EleFact Friday: Osteomyelosis Information

As we’ve talked about Lady and the difficulties she’s been having with her feet, her confirmed diagnosis of osteomyelitis has come up several times. For that reason, this week’s EleFact Friday is going to explain what the disease is, how you can get it, and what it means for those who have it. 

Osteomyelitis is an inflammation of the bone that is usually the result of an initial infection. It can be spread from surrounding tissue, direct trauma to the bone, or from systemic bacteria. It is often diagnosed via x-ray, MRI, or bone scan. It can have a sudden or slow onset or, as with Lady, it may be a chronic problem. Because Lady came to sanctuary already with osteomyelitis, we can’t know for sure how long she has had it, but we have ideas on how it came to be. 

In one of the enclosures Lady lived in prior to coming to Elephant Sanctuary Brazil, she was chained and stood in a black, tar-like muck that caused significant unsanitary conditions, including her standing in her own waste. Non-contaminated substrates like grass, natural soils, and varied vegetation cause normal wearing of pads, nails, and cuticles as elephants go about their day-to-day activities. Lady didn’t have those things or a large area to walk about, so her feet could have been compromised severely, given that scenario. 

According to a study on welfare assessment and activities of elephants, captive elephants might live in restricted areas and sometimes cold climates that require extended time inside, not allowing them to be physically active when they choose. Zoo enclosures, even the larger ones, are relatively small compared to what elephants experience in the wild, and often have hard surfaces like concrete or hard-packed dirt. The captive elephant therefore can’t properly exercise and may gain weight or develop some foot-related ailment. This study found that up to 50% of captive elephant deaths result from some side effect of lack of mobility. 

It’s possible that captive-held elephants can develop stereotypical behavior as a coping mechanism for when they are stressed. We know it can cause psychological harm, but it can also cause pads and nails to wear unevenly, causing irreversible damage to the nail bed. Another study indicates that age is a significant risk factor for foot problems. When studying elephants ten years apart in age, they found that increased age led to 19.5% increase in probability of foot abnormalities. 

There is no cure for osteomyelitis. In humans, if treated immediately, hospitalization with a range of strong IV antibiotics would be used. But even in those instances, amputation often remains the only impactful treatment. With Lady, the disease will continue to spread throughout her bones, but we can’t be sure about the pace. Lady has already survived years longer than we anticipated that she might. Our team has and will continue to consult all available experts and try every avenue of potential care, as long as it doesn’t cause her harm. We have always said that our goal with Lady is to try and slow the spread of infection and keep her comfortable. Our current mission is to simply see if we can find a way to get her comfort level back to where it was a couple of months ago. Unfortunately, her condition will continue to spread as time goes by. We are grateful for Lady’s grace throughout this process and always plan to do what is right by her. 

Photo of Lady sporting a little bit of hay on her head


Bansiddhi, P.; Brown, J. L.; Thitaram, C. Welfare assessment and activities of captive elephants in thailand. Animals (Basel) 2020, 10

Miller, Michele A et al. “Housing and Demographic Risk Factors Impacting Foot and Musculoskeletal Health in African Elephants [Loxodonta africana] and Asian Elephants [Elephas maximus] in North American Zoos.” PloS one vol. 11,7 e0155223. 14 Jul. 2016, doi:10.1371/journal.pone.0155223


  1. REPLY
    Jeanine says

    Poor elephants and all animals kept in captivity. It is so cruel. I hope Lady can live pain free as long as possible.❤️

  2. REPLY
    Suzanne Eaton says

    Thank you for enlightening your followers as to Miss Lady Bug’s osteomyelitis and future prognosis. I pray she can be as pain free as possible and still roam at sanctuary, swim, mud, dust and rest. Lady is a favorite of mine. Thank you for all you do for our girls. ❤️🐘

  3. REPLY
    Jane Whitfield says

    I myself had osteomyelitis many years ago & it was agony . My treatment involved surgeries & of course loads of drugs & constant monitoring .
    Somehow I had missed that that was Lady’s diagnosis so I am now devastated for her . She can’t have the treatments that cured me & I fear for her future – – despite the gargantuan efforts by you wonderful people . Am nearly in tears , poor poor girlie . To have had a dreadful life that had caused this equally dreadful ending .
    How will you know when it is time ?

    • REPLY
      Kat Blais says

      as always, we will allow her to guide us. 💜 i’m sorry for your struggles.

  4. REPLY
    Patricia says

    It’s heartbreaking what captive elephants go through. Precious Lady, thank God you are at EBS now. Sending love and prayers always! 💖🌸💖

  5. REPLY
    Terry says

    I am grateful Lady is no longer disregarded and her health and well-being is paramount in her freedom to live as she chooses. I am incredible grateful for sanctuary Brazil!!!❤️❤️❤️

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