Jan 31, 2016 - Please find attached a couple of case reports where we have used the L-Mesitran on rhino in. South Africa
31/01/2016 Dear Indra, Case reports – L- Mesitran Please find attached a couple of case reports where we have used the L-Mesitran on rhino in South Africa. This is by no means the total amount of patients we have treated, but I am not sure how many case reports you are in need of. There are still a couple of cases that are ongoing, that I will put in a next report to you. First of all, thanks so much for offering this product to us, so that mainly rhinos but also other wildlife may benefit from this product. We are still losing over 1000 rhinos a year, so every rhino we can save that has sustained an injury, whether from poaching or otherwise, is absolutely essential. There is no doubt in my mind that this product has been greatly beneficial in the many wounds that we have treated. “Honey and sugar are attractant for tissue macrophages and may exert an antibacterial effect when applied to contaminated wounds. Honey has been shown to up-regulate the expression by monocytes of some inflammatory cytokines [tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6], which may be the mechanism whereby it enhances fibroplasia and epithelialization. At the wound site the enzymes (inhibine) contained within the honey exert a strong antibacterial effect via acidification and the slow release of hydrogen peroxide, a mild disinfectant, and glucolactone/gluconic acid, a mild antibiotic. Honey also provides antioxidants, which protect wound tissues from the damage imparted by free oxygen radicals released from inflammatory cells. Honey’s antimicrobial effects have been demonstrated in vitro against 18 strains of methicillin-resistant Staphylococcus aureus, 7 strains of vancomycin-sensitive enterococci, and 20 strains of vancomycin-resistant enterococci. The latter study concluded that inhibition of bacterial growth was not solely dependent upon osmolality. Bang, et al. 2003, described the antibacterial effect of H as a result of hydrogen peroxide production by glucose oxidase in the wound. The concentrations of hydrogen peroxide produced in this study were very low; therefore, cytotoxicity is considered minimal. Further studies have shown that Honey contains inhibine, an enzyme from bee pharyngeal glands, which breaks down into hydrogen peroxide and glucolactone/gluconic acid; these compounds act as a mild disinfectant and mild antimicrobial, respectively. Equine Wound Management – Stashak and Theoret. Thank you again. Kind regards Johan Dr Johan Marais. BVSc, MSc. CEO: Saving the Survivors Equine and Wildlife Surgeon South Africa
(1) Adult White rhino cow with injury to horn base This cow sustained an unknown injury at the base of her left horn and developed an infection that spread to the bottom of her back horn, and into her left paranasal sinuses, as she also developed a left nasal discharge. Contrast medium can be seen entering the wound and extending to the bottom of the back horn.
The wound was debrided, flushed and treated with L-‐Mesitran, after which the area was closed with innovative screws, wire and dental acrylic, as bandages and normal suture material does not work in this area. This was left on for 4 weeks. She was not treated with antibiotics, but was given an anti-‐inflammatory. After 4 weeks the cow was immobilized and the dental acrylic was removed. There were no signs of a nasal discharge. The wound at the base of the horn healed exceptionally well. The screws and wire was removed and the cow was woken up.
(2) Subadult cow with gunshot wound to lower limb A subadlt White rhino cow presented with a 2 week old, infected wound due to a gunshot wound to the lower limb. A culture and antibiogram was done on the wound, and the following results were obtained: Enterococcus faecalis and Aeremonas hydrophila were grown, sensitive to Florfenicol, ceftiofur and enrofloxacin.
The wounds were flushed, cleaned and L-‐Mesitran was infused into the wounds. The wounds were dressed with a combination of L-‐Mesitran and calcium alginate and the limb was put in a cast.
Due to the aggressive nature of the cow, she cracked the cast within five days and the cast had to be replaced with a thicker one. On examination of the wounds, it was found that they have healed remarkably well in just a few days. Due to the fact that the culture results became available in the mean time, we felt there was no need to treat her with antibiotics.
(3) Adult White rhino bull whose horn was removed too short An adult White rhino was immobilized and he was dehorned for anti-‐poaching purposes. However, several weeks later his horn cracked and became infected. We were asked to removed the cracked, infected horn, as it had a smell and was visibly irritating him. Under immobilization the horn was removed and copious amount of L-‐Mesitran was applied. Unfortunately this area cannot be bandaged, as well as this particular bull was quite aggressive and probably will remove any covering soon.
The bull was released and responded very well to the treatment.
(4) Adult White rhino cow with injury to vulva This White rhino cow is thought to have been injured by the bull in the same area. She suffered from a small but very deep wound that extended from her right tuber coxae area, through her vulva, 30 degrees in to the level of her left tuber coxae (see blue line as indication). It was infected but no maggots were visible. Note the amount of flies in the area. The area was flushed, and liberal amounts of L-‐Mesitran was infused with a dog feeding tube. She was woken up.
We returned in 3 weeks time and according to the owner she is doing very well. No flies are seen around the tail and wound area. She was not immobilized as we felt she has healed completely and risk of anaesthesia is necessary.
(5) Adult White rhino bull with pressure sores from casting We are currently treating a large White rhino bull with severe fractures of metacarpus 2 and 3 in the right frontlimb. We attempted to leave the cast off after 4 weeks, however then he does barely bear weight on the limb. He developed some pressure sores from the fist casting procedure, which was treated with ample amounts of L-‐Mesitran. After only five days, the wound was evaluated and found to have healed remarkably with much less inflammation as well around the wound edges. The limb was again put in a cast.
(6) HOPE, the adult White rhino that is defying all odds! Hope is a 5-‐year-‐old White rhino cow who was mutilated by poachers to have her front and back horns removed. She developed massive infection in her facial area, and this was repeatedly treated with L-‐Mesitran and calcium alginate dressings. Healing has been remarkable, as can be seen from the pictures below. Treatment is ongoing. May 2015 September 2015
