To treat or not to treat?

Abstract

In a world of ever-increasing liability, the decision not to treat a patient comes less and less easily, even though both evidence-based medical and financial reasons may speak against treatment. Elephant haemorrhagic disease (EHD), associated with viraemia with elephant endotheliotropic viruses (EEHV), may kill within hours after onset of clinical signs. Here, the authors present a case, where a three-year-old female Asian elephant (<jats:italic>Elephas maximus</jats:italic>) developed viraemia with EEHV1 but was deliberately left without antiviral treatment and survived without developing clinical signs. Considering the mostly fatal outcome of EHD, this decision may at first glance appear hazardous. However, the reasoning included knowledge about herpesviruses in general, past and present EEHV status of the individual, EEHV epidemiology within the herd as well as stress and costs involved in treatment. It is important to consider those parameters for each impeding case separately in order to assure the best welfare of the animal.