A 29-year-old bottlenose dolphin recently underwent therapeutic bronchoscopy to treat airway narrowing - stenosis - that was interfering with her breathing.

The dolphin had developed a cough (chuffing) which initially responded to antifungal treatment, but she then developed a prolonged blowhole opening time during swimming. She was transported to a local hospital for diagnosis where a computed tomography scan and fiber optic bronchoscopy confirmed the presence of focal stenoses of the right mainstem bronchus and the tracheal bronchus. 

The veterinary team consulted an interventional pulmonology team with experience in complex human airway disorders. As a human flexible bronchoscope was too short for use in the dolphin's airway, a gastroscope was used to visualize the stenoses. Balloon dilation was performed, and the dolphin's respiratory cycle improved and she returned to her normal behavior.

"Many of the medical treatments and procedures used in humans were developed and tested in animals, and many are used in the care of both," said lead author Andrew R. Haas, MD, PhD, Director of Clinical Operations, Section of Interventional Pulmonology and Thoracic Oncology at the Hospital of the University of Pennsylvania. "Our case is notable not only because of the animal involved but also for the cross-disciplinary collaboration among specialists from far-ranging disciplines."

In addition to the marine mammal veterinary team which included a general marine mammal veterinarian, a marine mammal anesthesiologist, and a marine mammal veterinary radiologist and the human interventional pulmonology team, the treatment group included a trainer to keep the dolphin calm and dolphin care providers, who kept her in the proper position and kept her skin moist during the procedure.

"While the use of bronchoscopy in marine animals has been reported, ours is the first known case of therapeutic bronchoscopy performed in such a case," said Dr. Haas. "The sharing of knowledge, techniques and technology used in the care of humans and animals in this case may open the door to novel treatment approaches for both."

The case study in the Annals of the American Thoracic Society
notes that the dolphin, a therapy animal for mentally and physically challenged children at Island Dolphin Care in Key Largo, Florida, is doing well one year after the procedure.