title: Use of phlebotomy treatment in Atlantic bottlenose dolphins with iron overload.
abstract: METHODS
  3 adult (24- to 43-year-old) Atlantic bottlenose dolphins (Tursiops truncatus) with chronic episodic malaise and inappetence associated with high serum aminotransferase (alanine aminotransferase and aspartate aminotransferase) activities, high serum iron concentration, and serum transferrin saturation > 80% were evaluated.
  
  
  RESULTS
  Results of histologic examination of liver biopsy specimens revealed hemosiderosis in all 3 dolphins. Except for chronic lymphocytosis in 1 dolphin, results of extensive diagnostic testing revealed no other abnormalities. For each dolphin, a diagnosis of iron overload of unknown origin was made.
  
  
  RESULTS
  Phlebotomy treatment was implemented to reduce body stores of iron. Each phlebotomy procedure removed 7% to 17% (1 to 3 L) of estimated blood volume. Treatment consisted of an induction phase of weekly phlebotomy procedures for 22 to 30 weeks, which was complete when serum iron concentration and aminotransferase activities were within reference ranges and serum transferrin saturation was < or = 20% or Hct was < or = 30%. Total amount of iron removed from each dolphin was 53 to 111 mg/kg (24.1 to 50.5 mg/lb) of body weight. One dolphin required maintenance procedures at 8- to 12-week intervals when high serum iron concentration was detected.
  
  
  CONCLUSIONS
  Although the cause of the iron overload and high serum aminotransferase activities remained unknown, phlebotomy treatment successfully resolved the clinicopathologic abnormalities, supporting a role of iron overload in the hepatopathy of the 3 dolphins.
authors: United States Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, San Diego, CA 92152, USA.
authors: Shawn P
authors: SP
authors: Johnson
authors: Stephanie K
authors: SK
authors: Venn-Watson
authors: Stephen E
authors: SE
authors: Cassle
authors: Cynthia R
authors: CR
authors: Smith
authors: Eric D
authors: ED
authors: Jensen
authors: Sam H
authors: SH
authors: Ridgway
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D050681:Bottle-Nosed Dolphin / Q000097:blood; D005260:Female; D019190:Iron Overload / Q000097:blood / Q000628:therapy / Q000662:veterinary*; D008297:Male; D018962:Phlebotomy / Q000662:veterinary*
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase