 4.2 High No No Alk. Phos. [a] 33 U/L ~ 44 270 Low No No AST [a] 29 U/L ~ 6 38 ~ No No Ca ~ 9.2 12.0 ~ No No GGT [a] 0 U/L ~ 1 15 Low No No Total 7.6 g/dL Protein ~ 6.5 9.6 ~ No No Globulin 2.9 g/dL ~ 3.0 6.5 Low No No BUN 11 mg/dL ~ 6.0 20.0 ~ No No CK [a] 710 U/L ~ 53 461 High No No Phos 3.8 mg/dL ~ 3.1 7.4 ~ No No Mg 2.1 mg/dL ~ 1.62 2.94 ~ No No 9.2 mg/dL Reviewed Sample Detail (GSN: S-WCD15-040587-S01) Collection Date/Time Sample Type 21/12/2015 00:00 Serum Anatomical Source/Tissue EAR VEIN Additives/Preservatives ~ Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Recheck/Follow-up No 20/12/2015 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 22D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment Weight Info 20/12/2015 20/12/2015 00:00 Jennifer D'Agostino 1 animal ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Date Measurement Value 20/12/2015 3,405 kg Estimate Exclude From Reference Intervals Yes Yes Oklahoma City Zoological Park Page 17 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Treatment Detail Treatment Item/Drug Cosequin Equine (726.7 mg/g Solid > Powder) (Chondroitin sulfate (Nutriceutical Grade); Glucosamine Hydrochloride (Nutriceutical Grade)) (NUTRAMAX) Dose Amount Dosage Amount 25,200 mg 7.401 mg/kg Administrated Dose 34.677 g Quantity Frequency Duration twice a day (bid) 30days Delivery Route Loading Dose Oral (p.o.) ~ Form Of Drug Powder Concentration Of Drug 726.7 mg/g Treatment Response Clinical Response Adverse Effects Adverse Effects Note: ~ ~ ~ Staff Instructions Give 10 scoops orally twice daily for 30 days. Prescription Notes/Comments 10 scoops twice daily for loading dose Calendar Items Date Title Assigned To Done 18/01/2016 776414 / Asian elephant / 21517980 Cosequin Equine treatment is complete Jennifer D'Agostino No Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 19/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 19/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 21D ~ Keepers report that this animal did well overnight and did lay down to sleep on its left side and was able to rise on its own. Today this animal did well throughout the day on exhibit. Visual examination confirmed animal to be bright, alert, and active. Fecal boluses were moderately larger than normal, but not surprising after yesterday's stress and with the recent dental attrition. Complete blood count: Normal leukogram with persistent of toxic heterophils. Chemistry: Increased creatine kinase, 1066 u/l. This is a moderate increase and is consistent with muscle injury from being recumbent yesterday. No other significant findings. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 18 of 75 Report Start Date 31/01/2015 Animal Type Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 21D Test Request Detail Sample Quality Date Requested Requested By Analysis Start Date & Time Analysis By 19/12/2015 Gretchen Cole 19/12/2015 00:00 Liz McCrae Color Color Intensity Clarity Consistency ~ ~ ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments Bi-lobed monocytes: 36.5% Heterophil Toxicity: 1+ toxicity: 19% of the heterophils; 2+ toxicity:15% of heterophils; 3+ toxcity:5.7% of heterophils Test Requests & Test Results Excld. from RI Reviewed ~ No No 3.98 ~ No No 16.5 ~ No No 25.6 47.9 ~ No No ~ 94.8 143.9 ~ No No ~ 31 50 High No No 39.7 g/dL ~ 28.0 40.1 ~ No No RDW 17 % ~ ~ ~ ~ ~ No Platelets 126 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.09 % ~ ~ ~ ~ ~ No Mean Plate. Vol. 6.8 fL ~ ~ ~ ~ No No PDW-cv 28.5 % ~ ~ ~ ~ ~ No Neutrophil % [m] 26 % ~ ~ ~ ~ No No Lymphocyte % 19 % [m] ~ ~ ~ ~ No No Monocyte % [m] 18.5 % ~ ~ ~ ~ No No Eosinophil % [m] 0% ~ ~ ~ ~ No No Basophil % [m] 0% ~ ~ ~ ~ No No HCT [m] 37 % ~ 25.6 47.9 ~ No No Est. Platelets adequate ~ ~ ~ ~ ~ No Reactive Lymph % [m] 0.5 % ~ ~ ~ ~ ~ No Anisocytosis rare (1+) ~ ~ ~ ~ ~ No Poikilocytosis rare (1+) ~ ~ ~ ~ ~ No Polychromasia rare (1+) ~ ~ ~ ~ ~ No Target Cells ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 17.82 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.69 *10^12 cells/L ~ 2.15 HGB [a] 13.6 g/dL ~ 8.7 HCT [a] 34.17 % ~ MCV 127 fL MCH [a] 50.3 pg MCHC rare (1+) Sample Detail (GSN: S-WCD15-040579) Collection Date/Time Sample Type 19/12/2015 00:00 Whole Blood Anatomical Source/Tissue EAR VEIN Additives/Preservatives EDTA Printed: 05/02/2016 © 2015 International Species Information System Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Diagnostic No Oklahoma City Zoological Park Page 19 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 21D Test Request Detail Sample Quality Date Requested Requested By Analysis Start Date & Time Analysis By Analysis Equipment 19/12/2015 Gretchen Cole 19/12/2015 00:00 Liz McCrae ~ Color Color Intensity Clarity Consistency Additional Characteristics ~ ~ ~ ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Albumin 4.6 g/dL ~ 2.3 4.2 High No No Alk. Phos. [a] 43 U/L ~ 44 270 Low No No AST [a] 40 U/L ~ 6 38 High No No Ca ~ 9.2 12.0 ~ No No GGT [a] 5 U/L ~ 1 15 ~ No No Total 8.4 g/dL Protein ~ 6.5 9.6 ~ No No Globulin 3.8 g/dL ~ 3.0 6.5 ~ No No BUN 10 mg/dL ~ 6.0 20.0 ~ No No CK [a] 1,066 U/L ~ 53 461 High No No Phos 3.3 mg/dL ~ 3.1 7.4 ~ No No Mg 2.3 mg/dL ~ 1.62 2.94 ~ No No 9.7 mg/dL Reviewed Sample Detail (GSN: S-WCD15-040578-S01) Collection Date/Time Sample Type 19/12/2015 00:00 Plasma Anatomical Source/Tissue EAR VEIN Additives/Preservatives Heparin, Lithium Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Diagnostic No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 21D Test Request Detail Sample Quality Date Requested Requested By Analysis Start Date & Time Analysis By 19/12/2015 Gretchen Cole 19/12/2015 00:00 Liz McCrae Color Color Intensity Clarity Consistency ~ ~ ~ ~ Analysis Equipment Insufficient Sample VetScan VS2 No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 20 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No 270 Low No No 0 31 ~ No No ~ 414 7,023 ~ No No Tot. Bili. 0.3 mg/dL ~ 0.1 0.6 ~ No No BUN 9 mg/dL ~ 6.0 20.0 ~ No No Ca 9.5 mg/dL ~ 9.2 12.0 ~ No No Phos 3.3 mg/dL ~ 3.1 7.4 ~ No No Creat [a] 1.5 mg/dL ~ 0.8 2.3 ~ No No Glucose 88 mg/dL ~ 51 131 ~ No No Na 122 mmol/L ~ 123 141 Low No No K 4.5 mmol/L ~ 3.8 5.8 ~ No No Total Protein 8.6 g/dL ~ 6.5 9.6 ~ No No Globulin 5.6 g/dL ~ 3.0 6.5 ~ No No Total Protein (R) ~ 6.5 9.6 ~ No No Test Primary Result Secondary Result Low RI High RI Evaluation Albumin 2.9 g/dL ~ 2.3 4.2 Alk. Phos. [a] 32 U/L ~ 44 ALT 12 U/L ~ Amylase 5,500 U/L [a] 9.0 g/dL Sample Detail (GSN: S-WCD15-040578) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 19/12/2015 00:00 Plasma EAR VEIN Heparin, Lithium Collection Method Collected By Reason Exclude from reference intervals Phlebotomy Keeper Staff Diagnostic No 18/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 18/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D LATERAL RECUMBENCY Note Subtype: General Notes/Comments Keepers reported finding this animal recumbent and unable to rise. They reviewed overnight video monitoring and determined it had laid down at approximately 0545 and was seen attempting to rise without success. Visual observation of animal in stall. It was alert but quiet and in right lateral recumbency. It was responsive to keepers and would accept food with ease. Using sling and hoist animal was lifted using previously described procedure into standing position without difficulty. From there it transferred to another stall and was alert and bright, participating in an examination and bath. Pulse (left ear): 40 beats/minute. Eyes: clear. Oral cavity: pink mucous membranes, upper right molar eruption is visible. Integument: normal, no external injury found. Musculoskeletal: Evaluated the right fore and hindlegs with palpation. There was minor swelling over the right front digit 3 over P1 and P2. Palpation did not elicit a pain withdrawal and is likely a secondary injury from the time the animal was laying down and attempting to rise. Abdomen: There was decreased abdominal fill noted initially after rising. As animal eats the morning food this will likely resolve. Ultrasound: Peformed cardiac evaluation from the left thorax, with leg lifted on a box in a forward position. Was able to visualize the ventricles well and observed normal contractility, no pericardial effusion. Unable to evaluate heart base or atria. Heart rate: 45 beats/minute. This is elevated for this animal, but is likely due to stress of being recumbent. Complete blood count: Normal leukogram, but noted toxic heterophils in decreasing proportion from earlier this week. This can be due to inflammation or infection in the body. Chemistry: Mild increase in creatine kinase, 775 u/l. This is consistent with its most recent chemistry following assisted standing. Likely mild muscular inflammation from todays recumbency. Fibrinogen: normal. Protein electrophoresis: There are no normal values for protein electrophoresis for elephants, but the total protein and albumin/globulin ratio are normal. Compared to one conspecific 776313, that has had many samples evaluated by this technique there is a mild increase in the Beta-1 fraction. In other mammals this can be due to change in transferrin concentration, but it is unknown in an elephant. This animal does not currently demonstrate other symptoms of iron-binding disease. Will prescribe oral antiinflammatory medication and monitor. Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 21 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Addendum: Keepers reported this animal continued to do well through the morning and is standing and eating. At 1330, animal was alert, active, and participated well during radiographic examination. Abdominal fill has returned to normal. Radiographs: Obtained radiographs of right fore and hind legs from feet to the highest point possible (humeroulnar and femorotibial joints). There was mild to moderate osteoarthritis of the carpus and tarsus. This is consistent with aging. No fractures seen. There is no radiographically evident cause for this animal's difficulty standing from a right lateral position. Assessment: This elephant has had two episodes of inability to rise this week. Both times it was on the right side. Examinations have not determined the cause. Once animal is elevated it immediately resumes normal activity and attitude. As there is no obvious causes, suspect a soft-tissue injury such as a strain or sprain that limits mobility from that position. Treatment with antiinflammatory and rest is the ideal treatment at this time. Continue to monitor. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment Weight Info 18/12/2015 18/12/2015 00:00 Gretchen Cole 1 animal ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Date Measurement Value 18/12/2015 3,405 kg Estimate Exclude From Reference Intervals Yes Yes Oklahoma City Zoological Park Page 22 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Treatment Detail Treatment Item/Drug Firocoxib (227 mg Solid > Tablet) (Firocoxib) Dose Amount Dosage Amount 454 mg 0.133 mg/kg Administrated Dose 2 count Quantity Frequency Duration once a day (sid) 7doses Delivery Route Loading Dose Oral (p.o.) ~ Form Of Drug Tablet Concentration Of Drug 227 mg Treatment Response Clinical Response Adverse Effects ~ ~ Adverse Effects Note: ~ Staff Instructions Give 454 mg [2 count] of Firocoxib, once a day (sid) for 7 doses. Start treatment on 18/12/2015 Administration route: Oral (p.o.) Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done 24/12/2015 776414 / Asian elephant / 21517980 Firocoxib treatment is complete Gretchen Cole No Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D Test Request Detail Sample Quality Date Requested 18/12/2015 Color Colorless Requested By Analysis Start Date & Time Gretchen Cole 18/12/2015 10:09 Color Intensity Clarity ~ Clear Analysis By Analysis Equipment Liz McCrae VetScan VS2 Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 23 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Albumin 3.1 g/dL ~ 2.3 4.2 ~ No No Alk. Phos. [a] 37 U/L ~ 44 270 Low No No AST [a] 33 U/L ~ 6 38 ~ No No Ca ~ 9.2 12.0 ~ No No GGT [a] 3 U/L ~ 1 15 ~ No No Total 8.3 g/dL Protein ~ 6.5 9.6 ~ No No Globulin 5.2 g/dL ~ 3.0 6.5 ~ No No BUN 10 mg/dL ~ 6.0 20.0 ~ No No CK [a] 775 U/L ~ 53 461 High No No Phos 3.6 mg/dL ~ 3.1 7.4 ~ No No Mg 2.1 mg/dL ~ 1.62 2.94 ~ No No 9.5 mg/dL Reviewed Sample Detail (GSN: S-WCD15-040582-S01) Collection Date/Time 18/12/2015 09:06 Collection Method Phlebotomy Sample Type Plasma Anatomical Source/Tissue EAR VEIN Collected By Reason Keeper Staff Diagnostic Additives/Preservatives Exclude from reference intervals No Heparin, Lithium Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D Test Request Detail Sample Quality Date Requested 18/12/2015 Color ~ Requested By Laboratory Analysis Start Date Gretchen Cole ANTECH 18/12/2015 Color Intensity Clarity Consistency ~ ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ANTECH Accession No. DLBC45649674 Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 24 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed Total 8.1 g/dL Protein ~ 6.5 9.6 ~ No No Albumin 3.2 g/dL EPH ~ ~ ~ ~ No No Total Globulin 4.9 g/dL EPH ~ ~ ~ ~ ~ No α­1 Globulin 0.9 g/dL EPH ~ ~ ~ ~ No No α­2 Globulin 0.7 g/dL EPH ~ ~ ~ ~ No No β­1 Globulin 2.3 g/dL EPH ~ ~ ~ ~ ~ No γ Globulin 1.0 g/dL EPH ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-040581) Collection Date/Time 18/12/2015 09:06 Collection Method Phlebotomy Sample Type Serum Collected By Keeper Staff Anatomical Source/Tissue EAR VEIN Reason Diagnostic Additives/Preservatives Exclude from reference intervals No ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D Test Request Detail Date Requested Requested By Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample Sample Quality 18/12/2015 Gretchen Cole 18/12/2015 10:00 Liz McCrae VetScan HM5 No Color Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ ~ No Notes/Comments Slide Evaluation: Bilobed Monocytes [m]: 17% 1 nucleated red blood cell seen. Most heterophils are toxic, some with less basophilic granules than her previous sample. Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 25 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No ~ No No 16.5 ~ No No 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 ~ No No ~ 28.0 40.1 ~ No No 17.1 % ~ ~ ~ ~ ~ No Platelets 141 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.09 % ~ ~ ~ ~ ~ No Mean Plate. Vol. 6.7 fL ~ ~ ~ ~ No No PDW-cv 29.1 % ~ ~ ~ ~ ~ No Neutrophil % [m] 43 % ~ ~ ~ ~ No No Lymphocyte % [m] 2% ~ ~ ~ ~ No No Monocyte % [m] 38 % ~ ~ ~ ~ No No HCT [m] 38 % ~ 25.6 47.9 ~ No No Anisocytosis moderate (3+) Test Primary Result Secondary Result Low RI High RI Evaluation WBC 18.73 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.91 *10^12 cells/L ~ 2.15 3.98 HGB [a] 14.2 g/dL ~ 8.7 HCT [a] 37.27 % ~ 25.6 MCV 128 fL ~ MCH [a] 48.7 pg MCHC 38.0 g/dL RDW ~ ~ ~ ~ ~ No Poikilocytosis rare (1+) ~ ~ ~ ~ ~ No Target Cells ~ ~ ~ ~ ~ No few (2+) Sample Detail (GSN: S-WCD15-040583) Collection Date/Time Sample Type 18/12/2015 09:06 Whole Blood Collection Method Collected By Phlebotomy Keeper Staff Anatomical Source/Tissue EAR VEIN Reason Diagnostic Additives/Preservatives Exclude from reference intervals No EDTA, Potassium Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D Test Request Detail Date Requested Requested By Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample Sample Quality 18/12/2015 Gretchen Cole 18/12/2015 09:55 Liz McCrae VetScan VS2 No Color Color Intensity Clarity Consistency Additional Characteristics Degraded Colorless ~ Clear ~ ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 26 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No 270 ~ No No 0 31 ~ No No ~ 414 7,023 ~ No No Tot. Bili. 0.4 mg/dL ~ 0.1 0.6 ~ No No BUN 9 mg/dL ~ 6.0 20.0 ~ No No Ca 9.3 mg/dL ~ 9.2 12.0 ~ No No Phos 3.7 mg/dL ~ 3.1 7.4 ~ No No Creat [a] 1.4 mg/dL ~ 0.8 2.3 ~ No No Glucose 105 mg/dL ~ 51 131 ~ No No Na 122 mmol/L ~ 123 141 Low No No K 3.7 mmol/L ~ 3.8 5.8 Low No No Total Protein 8.6 g/dL ~ 6.5 9.6 ~ No No Globulin 5.6 g/dL ~ 3.0 6.5 ~ No No Total Protein (R) ~ 6.5 9.6 ~ No No Test Primary Result Secondary Result Low RI High RI Evaluation Albumin 3.0 g/dL ~ 2.3 4.2 Alk. Phos. [a] 45 U/L ~ 44 ALT 8 U/L ~ Amylase >5500 U/L [a] 8.8 g/dL Sample Detail (GSN: S-WCD15-040582) Collection Date/Time Sample Type 18/12/2015 09:06 Plasma Collection Method Collected By Phlebotomy Keeper Staff Anatomical Source/Tissue EAR VEIN Reason Diagnostic Additives/Preservatives Exclude from reference intervals No Heparin, Lithium Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 20D Test Request Detail Date Requested Requested By Laboratory Analysis Start Date Analysis Equipment Insufficient Sample Sample Quality 18/12/2015 Gretchen Cole ANTECH 18/12/2015 ~ No Color Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ ~ No Notes/Comments ANTECH Accession No. DLBC45649674 Test Requests & Test Results Test Primary Result Fibrinogen 369 mg/dL [a] Secondary Result Low RI High RI Evaluation ~ 1 927 ~ Excld. from RI Reviewed No No Sample Detail (GSN: S-WCD15-040584) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 18/12/2015 09:06 Plasma EAR VEIN Citrate Printed: 05/02/2016 © 2015 International Species Information System Collection Method Collected By Reason Exclude from reference intervals Oklahoma City Zoological Park Phlebotomy Keeper Staff Diagnostic No Page 27 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 15/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 15/12/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 17D ~ This morning Chai is alert and active. Appetite remains normal and feces and urination remain normal. She appears to be moving very well and has no further muscle fasciculations noted. She is participating in training sessions and interacting with keepers normally. Oral exam shows normal, pink mucous membranes. there is some food material in the empty tooth socket but keepers are keeping it flushed out daily. Plan to put her with the herd today and allow normal access outdoors. Blood collected for repeat CBC/Chemistry and objective body condition scoring performed. Body condition is slightly thin and lies between 3-4/9 depending on which scoring method is used. Plan to increase diet slightly with the goal of increasing her body weight approximately 300-400 pounds. Addendum: Bloodwork remains normal. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 17D Test Request Detail Sample Quality Date Requested 15/12/2015 Color ~ Requested By Analysis Start Date & Time Analysis By Jennifer D'Agostino 15/12/2015 00:00 Liz McCrae Color Intensity Clarity Consistency ~ ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 28 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No 270 ~ No No 0 31 ~ No No ~ 414 7,023 ~ No No Tot. Bili. 0.3 mg/dL ~ 0.1 0.6 ~ No No BUN 7 mg/dL ~ 6.0 20.0 ~ No No Ca 9.9 mg/dL ~ 9.2 12.0 ~ No No Phos 2.6 mg/dL ~ 3.1 7.4 Low No No Creat [a] 1.5 mg/dL ~ 0.8 2.3 ~ No No Glucose 101 mg/dL ~ 51 131 ~ No No Na 125 mmol/L ~ 123 141 ~ No No K 4.7 mmol/L ~ 3.8 5.8 ~ No No Total Protein 7.9 g/dL ~ 6.5 9.6 ~ No No Globulin 4.8 g/dL ~ 3.0 6.5 ~ No No Test Primary Result Secondary Result Low RI High RI Evaluation Albumin 3.1 g/dL ~ 2.3 4.2 Alk. Phos. [a] 49 U/L ~ 44 ALT 9 U/L ~ Amylase 5,500 U/L [a] Sample Detail (GSN: S-WCD15-040558) Collection Date/Time 15/12/2015 00:00 Sample Type Serum Anatomical Source/Tissue EAR VEIN Collection Method Collected By Reason Phlebotomy Julia Jones Recheck/Follow-up Additives/Preservatives Exclude from reference intervals No ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 17D Test Request Detail Sample Quality Date Requested Requested By 15/12/2015 Jennifer D'Agostino Color Color Intensity ~ ~ Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample 15/12/2015 00:00 Jennifer D'Agostino ~ No Clarity Consistency Additional Characteristics Degraded ~ ~ ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 29 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Albumin 3.3 g/dL ~ 2.3 4.2 ~ No No Alk. Phos. [a] 37 U/L ~ 44 270 Low No No AST [a] 35 U/L ~ 6 38 ~ No No Ca ~ 9.2 12.0 ~ No No GGT [a] 5 U/L ~ 1 15 ~ No No Total 7.8 g/dL Protein ~ 6.5 9.6 ~ No No Globulin 4.5 g/dL ~ 3.0 6.5 ~ No No BUN 7 mg/dL ~ 6.0 20.0 ~ No No CK [a] 726 U/L ~ 53 461 High No No Phos 2.1 mg/dL ~ 3.1 7.4 Low No No Mg 2.6 mg/dL ~ 1.62 2.94 ~ No No 10.1 mg/dL Reviewed Sample Detail (GSN: S-WCD15-040558-S01) Collection Date/Time 15/12/2015 00:00 Sample Type Serum Anatomical Source/Tissue EAR VEIN Additives/Preservatives ~ Collection Method Phlebotomy Collected By Reason Exclude from reference intervals Julia Jones Recheck/Follow-up No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 17D Test Request Detail Sample Quality Date Requested 15/12/2015 Color ~ Requested By Analysis Start Date & Time Analysis By Jennifer D'Agostino 15/12/2015 00:00 Liz McCrae Color Intensity Clarity Consistency ~ ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments bi-lobed monocytes: 31% Total Proein: 8.5g/dl Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 30 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No ~ No No 16.5 ~ No No 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 High No No ~ 28.0 40.1 High No No 16.3 % ~ ~ ~ ~ ~ No Platelets 141 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.10 % ~ ~ ~ ~ ~ No Mean Plate. Vol. 7 fL ~ ~ ~ ~ No No PDW-cv 29.1 % ~ ~ ~ ~ ~ No Neutrophil % [m] 34 % ~ ~ ~ ~ No No Lymphocyte % 19 % [m] ~ ~ ~ ~ No No Monocyte % [m] 15 % ~ ~ ~ ~ No No Eosinophil % [m] 1% ~ ~ ~ ~ No No Basophil % [m] 0% ~ ~ ~ ~ No No HCT [m] 38 % ~ 25.6 47.9 ~ No No Est. Platelets adequate ~ ~ ~ ~ ~ No Anisocytosis rare (1+) ~ ~ ~ ~ ~ No Poikilocytosis rare (1+) ~ ~ ~ ~ ~ No Polychromasia rare (1+) ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 19.05 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.61 *10^12 cells/L ~ 2.15 3.98 HGB [a] 15 g/dL ~ 8.7 HCT [a] 33.29 % ~ 25.6 MCV 128 fL ~ MCH [a] 57.7 pg MCHC 45.2 g/dL RDW Sample Detail (GSN: S-WCD15-040557) Collection Date/Time 15/12/2015 00:00 Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN Collection Method Collected By Reason Phlebotomy Julia Jones Recheck/Follow-up Additives/Preservatives Exclude from reference intervals No EDTA 14/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 14/12/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D ~ Notes/Comments Problem: This morning Chai appeared completely normal in behavior, attitude and appetite. During routine morning bath and training session, keeper asked Chai to lay down which is part of the normal routine. Today he had her lay on her right side when normally she is asked to lay on her left side. After the bath was complete she appeared to be unwilling or unable to rise and vet staff was alerted. After about 15 minutes, Asha and Chandra were allowed access to her stall in an effort to have them assist her in geting up. Chandra tried to help Chai get up but Chai was uncooperative, started to vocalize and was still not able to rise. At that time, all other elephants were shifted into the exhibit yard for the day and staff immediately started to assist Chai. Exam: Visual examination performed and showed slight lethargy although she continued to respond relatively well to keepers. Eyes were normal but she tended to hold them closed. Mucous membranes were pale and slightly blue/purple in color. Respirations were normal in frequency but appear somewhat labored. There were no external lesions Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 31 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology noted and feet were normal. Chai passed several piles of normal feces this morning before and during her bath. While assisting her she did pass some liquid diarrhea. Urine appears normal. All four limbs and trunk have normal voluntary motion. Chai did try several times to get up on her own but appeared unable to lift her head enough to get to a sternal position. Assist procedure: Straps were placed under her shoulder and hip and attached to the hoist. The hoist was gently elevated lifting Chai to a sitting position. Once she was in a sitting position she was able to get her feet under her and stood readily. She was able to extricate herself from the straps quickly and started walking around the stall. Keepers shifted her to the adjoining stall and further examination was completed. Mucous membrane quickly returned to a normal pink coloration, respirations returned to normal. On oral exam it was noted that she lost a tooth last night in the upper right quadrant and the socket appears normal. There was some muscle fasciculations in the hind limbs and she seemed a bit more weak than normal when asked to raise her trunk. She did immediately eat food and participated in training allowing keepers to get blood samples and trunk wash for diagnostic analysis. Diagnostics: 1) Blood collected for CBC/Chemistry/I-stat/Fibrinogen/EEHV screening 2) Trunk wash collected for EEHV screening Plan: It is unclear what caused her inability to rise. No physical abnormalities were detected. It is possible that she is not able to sit up as easily from her right side as from her left. The muscle weakness noted could have been part of the cause of her inability to rise or fatigue from the efforts of trying to get up. Plan to keep her inside the barn today for rest and observation. Addendum: At the end of the day Chai is doing much better and has basically returned to normal, other than being slightly slow to shift to adjacent stall this afternoon. She is eating very well and has had no more muscle weakness or fasciculations. Feces and urine are normal. Bloodwork is unremarkable. Plan to repeat bloodwork tomorrow. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Test Request Detail Sample Quality Date Requested 14/12/2015 Color ~ Requested By Jennifer D'Agostino Color Intensity ~ Laboratory Analysis Start Date ANTECH 15/12/2015 Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments antech Accession #: DLBC45557572 Test Requests & Test Results Test Primary Result Fibrinogen 311 mg/dL [a] Secondary Result Low RI High RI Evaluation ~ 1 927 ~ Excld. from RI Reviewed No No Sample Detail (GSN: S-WCD15-040553) Collection Date/Time 14/12/2015 00:00 Collection Method Phlebotomy Sample Type Plasma Collected By Keeper Staff Reason Exclude from reference intervals Diagnostic No Anatomical Source/Tissue EAR VEIN Additives/Preservatives EDTA Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 32 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Request Detail Sample Quality Date Requested Requested By 14/12/2015 Jennifer D'Agostino Color Color Intensity Colorless light Analysis Start Date & Time Analysis By 14/12/2015 00:00 Julia Jones Clarity Consistency Clear ~ Analysis Equipment VetScan VS2 Additional Characteristics ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Albumin 4.5 g/dL ~ 2.3 4.2 High No No Alk. Phos. [a] 32 U/L ~ 44 270 Low No No AST [a] 30 U/L ~ 6 38 ~ No No Ca 9.7 mg/dL Reviewed ~ 9.2 12.0 ~ No No GGT [a] 2 U/L ~ 1 15 ~ No No Total 8.4 g/dL Protein ~ 6.5 9.6 ~ No No Globulin 4 g/dL ~ 3.0 6.5 ~ No No BUN 9 mg/dL ~ 6.0 20.0 ~ No No CK [a] 380 U/L ~ 53 461 ~ No No Phos 3.1 mg/dL ~ 3.1 7.4 ~ No No Mg 2.2 mg/dL ~ 1.62 2.94 ~ No No Sample Detail (GSN: S-WCD15-040550) Collection Date/Time Sample Type 14/12/2015 00:00 Plasma Anatomical Source/Tissue EAR VEIN Additives/Preservatives Heparin, Lithium Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Diagnostic No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Test Request Detail Sample Quality Date Requested Requested By 14/12/2015 Jennifer D'Agostino Color Color Intensity ~ ~ Analysis Start Date & Time 16/12/2015 00:00 Clarity ~ Analysis By Analysis Equipment Julia Jones VetScan HM5 Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Notes/Comments bi-lobed monocytes: 22% Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 33 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No ~ No No 16.5 ~ No No 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 High No No ~ 28.0 40.1 High No No 17 % ~ ~ ~ ~ ~ No Platelets 104 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.07 % ~ ~ ~ ~ ~ No Mean Plate. Vol. 6.9 fL ~ ~ ~ ~ No No PDW-cv 29.6 % ~ ~ ~ ~ ~ No Neutrophil % [m] 32 % ~ ~ ~ ~ No No Lymphocyte % 18 % [m] ~ ~ ~ ~ No No Monocyte % [m] 28 % ~ ~ ~ ~ No No Eosinophil % [m] 0% ~ ~ ~ ~ No No Basophil % [m] 0% ~ ~ ~ ~ No No HCT [m] 40 % ~ 25.6 47.9 ~ No No Est. Platelets adequate ~ ~ ~ ~ ~ No Anisocytosis rare (1+) ~ ~ ~ ~ ~ No Poikilocytosis rare (1+) ~ ~ ~ ~ ~ No Polychromasia rare (1+) ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 13.9 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.48 *10^12 cells/L ~ 2.15 3.98 HGB [a] 14.5 g/dL ~ 8.7 HCT [a] 31.64 % ~ 25.6 MCV 128 fL ~ MCH [a] 58.5 pg MCHC 45.8 g/dL RDW Sample Detail (GSN: S-WCD15-040549) Collection Date/Time Collection Method Phlebotomy Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN 14/12/2015 00:00 Collected By Reason Keeper Staff Diagnostic Additives/Preservatives Exclude from reference intervals No EDTA Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Test Request Detail Sample Quality Date Requested 14/12/2015 Color Colorless Requested By Analysis Start Date & Time Jennifer D'Agostino 14/12/2015 00:00 Color Intensity Clarity light Clear Analysis By Julia Jones Consistency ~ Analysis Equipment Insufficient Sample VetScan VS2 No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 34 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No 270 Low No No 0 31 ~ No No ~ 414 7,023 ~ No No Tot. Bili. 0.3 mg/dL ~ 0.1 0.6 ~ No No BUN 8 mg/dL ~ 6.0 20.0 ~ No No Ca 9.4 mg/dL ~ 9.2 12.0 ~ No No Phos 3.5 mg/dL ~ 3.1 7.4 ~ No No Creat [a] 1.0 mg/dL ~ 0.8 2.3 ~ No No Glucose 93 mg/dL ~ 51 131 ~ No No Na 120 mmol/L ~ 123 141 Low No No K 4.2 mmol/L ~ 3.8 5.8 ~ No No Total Protein 8.3 g/dL ~ 6.5 9.6 ~ No No Globulin 5.7 g/dL ~ 3.0 6.5 ~ No No Total Protein (R) ~ 6.5 9.6 ~ No No Test Primary Result Secondary Result Low RI High RI Evaluation Albumin 2.7 g/dL ~ 2.3 4.2 Alk. Phos. [a] 40 U/L ~ 44 ALT 9 U/L ~ Amylase 5,120 U/L [a] 8.8 g/dL Sample Detail (GSN: S-WCD15-040550-S01) Collection Date/Time Sample Type 14/12/2015 00:00 Plasma Collection Method Collected By Phlebotomy Keeper Staff Anatomical Source/Tissue EAR VEIN Reason Diagnostic Additives/Preservatives Exclude from reference intervals No Heparin, Lithium Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Test Request Detail Sample Quality Date Requested 14/12/2015 Color ~ Requested By Analysis Start Date & Time Jennifer D'Agostino 14/12/2015 00:00 Color Intensity Clarity ~ ~ Analysis By Analysis Equipment Julia Jones VetScan i-STAT 1 Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 35 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ ~ No ~ ~ No No ~ ~ ~ ~ No ~ ~ ~ ~ ~ No ~ ~ ~ ~ No No Total 30 mmol/L CO2 [a] ~ 18.5 31.1 ~ No No O2 sat (BGA) 99 % ~ ~ ~ ~ ~ No Na 125 mmol/L ~ 123 141 ~ No No K 3.6 mmol/L ~ 3.8 5.8 Low No No ion Ca++ 0.98 mmol/L ~ ~ ~ ~ No No Glucose 98 mg/dL ~ 51 131 ~ No No HCT [a] 40 % ~ 25.6 47.9 ~ No No HGB [a] 13.6 g/dL ~ 8.7 16.5 ~ No No Test Primary Result Secondary Result Low RI High RI Evaluation Arterial 7.470 pH pH ~ ~ ~ pCO2 39.4 mmHg ~ ~ Arterial 122 mmHg pO2 ~ Base 5 mmol/L Excess HCO3 28.7 mmol/L Sample Detail (GSN: S-WCD15-040552) Collection Date/Time Collection Method Phlebotomy Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN 14/12/2015 00:00 Collected By Reason Keeper Staff Diagnostic Additives/Preservatives Exclude from reference intervals No Heparin, Lithium Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Test Request Detail Sample Quality Date Requested 14/12/2015 Color ~ Requested By Laboratory Jennifer D'Agostino National Zoo Departm Color Intensity Clarity ~ ~ Analysis Start Date 17/12/2015 Consistency ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 36 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-040568) Collection Date/Time Sample Type 14/12/2015 00:00 Wash/Lavage Fluid Collection Method Collected By ~ Keeper Staff Anatomical Source/Tissue ~ Reason Diagnostic Additives/Preservatives Exclude from reference intervals No ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 16D Test Request Detail Sample Quality Date Requested 14/12/2015 Color ~ Requested By Laboratory Jennifer D'Agostino National Zoo Departm Color Intensity Clarity ~ ~ Analysis Start Date Analysis Equipment 15/12/2015 ~ Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Reviewed Page 37 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Sample Detail (GSN: S-WCD15-040549-S01) Collection Date/Time 14/12/2015 00:00 Collection Method Phlebotomy Sample Type Whole Blood Collected By Keeper Staff Reason Exclude from reference intervals Diagnostic No Anatomical Source/Tissue EAR VEIN Additives/Preservatives EDTA 10/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 10/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 12D ~ Notes/Comments Repeat fecal sample provided and it did not have an unusual odor today. Also provided urine for routine urinalysis: There was a low specific gravity on dipstick. All other values were normal. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 08/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 08/12/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 10D ~ Notes/Comments Routine CBC performed. Results are normal. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 10D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 38 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Request Detail Sample Quality Date Requested 08/12/2015 Color ~ Requested By Jennifer D'Agostino Color Intensity ~ Analysis Start Date & Time Analysis By 08/12/2015 11:50 Liz McCrae Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample VetScan HM5 No Additional Characteristics Degraded ~ No Notes/Comments Slide Evaluation: Bilobed Monocytes [m]: 19% Test Requests & Test Results Excld. from RI Reviewed ~ No No 3.98 ~ No No 16.5 ~ No No 25.6 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 High No No 44.8 g/dL ~ 28.0 40.1 High No No RDW 17.0 % ~ ~ ~ ~ ~ No Platelets 126 *10^9 cells/L ~ ~ ~ ~ No No Plateletcrit 0.08 % ~ ~ ~ ~ ~ No Mean Plate. 6.6 fL Vol. ~ ~ ~ ~ No No PDW-cv ~ ~ ~ ~ ~ No Neutrophil % 24 % [m] ~ ~ ~ ~ No No Lymphocyte 8% % [m] ~ ~ ~ ~ No No Monocyte % 48 % [m] ~ ~ ~ ~ No No Basophil % [m] 1% ~ ~ ~ ~ No No HCT [m] 37 % ~ 25.6 47.9 ~ No No Anisocytosis moderate (3+) ~ ~ ~ ~ ~ No Target Cells rare (1+) ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 16.73 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.38 *10^12 cells/L ~ 2.15 HGB [a] 13.6 g/dL ~ 8.7 HCT [a] 30.43 % ~ MCV 128 fL ~ MCH [a] 57.3 pg MCHC 27.2 % Sample Detail (GSN: S-WCD15-040503) Collection Date/Time Sample Type 08/12/2015 00:00 Whole Blood Anatomical Source/Tissue EAR VEIN Additives/Preservatives EDTA, Potassium Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Routine No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 10D Test Request Detail Sample Quality Date Requested Requested By 08/12/2015 Jennifer D'Agostino Color Color Intensity Colorless ~ Analysis Start Date & Time 08/12/2015 00:00 Clarity Clear Analysis By Analysis Equipment Liz McCrae ~ Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 39 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Notes/Comments ~ Test Requests & Test Results Test Primary Result Total Protein 8.6 g/dL (R) Secondary Result Low RI High RI Evaluation ~ 6.5 9.6 ~ Excld. from RI Reviewed No No Sample Detail (GSN: S-WCD15-040502) Collection Date/Time 08/12/2015 00:00 Collection Method Phlebotomy Sample Type Plasma Anatomical Source/Tissue EAR VEIN Collected By Reason Keeper Staff Routine Additives/Preservatives Exclude from reference intervals No EDTA, Potassium 03/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 03/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 5D ~ Notes/Comments In discussion with keeper staff about the atypical stool appearance, they mentioned that this animal has an abnormal tooth. Opportunistic examination of animal in yard. This animal's right maxillary molar is abnormal. It is placed more rostrally than the left maxillary molar, and both deviates medially and has a curvature. Unable to visualize lower teeth at this time, but I suspect that occlusal surfaces do not match. The left side appears normal. This may be the source of the different fibrous feed material in the stool. In discussion with staff, this tooth abnormality was known by the former keeper staff at this animal's previous institution and they said it had been that way for 20 years. With molar attrition, it is likely all teeth of this arcade are abnormal and this will continue to occur even when the next tooth erupts. No further monitoring of teeth needed unless staff notices a new problem. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 01/12/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 01/12/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 10M 3D ~ Notes/Comments Routine fecal examination was performed on this animal today. When compared to the conspecifics its stool had a longer stem length and sweeter smell. This may be due to a novel dietary addition or dental changes. Will continue to monitor. Animal Care Staff Medical Summary Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 40 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 10M 3D Test Request Detail Sample Quality Date Requested Requested By 01/12/2015 Gretchen Cole Color Color Intensity Brown/Tan ~ Analysis Start Date & Time 01/12/2015 00:00 Clarity ~ Analysis By Analysis Equipment Julia Jones ~ Consistency Additional Characteristics formed ~ Insufficient Sample No Degraded No Notes/Comments Sample Note: Sweet smelling, hay still very large, not chopped up. Test Requests & Test Results Excld. from Reviewed RI Test Primary Result Secondary Result Low RI High RI Evaluation Direct Exam. No parasites found ~ ~ ~ ~ ~ No Sheather’s/Centrifug No parasites found ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-040425) Collection Date/Time Collection Method Obtained off substrate Sample Type Feces Anatomical Source/Tissue ~ 01/12/2015 00:00 Collected By Reason Keeper Staff Routine Additives/Preservatives Exclude from reference intervals No ~ 12/11/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 12/11/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 9M 15D ~ Notes/Comments Received results of serum vitamin E analysis. This animal's result, 0.88 ug/ml is at the recommended level of 0.80ug/ml. Will discuss if additional supplementation is needed. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 07/11/2015 Clinical note Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 41 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex 776414 Elephas maximus/Asian Female elephant Date Time Note Author 07/11/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 9M 10D ~ Notes/Comments Keepers report this animal had been pushed into lateral recumbency yesterday by conspecific , during routine training demonstration. Animal made contact with hotwire and laid in lateral position for a minute before rising and returning to barn. They reported no swelling, lameness, or other visual injury. Visual examination of animal during morning training session. Animal was alert and active. Confirmed that animal was in good condition with no evidence of injury. Animal was eating, drinking, urinating, and defecating normally. Keepers to monitor. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 03/11/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 9M 6D Test Request Detail Sample Quality Date Requested Requested By 03/11/2015 Jennifer D'Agostino Color Color Intensity ~ ~ Laboratory Analysis Start Date MSU DCPAH 07/11/2015 Clarity Consistency ~ ~ Analysis Equipment ~ Additional Characteristics ~ Insufficient Sample No Degraded No Notes/Comments DCPAH Diagnostic Center for Population & Animal Health Report #: C15311005 Case Comments: In approximately 1000 elephant serum samples analyzed at DCPAH over the last five years the percentile values for serum vitamin E concentrations were 5th 0.23, 25th - 0.5, 50th - 0.81, 75th - 1.19, and 95th - 2.02 ug/mL. These were all clinical samples received for analysis; no health or diet information was available. Many were repeat samples from the same animal. Test Requests & Test Results Test Primary Result Vit. E 0.88 µg/ml HPLC Secondary Result Low RI High RI Evaluation ~ ~ ~ ~ Excld. from RI Reviewed ~ No Sample Detail (GSN: S-WCD15-040184) Collection Date/Time 03/11/2015 00:00 Collection Method Phlebotomy Sample Type Serum Anatomical Source/Tissue EAR VEIN Collected By Reason Keeper Staff Routine Additives/Preservatives Exclude from reference intervals No ~ 06/10/2015 Test & Result Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 42 of 75 Report Start Date 31/01/2015 Animal Type Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 8D Test Request Detail Sample Quality Date Requested Requested By 06/10/2015 Jennifer D'Agostino Color Color Intensity ~ ~ Laboratory Analysis Start Date National Zoo Departm 06/10/2015 Clarity Consistency ~ ~ Analysis Equipment ~ Additional Characteristics ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041352) Collection Date/Time Sample Type 06/10/2015 00:00 Whole Blood Anatomical Source/Tissue EAR VEIN Additives/Preservatives EDTA Collection Method Collected By Phlebotomy Keeper Staff Reason Exclude from reference intervals Routine No 05/10/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 7D Test Request Detail Sample Quality Date Requested 05/10/2015 Color ~ Requested By Laboratory Analysis Start Date Analysis Equipment Insufficient Sample Jennifer D'Agostino National Zoo Departm 05/10/2015 ~ No Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ No Notes/Comments ~ Test Requests & Test Results Test Primary Result EEHV 1 0 ge/ml qPCR Secondary Result Low RI High RI Evaluation ~ ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Excld. from RI ~ Reviewed No Page 43 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Sample Detail (GSN: S-WCD16-041350) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 05/10/2015 00:00 Whole Blood EAR VEIN EDTA Collection Method Collected By Reason Exclude from reference intervals Phlebotomy Keeper Staff Routine No 04/10/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 6D Test Request Detail Sample Quality Date Requested 04/10/2015 Color ~ Requested By Laboratory Analysis Start Date Analysis Equipment Insufficient Sample Jennifer D'Agostino National Zoo Departm 04/10/2015 ~ No Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ No Notes/Comments ~ Test Requests & Test Results Test Primary Result EEHV 1 0 ge/ml qPCR Secondary Result Low RI High RI Evaluation ~ ~ ~ ~ Excld. from RI Reviewed ~ No Sample Detail (GSN: S-WCD16-041349) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 04/10/2015 00:00 Whole Blood EAR VEIN EDTA Collection Method Collected By Reason Exclude from reference intervals Phlebotomy Keeper Staff Routine No 03/10/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 03/10/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 8M 5D ~ Routine complete blood count performed. Total white blood cell count, 15870 cells/mm3, was normal, but there was a relative monocytosis, 42%. This is only midly above a previous sample, which was 36% Animal is behaving normally. No treatment indicated at this time. Animal Care Staff Medical Summary ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 44 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 5D Test Request Detail Sample Quality Date Requested Requested By Laboratory Analysis Start Date Analysis Equipment 03/10/2015 Jennifer D'Agostino National Zoo Departm 03/10/2015 ~ Color Color Intensity Clarity Consistency Additional Characteristics ~ ~ ~ ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result EEHV 1 0 ge/ml qPCR Secondary Result Low RI High RI Evaluation ~ ~ ~ ~ Excld. from RI Reviewed ~ No Sample Detail (GSN: S-WCD15-039539-S01) Collection Date/Time 03/10/2015 00:00 Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN Collection Method Collected By Reason ~ Keeper Staff ~ Additives/Preservatives Exclude from reference intervals No ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 5D Test Request Detail Sample Quality Date Requested Requested By 03/10/2015 Gretchen Cole Color Color Intensity ~ ~ Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample 03/10/2015 00:00 Liz McCrae ~ No Clarity Consistency Additional Characteristics Degraded ~ ~ ~ No Notes/Comments Hets- 14% Bilobed -28% HCT- 37.5% Total Protein- 8.8g/dl occasional traget cells Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 45 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No ~ 10.31 ~ No ~ 0.000 9.227 ~ No ~ ~ 0.95 8.77 ~ No ~ ~ *10^9 cells/L ~ 0.000 0.830 ~ No ~ Basophil count [a] ~ *10^9 cells/L ~ 0.000 0.135 ~ No ~ Lymphocyte % [a] 12 % ~ ~ ~ ~ No Yes Monocyte % [a] 42 % ~ ~ ~ ~ No Yes Neutrophil % [a] ~% ~ ~ ~ ~ No ~ Eosinophil % 4% [a] ~ ~ ~ ~ No Yes Basophil % [a] ~% ~ ~ ~ ~ No ~ RBC [a] 2.51 *10^12 cells/L ~ 2.15 3.98 ~ No Yes HGB [a] 14.30 g/dL ~ 8.7 16.5 ~ No Yes HCT [a] 37.75 % ~ 25.6 47.9 ~ No Yes MCV 126 fL ~ 94.8 143.9 ~ No Yes MCH [a] 55.8 pg ~ 31 50 High No Yes MCHC 44.1 g/dL ~ 28.0 40.1 High No Yes RDW 17.1 % ~ ~ ~ ~ ~ Yes Platelets 110 *10^9 cells/L ~ ~ ~ ~ No Yes Plateletcrit 0.08 % ~ ~ ~ ~ ~ Yes Mean Plate. Vol. 6.9 fL ~ ~ ~ ~ No Yes PDW-cv 29.6 % ~ ~ ~ ~ ~ Yes Anisocytosis rare (1+) ~ ~ ~ ~ ~ Yes Poikilocytosis rare (1+) ~ ~ ~ ~ ~ Yes Test Primary Result Secondary Result Low RI High RI Evaluation WBC ~ *10^9 cells/L ~ 7.1 19.9 Lymphocyte count [a] ~ *10^9 cells/L ~ 0.38 Monocyte count [a] ~ *10^9 cells/L ~ Neutrophil count [a] ~ *10^9 cells/L Eosinophil count [a] Sample Detail (GSN: S-WCD15-039539) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 03/10/2015 00:00 Whole Blood EAR VEIN ~ Collection Method Collected By Reason Exclude from reference intervals ~ Keeper Staff ~ No 02/10/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 4D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 46 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Request Detail Sample Quality Date Requested 02/10/2015 Color ~ Requested By Laboratory Analysis Start Date Analysis Equipment Insufficient Sample Jennifer D'Agostino National Zoo Departm 02/10/2015 ~ No Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ No Notes/Comments ~ Test Requests & Test Results Test Primary Result EEHV 1 0 ge/ml qPCR Secondary Result Low RI High RI Evaluation ~ ~ ~ ~ Excld. from RI Reviewed ~ No Sample Detail (GSN: S-WCD16-041348) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 02/10/2015 00:00 Whole Blood EAR VEIN EDTA Collection Method Collected By Reason Exclude from reference intervals Phlebotomy Keeper Staff Routine No 01/10/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 3D Test Request Detail Sample Quality Date Requested 01/10/2015 Color ~ Requested By Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample Lynnette Waugh 01/10/2015 00:00 Julia Jones ~ No Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 47 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Secondary Result Low RI High RI Evaluation WBC Excld. from RI Reviewed ~ *10^9 cells/L ~ 7.1 19.9 ~ No ~ Lymphocyte ~ *10^9 cells/L count [a] ~ 0.38 10.31 ~ No ~ Monocyte count [a] ~ *10^9 cells/L ~ 0.000 9.227 ~ No ~ Neutrophil count [a] ~ *10^9 cells/L ~ 0.95 8.77 ~ No ~ Eosinophil count [a] ~ *10^9 cells/L ~ 0.000 0.830 ~ No ~ Basophil count [a] ~ *10^9 cells/L ~ 0.000 0.135 ~ No ~ Lymphocyte ~% % [a] ~ ~ ~ ~ No ~ Monocyte % [a] ~% ~ ~ ~ ~ No ~ Neutrophil % [a] ~% ~ ~ ~ ~ No ~ Eosinophil % [a] ~% ~ ~ ~ ~ No ~ Basophil % ~% [a] ~ ~ ~ ~ No ~ RBC [a] 2.20 *10^12 cells/L ~ 2.15 3.98 ~ No Yes HGB [a] 12.4 g/dL ~ 8.7 16.5 ~ No Yes HCT [a] 27.77 % ~ 25.6 47.9 ~ No Yes MCV 126 fL ~ 94.8 143.9 ~ No Yes MCH [a] 56.3 pg ~ 31 50 High No Yes MCHC 44.6 g/dL ~ 28.0 40.1 High No Yes RDW 16.1 % ~ ~ ~ ~ ~ Yes Platelets 105 *10^9 cells/L ~ ~ ~ ~ No Yes Plateletcrit 0.07 % ~ ~ ~ ~ ~ Yes Mean Plate. 6.7 fL Vol. ~ ~ ~ ~ No Yes PDW-cv ~ ~ ~ ~ ~ Yes 29.1 % Sample Detail (GSN: S-WCD15-039536) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 01/10/2015 00:00 Whole Blood EAR VEIN ~ Collection Method Collected By Reason Exclude from reference intervals ~ Keeper Staff ~ No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 3D Test Request Detail Sample Quality Date Requested Requested By Laboratory 01/10/2015 Jennifer D'Agostino National Zoo Departm Color Color Intensity Clarity ~ ~ ~ Analysis Start Date Analysis Equipment Insufficient Sample 01/10/2015 ~ No Consistency Additional Characteristics Degraded ~ ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 48 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 100 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-039536-S01) Collection Date/Time 01/10/2015 00:00 Sample Type Whole Blood Anatomical Source/Tissue EAR VEIN Collection Method Collected By Reason ~ Keeper Staff ~ Additives/Preservatives Exclude from reference intervals No ~ 30/09/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 30/09/2015 00:00 Lynnette Waugh Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 8M 2D ~ Routine serum chemistry. Albumin is mildly elevated at 4.9 g/dL (ISIS reference interval 2.3-4.2). 4/4 elephants tested today were all elevated (relative to their normal values and elephant ISIS interval). Will recheck the animal with the highest albumin in one to two weeks and the rest of the animals during routine lab work- suspect transient or spurious result. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 29/09/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 8M 1D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 49 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Request Detail Sample Quality Date Requested Requested By 29/09/2015 Jennifer D'Agostino Color Color Intensity ~ ~ Analysis Start Date & Time Analysis By 29/09/2015 00:00 Liz McCrae Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample VetScan VS2 No Additional Characteristics Degraded ~ No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Albumin 4.9 g/dL ~ 2.3 4.2 High No No Alk. Phos. [a] 32 U/L ~ 44 270 Low No No AST [a] 19 U/L ~ 6 38 ~ No No Ca 9.5 mg/dL Reviewed ~ 9.2 12.0 ~ No No GGT [a] 3 U/L ~ 1 15 ~ No No Total 7.2 g/dL Protein ~ 6.5 9.6 ~ No No Globulin 2.3 g/dL ~ 3.0 6.5 Low No No BUN 8 mg/dL ~ 6.0 20.0 ~ No No CK [a] 141 U/L ~ 53 461 ~ No No Phos 4.2 mg/dL ~ 3.1 7.4 ~ No No Mg 2.3 mg/dL ~ 1.62 2.94 ~ No No Sample Detail (GSN: S-WCD15-039506) Collection Date/Time 29/09/2015 00:00 Sample Type Serum Anatomical Source/Tissue EAR VEIN Collection Method Collected By Reason Phlebotomy Keeper Staff Opportunistic Additives/Preservatives Exclude from reference intervals No ~ 17/07/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 5M 19D Test Request Detail Sample Quality Date Requested Requested By 17/07/2015 Jennifer D'Agostino Color Color Intensity ~ ~ Laboratory Analysis Start Date National Zoo Departm 17/07/2015 Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 50 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041456) Collection Date/Time Sample Type 17/07/2015 00:00 Wash/Lavage Fluid Anatomical Source/Tissue TRUNK Additives/Preservatives ~ Collection Method Collected By Wash/lavage Keeper Staff Reason Exclude from reference intervals Routine No 15/07/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 15/07/2015 00:00 Gretchen Cole Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 5M 17D ~ Will begin animal on nutrition supplement, Red Cell. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 5M 17D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 51 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Basic Info Weight Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 15/07/2015 15/07/2015 00:00 Gretchen Cole 1 animal ~ ~ ~ Date Measurement Value 15/07/2015 3,450 kg Estimate Exclude From Reference Intervals Yes Yes Treatment Detail Treatment Item/Drug RED CELL Dose Amount Dosage Amount 80 g 0.023 g/kg Frequency Duration Administrated Dose 80 g Quantity Delivery Route Loading Dose Form Of Drug ~ once a day (sid) 169doses Concentration Of Drug ~ Oral (p.o.) ~ Treatment Response Clinical Response Adverse Effects ~ ~ Adverse Effects Note: ~ Staff Instructions Give 80 g of RED CELL, once a day (sid) for 169 doses. Start treatment on 15/07/2015 Administration route: Oral (p.o.) Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done 30/12/2015 776414 / Asian elephant / 21517980 RED CELL treatment is complete Gretchen Cole No Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 13/07/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 13/07/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 5M 15D PRURITUS Note Subtype: General Notes/Comments Verbal uopdate from keepers, pruritus is no longer present. Since introduction to the herd and yard 3, pruritus has resolved. Suspect that this was a combination of true pruritus and behavior. Plan to stop the diphenhydramine once prescription is completed and monitor for recurrence. Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 52 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 09/07/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 5M 11D Test Request Detail Sample Quality Date Requested 09/07/2015 Color ~ Requested By Laboratory Jennifer D'Agostino National Zoo Departm Color Intensity Clarity ~ ~ Analysis Start Date 09/07/2015 Consistency ~ Analysis Equipment ~ Additional Characteristics ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041455) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 09/07/2015 00:00 Wash/Lavage Fluid TRUNK ~ Collection Method Collected By Reason Exclude from reference intervals Wash/lavage Keeper Staff Routine No 02/07/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 5M 4D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 53 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Request Detail Sample Quality Date Requested 02/07/2015 Color ~ Requested By Jennifer D'Agostino Color Intensity ~ Laboratory Analysis Start Date National Zoo Departm 02/07/2015 Clarity Consistency ~ ~ Analysis Equipment ~ Additional Characteristics ~ Insufficient Sample No Degraded No Notes/Comments repli-g with EEHV6 concentration: undil, TNF (+), EEHV6 (-) concentration: 1:20, TNF (+), EEHV6 (-) Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 1 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041453) Collection Date/Time Sample Type 02/07/2015 00:00 Wash/Lavage Fluid Anatomical Source/Tissue TRUNK Additives/Preservatives ~ Collection Method Collected By Wash/lavage Keeper Staff Reason Exclude from reference intervals Routine No 01/07/2015 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 5M 3D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment Weight Info 30/06/2015 01/07/2015 00:00 Jennifer D'Agostino 1 animal ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Date Measurement Value Estimate Exclude From Reference Intervals Oklahoma City Zoological Park 30/06/2015 3,450 kg Yes Yes Page 54 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Treatment Detail Treatment Item/Drug Diphenhydramine Dose Amount 2,000 mg Dosage Amount 0.580 mg/kg Administrated Dose 2,000 mg Quantity Frequency Duration Delivery Route Loading Dose Form Of Drug ~ once a day (sid) 14days Oral (p.o.) ~ Concentration Of Drug ~ Treatment Response Clinical Response Adverse Effects Adverse Effects Note: ~ ~ ~ Staff Instructions Give 2,000 mg orally once daily for 14 days. Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done 14/07/2015 776414 / Asian elephant / 21517980 Diphenhydramine treatment is complete Jennifer D'Agostino No Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 25/06/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 28D Test Request Detail Sample Quality Date Requested 25/06/2015 Color ~ Requested By Laboratory Jennifer D'Agostino National Zoo Departm Color Intensity Clarity ~ ~ Analysis Start Date Analysis Equipment 25/06/2015 ~ Consistency Additional Characteristics ~ ~ Insufficient Sample No Degraded No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 55 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041452) Collection Date/Time 25/06/2015 00:00 Collection Method Wash/lavage Sample Type Wash/Lavage Fluid Collected By Keeper Staff Reason Exclude from reference intervals Routine No Anatomical Source/Tissue TRUNK Additives/Preservatives ~ 18/06/2015 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 21D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment Weight Info 15/06/2015 18/06/2015 00:00 Jennifer D'Agostino 1 animal ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Date 15/06/2015 Measurement Value Estimate 8,150 lb Yes Exclude From Reference Intervals Yes Oklahoma City Zoological Park Page 56 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Treatment Detail Treatment Item/Drug Diphenhydramine Dose Amount 2,000 mg Frequency once a day (sid) Dosage Amount ~ Duration 14days Delivery Route Loading Dose Oral (p.o.) ~ Administrated Dose 2,000 mg Quantity Form Of Drug ~ Concentration Of Drug ~ Treatment Response Clinical Response ~ Adverse Effects Adverse Effects Note: ~ ~ Staff Instructions Give 2,000 mg orally once daily for 14 day (starting June 18). Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done Jennifer D'Agostino No Start Diphenhydramine 2000 mg once a day (sid) 14 days Oral (p.o.) / Asian elephant / 776414 / Jennifer D'Agostino 21517980 No 01/07/2015 776414 / Asian elephant / 21517980 Diphenhydramine treatment is complete 18/06/2015 Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 12/06/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 12/06/2015 00:00 Gretchen Cole Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 4M 15D PRURITUS Note Subtype: General Notes/Comments Received results of Fecal testing collected 12 Jun 2015. Gastrointestinal disease PCR panel: negative. Fecal culture: no salmonella, shigella, yersinia isolated. Campylobacter: Negative at 24 hours Animal Care Staff Medical Summary ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 57 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 15D Test Request Detail Sample Quality Date Requested 12/06/2015 Color ~ Requested By Laboratory Jennifer D'Agostino ANTECH Color Intensity Clarity ~ ~ Analysis Start Date 12/06/2015 Consistency ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ANTECH Accession No. DLBC42349398 Fastpanel PCR Canine GI ProfileANAAnte Negative; Canine enteric coronavirus Negative; Campylobacter jejuni/coli Negative; Cryptosporidium spp Negative; Salmonella spp Negative; Giardia spp Negative; Clostridium difficile toxins A/B Negative; Clos perfingens enterotoxin Negative; Canine parvovirus Fecal Culture Final Report; Mixed gastrointestinal flora isolated; No Salmonella, Shigella, Yersinia isolated Campylobacter Negative for Campylobacter in 72 hours Test Requests & Test Results Excld. from RI Test Primary Result Secondary Result Low RI High RI Evaluation Enteric Path. Cult. No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ No clinically significant Salmonella/Shigella microorganism was isolated ~ ~ ~ ~ ~ ~ Yersinia culture No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ Campylobacter cultur No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ Crypto. PCR negative ~ ~ ~ ~ ~ No Giardia PCR negative ~ ~ ~ ~ ~ No C diff toxin A/B PCR negative ~ ~ ~ ~ ~ No ~ ~ ~ ~ ~ ~ No clinically significant C perfringen culture microorganism was isolated Reviewed Sample Detail (GSN: S-WCD15-038508) Collection Date/Time 12/06/2015 00:00 Collection Method Obtained off substrate Sample Type Feces Collected By Julia Jones Reason Exclude from reference intervals Other No Anatomical Source/Tissue ~ Additives/Preservatives ~ 11/06/2015 Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 58 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 14D Basic Info Weight Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 10/06/2015 11/06/2015 00:00 Jennifer D'Agostino 1 animal ~ ~ ~ Date Measurement Value 10/06/2015 8,150 lb Estimate Yes Exclude From Reference Intervals Yes Treatment Detail Treatment Item/Drug Diphenhydramine Dose Amount 2,000 mg Frequency once a day (sid) Dosage Amount ~ Duration 7days Administrated Dose 2,000 mg Quantity Delivery Route Loading Dose Form Of Drug ~ Concentration Of Drug ~ Oral (p.o.) ~ Treatment Response Clinical Response ~ Adverse Effects Adverse Effects Note: ~ ~ Staff Instructions Give 2,000 mg orally once daily for 7 days. Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done 17/06/2015 776414 / Asian elephant / 21517980 Diphenhydramine treatment is complete Jennifer D'Agostino No Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 14D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 59 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Request Detail Sample Quality Date Requested 11/06/2015 Color ~ Requested By Jennifer D'Agostino Color Intensity ~ Laboratory Analysis Start Date National Zoo Departm 11/02/2016 Clarity Consistency ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments repli-g with EEHV6 concentration: undiluted, TNF (-) concentration: 1:20, TNF (-) Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 1 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041449) Collection Date/Time Sample Type 11/06/2015 00:00 Wash/Lavage Fluid Collection Method Collected By Wash/lavage Keeper Staff Anatomical Source/Tissue TRUNK Reason Routine Additives/Preservatives Exclude from reference intervals No ~ 10/06/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 10/06/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 4M 13D PRURITUS Note Subtype: General Notes/Comments Pruritus appears to be somewhat improved, although not resolved. Elephant has been transferred over now to yard 2 which may be helping along with the diphenhydramine. Suspect it could be the new load of sand that was placed in yard 1 prior to the arrival of this elephant that is contributing to the pruritus. Plan to continue the diphenhydramine at the current dose until the cows are integrated into one herd and in yard 3. Yard 3 does not have sand and has a larger, deeper pool. Once in yard 1, plan to discontinue diphenhydramine and monitor closely. Skin continues to be normal with no redness, irritation or lesions noted. Appetite and attitude also remain normal. Animal Care Staff Medical Summary ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 60 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 07/06/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 07/06/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 4M 10D PRURITUS Note Subtype: General Notes/Comments Fecal Salmonella testing is negative. Keepers will shift Bamboo and Chai over to yard 2 today while still maintaining isolation from the rest of the herd until completion of quarantine on Wednesday. Plan to see if reducing exposure to sand in the yard will help decrease pruritus. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 06/06/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 06/06/2015 00:00 Gretchen Cole Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 4M 9D PRURITUS Note Subtype: General Notes/Comments Keeper (TR) reported this animal's pruritis is not substantially changed. Visual examination of animal in stall. It was bright, alert, active. Observed repeated front and hindleg scratching and animal spraying water on back. Will increase dose and reevaluate effectiveness. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 9D Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 61 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Basic Info Weight Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 06/06/2015 06/06/2015 00:00 Gretchen Cole 1 animal ~ ~ ~ Date 06/06/2015 Measurement Value Estimate 8,150 lb Yes Exclude From Reference Intervals Yes Treatment Detail Treatment Item/Drug Diphenhydramine Dose Amount Dosage Amount 2,000 mg 0.541 mg/kg Frequency Duration Administrated Dose 2,000 mg Quantity Form Of Drug ~ once a day (sid) 5days Delivery Route Oral (p.o.) Loading Dose ~ Concentration Of Drug ~ Treatment Response Clinical Response ~ Adverse Effects ~ Adverse Effects Note: ~ Staff Instructions Give 2,000 mg of Diphenhydramine, once a day (sid) for 5 days. Start treatment on 06/06/2015 Administration route: Oral (p.o.) Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 04/06/2015 Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 7D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment Weight Info 04/06/2015 04/06/2015 00:00 Jennifer D'Agostino 1 animal Administration success too low 2015-06-05 ~ Printed: 05/02/2016 © 2015 International Species Information System Date 04/06/2015 Measurement Value Estimate 8,150 lb Yes Exclude From Reference Intervals Yes Oklahoma City Zoological Park Page 62 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Treatment Detail Treatment Item/Drug Diphenhydramine Dose Amount 1,000 mg Frequency once a day (sid) Dosage Amount ~ Duration 5days Delivery Route Loading Dose Oral (p.o.) ~ Administrated Dose 1,000 mg Quantity Form Of Drug ~ Concentration Of Drug ~ Treatment Response Clinical Response ~ Adverse Effects Adverse Effects Note: ~ ~ Staff Instructions Give 1000mg orally once daily for 5 days. Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes ~ ~ ~ ~ 03/06/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 03/06/2015 00:00 Gretchen Cole Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 4M 6D PRURITUS Note Subtype: General Notes/Comments Recieved results of fecal testing. Gastrointestinal disease PCR panel: negative results Fecal culture: negative for salmonella, shigella, yersinia. Campylobacter: negative at 72 hours. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Clinical note Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 63 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 03/06/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Sex Report End Date 01/02/2016 Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 4M 6D PRURITUS Note Subtype: General Notes/Comments Keepers and curator all report that Chai has seemed increasingly pruritic since her arrival three weeks ago. On visual exam today Chai is bright, alert and active. Urination and defecation are normal. Appetite is normal. When standing in the stall she consistently rubs her feet and seems to scratch her legs with her trunk. She also throws sand and dirt over her back more often than the other elephants. During training sessions she appears antsy and won't hold still because she is rubbing her feet. Skin is normal and there are no raised lesions or redness noted. Suspect that she may have a mild allergic reaction to plant material in the exhibit or irritation from insects (flies and mosquitoes are abundant due to recent rains). Plan to try a course of low dose antihistimine to see if that reduces pruritus. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 6D Test Request Detail Sample Quality Date Requested Requested By Laboratory Analysis Start Date Analysis Equipment 03/06/2015 Gretchen Cole ANTECH 03/06/2015 ~ Color Color Intensity Clarity Consistency Additional Characteristics ~ ~ ~ formed ~ Insufficient Sample No Degraded No Notes/Comments Antech Accession # DBLC42155483 Canine enteric coronoavirus Negative Campylobacter jejuni/coli Negative Clos perfringens enterotoxin Negative Canine Parvovirus Negative Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 64 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Test Primary Result Secondary Result Low RI High RI Evaluation Reviewed Enteric Path. Cult. No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ No clinically significant Salmonella/Shigella microorganism was isolated ~ ~ ~ ~ ~ ~ Yersinia culture No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ Campylobacter cultur No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ C diff toxin A/B PCR negative ~ ~ ~ ~ ~ No Giardia PCR negative ~ ~ ~ ~ ~ No Salmonella PCR negative ~ ~ ~ ~ ~ No Crypto. PCR negative ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-038428) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 03/06/2015 00:00 Feces ~ ~ Collection Method Collected By Reason Exclude from reference intervals Obtained off substrate Julia Jones Preventative Health No 01/06/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 4D Test Request Detail Sample Quality Date Requested 01/06/2015 Color Brown/Tan Requested By Analysis Start Date & Time Analysis By Analysis Equipment Gretchen Cole 01/06/2015 00:00 Julia Jones ~ Color Intensity Clarity Consistency Additional Characteristics ~ ~ formed ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Excld. from Reviewed RI Test Primary Result Secondary Result Low RI High RI Evaluation Direct Exam. No parasites found ~ ~ ~ ~ ~ No Sheather’s/Centrifug No parasites found ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-038409) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 01/06/2015 00:00 Feces ~ ~ Collection Method Collected By Reason Exclude from reference intervals Obtained off substrate Julia Jones Other No 28/05/2015 Test & Result Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 65 of 75 Report Start Date 31/01/2015 Animal Type Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 4M 0D Test Request Detail Sample Quality Date Requested 28/05/2015 Color ~ Requested By Laboratory Analysis Start Date Analysis Equipment Jennifer D'Agostino National Zoo Departm 28/05/2015 ~ Color Intensity Clarity Consistency Additional Characteristics ~ ~ ~ ~ Insufficient Sample No Degraded No Notes/Comments repli-g with EEHV6: Concentration:undiluted, TNF (+), EEHV6 (-) concentration 1:20, TNF (-) Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 1 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041447) Collection Date/Time 28/05/2015 00:00 Sample Type Wash/Lavage Fluid Anatomical Source/Tissue TRUNK Collection Method Collected By Reason Wash/lavage Keeper Staff Routine Additives/Preservatives Exclude from reference intervals No ~ 25/05/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 27D Test Request Detail Sample Quality Date Requested Requested By Analysis Start Date & Time Analysis By 25/05/2015 Gretchen Cole 25/05/2015 00:00 Julia Jones Color Color Intensity Clarity Consistency Brown/Tan ~ ~ formed Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 66 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from Reviewed RI Test Primary Result Secondary Result Low RI High RI Evaluation Direct Exam. No parasites found ~ ~ ~ ~ ~ No Sheather’s/Centrifug No parasites found ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD15-038366) Collection Date/Time 25/05/2015 00:00 Sample Type Feces Anatomical Source/Tissue ~ Collection Method Collected By Reason Obtained off substrate Keeper Staff Other Additives/Preservatives Exclude from reference intervals No ~ 20/05/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 20/05/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 3M 22D ~ Chai continues to settle in very well. Daily routine is has normalized and she participates normally in training sessions with both Woodland Park and OKC Zoo keeper staff. Appetite is normal and diet transition is going smoothly. Urination and defecation are normal. Fecal boluses are normal in size, shape and consistency and is produced in a normal amount. Both animals have been utilizing the indoor and outdoor space. Healthy elephant, continue quarantine as planned. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ 18/05/2015 Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 20D Test Request Detail Sample Quality Date Requested 18/05/2015 Color Brown/Tan Requested By Laboratory Analysis Start Date Analysis Equipment Jennifer D'Agostino OSU CVM 19/05/2015 ~ Color Intensity Clarity Consistency Additional Characteristics medium ~ formed ~ Insufficient Sample No Degraded No Notes/Comments Acession Munber: 15051110 Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 67 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Primary Result Excld. from RI Reviewed ~ ~ No ~ ~ No Secondary Result Low RI High RI Evaluation Sugar No parasites found Flotation ~ ~ ~ ZnSO4 No parasites found Flotation ~ ~ ~ Sample Detail (GSN: S-WCD15-038343) Collection Date/Time 18/05/2015 00:00 Sample Type Feces Anatomical Source/Tissue ~ Additives/Preservatives ~ Collection Method Obtained off substrate Collected By Reason Exclude from reference intervals Julia Jones Diagnostic No Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 20D Test Request Detail Sample Quality Date Requested Requested By Laboratory Analysis Start Date 18/05/2015 Jennifer D'Agostino National Zoo Departm 18/05/2015 Color Color Intensity Clarity Consistency ~ ~ ~ ~ Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments ~ Test Requests & Test Results Test Primary Result Excld. from RI Secondary Result Low RI High RI Evaluation Reviewed EEHV 1 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 2 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 3/4 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 5 0 ge/ml qPCR ~ ~ ~ ~ ~ No EEHV 6 0 ge/ml qPCR ~ ~ ~ ~ ~ No Sample Detail (GSN: S-WCD16-041446) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 18/05/2015 00:00 Wash/Lavage Fluid TRUNK ~ Collection Method Collected By Reason Exclude from reference intervals Wash/lavage Keeper Staff Routine No 14/05/2015 Clinical note Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 68 of 75 Report Start Date 31/01/2015 Animal Type Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 14/05/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Notes/Comments Sex Report End Date 01/02/2016 Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 3M 16D ~ Summary of travel provided by Dr. Kelly Helmick. Clinical notes May 11-May 14, 2015 for elephants Bamb00/20073 and Chai/2113. Left San Diego Zoo approximately 745 PM PST on May 11, arrived Oklahoma City Zoo approximately 3 AM CST on May 13, transport time approximately 29 hr. Elephant Bamboo/20073 administered 150 mg zuclophenthixol acetate IM RT hip approximately 10 hr prior to crating. In veterinary application, a long-acting calming agent with a wide margin of safety used in a variety of hoofstock species to facilitate safe transport, including captive and wild elephants, administered with the goal to lessen behaviors (leaning, stretching, and sitting) observed on transport from Seattle, WA to San Diego, CA. Behaviors were attributed to restlessness in the crate, leading to concerns that physical fatigue could develop over time if allowed to continue (see notes April 20). This medication is not expected to cause tranquilization, sedation, or other noticeable changes and no adverse effects associated with zuclophenthixol administration noted before, during, or after transport. No change in attitude, trained behaviors, appetite/water consumption or fecal/urine output noted. No changes in mentation or attitude before, during, or after transport. Behaviors (leaning, stretching, and sitting) were not observed as frequently as prior transport, may/may not reflect zuclophenthixol effects. Crate inspections performed day of load and no concerns noted. Physical exam conducted day of loading, both elephants BAR, normal ambulation, resting RR WNL, eyes bright and clear, oral findings WNL, good skin quality w/o abrasions or other concerns, perineal region clean, all feet WNL, all other findings WNL. RT hip callous and tail WNL for elephant Bamboo/20073 without concerns or changes noted. Both elephants eating/drinking and urinating/defecating normally. Both elephants visually inspected in crates after loading, both BAR and calm in crates, taking food from keeper staff, no concerns or changes noted. Both elephants crated easily, and voluntarily walked into crates within minutes of crate access. Load and travel leaving San Diego was scheduled for evening to allow for travel through warmer regions when ambient temperatures were cool. Monitoring through real-time close-circuit video throughout transport, visual inspections at each welfare stop, and crate and ambient temperature and humidity monitoring. Ambient temperatures throughout transport were mild, inclement or other weather changes not encountered, and crate temperatures stayed above 45F and below 75F throughout transport. Supplemental heating or cooling was not required during transport. Both elephants ate and drank, produced normal feces and urine throughout travel. Both elephants were alert, responsive, and interacted with keeper staff at welfare stops. Travel was uneventful. Elephant Bamboo/20073 demonstrated behaviors observed during prior travel (leaning, sitting, and stretching) shortly after leaving San Diego. Behaviors were observed only by camera monitoring and ceased at welfare stops. These behaviors would appear for a short interval when travel resumed after welfare stops but did not persist and Bamboo demonstrated long periods of rest or other normal activity between welfare stops compared to prior transport. Persistent signs of restlessness, other abnormal behaviors, muscle weakness, or fatigue were not noted in either elephant throughout travel. No colic or cramping was observed in either elephant, before, during, or after transport. No health concerns noted or developed in either elephant before, during, or after transport. Both elephants walked quickly and easily out of the crates upon arrival at Oklahoma City Zoo. No gait changes, stiffness, or soreness noted in either elephant. Both elephants ate and drank upon arrival and produced normal urine and feces. Due to early AM arrival, both elephants were allowed to rest and slept for several hours. Both elephants were compliant with behaviors for diagnostic sample collection conducted later the day of arrival. Veterinary inspections and monitoring conducted upon arrival and for the next 36 hr were WNL, both elephants remained BAR, eyes bright and clear, normal ambulation, no abnormal behavioral changes, good food/water intake, appropriate urine/fecal production, all other findings during visual inspections WNL. Reviewed medical history and provided summary of transport and visual inspection findings to OKCZ. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Clinical note Animal Type GAN Individual 21517980 Date Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Time Printed: 05/02/2016 © 2015 International Species Information System Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 3M 16D Note Author Oklahoma City Zoological Park Page 69 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology 14/05/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Note Subtype: General Notes/Comments ~ Elephant continues to settle in well. Today Chai is bright, alert and active. Behavior is normal and appetite continues to improve. Feces continue to be dry and somewhat reduced in amount but bolus size is good and there is no straining observed. Urinations are normal. Anklets were removed through behavioral restraint. Chai received a bath this morning as part of the normal routine. Keepers collected fecal sample for parasite analysis and enteric pathogen culture. Continue quarantine as planned. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 16D Test Request Detail Sample Quality Date Requested Requested By 14/05/2015 Jennifer D'Agostino Color Color Intensity Brown/Tan ~ Laboratory Analysis Start Date ANTECH 14/05/2015 Clarity Consistency ~ formed Analysis Equipment Insufficient Sample ~ No Additional Characteristics Degraded ~ No Notes/Comments Antech Accession Number: DBLC41831378 Canine Enteric coronavirus PCR: Negative Campylocabter jejuni/coli PCR: Negative Clos perfringens enterotoxin PCR: Negative Canine parovirus PCR: Negative Test Requests & Test Results Excld. from RI Test Primary Result Secondary Result Low RI High RI Evaluation Crypto. PCR negative ~ ~ ~ ~ ~ No Giardia PCR negative ~ ~ ~ ~ ~ No C diff toxin A/B PCR negative ~ ~ ~ ~ ~ No Salmonella PCR negative ~ ~ ~ ~ ~ No Salmonella culture No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ No clinically significant Salmonella/Shigella microorganism was isolated ~ ~ ~ ~ ~ ~ Yersinia culture No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ Campylobacter cultur No clinically significant microorganism was isolated ~ ~ ~ ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Reviewed Page 70 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Sample Detail (GSN: S-WCD15-038299-S01) Collection Date/Time Sample Type 14/05/2015 00:00 Feces Obtained off substrate Liz McCrae Reason Exclude from reference intervals Other No Anatomical Source/Tissue ~ Additives/Preservatives ~ Collection Method Collected By Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 16D Test Request Detail Sample Quality Date Requested 14/05/2015 Color Brown/Tan Requested By Analysis Start Date & Time Gretchen Cole 14/05/2015 00:00 Color Intensity Clarity ~ ~ Analysis By Analysis Equipment Liz McCrae ~ Consistency Additional Characteristics formed ~ Insufficient Sample No Degraded No Notes/Comments ~ Test Requests & Test Results Test Primary Result Direct Exam. Sheather’s/Centrifug Secondary Result Excld. from Reviewed RI Low RI High RI Evaluation Taxon Result - coccidia rare (1+) / Coccidia ~ ~ ~ ~ No Taxon Result - coccidia moderate (3+) / Coccidia ~ ~ ~ ~ No ~ ~ ~ ~ No Other Result - CoccidiaSheather’s/Centrifug like organisms; ~ probably pollen (4+) Sample Detail (GSN: S-WCD15-038299) Collection Date/Time 14/05/2015 00:00 Sample Type Feces Anatomical Source/Tissue ~ Collection Method Collected By Reason Obtained off substrate Liz McCrae Other Additives/Preservatives Exclude from reference intervals No ~ 13/05/2015 Clinical note Animal Type GAN Individual 21517980 Preferred ID Taxonomy 776414 Elephas maximus/Asian Female elephant Date Time Note Author 13/05/2015 00:00 Jennifer D'Agostino Significant Private Active Problems No No Sex Birth Date Age ~ from 28/01/1978 to 28/01/1980 36Y 3M 15D OPACITY, EYE (NOS) NEOPLASIA, LEIOMYOMA OVARY (RIGHT), CYST HYPERKERATOSIS, REAR MEDIAL HOOF (NOS) CORNEAL OPACITY, BILATERAL Note Subtype: General Notes/Comments Proc: Quarantine entry and visual exam Animal arrived into the zoo from San Diego this morning at 3am with conspecific "Bamboo". Unloading was uneventful and both animals were together in the stall by 4:30am. Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 71 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Visual exam: Animal is bright and alert in the stall. No external lesions are noted. Ambulation and gait are normal, no sign of stiffness or lameness. Mucous membranes are pink and moist. There is a small amount of white ocular discharge OU but eyes appear otherwise normal. Elephant is taking dried cranberries from keeper but is not interested in other food items yet. Elephant immediately began exploring surroundings and responded to keepers appropriately. Drank water from the hose and took a sand bath. Urination and defecation not witnessed but was normal during transport. Proceed with quarantine as planned. Addendum 9am: USDA vet inspection. Both animals are alert and active. Both appear normal and appear to be settling in well. Both have been outside in yard 1 and have access. Chai has eaten a few more food items (hay and produce) and interacts normally with keepers. Normal urination observed but no defecation yet. Instructed keepers to administer 1 gallon mineral oil mixed in bran prophylactically to help keep the GI tract moving. Keepers were also instructed to obtain a blood sample if possible for routine CBC/Chemistry and trunk wash for routine EEHV screening. Addendum 4pm: Chai took half the dose of mineral oil and bran mixture. Bloodwork is unremarkable. Appetite continues to improve. Animal did defecate a small amount of feces and continues to urinate normally. Fecal bolus size is good and is slightly dry. Animal Care Staff Medical Summary ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Prescription/Treatment Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age (at the start date) 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 15D Basic Info Date Written Start Date Prescribed By Prescribed For Reason For Terminate Terminate Date Reason For Treatment 13/05/2015 13/05/2015 00:00 Jennifer D'Agostino 1 animal ~ ~ ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 72 of 75 Report Start Date 31/01/2015 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Report End Date 01/02/2016 Treatment Detail Treatment Item/Drug MINERAL OIL Dose Amount Dosage Amount 1 gal liq (US) ~ Administrated Dose 1 gal liq (US) Quantity Form Of Drug ~ Frequency Duration once 1doses Delivery Route Oral (p.o.) Loading Dose ~ Concentration Of Drug ~ Treatment Response Clinical Response ~ Adverse Effects ~ Adverse Effects Note: ~ Staff Instructions Give 1 gallon orally mixed in bran prophylactically to help with GI motility. Prescription Notes/Comments ~ Calendar Items Date Title Assigned To Done ~ ~ ~ ~ Dispensing Records Date Dispensed Dispensed By Quantity Dispensed ~ ~ ~ Administration Records Administration Date/Time Administered By Success Notes 13/05/2015 00:00 Jennifer D'Agostino 50% Adminstered by Woodland Park keepers mixed in bran. Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 15D Test Request Detail Date Requested Requested By Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample Sample Quality 13/05/2015 Jennifer D'Agostino 13/05/2015 15:05 Liz McCrae VetScan HM5 No Color Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ ~ No Notes/Comments bi-lobed Monocytes: 24% Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 73 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Excld. from RI Reviewed ~ No No ~ No No 16.5 ~ No No 47.9 ~ No No 94.8 143.9 ~ No No ~ 31 50 High No No ~ 28.0 40.1 ~ No No 14.9 % ~ ~ ~ ~ ~ No Platelets 248 *10^9 cells/L ~ ~ ~ ~ No No Mean Plate. Vol. 7.5 fL ~ ~ ~ ~ No No PDW-cv 29.6 % ~ ~ ~ ~ ~ No Neutrophil % [m] 27 % ~ ~ ~ ~ No No Lymphocyte % [m] 12 % ~ ~ ~ ~ No No Monocyte % [m] 36 % ~ ~ ~ ~ No No Eosinophil % 1% [m] ~ ~ ~ ~ No No Basophil % [m] 0% ~ ~ ~ ~ No No HCT [m] 39 % ~ 25.6 47.9 ~ No No Anisocytosis moderate (3+) ~ ~ ~ ~ ~ No Poikilocytosis few (2+) ~ ~ ~ ~ ~ No Target Cells ~ ~ ~ ~ ~ No Test Primary Result Secondary Result Low RI High RI Evaluation WBC 17.72 *10^9 cells/L ~ 7.1 19.9 RBC [a] 2.86 *10^12 cells/L ~ 2.15 3.98 HGB [a] 14.7 g/dL ~ 8.7 HCT [a] 36.72 % ~ 25.6 MCV 129 fL ~ MCH [a] 51.5 pg MCHC 40.1 g/dL RDW few (2+) Sample Detail (GSN: S-WCD15-038322) Collection Date/Time Sample Type 13/05/2015 00:00 Whole Blood Collection Method Collected By Phlebotomy Jennifer D'Agostino Anatomical Source/Tissue EAR VEIN Reason Medical Additives/Preservatives Exclude from reference intervals No EDTA Test & Result Animal Type GAN Individual 21517980 Preferred ID Taxonomy Sex Birth Date Age 776414 Elephas maximus/Asian elephant Female ~ from 28/01/1978 to 28/01/1980 36Y 3M 15D Test Request Detail Date Requested Requested By Analysis Start Date & Time Analysis By Analysis Equipment Insufficient Sample Sample Quality 13/05/2015 Jennifer D'Agostino 13/05/2015 00:00 Liz McCrae VetScan VS2 No Color Color Intensity Clarity Consistency Additional Characteristics Degraded ~ ~ ~ ~ ~ No Notes/Comments ~ Printed: 05/02/2016 © 2015 International Species Information System Oklahoma City Zoological Park Page 74 of 75 Report Start Date 31/01/2015 Report End Date 01/02/2016 Medical History Report for Clinical notes, Prescriptions/Treatments, Test & Results, Anesthesia and Pathology Test Requests & Test Results Test Excld. from RI Reviewed High No No ~ No No 270 ~ No No 44 270 ~ No No ~ 6 38 High No No 9 U/L ~ 0 31 ~ No No 10.5 mg/dL Primary Result Secondary Result Low RI High RI Evaluation Albumin 5.3 g/dL ~ 2.3 4.2 Albumin 3.7 g/dL ~ 2.3 4.2 Alk. Phos. [a] 91 U/L ~ 44 Alk. Phos. [a] 98 U/L ~ AST [a] 39 U/L ALT Ca ~ 9.2 12.0 ~ No No Amylase 3,835 U/L [a] ~ 414 7,023 ~ No No Tot. Bili. 0.4 mg/dL ~ 0.1 0.6 ~ No No GGT [a] 6 U/L ~ 1 15 ~ No No BUN 5 mg/dL ~ 6.0 20.0 Low No No Total Protein 8.2 g/dL ~ 6.5 9.6 ~ No No Globulin 2.8 g/dL ~ 3.0 6.5 Low No No Ca 10.4 mg/dL ~ 9.2 12.0 ~ No No Phos 3.6 mg/dL ~ 3.1 7.4 ~ No No BUN 5 mg/dL ~ 6.0 20.0 Low No No Creat [a] 1.7 mg/dL ~ 0.8 2.3 ~ No No CK [a] 1,901 U/L ~ 53 461 High No No Phos 3.9 mg/dL ~ 3.1 7.4 ~ No No Glucose 116 mg/dL ~ 51 131 ~ No No Mg 2.0 mg/dL ~ 1.62 2.94 ~ No No Na 131 mmol/L ~ 123 141 ~ No No K 3.7 mmol/L ~ 3.8 5.8 Low No No Total Protein 8.6 g/dL ~ 6.5 9.6 ~ No No Globulin 4.9 g/dL ~ 3.0 6.5 ~ No No Sample Detail (GSN: S-WCD15-038323) Collection Date/Time Sample Type Anatomical Source/Tissue Additives/Preservatives 13/05/2015 00:00 Serum EAR VEIN ~ Printed: 05/02/2016 © 2015 International Species Information System Collection Method Collected By Reason Exclude from reference intervals Oklahoma City Zoological Park Phlebotomy Jennifer D'Agostino Medical No Page 75 of 75