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The skin of the Asian elephant is 1-3.5 centimetres thick. The skin on the back and the haunches is the thickest and the skin behind the ears is the thinnest. The skin is important in controlling temperature, especially dissipating heat. The elephant's skin is so wrinkly partly to increase surface area to shed warmth from its body. Oddly, the skin has no sweat glands except for those right above the elephant's toenails. Healthy skin plays a great part in an elephant's vitality. Elephants love to roll in mud and to throw dirt over themselves, both of which protect against sun and insects. They also love to bathe for long periods, and bathing is a good opportunity for the mahout to look for anything unusual with the skin, such as wounds, abscesses and parasites.


Papilloma warts, which are caused by a virus, are not found very frequently in elephants. Papilloma warts most often arise in calves, particularly those that have not drunk mother's milk regularly since birth, the lack of which causes the calf to be deficient in antibodies against the virus.

The warts are characteristically like round balls of flesh, much like warts in people but larger. Warts are often found on the trunk, from the tip to the base. Mostly you find only one wart, but sometimes there are many.

Clinical signs:


Fungus on the skin

In the old days, there were basically no fungal infections on the skin because elephants were kept in appropriate, natural conditions and not overworked, which is quite different from today.

Fungal infections are often found on elephants fed insufficient food, or poor food, or on elephants that have been worked to the point of exhaustion. The fungi are found everywhere in the environment. Infection often comes when elephants are kept in a very confined space.

Path of infection:

Clinical signs:

The fungus first appears as specks, often starting as small grey-white spots on the back of the ears or on the throat. If left untreated, these spots will enlarge into blotches and can spread all over the body. Some cases have distinct blotches of bright pink with a diameter of up to 10 centimetres. (The pink is not the colour of the fungus but rather the colour of the skin after the fungus has caused depigmentation.) These blotches cause irritation and itching in the elephant, so it will often scratch the infected area or rub it against a tree until wounds form. The condition can effect eating and sleeping, ultimately leading to secondary illnesses.

See photographs, pages 139-140.


Warning: Fungal infections require a methodical and often very long course of treatment. Very often the condition proves drug resistant, and thus treatment can become very expensive. Therefore, if you have an elephant that is just starting to show the signs, even a very little bit, treat it as quickly as possible. In the end you will save much money.

Ventral oedema

Ventral oedema is a swelling caused by water [fluid] collecting in the tissues under the skin on the elephant's under surface. Ventral oedema is a sign of something wrong inside the elephant's body. It is often found in elephants that have been fed an unbalanced diet, such as eating too many banana tree stalks. Ventral oedema is also common in elephants under stress or with low protein levels in the blood.

Clinical signs: A watery swelling on the under side of the body, the throat or the belly or the sex organ or any combination thereof.


Note to camp managers: Ventral oedema is a condition that manifests itself externally but indicates some internal abnormality. There are many possible causes. Beyond causes described above, oedema can be caused by liver flukes, renal failure, heart disease, tuberculosis, or even simply an upset digestive tract. Thus, only a veterinarian can diagnose the real cause in order to alleviate or treat the condition.

External parasites

Most Thai elephants still spend their lives in nature and therefore they often come into contact with external parasites. The parasites that are most often found on elephants are gad flies, fleas, hair lice, lice, and bot flies. External parasites harm elephants in various ways:

Warning: If one elephant is infested with ticks, lice or fleas, you can assume that all other nearby elephants are also infested.

The best way to prevent or lessen external parasites is to maintain cleanliness by careful collection and disposal of dung and urine. It is essential to cleanse the elephant's body carefully every day by using half of a coconut shell to scrape the elephant on a daily basis.

Gad flies

Gad flies [duang or malaeng wan pa] lay their eggs on the skin, where they become larvae. When mature, they bore out and fall to and enter the earth, where they pupate to become adult gad flies.

Clinical signs: The elephant's skin has many bumps the size of soy beans, particularly on the sides, hips, and belly. The elephant is irritated, which it shows by rubbing against trees and rocks. Some of the bumps break open and turn into nasty sores as the larvae emerge, especially in the area of the belly. If you dig into one of the bumps, you will find a white worm [larva], with both the 'mouth' and the rear end being black.


Warning: Insecticides are dangerous to elephants and people and should not be used as a preventative. Spraying works only temporarily.

Fleas and mites on the tail

Fleas and hair lice are the primary cause of tail hair dropping out and of sores at the end of the tail.

Clinical signs: The elephant will swing and rub its tail against trees, rocks, posts, etc., and against its own body. Hairs will break off and fall out, and this activity often results in open sores.


Hair lice

Hair lice [Haematomyzus elephantis] irritate elephants so much that some become exhausted. Some elephants become bad-tempered.

Clinical signs: The elephant will show indications of itching. If you look very closely, you will notice lice as small red or brown lumps the size of the head of pin. The lumps will be found in groups in creases in the elephant's skin. Lice are mostly found in the soft tissue behind the ears, at the end of the trunk, the reproductive organs, and the tail. Elephants will often rub up against trees, and many are so constantly agitated that they get no rest and become exhausted and finally contract a secondary disease.


Tabanus flies

Tabanus flies are blood suckers. They are extremely aggravating to elephants and they can be transmitters of contagious diseases such as anthrax and trypanosomiasis (Surra).

Clinical signs: The elephant will move continuously to keep the flies away.




The elephant's eyes are small, about the size of a horse, and nearly all books say that its vision is not very efficient compared to its hearing and smell. Still, the elephant's ability to move around quite well in dim moonlight suggests their eyes are well adapted for low light levels. Elephants do not like it when it is totally dark or very bright, rather preferring the light at dawn and at dusk or in shady areas during the day.

Healthy elephant eyes are clear and are well lubricated.

Eye conditions are a big problem, whether elephants are kept in the forest or are wandering city streets. Eye problems tend to arise very quickly and it is best to see a veterinarian for all eye problems.

The most common problems are conjunctivitis and infected cornea. S

Conjunctivitis comes from irritation caused by dust, wind (especially from being trucked), smoke, leaves, etc. (See photograph, page 138.)

Clinical signs: The elephant will have copiously flowing tears, red eyes, swelling and signs of infection. The eyes blink frequently and most elephants will use their trunk to rub the eyes. In some cases there will be a yellow discharge.


Infected cornea [keratitis] can come from disease but usually proceeds from mechanical injury. Infected corneas cause many elephants to go blind. Keratitis can be divided into four types.

Treatment: All four types of keratitis are treated exactly the same as conjunctivits.

1. Infected cornea with highly visible blood vessels [superficial keratitis with vascularization] arises from irritation and a subsequent infected conjunctiva that has been left untreated.

Clinical signs: The eyes are red with copious tears. Blood vessels are seen in the cornea. The elephant rubs its eyes with its trunk.

2. Ulcerated cornea [ulcerative keratitis] comes from the eye being struck hard, or pierced by a thorn, twig, etc., until there is a wound. The eye becomes opaque and there will be pus. Blindness often follows.

Clinical signs: There is an ulcer on the cornea. Often the eye is opaque. There are copious tears.

3. Infected cornea with an infected eyelid [keratoconjunctivitis] comes from irritation caused by a foreign object (usually a twig, leaf, etc.), smoke, etc.

Clinical signs: There are copious tears. The eyes are red and infected and there is frequent blinking. The elephant rubs its eyes with its trunk. Sometimes there is a yellow discharge.

4. Infected cornea with a puncture [punctate keratitis] often comes from being frequently struck hard on the brow. There is an opening on the cornea, and there is pus from the eye chamber.

Clinical signs: A puncture on the cornea with tissue drooping.' Sometimes there is pus. There are copious tears. If the condition is not treated, the eye will become opaque. The elephant may become blind.

Cataracts, lesions of the lens that become opaque, arise from many causes, such as an injury to another part of the eye that spreads to the cornea. Cataracts affect mainly old elephants but malnutrition can cause cataracts at any age. Too much exposure to direct sunlight (or other strong light) can also cause cataracts. Cataracts cause opacity and the elephant will become progressively blind. (See photograph, page 138.)

Clinical signs: The lens is opaque and sometimes becomes hard and dry. Some eyes will exhibit a milky discharge. The central eye can bulge.

Treatment: See a veterinarian.

Medicating eyes

The elephant's eyes are very small in proportion to the size of its body. The eye has three lids to protect the eye. When the eye is infected or irritated by a foreign body, the third eye lid becomes very prominent and often red coloured. The mahout should be expert in the following technique.

How to apply liquid eye medicine:

Ear infections

An elephant's ears are a primary indicator of the animal's health. A healthy elephant will constantly, vigorously flap its ears, but an elephant in poor health will do so only very slowly.

Ear infections can be divided into two types, infections of the external ear and infections inside the ear [the auditory canal].

Infections of the external ear [Otitis Externa] and auricle come from two sources.

Clinical signs: The auricle is swollen and red. The wound emits pus and a foul smell. The elephant shows pain. If you explore the wound, sometimes there will be maggots.


Infections of the internal ear [Otitis Media] begin with external infections that, if left untreated, spread to the inside. Sometimes germs will enter the ear and an infection will erupt.

Clinical signs: When the elephant lies on its side or if you press the sore ear's auricle, pus will come out. If you get close to the ear it will have a bad smell.

Treatment: Consult a veterinarian.


The elephant's trunk is a critical organ in the life process. The trunk can be compared to a human's hand. It plucks grass from the ground and pulls food down from places as high as 4 or 5 meters. The elephant uses the trunk as weapon to defend itself, as a way to communicate with its fellows, to smell, and, of course, to breathe.

The trunk is composed of 40 000 muscle bundles. The trunk has very extensive networks of both blood vessels and nerves. A desirable elephant will have a trunk with a very thick base, muscular throughout its length, and the end of the trunk must be able to be closed tightly. Thus, any significant injury to the trunk can cause death. Because the trunk is very sensitive, an experienced mahout will therefore use only the tip of his hook in order to control the elephant.

The only conditions that afflict the trunk are papilloma (see page 95) and wounds. There have been unsubstantiated reports from southern Thailand of a condition that sounds similar to floppy trunk disease, a mysterious condition that affects African elephants, leaving the trunk paralyzed and pliable. We would very much appreciate being informed about such cases.


What we call a tusk is actually an incisor tooth, and not a canine tooth as would be logical. If you read about tusks of Asian elephants in Thai books, you will always read that only males elephants have tusks. If you read just a bit further, though, you will be told that some male elephants [chang si daw in Thai], and all female elephants have tusks that are too small to be called tusks and are called khanai [tush].

From a medical point of view, all elephants have tusks, with the variation being only in size. It is true that what we call a tusker (chang phlai) is more likely to have more problems with its tusks, both because of their size and because they are made to use their tusks to do hard work. Still, any elephant can suffer infected tusks,

The base of the tusks are embedded deeply in the elephant's skull, set in sockets under the eyes. Tusks are very strong and in a mature male elephant grow on average about 17 centimetres a year. A hollow inside the tusk [pulp cavity] contains blood vessels and a nerve. Consequently, before cutting or trimming an elephant's tusks you should know how much is to be cut off in order to not cut the blood vessels and the nerves. Opening the pulp cavity can cause the elephant to die through loss of blood or infection or even through contracting tetanus.

Recommendation to camp managers: When trimming tusks always seek the advice and services of an expert mahout. Because there is so much variation between tusks, never follow any rules for cutting that you read in a book.

Tusk infections are of many kinds:

1. Tusks that have cracked from elephants that habitually "play with their chains," [len sod] that is, try to break them. The tusk can suffer a great deal of impact force.

2. Tusks that wobble because they are loose in their socket come from elephants that "spear" [thaeng] the earth or trees for fun. The socket becomes infected.

3. Tusks that are broken or cut so close to the base that the pulp cavity becomes infected. This condition often arises when tusks are cut by ivory thieves.

4. Tusks that have fallen out but the socket is still infected.

Cracked tusks

Clinical signs: The crack may be only near the tip or it may extend up to and into the base. In the latter case, the tissue that covers the base may be swollen. The elephant has copious tears from its eyes if the tusk is infected. If left untreated there will be pus seeping from the cracked tusk and there will be a foul smell.


Loose, wobbly tusks

Clinical signs: Foul smelling pus secretes from the tusk base, not the tusk itself. The elephant will regularly blow air or dirt on the area with its trunk. If you move the tusk, the elephant will show pain.

Treatment: Wash the area where there is pus with a solution of clean water and Povidone-iodine 1% (mixed 1:20) on a daily basis. Then consult a veterinarian.

Tusk broken or cut too close to the base

Clinical signs: There is pus in the pulp cavity and the elephant will usually spray dirt with its trunk and use sticks to probe into the cavity. If the tusk is newly broken or cut, there will likely be blood seeping from the tusk.


Empty sockets

Clinical signs: The elephant will use its trunk to blow or stuff dirt into the empty socket. There is likely to be pus.


Feet and nails

Asian elephants usually have between 16 and 20 toenails. The normal elephant has 18 toenails, with 5 in front and 4 in back. The nails are shaped as elongated semicircles, and emerge from the skin spaced apart. The front feet are round while the hind feet are more oval and smaller. The bottom of the elephant foot has a thick footpad (1-2 centimetres). The ideal footpad has grooves [fissures] in order to prevent the elephant from slipping, much like the treads on a tyre.

Elephant toenails are likely to break, split, and fall off. Without treatment, such conditions will damage the animal's general health. Movement becomes difficult and it is possible the elephant will die.

There are two general causes of problems in feet and toenails:

Internal causes: Sometimes problems arrive from poor nutrition, lack of minerals and certain vitamins. Sometimes problems come from conditions within the animal's own physiology. The elephant's toenails can become thin or brittle and can peel [exfoliate] or crack easily. Elephants can have abnormal or crippled feet from birth or by accident. Movement is made difficult by, for example, stiff legs, stiff joints, sprains, twisted legs, etc. An elephant might drag a leg or stand in an abnormal posture, causing toenails to grow unusually long.

External causes: If the surface where the elephant walks or is working is potholed and not smooth, if it is slanted or hard or is rocky, nails will be prone to split and break. If the elephant stands for a long time in dirty water or water fouled by its own urine and dung, or by chemicals, the quality of the nails can deteriorate.

Prevention in ordinary, healthy elephants:

Cracks in the footpad are often found in the footpads of elephant made to walk in cities or elephants housed on concrete floors.

Clinical signs: The footpad peels off from the foot. The elephant will not put its full weight on the foot. In some cases, the elephant will use its trunk to spray or put dirt or mud in the crack or cracks.


Split toenails are often found in elephants that must often walk in steep and hilly areas. Nail problems are particularly common in elephants that do illegal logging in northern Thailand and also in elephants that spend much time on concrete. Poor nutrition or malnutrition also lead to split or broken nails.

Clinical signs: The elephant avoid putting weight on the foot and limps.


Abnormal nail growth is often found in elephants that must walk in steep and hilly terrain. Abnormal nails are frequently found in elephants doing illegal logging in northern Thailand and also elephants that spend much time on concrete.

Clinical signs: The elephant will not walk smoothly. Some animals will hobble. Often the nail grows very long.


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