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Elephants have very strong muscles. Mahouts say that the elephant' s 'muscle bundles' are tighter than those of other animals, especially the leg muscles that must support such great weight. The legs must bear a weight of about 2 000-3 000 kilograms in the case of mature elephants. The front legs bear two out of three parts of the weight.

The feet and legs are like those of the hippopotamus and tapir with the front legs longer than the back. Weight is distributed on a foot pad. The elephant has only one gait, the walk, so, unlike a horse, it can neither trot or gallop. Still, using the walking footfall pattern, elephants can "run" [technically, amble] quite quickly. The world record was set by a Thai elephant electronically measured at 23.84 kph. In a working day, a mature elephant can safely transport goods or people over level ground for 25 kilometres. Traversing hills, that distance should not exceed 15 kilometres. (Wild elephants on average cover only 4 kilometres a day.)

In Thailand today some mahouts force elephants to walk on two hind legs, which can lead to injuries of the pelvic area.

Strained muscles

Muscle strains are found mostly in elephants that are at very hard work or are put to unusual work or are fed an unbalanced diet. Most muscle strains are found in the legs.

Clinical signs: The elephant limps and shows it does not want to walk or refuses to make steep climbs. The muscles will be hot and swollen in the strained area, especially if it is on the legs, but if the strain is elsewhere, such as the back, the elephant will use its trunk to suck up water, dust, or dirt to spray on the afflicted area.



The elephant has a very large body, weighing on average 2 000 to 4 000 kilograms. The bones thus need to be very big and very strong in order to support the animal's weight and to withstand the activities of daily life. But if the bones that support the massive body are damaged, such as a crack or a dislocation, the elephant - unlike other animals - normally has but little chance of recovering to an ordinary life.

The bones most likely to suffer damage are the hind legs, the ribs, the pelvic girdle, and the lower [lumbrosacral] vertebrae.

The major cause of cracks, breaks and dislocations are accidents such as being struck by a vehicle or another elephant, being struck by a large log, falling downhill, or a landmine explosion. Immediately after an elephant suffers a bone injury, the mahout should help the elephant thus:

Bone problems are also often found in calves that have received inadequate nutrition, particularly an insufficient amount of mother's milk that has caused weak bones or incomplete growth, leading to abnormal development. In some cases, such calves are prone to being injured easily, even by minor accidents. Therefore, if you have a calf with such a history, you should avoid putting it to work where accidents are likely to occur. You should also consult a veterinarian.

Warning: Diagnosing whether a bone is broken, cracked, or dislocated is difficult because accurate analysis requires X-rays.


Arthritis is a painful condition affecting the joints that comes from both internal causes, such as old age or being overweight or being fed insufficient or poor quality food, and from external causes, such as an elephant being worked beyond its capacity or doing inappropriate work.

Arthritis comes in both acute and chronic forms. The chronic form is very difficult to heal completely, especially because the condition is very difficult to diagnose accurately and because treatment requires such a long period of time. Veterinarians treating chronic cases generally recommend taking the elephant off of work and stopping all activities that might pose danger to the joints and cause the arthritis to worsen.

As for acute cases of arthritis, the onset can happen very quickly. Acute arthritis is usually brought about by overwork or by inappropriate work such as hind-leg walking, head stands, etc. Arthritis can also occur as the side effect of an injury to the feet or legs.

Clinical Signs: The elephant will not use the affected limb or will do so only with great difficulty. The affected area is often swollen.


Alimentary tract

There are four very interesting facts about the elephant's alimentary tract that are very different from other animals. First, the elephant's digestive system is that of a single stomach, unlike cattle and water buffalo, and it is not very efficient; an elephant digests and absorbs only about 44 percent of the food ingested whereas cattle and water buffalo absorb about 60 percent of what they eat. Second, elephants eat a great amount of food, over 100 kilograms a day or 6-12 percent of their own body weight. Third, to get so much food, elephants will eat plants of such poor nutritional value that other animals will not normally eat them. Fourth, much of the digestion of nutrients is done not by the elephant's own digestive juices but by tiny germs [bacteria] and animals [protozoa].

With elephants you have huge amounts of poor quality food passing through a tube 40 to 70 metres long and very wide, with much of the digestion being done by guest creatures - the whole process taking 24-50 hours before the dung emerges. Given these strange facts, it should not be surprising that the elephant's guts are perhaps its weakest point.

Parasites in the alimentary tract

There are two important types of worms in the alimentary tract, flatworms and roundworms. They are often found in elephants that are raised in natural conditions. The spread of worms can be controlled by daily cleaning of the elephants' living and working areas, specifically by systematically collecting and processing dung. Mahouts should visually inspect the dung of their elephant every day. If they find worms they should consult a veterinarian.

Recommendation to camp managers: An inspection of each elephant's dung for parasites should be done every three months.

1. Liver flukes

Liver flukes (Fasciola gigantica, Fasciola hepatica, Fasciola jacksoni) are a kind of flatworm found in the liver and the bile duct. Infection comes from snails on the food that the elephant eats.

Clinical signs: The elephant is very thin and has little strength. The skin is rough and the eyes, mouth, and the end of the trunk (on the inside) are very pale and with a yellowish. Digestion is imperfect. The belly is often bloated with water, sometimes leading to dropsy [subcutaneous ventral oedema]. In extreme cases the elephant can die.


2. Cestode worms

Cestodes are about.5-1 cm long and have a sucker-like mouth that attaches to the wall of the stomach and both the short and long intestines, which the worms then eat. At present in Thailand it is not possible to identify exactly which species of cestode worms infect elephants or exactly how the elephants get infected, but it seems most likely that elephants ingest worm eggs found in insects eaten with their food.

Clinical signs: The elephant is listless and remains thin no matter how much it eats. The skin is rough, and hairs are brittle from poor nutrition. The inside of the end of the trunk, the mouth, and the soft tissue of the eyes are very pale. The elephant has little strength because of insufficient nutrients.


Warning: If one elephant is infected with cestodes, you can assume that all nearby elephants are probably infected as well.

3. Round worms

Roundworms (mostly Strongyle species) resemble the roots of onions and are 1-2 centimetres long. Infection is through worm eggs on the elephant's food.

Clinical signs: Usually the elephant exhibits no strong symptoms, but it might show the following signs. The elephant is emaciated and exhausted. In young elephants, worms will cause its growth to be stunted. The dung will have many worms.

Treatment: Normally elephants will purge themselves of worms, mostly roundworms, once a year. You can see worms in the dung. As a vermifuge, the elephants eat the leaves or roots or stems of the thorny plant ton jii (Harrisonia perforate Merr.) or mineral earth at a salt lick to disinfect themselves naturally. The mahout can help by taking the elephant off of work. Many other plants can be consumed:

If the condition does not improve, consult a veterinarian.

· Advice: In some areas where there are no natural salt licks, the mahout can, in consultation with a veterinarian, make an artificial one or can supplement mineral salts.

Recommendations on using Ivermectin

Ivermectin is a drug that can legally be given only by a veterinarian. It is very effective against parasites in the alimentary tract and comes in two types: Ivermectin, which works against roundworms; and Ivermectin-F, which works against both roundworms and flatworms and is particularly effective with liver flukes. Both drugs work through paralysing the nervous system of the parasites, causing them to lose their grip and to be purged from the elephant's body.

Ivermectin should be given as a preventive [prophylactic] twice a year. If you are working for a long time in a camp where there is a veterinarian or if you always work very closely with the same veterinarian, he will see to this schedule. But for the mahout who moves around or uses different veterinarians, you should keep very careful records of (1) the day of injection, and (2) the dose. If you do not ensure that your elephant is dosed twice a year, it might get parasites. If the elephant is dosed before scheduled, the elephant is given an expensive drug unnecessarily, since a dose will keep the parasite at an acceptable level for a full six months.

Do keep good records. You can write the date and dose given on a calendar, including the next bi-annual treatment. Best, though, is to use the treatment form provided in the Mahout's Handbook.

Like many medicines, if too much Ivermectin is used the drug can have bad side effects. If Ivermectin causes your elephant to salivate continually and its eyes to cloud, appearing as if it cannot focus, that is a sign of an overdose. Ivermectin is so powerful that residues in the urine can poison and kill earthworms that are very useful to the soil.

Camp managers: If you own all of the elephants in your camp, it's best if you get a good veterinarian. Even then it is best if you keep health records of your own. If you employ good numbers of elephants owned by other people, you have a choice to leave worming and inoculations to each owner or you can coordinate (and possibly even pay for) treatments. Considering how closely together most camp elephants live, there is a great likelihood of parasites being transmitted between the other owners' elephants. Planned prevention is something you must think about and you should consult with a veterinarian about a program.


The elephant is unable to excrete waste from its body, which comes about from various causes:

Clinical signs: The elephant is listless, not interested in food and sometimes is agitated or uses its trunk to strike its belly or apply dirt or mud to its stomach. The belly is swollen or inflated beyond normal and may have involuntary tremors. Some animals will repeatedly stand up and lay down. Some will trumpet or bellow in pain. If the condition is not treated, the animal can die.

Treatment: Usually dyspepsia arises from poor management, such as the mahout giving the elephant food that is hard to digest or repeatedly giving too much food. Thus, the first step of treatment is to find the cause and stop it. Treatment is as follows:


The elephant cannot evacuate its bowels.

Clinical signs: The elephant is listless and moves nervously in obvious discomfort. It does not eat or drink. The bowels do not move. Some animals will repeatedly lay down and stand up. Constipation is an important factor in causing dyspepsia.

Treatment: With old elephants, it is important to carefully analyse the food they are given. Old elephants should be given food that is easily digested such as ripe bananas. For ordinary healthy elephants it is important to consider how the food is given, such as whether banana stalks and palm fronds have been properly cut into short pieces.


There is a watery, loose discharge that can lead to serious dehydration. There are two major kinds of diarrhoea, non-infectious and infectious.

Diarrhoea without germs

Three main kinds of diarrhoea that do not involve infection by germs.

Diarrhoea from 'self de-worming': Normally elephants will purge themselves of internal parasites once or twice a year over two or three days. The elephant will seek out a natural vermifuge such as mineral earth, tree bark, or the roots of, for example, a shrub called ton jii (Harrisonia perforate Merr.).

Clinical signs: The elephant is listless and does not eat normal food. The dung is loose and watery, often with bits of undigested grass.

Treatment: Generally, this kind of diarrhoea or purging goes away on its own after two or three days.

Warning: Worm eggs emerge with the dung. These eggs can infect other elephants if you do not destroy or bury the dung and control the dispersal of worm eggs. For details on internal parasites, see page 113.

Diarrhoea from bad or inappropriate food: This condition can occur from the elephant, for example, eating too much of one kind of food, such as too much sticky tamarind, too much of commercially-bought pellets, or eating only ripe bananas. Diarrhoea can also come from eating food that is difficult to digest or food contaminated with sand or earth or some kinds of antibiotics or disinfectants, for example Povidone-iodine 1%, which can cause irritation that leads to diarrhoea.

Clinical signs: The discharge is much like with self-purging diarrhoea, but you will not normally find many parasites. You will sometimes find some bits of blood if sand or earth was eaten.


Warning: If the diarrhoea extends beyond three days or is very bloody or the elephant shows other signs such as pain, straining, weakness, or extreme listlessness, urgently bring a veterinarian.

Diarrhoea from stress: Elephants, particularly calves and females, are also highly susceptible to sudden diarrhoea when frightened or stressed. (See page 80.) This is what we mean by the idiom "excrement splits" [khii taek]. Elephants that are being trucked or separated from familiar companions or their mother can suffer such diarrhoea within 2 or 3 minutes. Sometimes the stress happens over a longer period of time, for example when when a strange elephant is chained nearby.

Diarrhoea caused by germs

Several kinds of germs can cause diarrhoea, including bacteria (e.g., E. coli, Salmonella, Clostridium, and Pseudomonas).

Clinical signs: Symptoms are much like non-infectious diarrhoea but if the condition continues past three days the cause is probably germs.

Treatment: Apart from keeping the elephant cool, watered, and rested, there is nothing the mahout can do but call a veterinarian.


Enterotoxemia is due to infection with a bacterium called Clostridium perfringens, and the disease has a history of killing many elephants. Enterotoxemia infects mostly elephants that have eaten contaminated food. Enterotoxemia is common in Thailand.

Clinical signs:



Salmonellosis is a disease that causes diarrhoea and that can kill elephants, especially calves. Caused by a bacterium called Salmonella, it is most often found in enclosures or camps with poor sanitation. It can spread amongst elephants very quickly.

Path of infection: Salmonellosis is spread through food and water contaminated with the bacteria, especially food that has been stored for a long time, because that enables the germs to multiply.

Clinical signs:


Warning: The mahout should be careful to practice good hygiene and wash his hands because salmonellosis is transmissible to other elephants and may be transmissible to humans.


The cause of the diarrhoea is the bacterium Escherichia coli (which everybody simply calls "E. coli") that has contaminated the elephant's food, water or some other ingested source. Colibacillosis is very often found in newly born calves with weak immune systems from having received insufficient colostrum. Also particularly susceptible are young elephants that receive dirty food or that live in unsanitary and improper conditions.

E. coli infects many different mammals, including humans. One common path of infection is when a human, after having had a bowel movement, has not properly washed his hands, and then transmits faecal matter to an elephant by feeding it by hand.

Warning to camp managers: Many zoos in the West have totally banned hand-feeding elephants out of fear of spreading E. coli and similar bacteria. While stopping hand-feeding is probably impossible in Thailand, where it generates much income, camp managers should be aware of the danger of infection.

Clinical signs:




Pneumonia is a disease of the elephant's respiratory system. Pneumonia comes in both viral and bacterial forms, so the exact cause is usually not clear, at least unless very sophisticated testing is done in a laboratory. Pneumonia often attacks after an elephant has been debilitated by another disease.

There is presently no vaccine or other medical means to prevent the disease, but it is clear that pneumonia often effects elephants exhausted from overwork; also particularly susceptible are poorly fed or underfed elephants, as are elephants in prolonged stress.

Pneumonia is found in elephants of all ages.

Clinical signs:



Anthrax is a highly infectious disease, a bacterium that strikes elephants of all ages. Anthrax also attacks cattle, horses, water buffalo and other warm-blooded animals, including humans who work with those animals. When the bacteria enter the bloodstream, they multiply very quickly. Septicaemia, a blood infection, usually follows. Death happens very quickly, usually within one or two days. Sometimes the elephant dies very soon after the sickness is recognized. Even after elephants' deaths, the anthrax bacteria infect not only their carcasses but also their skins and even their ivory.

The path of infection: The anthrax bacteria create spores, very hardy organisms that can survive for many decades and are highly resistant to heat and to chemical disinfectants. Domesticated elephants usually catch anthrax when grazing on infected pastures or eating contaminated food. Infection happens most often when grass is low and scarce, and often becomes epidemic when heavy rains follow the dry season. Infection can occur through respiration, exposure to blood, lymphatic fluids, and dung.

Clinical signs:


Haemorrhagic septicaemia (Pasteurellosis)

Haemorrhagic septicaemia is a virulently infectious and contagious disease with a very high death rate. It is very easily confused with anthrax because the symptoms are similar and because, like anthrax, more victims die than respond to treatment. The infection can run through a herd of elephants very quickly, in about 10-15 days. Elephants usually die within 3-36 hours, although some last for 15 days.

Path of infection:

Clinical signs:


Prevention: Haemorrhagic septicemia is preventable by an annual vaccination good for a year, but this vaccine often causes the area around the injection to have an allergic reaction and to swell for three or four days. This swelling can be treated by hot compresses and fomentation.


Tetanus is caused by a long-living anaerobic bacterium that is found in the soil and in moist areas. Tetanus is usually found in elephants that have suffered deep wounds, usually in the foot and particularly through the footpad being pierced by a metal object such as an old, rusty nail. After the bacteria have entered the elephant's body they thrive and, after an incubation period of 15-20 days, neurotoxins are produced that damage the nervous system and cause typical muscular spasms.

Between about 1977 and 1992 Thailand experienced, on a massive scale, thieves cutting off elephants' tusks by stealth in order to sell them. One result was that many tuskers contracted tetanus and died.

Path of infection: Infection proceeds from stepping on a piece of metal or other contaminated object that causes a deep wound. With elephants, however, the wound might not be obvious because elephants can and do use their trunks to gather dirt (which might be contaminated) to stuff in wounds, including cut tusks. When tetanus enters a tusk's pulp cavity, it spreads very quickly because it thrives in environments where there is no oxygen.

All wounds must, of course, be carefully cleaned but be especially careful where the puncture is from nails or rusty old metal, especially in an area that has long housed many animals. After infection, the disease does not progress quickly and the elephant will appear normal for 15-20 days (sometimes even longer) before symptoms appear. Even if the elephant receives treatment, the survival rate is very low.

Clinical signs:


Prevention: For elephants that have open wounds or exposed pulp cavities in tusks, prevent the elephant from contracting tetanus by daily cleaning of the wound and by keeping the elephant on a clean surface. Otherwise the elephant is likely to introduce dirt or other unclean material that could contain tetanus germs into the wound.

No vaccine yet exists for elephants but if an elephant with a wound seems to have been exposed to tetanus, a veterinarian can inject an antitoxin to prevent infection from the bacteria.


Tuberculosis is a chronic disease of the respiratory system that usually enters the body through the trunk, the windpipe [trachea], and the lungs. Tuberculosis is a bacterial disease (Mycobacterium spp.) that can infect both elephants and humans. Tuberculosis is a critically important disease because it can be transmitted from people to elephants, from elephants to people, and from elephants to elephants. Besides people and elephants, tuberculosis also affects primates, cattle, horses and other animals.

Tuberculosis in elephants has been reported in Thailand, but in the early stages the disease is notoriously difficult to diagnose and to verify. The high human rate of infection and the intimacy of mahouts with their elephants strongly suggest that there are many tuberculosis-infected elephants in Thailand.

Today in Thailand the disease AIDS is epidemic in humans. A major cause of death brought about by AIDS, which compromises the immune system, is tuberculosis because tuberculosis is an opportunistic disease that attacks when the body's defence systems are weak. Consequently, tuberculosis in humans is spreading in Thailand, and thus the chances of elephants contracting tuberculosis are increasing.

Tuberculosis in elephants can be very expensive and very difficult to treat. The disease is a big problem in European and American zoos.

Path of infection: The bacteria is usually transmitted directly through exhaled air [infected respiratory droplets] and phlegm. Transmission can also occur through contaminated food or water and also dung, urine, milk, semen, and other bodily secretions.

Clinical signs:


Prevention: Annually inspect the health, including chest X-rays, of all mahouts, care givers and other involved persons. If an infected person is found, provide treatment and keep that person from having any contact with elephants until the condition is cured. Camp managers of large facilities, especially, should be careful to follow this procedure; while it will entail some inconvenience and some costs, they are far less trouble and expense than if tuberculosis should erupt in your camp.

Herpes virus

Herpes virus has a history in African elephants, where it is found in the lungs as has been shown by necropsies. The disease is usually found in elephants kept in confined enclosures with poor air circulation. In Western zoos, herpes virus has been found in both African and Asian elephants. Young animals are particularly susceptible.

Herpes virus has not been reported in Thailand. In any case, the symptoms are not very obvious and thus a confirmed diagnosis can only come from a veterinarian, and even then only after extensive laboratory testing. In some elephants, especially calves, the tongue, mouth, and the inside of the tip of the trunk will show a blue discolouration [cyanosis].

Symptoms are likely to appear at times when elephants are in poor condition or their immune systems are low, leading to secondary infections such as respiratory diseases.

Foot and mouth disease

Foot and mouth disease is an important contagious disease of hoofed livestock. This highly infectious disease is often found in cattle, water buffalo, and pigs. Foot and mouth disease is a virus that in Thailand is contracted by elephants mainly through contact with infected cattle and water buffalo. The disease is not common among elephants.

Livestock infected with foot and mouth disease are usually destroyed, but because elephants are considered to be very important, having spiritual importance in Thai culture, they are not destroyed.

The path of infection:

Clinical signs:


Elephant pox

Elephant pox is a serious, infectious viral disease that has a history of being epidemic. (Out of 18 elephants in a European circus, 11 became infected and one died.) Elephant pox, which is related to the human disease smallpox, can be contracted by humans. Asian elephants are more susceptible to pox virus infection than are African elephants.

Wild rodents are suspected of being the reservoir of elephant pox virus. It seems that there has never been a case of elephant pox in Thailand, but the disease has been reported in Myanmar.

Path of infection: Elephant pox is contracted, both by elephants and humans, by direct contact with the sores or mucous of an infected elephant.

Clinical signs:



Rabies is a viral disease contacted by being bitten by an infected animal, in Thailand almost always a dog. The virus germs are found in the dog's saliva and some will stay with the wound. The virus will then incubate in an elephant for a period of up to 30 days, depending partly on the severity of the bite wound. After the incubation the virus will find its way to the elephant's nerves, spinal cord, and the brain. In elephants, rabies almost invariably brings paralysis and then death.

Anytime an elephant is bitten, particularly if the bite has drawn blood, the mahout and owner should take four actions. First, write the day on a calendar; then you will be able to predict when the elephant may show clinical signs if it was infected. Second, talk to people who know the dog and ask about its behaviour in the days prior to the attack; if the dog has been acting strangely (staring fixedly, foaming at the mouth, etc.) there is a good chance the dog is rabid. Third, inform everybody in the community of the health hazard, because the disease also attacks humans, and ask them to help track down the dog. Fourth, very carefully capture the dog, confine it securely, and observe its condition; if after ten days it is normal then the elephant does not have rabies.

Clinical signs:

The initial signs of rabies in elephants may be vague but most often the elephant:

As the disease progresses the elephant likely:

Death may shortly follow the appearance of these more severe signs. If the elephant dies, see "Disposal of Elephant Carcasses" (page 55).


Prevention: Because rabies is incurable the best prevention is to eradicate all stray dogs from the area and to annually vaccinate all the dogs and cats in the community.

Trypanosomiasis (Surra)

Trypanosomiasis comes from a protozoal blood parasite. It can infect horses, donkeys, mules, camels, cattle, buffaloes, dogs and elephants. While not often seen in elephants, cases have occurred in Thailand.

The trypanosomes are carried by jungle flies and gadflies [Tabanid and Stomoxys spp.] that suck blood from infected animals and then transmit the parasite to healthy animals when they bite them.

Trypanosomiasis is most often found in elephants that have been worked very hard and is usually found in the rainy season, when biting flies are in great abundance.

Clinical Signs:

The clinical signs of trypanosomiasis are usually very difficult to observe.


Prevention: The best prevention is to keep the flies from biting the elephants by spraying them with a mixture of medicines such as Arsuntol and Neguvon. (See page 61.)

Biting flies may be reduced in numbers by regular disposal of the dung and soiled bedding in which some species breed.

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