Young lioness undergoes steep decline in health

Tajiri came to Philadelphia from her Wisconsin birthplace a robust young lioness. But her health was short-lived.

Just shy of two years old when she arrived, the playful cat had sailed through her pre-shipment medical clearance, as well as her one-month health quarantine at the Philadelphia Zoo. There, she was observed closely and screened for everything from parasites to feline viruses before being placed in the zoo's Big Cat Falls exhibit.

Nine months later, Tajiri experienced her first heat cycle. And then things changed quickly. One of the keepers noticed that her third eyelid - a light-pink membrane that is present in most animals but normally not visible - was fully unfurled in both eyes. And she seemed a bit lethargic.

Oral antibiotics were started twice a day. But within a couple days, Tajiri was unsteady on her feet. Soon, she would stand or eat only when prodded. Her eyes were now almost fully concealed by her third eyelids.

On Dec. 19, 2012 - four days after she first appeared sick - zoo veterinarian Keith Hinshaw anesthetized Tajiri for examination and testing. Her body condition, vital signs and eye exam were all normal, as were routine blood work and urine and fecal exams; nothing noteworthy appeared on X-rays and ultrasounds of her chest and abdomen. Tajiri's blood was retested for viruses, and checked for toxoplasma, a protozoan that can sicken felines. All came back negative.

The lioness was given intravenous fluids and antibiotics, as well as B vitamins.

The next day, she lay in her enclosure, eyes closed. A normally gregarious cat, she did not react to the keepers working around her. A hose placed on fine mist - lions generally don't like water - barely evoked a response. Coaxed to walk, Tajiri was slow and stilted. She ate a small amount of food placed under her nose, but her chewing was sluggish and uncoordinated.

Since she was now displaying neurologic symptoms, Hinshaw tested her for two diseases that attack the central nervous system - Eastern equine encephalitis and West Nile virus. Both were negative.

Tajiri was placed on an oral, nonsteroidal anti-inflammatory medication, but by the next morning her condition had worsened. Her movements were slower, she was pressing her head against the wall of her enclosure, and she bobbed back and forth. On seeing her decline, one of the keepers commented that Tajiri's mother had died of a "strange disease" in Wisconsin.

They raced to the phone.

The zoo where Tajiri was born reported that her mother had died shortly after the young lioness arrived in Philadelphia. Her diagnosis was blastomycosis, a serious fungal infection that is sometimes fatal.

Hinshaw rushed a urine sample to the Tennessee lab that specializes in testing for the infection. It came back positive for Blastomyces dermatitidis.

Blastomycosis is not common here. Blastomyces thrives in moist, sandy soil near freshwater sources, notably the Mississippi-Ohio river basin and Wisconsin.

The disease is acquired through inhalation of fungal spores. Because they roam and sniff, dogs are the most commonly affected domestic species. But it has been reported in a range of animals, and in people. Only a few known cases have been seen in big cats. The majority died.

Once inhaled, the fungus usually settles in the lungs. Months or years may pass before it causes symptoms, typically respiratory distress; the organism may travel to the skin, eyes, bones, and, less commonly, spinal cord and brain.

Treatment requires several months of oral antifungal medications. Prognosis depends on the patient's immune status and how far the disease has progressed.

So Hinshaw didn't wait for test results from Tennessee. He immediately started Tajiri on fluconazole. But she declined over three days: Her gait stiffened, neck muscles tremored, she walked in circles.

Believing that the cat's neurologic deterioration was due to nerve inflammation caused by her immune response to the fungus, the vet anesthetized her for aggressive, do-or-die treatment with a fast-acting steroid. To no avail.

"She was still a mess," Hinshaw recalls. "At this point, I was pretty pessimistic. The big question was, 'What will she be like in the morning?' "

The next morning, Christmas Eve, Tajiri was jumping around her enclosure and playing, to everyone's amazement. But she declined as the steroid's antiinflammatory effects wore off. On a short-term oral steroid, she bounced back.

Fluconazole was stopped nine months later. Tajiri's subsequent urine tests for Blastomyces have been negative. The four-year-old lioness has made a full recovery, and her life expectancy is normal - about 20 years in captivity.