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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

Sources:

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