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   Aust Vet   Vol 6 No 10 October 1998664 T he Malayan tapir ( Tapirus indicus  ) is one of four tapirspecies. It is a browsing animalthat is found in lowland tropical orneotropical habitats in south-east Asia (Figure 1), whereas the other threespecies are found in central and south America. Tapiridae are classified withinthe order Perrissodactyla, a small orderof mammals comprised of two otherfamilies, Equidae and Rhinocerotidae. All members of the order have similaranatomical features. 1 Informationregarding bacterial, viral, and mycoticdiseases of the tapir and rhinoceros islimited and largely derived from descrip-tions of captive animals. 1 It is generally accepted that the pathogens affecting the tapir and rhinoceros are similar tothose affecting equids, and therefore thediagnostic and therapeutic approach todisease is usually based on those devel-oped for domestic horses. However,implementation of diagnostic and thera-peutic techniques in non-domesticatedspecies is often complicated by theirintractable nature. This article describesthe approach to diagnosis and treatmentof an abdominal abscess in a Malayantapir. Case report   An 18-month-old female Malayantapir weighing 265 kg was observed over45 days because of episodes of inappe-tence, apparent weight loss, signs of depression, and lethargy. Faecal output was reduced and faeces occasionally hada loose consistency. During this periodseveral limited physical examinations were possible with the tapir unre-strained. It was not pyrexic and ausculta-tion of the abdomen revealed, at times,gastrointestinal sounds that were dimin-ished in frequency. During the initialexamination, venous blood samples werecollected for haematological andbiochemical analyses. The haematocrit was increased (0.53 L/L; reference range31 to 47), there was neutrophilia (7.72 x10 9 /L; reference range 2.47 to 6.96 ),the fibrinogen concentration wasincreased (8 g/L; reference range 1 to 4),but all other variables were normal. 2  Anaerobic and anaerobic bacterial bloodculture produced no growth. After 45 days of observation, the tapir was immobilised and then anaesthetisedfor further diagnostic investigation. A combination of etorphine (2.45 mg) andacetylpromazine (10 mg) was adminis-tered by remote injection using a dartpistol (Telinject, Germany) to immo-bilise the tapir. Once it was immo-bilised, a 14 gauge, 133 mm, over-the-needle catheter was placed in the left jugular vein and guaiphenesin wasadministered until there was sufficientmuscle relaxation to facilitate passage of an 18 mm cuffed endotracheal tube. Anaesthesia was maintained with isoflu-rane in oxygen. Electrocardiogram, heartrate, respiratory rate, blood pressure,and oxygen saturation of haemoglobin were monitored and recorded using a Dinamap plus (Critikon, Australia)throughout anaesthesia. Results of haematological and serumbiochemical tests performed on bloodtaken while the tapir was under anaes-thesia were normal apart from low haematocrit (0.18 L/L) and hypopro-teinaemia (58 g/L; reference range 60 to73). Faecal examination was normal andfaecal culture on salmonella-selectiveagar yielded no growth. A 16.9 cmdiameter spherical mass was imagedultrasonically in the cranial abdomenusing an Aloka SSD 500 machine andConvex sector 3.5 MHZ transducerhead (Aloka, Japan). The mass wasencased in a 1.6 cm capsule. Pus wasaspirated from the abscess using an 18gauge needle passed transabdominally using ultrasound guidance. Culture of the pus yielded a mixed growth of  Enterococcus sp, Lactobacillus sp, andanaerobic Gram-negative rods. Becauseof the size of the abscess and proximity to the ventral abdominal wall, marsupi-alisation of the abscess to the abdominal wall was recommended. Trimethoprim-sulfadimidine powder (5 mg/kg of thetrimethoprim fraction, twice daily) infeed was administered based on theresults of the culture and sensitivity testing.The tapir was anaesthetised 1 week later and a ventral midline laparotomy performed. The technique for immobili-sation, anaesthetic induction and main-tenance were as before. A 15 cm ventralmidline incision was made cranial to theumbilicus. The abscess was closely asso-ciated with the root of the mesentery and since it could not be exteriorised, it was isolated from the remainder of the Surgical management of an abdominalabscess in a Malayan tapir RR LAMBETH, AJ DART, L VOGELNEST a  , CM DART, DR HODGSONUniversity Veterinary Centre, Department of Veterinary Clinical Sciences, Werombi Road, Camden, New South Wales 2570 a Veterinary and Quarantine Centre, Taronga Zoo,Mosman, New South Wales 2088 Acaptive Malayan tapir was observed to have inappetence, weight loss, signs of depression, mild dehydration and diar-rhoea. Haematological and serum biochemical tests showed anaemia, hypoproteinaemia, hyperfibrinogenaemia and neu-trophilia with a left shift. Ultrasonic examination of the abdomen under anaesthesia revealed a well-encapsulated abscess.The abscess was marsupialised to the ventral body wall. Culture of the pus produced a mixed bacterial growth. Antimicrobialtherapy was based on bacterial sensitivity results. Follow-up ultrasonic examinations showed resolution of the abscess.Ninety-one days after surgery the tapir began regurgitating food and water. An abscess srcinating from the stomach andoccluding the lumen of the duodenum was identified at surgery. The abscess ruptured during surgical manipulations andthe tapir was euthanased. Aust Vet J  1998,76:664-666Key words: Malayan tapir, Tapiridae, Perrissodactyla, abdominal abscess.   Aust Vet   Vol 6 No 10 October 1998 66 abdominal cavity with sterile saline-soaked gauze sponges. Three litres of pus was sucked from the abscess cavity through a 5 cm incision in the capsule.The cavity was digitally explored forforeign bodies but none was found. A 5cm long incision was made through theventral abdominal wall immediately overlying the incised abscess and theedges of the incisions in the abscess andventral abdominal wall were suturedusing four cruciate sutures of 2polyglactin 910. This created directcommunication between the abscesscavity and the exterior through which a 24 French sump drain was inserted andsutured to the skin. The abdomen wasflushed with saline and closed using a similar technique to that described forhorses. The skin was apposed using 1polydioxanone in a horizontal mattresspattern.Culture of the pus collected at surgery grew Streptococcus milleri  , Enterococcus  sp, Salmonella typhimurium  and anaer-obic Gram-negative rods. Antimicrobialsusceptibility test results suggested theorganisms were sensitive to penicillincombined with gentamicin andtrimethoprim-sulfadimidine. Apart fromleukopenia (4.07 x 10 9 /L ) and low haematocrit (0.20 L/L), haematologicaland serum biochemical values werenormal in samples collected beforesurgery. Antimicrobial therapy was changed toa combination of procaine and benza-thine penicillin (20 mg/kg intramuscu-larly once daily) and gentamicin (6.6mg/kg intramuscularly once daily). Fourdays after treatment the tapir becameaggressive and was trying to bite whilebeing injected. The antimicrobialtherapy was changed to trimethoprim-sulfadimidine orally for 10 days. Thetapir removed the sump drain 2 daysafter surgery.The tapir was anaesthetised and trans-abdominal ultrasonic examinations wereperformed 10 and 44 days after surgery. At 10 days the opening to the abscess was still patent and the cavity was 6 cmin diameter. By 44 days the skin hadhealed and there was a small, fluid-filledpocket beneath it. No other abnormali-ties were detected. At both examinationshaematological and serum biochemicaltest values were normal. The tapir wasreturned to the exhibit.Ninety-one days after the srcinalsurgery, the tapir became inappetent andbegan regurgitating water and food.Laparotomy was performed. Thestomach and proximal duodenum weredistended and an abscess srcinating from the stomach was adhered to theduodenum causing a partial smallintestinal obstruction. Attempts to break down adhesions resulted in rupture of the stomach and abscess. The tapir waseuthanased because of the poor prog-nosis for survival.Necropsy revealed a large, multilocu-lated abscess cavity associated with thegreater curvature of the stomach. A thick band of fibrous tissue extendedfrom the abscess to the scar in theabdominal wall where the srcinalabscess was marsupialised. The distalduodenum was adhered to the serosalsurface of the abscess causing narrowing of the lumen and partial obstruction.The remainder of the gastrointestinaltract appeared normal. A mixed bacterialgrowth cultured from the abscessincluded Streptococcus milleri, Salmonella typhimurium,Klebsiella pneumoniae  andanaerobic Gram-positive and Gram-negative branching rods. Discussion Generally it is believed that the disor-ders affecting the tapir are similar tothose affecting domestic equids.Consequently, the approach to diagnosisand treatment of diseases of the tapir aresimilar to those developed for horses. 1  A variety of gastrointestinal conditionshave been described in the tapir, 2 butabdominal abscessation has not previ-ously been reported. 1 Because of thesimilarities between the anatomy of thegastrointestinal tract of the tapir and thehorse, the approach to diagnosis andtreatment of this tapir followed thecurrent recommendations for domesticequids. 3-13 The signs initially observed weresuggestive of a nonspecific gastroin-testinal lesion. The abnormal laboratory results, including anaemia, hypopro-teinaemia, hyperfibrinogenaemia, andneutrophilia with left shift, suggested a chronic inflammatory disease process.Signs consistent with an abdominalabscess in horses, including pyrexia andsigns of gastrointestinal pain, 7  were notapparent. Because of the tapir’sintractable nature, further evaluationrequired general anaesthesia. Severalshort-acting, intravenous or intramus-cular, anaesthetic drug combinationshave been recommended to restraintapirs, 2 but a longer acting anaestheticregimen was preferred here to facilitatethorough examination. The combina-tion used (etorphine for immobilisation,guaiphenesin for muscle relaxation,intubation, maintenance on isofluranein oxygen) proved very effective. Transrectal examination and transab-dominal or transrectal ultrasonicimaging can be useful in diagnosing  Figure 1. The Malayan tapir is found in lowland tropical or neotropical habitats in southeast Asia.   Aust Vet   Vol 6 No 10 October 1998666 abdominal abscesses in horses, 7 but wereof limited use in the tapir because thetight anal sphincter limited palpation tothe caudal abdomen. Transabdominalultrasonic examination provided animage of the mass and facilitated collec-tion of an aspirate percutaneously. A diagnosis of an abdominal abscess wasconfirmed following the examinationand culture of the fluid. The aetiology of abdominal abscessesin horses vary. 3-13 The srcin of theabscess in this tapir was not established,although the close association betweenthe abscess and the greater curvature of the stomach suggests perforation of thestomach as a possible cause. Bacteria isolated from abdominal abscesses inhorses include Corynebacterium pseudo- tuberculosis  , 9 Streptococcus equi and S zooepidemicus  , 7 Peptostreptococcus  sp, Bacteroides  sp , Fusobacterium necro-  phorum, Escherichia coli, Pseudomonas aeruginosa and  Aeromonas sp. 3-13 Theisolation of mixed aerobic and anaerobicbacteria from the abscess in this tapir isconsistent with descriptions in thehorse.Long courses of appropriate antimi-crobial drugs, chosen on the basis of culture and sensitivity results, combined with surgical resection or marsupialisa-tion of the abscess where possible, arerecommended for abdominal abscessesin the horse. 3-13 Total resection of theabscess was not possible here because itsdorsal extent could not be established.However, marsupialisation was achiev-able. Potential postoperative complica-tions of abscess marsupialisation includebreakdown of the abscess capsule orbreakdown of the suture line betweenthe body wall and the abscess capsuleresulting in abdominal contamination,peri-incisional herniation of abdominalviscera, continuing signs of gastroin-testinal obstruction, and early closure of the opening. 11 The well-developedfibrous capsule reduced the risk of breakdown of the abscess capsule andfacilitated a secure apposition betweenthe abscess and the ventral body wall.The limits of the abscess cavity identi-fied initially prior to surgery wereconfirmed by digital palpation during the operation, and serial postoperativeultrasonic examinations suggested theabscess was resolving. It is more likely,given the multiloculated appearance of the abscess at necropsy, that the abscesscavity identified on ultrasound examina-tion before surgery and the cavity explored at the time of surgery repre-sented only part of the srcinal abscess.The unresolved abscess complex may have enlarged after initial surgery, ulti-mately leading to gastrointestinalobstruction. Obstruction to the flow of ingesta, rather than the effects of chronicsepsis, is believed to be the more signifi-cant complication of abdominal absces-sation in horses. 10 The selection of antimicrobial agentsfor the treatment of sepsis in non-domesticated species is limited by possible routes of administration and a scanty knowledge of pharmacokineticsof drugs in these species. The combina-tion of penicillin and gentamicin is a commonly used parenteral broad-spec-trum antibiotic in horses. Using itduring the perioperative period wasconsidered to give a better chance inachieving therapeutic concentrationsthan the use of oral drugs.Unfortunately, the tapir became increas-ingly uncooperative in response to injec-tions so the therapy was changed to oraltrimethoprim-sulphadimidine.Trimethoprim-sulfadimidine is oftenused orally in equids when protractedcourses of antimicrobial therapy areanticipated. Antimicrobial therapy wasstopped 14 days after surgery becausethe condition of the tapir improved clin-ically, there was an improvement inhaematological and serum biochemicalvalues, and the abscess appeared ontransabdominal ultrasonic examinationto have resolved.Clinical, haematological, and ultra-sound examination at 10 and 44 daysafter surgery and observation until 3months after drainage indicated that theabscess had resolved and revealed nolong-term complications. While it ispossible a longer course of antimicrobialtherapy may have been appropriate, thefailure to resolve the abdominal abscesscan be partly attributed to limitations inthe ability to diagnose and treat non-domesticated animals. References 1. Ramsay EC, Zainuddin ZZ.Infectious diseasesof the rhinoceros and tapir. In: Fowler ME, editor. Zoo and wild animal medicine. 3rd edn. Saunders,Philadelphia, 1993:459-466.2. Janssen DL, Rideout BA, Edwards ME. Medicalmanagement of captive tapirs. Proc Am Assoc Zoo Vet 1996:1-15. 3. Valdez H, McLaughlin SA, Taylor TS. A case ofcolic due to an abscess of the jejunum and itsmesentery. J Equine Med Surg  1979;3:36-38.4. Torske K, Lofstedt J, Miller L, Horney B. Dysuriaand stranguria associated with colonic ulcerationand abdominal abscess in a horse. Can Vet J  1992;33:809-811.5. Hanselaer JR, Nyland TG. Chyloabdomen andultrasonographic detection of an intra-abdominalabscess in a foal. J Am Vet Med Assoc  1983;183:1465-1466.6. Zicker SC, Wilson D, Medearis I. Differentiationbetween intra-abdominal neoplasms andabscesses in horses using clinical and laboratorydata: 40 cases (1973-1988). J Am Vet Med Assoc  1990;196:1130-1134.7. Rumbaugh GE, Smith BP, Carlson GP. Internalabdominal abscesses in the horse: a study of 25cases. J Am Vet Med Assoc 1978;172:304-309.8. Koblik PD, Lofstedt J, Jakowski RM, JohnsonKL. Use of 111 In-labelled autologous leukocytes toimage an abdominal abscess in a horse. J Am Vet Med Assoc 1985;186:1319-1322.9. Hughes JP, Biberstein EL, Richards WPC. Twocases of generalised Corynebacterium pseudotu- berculosis  infection in mares. Cornell Vet  1961;52:51-62.10. Hutchins DR, Brownlow MA, Johnston KG,Laing EA. Intra-abdominal abscessation in thehorse.In: Equine gastroenterology  . University ofSydney Post Graduate Committee in VeterinaryScience, Proceedings 1985;74:97-103.11. Prades M, Peyton L, Pattio N, Langlois J.Surgical treatment of an abdominal abscess bymarsupialization in the horse: a report of twocases. Equine Vet J 1989;21:459-461.12. Rigg DL, Gatlin SJ, Reinertson EL.Marsupialization of an abdominal abscess causedby Serratia marcescens  in a mare. J Am Vet Med Assoc 1987;191:222-224.13. Skidell J. Resection of an intra-abdominalabscess in a horse using a stapling technique. Equine Vet Educ 1996;8:140-142. (Accepted for publication 21 July 1998) 


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