Nepal Elephant TB Control and Mgt Action Plan.pdf - Elephant Care ...

Nepal Elephant Tuberculosis ulosisControl andManagement agemenAction Plan (2011-2015)2015)treatment should be segregated and restrictedfrom work unl they have completed 30consecuve full doses of an-TB drugs.Group 3 elephants (Elephant TB Stat-Pak ® reacve/ DPP ® VetTB reacve) should be segregatedand restricted from work and public contactunl the elephant has completed 90 consecuvedoses of an-TB drugs. Culture posive elephantspotenally have more advanced disease andshould be segregated and restricted from workfor the duraon of treatment.Majority of the elephants have tendencyof refusing medicaons. The TB drugs arebi er-tasng and many tablets are required.Prophylacc treatment lasts nine months andfull TB treatment lasts one year so it is importantto take me to slowly condion the elephant toaccept a new roune before starng medicaon.Once the elephant accepts the new roune theyare more likely to complete the enre treatmentwithout a problem. Each elephant is different andrequires paence and ingenuity to determine thebest method for each individual elephant. Thefollowing methods have been used successfullyin Nepal. Note that the paral doses suggestedbelow during the condioning period do notcount toward the full dose goal.Method 1. Direct administraon in smallmolasses balls or bananasBegin training elephants to accept small ballsof molasses with no medicaon. These shouldbe small enough to be placed towards the backof the elephant’s tongue so that they swallowthem without chewing. Each elephant shouldreceive about 100-150 small molasses balls eachday in the morning before other food. Once theelephant rounely accepts the un-medicatedmolasses balls, the drugs may be added graduallyas described below. Place only 1-2 pills in eachmolasses ball. Once the medicaons are reliablyaccepted at the full dose it is best to give them allat once in the morning before the elephant eatsa lot of food. If this does not work then the drugscan be divided so that the elephant receives 1/2of the pills in the morning and 1/2 in the evening.Small pieces of banana (with skin), eachcontaining 1-2 pills can be used in place ofmolasses and may work be er for someelephants. Sugar should not be used as itintereferes with the absorpon of INH.Method 2. Direct administraon in large molassesballs (or dana/ kuchi)Some elephants have accepted mulple tabletsin large molasses balls or in their regular dana/kuchi.Method 3. Direct administraon in the mouthA few elephants have been trained to open theirmouths widely and will accept the pills beingtossed directly into their mouths. The pills shouldbe followed by a liter of water to make sure thatthey swallow.Introduce INH-RIF at 80% of the calculated dose.Place 1-2 pills in small molasses balls (or bananapieces). Try to place in the back of the mouth sothat the elephant does not crush and taste thedrugs. Place several pills if using large molassesball or dana/kuchi.Once INH and RIF have been accepted for 3 daysin a row, increase to 90% of the calculated dose.Once INH and RIF at 90% of the calculated doseare accepted for 3 days in a row, increase to 100%of the calculated dose. If there are any problemsnoted at 100% of the dose, back down to 90%.For Group 3 elephants it is important to add EMBas soon as possible a!er the INH and RIF are12