Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena S.Gans 3274683 12-07-2013 Project Tutor University of Utrecht dr. M.G. van Emst Project Tutor Dolfinarium C.E. van Elk DVM Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Table of contents Abstract…………………………………………………………………………………………………………….…………….3 Used abbreviations………………………………………………………………………………………………………….4 Introduction…………………………………………………………………………………………………………………….5 - 6 Aim of the study………………………………………………………………………………………………………………7 Materials and methods………………………………………………………………………………………………..…8 - 14 Animals……………………………………………………………………………………………………………………….…..8 Harbour porpoises…………………………………………………………………………………….….…….8 Bottlenose dolphins………………………………………………………………………….………….……..9 Equipment……………………………………………………………………………………………….……………..……….9 Measurements…………………………………………………………………………………………………………………9 Parameters …………………………………………………………………………………………………….…..10 Preparing the spirograph…………………………………………………………………………….………10 Harbour porpoises………………………………………………………………………….…………………..10 Bottlenose dolphins……………………………………………………………………..……………..……..10 Sick or healthy………………………………………………………………………………………………………...………11 Processing data…………………………………………………………………………………………………….………...11 Statistics…………………………………………………………………………………………………………………..……..14 Results………………………………………………………………………………………………………………………...15 - 41 Harbour porpoises……………………………………………………………………………………………………..……15 Overview results……………………………………………………………………………………………..….15 Flow/volume curves…………………………………………………………………………………………...15 Statistics and graphs…………………………………………………………………………………………...18 Correlation……………………………………………………………………………………………..18 Regression………………………………………………………………………………………………19 Inside versus outside the water………………………………………………………………25 Animals with confirmed pulmonary disorder versus healthy animals……..26 Bottlenose dolphins…………………………………………………………………………………………………………30 Overview results………………………………………………………………………………………………...30 Flow/volume curves……………………………………………………………………………………………30 Statistics and graphs………………………………………………………………………………….……….33 Correlation …………………………………………………………………………….……..………33 Inside versus outside the water …………………………………………………………….34 Animals with confirmed pulmonary disorder versus healthy animals…….37 Discussion………………………………………………………………………………………………………….………..42 - 45 Harbour porpoises…………………………………………………………………………………………………...........43 Bottlenose dolphins……………………………………………………………………………………………………..….44 Acknowledgements……………………………………………………………………………………………..….……...46 References……………………………………………………………………………………………………………..……….47 Attachments………………………………………………………………………………………………………...….…..48-86 Research project University of Utrecht: S.Gans 2 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Abstract Pulmonary function testing, such as spirometry is a validated method to evaluate lung mechanics and resistance of the conducting airways. Until this moment there is very limited experience in the use of spirometry in small cetaceans. In this study 13 harbour porpoises (Phocoena phocoena) and 7 bottlenose dolphins (Tursiops truncatus) were measured using a pneumotachograph specifically designed for this purpose. They were measured inside as well as outside the water. Three of the animals had confirmed respiratory disorders. The measurements were well tolerated and the results were reproducible and reliable. The results represented a good overview of spirometric data in small cetaceans. Correlations were found in the porpoises between body size and spirometric data. Furthermore, differences were found in bottlenose dolphins while inside or outside the water, and in both species in animals with confirmed lung disorders. Because of the limited number of animals further studies are needed to confirm these findings. Research project University of Utrecht: S.Gans 3 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Used abbreviations VC: Vital Capacity TLC: Total Lung Capacity TV: Tidal Volume PEF: Peak Expiratory Flow PIF: Peak Inspiratory Flow Te: Expiration time Ti: Inspiration time Vins: Inspiration Volume Vex: Expiration Volume Df: Degrees of freedom SD: Standard Deviation df: degrees of freedom SEM: Standard Error of the Mean CT: Computed Tomography β: regression coeficent ρ: population correlation coefficient P: calculated probability t: test result Research project University of Utrecht: S.Gans 4 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Introduction Like many species, cetaceans are perfectly adapted to their particular niche. Because of their life in the water behavioral, physiological and anatomical features are different from terrestrial animals. An extremely important part of the life of a cetacean is diving. 1, 2 The large toothed whales, such as sperm whales (Physeter macrocephalus) typically dive approximately 400-800 meters for a duration of 40-60 minutes. Bottlenose dolphins on the other hand, often dive for less than 5 minutes to shallow depths. The maximum depth measured is 390 meters. Harbour porpoises dive to depths of approximately 14-40 meters. 3 To make diving possible there are marked changes in the delivery, storing and utilizing of oxygen compared to terrestrial animals. 2, 4 It seems logical to assume a cetacean would have large lungs to carry much oxygen. This is not the case, as large lungs that are filled with air would cost the animal a lot of energy to overcome the large buoyancy during a dive. 1, 4 The lung volume of diving mammals is therefore dictated by body size. 5 As marine mammals don’t have large lungs for the storage of oxygen, they have to get their oxygen elsewhere when diving. Oxygen is transported and stored in the body by reversibly binding to myoglobin found in the muscle, or to hemoglobin found in the red blood cells. 2, 3, 6 7 Marine mammals store oxygen in their muscles by increased myoglobin stores 2, 3, 7, the concentration of myoglobin is 10-30 times higher than found in terrestrial animals. 3 They also possess more hemoglobin, because of an increased blood volume 7 and also because they have a higher concentration of hemoglobin. 3, 7 The amount of oxygen stored in the blood of small cetaceans ranges from normal to 3 times the amount found in terrestrial animals. As there is a limited amount of oxygen available during a dive, marine mammals have to be careful how to spend it. They have developed mechanisms to preserve their storage of oxygen for as long as possible. The first adaptation is a decrease in heart rate during dives. Normal heart rates during a dive are 30-50 beats per minute. When ascending after a dive the animals are tachycardic, with heart rates between 120-150 beats per minute. This maximizes respiratory gas exchange and cardiac output and refills the muscles and blood with oxygen for the next dive. The second adaptation is peripheral vasoconstriction; blood flow is conserved for the brain and the heart while other organs receive almost no blood. 3, 7 Marine mammals can tolerate low concentrations of oxygen in the blood and have adaptations in their brains for better hypoxemic tolerance. Their anaerobic metabolism is much more developed. 3 The airways in cetaceans are reinforced with cartilage from the trachea to the level of the alveolar sac. When the lung collapses, air is forced out of the alveoli into the reinforced bronchi. 3, 5, 7 This prevents both air trapping and gas exchange. Stopping gas exchange is very important for the prevention of decompression sickness. 3, 5 The reinforcements in the airways also contribute to the fast inhale and exhale of large volumes of air. 5, 7 The blowhole located on the top of the heads of cetaceans is the most obvious adaptation of their respiratory system for life in the water. The position of the blowhole allows the animals to breath quickly with little to no interruption during locomotion. Cetaceans do not have conchae. The lack of conchae contributes to the fast inhale and exhale of large volumes of air. 2 Inside the entrance of the blowhole the nasal plug is located. This plug occludes the airway when in neutral position and stops water from entering the respiratory system, even at high pressures. When the animal breathes muscles contract, pulling the plug forward and opening the airway. 8 Research project University of Utrecht: S.Gans 5 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena The larynx of cetaceans is the most specialized of all marine mammals. It has the form of an elongated goose beak and separates the digestive tract form the respiratory tract. 9 Because of this adaptation cetaceans are obligate nasal breathers. 2 Respiratory tract infections are an important factor in the mortality and morbidity in dolphins. 10 Dolphins do not show symptoms of a disease until a late stage because they are prey animals. 11 When they have a respiratory tract infection the symptoms are not specific. Dolphins cough mainly when they have a problem in the upper airways. A higher breathing frequency is only seen if a substantial part of the lung is damaged. 11 Often the only symptoms are a lower appetite or anorexia. 11 12 It is very important to recognize an infection at an early stage, because treatment is more difficult in a more advanced stage of disease. 13 Auscultation is very difficult in small cetaceans, because of their thick layer of blubber, their fast breathing and the loud noises the animals produce. Blood work can show a leucocytosis and left warded shift, but this test is not reliable because of the large variation in results between animals. At this moment plasma fibrinogen is the most used indicator of an infection in cetaceans. It can be used to identify an infection at an early stage. Plasma fibrinogen is however not always reliable and it is not specific for the identification of a respiratory infection. 11 CT-scanning is very useful in diagnosing an infection in the lungs. However, using this technique is complicated, expensive, and the animals have to be taken out of the water and transported to the scanner, which is very stressful. Sputum culture can be a useful diagnostic tool and could deliver relevant information, but often commensal bacteria are found. It is therefore very difficult to determine if the grown micro-organism is the cause of the infection. 11 Bronchoscopy can be used to circumvent this problem. A diagnosis can be made using a bronchial washing or by using a protected brush. Bronchoscopy is however an invasive method and, just like using a CT-scan, the animals have to be taken out of the water. 14, 15 Diagnosing a problem in the respiratory tract of dolphins is difficult and often invasive. A non-invasive diagnostic technique that can be used to recognise a problem in the respiratory tract of dolphins would therefore be extremely helpful. Spirometry is theoretically an ideal tool that can be used to make a diagnosis, as it might be possible to document the integrity of the respiratory system in morphological and physiological sense. Spirometry can be used for both screening as for management of disease. As for now there is very limited experience in the use of spirometry in small cetaceans. In the Dolfinarium (marine mammal park located in the Nederlands) research has been performed for about a decade trying to improve the quality of diagnosing and managing respiratory disease in small cetaceans. 16 In these studies advanced techniques are used applying techniques commonly used in human medicine. Apart from spirometry, endoscopy and CT-scanning have been evaluated. This research is funded by the Dolfinarium and by private contributions. Research project University of Utrecht: S.Gans 6 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Aim of the study This study has several aims. The determination of spirometric parameters of healthy bottlenose dolphins and porpoises. The determination of inter-individual and intra-individual variation of the measurements, both with animals in and out of the water. Comparing and describing the spirometric parameters of healthy bottlenose dolphins and porpoises. Performing measurements in diseased animals in order to determine which parameter(s) might be useful to recognise pathology. Most of the time these will be stranded animals. Research project University of Utrecht: S.Gans 7 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Materials and methods Animals: Harbour porpoises (Phocoena phocoena) 13 porpoises were measured, which were kept at two different locations (table 1 and 2). The first is the Bruinvisbaai, here the healthy animals are located that cannot be returned into the wild because of various reasons. The second location is SOS Dolfijn where stranded animals are located for rehabilitation and return to the wild. Name Sex Age in months Length in cm Average weight in kg Amber Berend Ellen Ester Gerhard Joelle Jose Siepy Female Male Female Female Male Female Female Female 108 (or older) 22 93 11,5 23 11 36 71 154 118 149 116 116 127 136 147 45,1 29,4 50,7 36,7 34 36,9 40,1 44 Table 1: animals measured at Bruinvisbaai, data arranged alphabetically Name Sex Age in months Length in cm Average weight in kg Desiree Renske Sietske Thom Tonia Female Female Female Male Female 58 70 (or older) 22 12 22 149 159 119 105 122 50,8 72 29,3 22,7 31,9 Table 2: animals measured at SOS Dolfijn, data arranged alphabetically Research project University of Utrecht: S.Gans 8 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Bottlenose dolphins (Tursiops truncatus) 7 bottlenose dolphins were measured. (table 3 and 4) These animals were also located on two different locations. The first location is the Domein. The animals that perform in a show for general public are housed here. The second location is the Sickbay. Sick animals are kept separate from the rest of the animals in this location. The length of the single female dolphin was unknown, so her length was estimated based on the data of the other animals. Name Sex Age in months Length in cm Weight in kg Apollo Juno Nemo Tlisaka Tsalka Tucker Male Male Male Male Male Male 292 352 319 148 184 388 285 274 262 275 274 289 225 208 223 217 217 232 Table 3: animals measured at the Domein, data arranged alphabetically Name Sex Age in months Length in cm Weight in kg Maaike* Female 360 ** 266 Table 4: animal measured in the Sickbay *Maaike was pregnant in the first trimester when the measurement was performed. **Due to her location in the sick bay it was not possible to measure this animal without taking her out of the water, which was considered inappropriate just for this purpose. Equipment: A Masterscope (Viasys HC) modified spirometer manufactured by CareFusion using an adapted pneumotachograph with conforming software and hardware. The sample frequency of the pneumotachograph is 0,5 kiloHerz, Resistance= 36 Pascal/Liter/seconds. A blowhole-mask has been designed and manufactured also especially for this study. The mask fits both the porpoises and the dolphins. It is manufactured out of silicone and doesn’t irritate the skin, does not leak air when put over the blowhole and can be disinfected. It is connected to the pneumotachograph by a hose of eight centimetres diameter. Measurements The study was performed in the Dolfinarium from 02-11-2012 to 30-05-2013.The measurements were performed on both animal species while in the water as well as outside. The animals were only measured outside the water when the animals were taken out of the water for other reasons. The animals were not taken out of the water specifically for this experiment, therefore minimising stress and avoiding discomfort of the animal. As many as possible representative and repeatable measurements were performed in every animal. Length and weight of the animals were recorded. The breathing effort had to be incorporated in the interpretation of the results. Therefore observations were made to distinguish between a maximum effort breath and a tidal volume breath. Obviously this is a subjective and qualitative observation. In diseased animals the spirometric results were Research project University of Utrecht: S.Gans 9 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena correlated with disease activity as measured by routinely used methods. The gathered data were evaluated immediately on technical quality and reliability, and were saved for further analysis. Afterwards they were converted in workable tables and graphs. A dierexperimentencommissie (DEC) appliance was not considered necessary by the responsible veterinarian as performing spirometry is non-invasive and does not cause any discomfort to the animals. Parameters 1. 2. 3. 4. 5. Vital features: species, weight, length, age, sex Absence or presence of disease Inside or outside of the water Volume parameters: vital capacity, inspiratory capacity, expiratory capacity Flow parameters: expiration time, inspiration time, expiratory to inspiratory ratio, maximum expiratory and inspiratory flow 6. Further observations: shape and features of the flow/volume curves, subjective judgement of the breathing technique 7. Integration of 1-6 including determination of averages, standard deviations, intraindividual and inter-individual variation Preparing the spirograph Before each measurement the measuring equipment was prepared and calibrated with a three liter volume pump. The pneumotachograph needed fifteen minutes to reach working temperature. The current ambient conditions were then added into the program. After this the calibration of the spirograph was checked once more. This calibration measurement was also used to calculate the correction factor. The use of a correction factor is necessary because of the large, adapted pneumotachograph. The software has been designed for the normal sized pneumotachograph for use in humans. Measuring the animals The trainers helped the animals to go on shore or remain steady in the water. The mask was placed over the blowhole and was fit tightly to prevent air leakage. This was especially important in the smaller animals. Measurements were performed by allowing the animal to breathe a couple of times (mostly 1-4 times) with the mask on. Then the mask was removed, so the animal could breathe freely preventing dead space ventilation as much as possible. The mask was then placed back on the animal so more breathing efforts could be measured. This was continued until a sufficient number of breathing efforts was recorded. As many breathing cycles as were feasible under the circumstances were recorded. In between different animals the mask and the hose were disinfected with alcohol. Research project University of Utrecht: S.Gans 10 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Sick or healthy The animals were placed in four categories. 0. No signs or symptoms of disease 1. Most likely no pulmonary disorder 2. Most likely pulmonary disorder 3. Definite pulmonary disorder In order to make this judgement a number of diagnostic tools was used. 1. Behaviour of the animals 2. Blood tests 3. Bronchoscopy 4. CT-scans 5. Necropsy Processing data The data were processed using Microsoft excel for mac 2011. When processing a series of data the file containing the data of the calibration pump was processed first. Using this data the correction factor was calculated. (see graph 1) The correction factor in this series of measurements is 12, as a 3 liter volume pump was used. Graph 1 shows a volume of 0,25 liter which is 1/12th of three liter. Because of the calibration before the measurements this value is the same in all measurements. Graph 1: Flow volume curves of the calibration pump Research project University of Utrecht: S.Gans 11 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena The timeframe in which the animal breathes was determined by flow versus time and volume versus time curves. This facilitates searching for the breathing in the raw data. Graph 2 shows an animal exhaling approximately 30 seconds after the start of the measurement. After this the animal inhales and exhales 4 times. Graph 2 Flow (l/s) and Volume (l) versus Time (s), measurement of harbour porpoise (Thom) Flow/volume curves were then constructed. Because of the sensitivity of the machine the wind and small air vibrations are also measured, this causes the volume to shift during the measurements. Sometimes the animal exhales more air than it inhales or vice versa. This also affects the volume, as it does not return to zero after that breathing session. These effects can be seen in graph 2. Because of these effects the volume had to be adjusted to zero by hand before each breathing session. Then all flow/volume curves were plotted into one graph according to international standards of the European Respiratory Society/ American Thoracic Society. In some porpoises the flow is very low at the end of an inspiration. It is therefore difficult to determine when the inspiration stops. Strictly spoken it ends when the flow reaches zero, but because these are difficult measurements and the equipment is very sensitive, a fixed value as the end of the inspiration was determined. As the mean flow of the porpoises is around 7,5 l/s, 3 1/3 % is 0,25. Flow was considered zero when decreasing below this threshold. From the flow/volume curves the vital capacity (VC) and the volume of each inspiration or expiration (Vins, Vex) could be determined. It was decided to only include the volumes of the inspirations or expirations that were no less than 50% of the vital capacity. The other breathing efforts were considered too small, this was most likely due to a reaction of the animal to the mask. The mean and standard deviation (SD) of the Vins and Vex were calculated. Research project University of Utrecht: S.Gans 12 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena The peak expiration flow (PEF) and peak inspiration flow (PIF) could be determined with the help of the graph or from the raw data. The shape of the flow/volume curve was decisive in considering if a measurement was representative. If for example the curve has a very high flow but a low volume compared to the other curves the flow value was not used. The expiration and inspiration time (Te, Ti) could be determined from the raw data. The mean and SD of the Te and Ti were calculated. The ratio of Te and Ti was also calculated. Only the closed flow/volume curves were used for this, because the animal than exhales and inhales the same amount of air. A curve was determined closed if the difference in inspiration and expiration volumes was less than 10%. The mean and SD of the Te/Ti ratio were calculated. Measurements of obviously poor quality by any reason were disregarded. Breathing cycles were excluded when the shape of their flow/volume curve was clearly abnormal. In these measurements the animals inhaled or exhaled in two parts as shown in graph 3. Incomplete breathing cycles were also rejected, for example only an exhalation. Graph 3: Flow/Volume curve of a bottlenose dolphin (Tsalka) Research project University of Utrecht: S.Gans 13 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Statistics SPSS statistics for mac version 21 and the SAS system were used to perform the statistics. Correlation analysis and linear regression were performed on the data. The animals with confirmed pulmonary disease were disregarded. Measurements performed in the water were used whenever possible. Correlation: Null hypothesis: the population correlation coefficient (ρ) is equal to zero Alternative hypothesis: the population correlation coefficient (ρ) is not equal to zero P values < 0,05 were considered significant Regression: Null hypothesis: the regression coeficent (β) is equal to zero Alternative hypothesis: β is not equal to zero P values < 0,05 were considered significant Differences between measurements done inside and outside the water were assessed using the paired t-test. Null hypotheses: there is no significant difference between measurements performed inside or outside the water. Alternative hypothesis: there is a significant difference between measurements performed inside or outside the water. P values < 0.05 were considered significant. Statistical differences between animals with confirmed pulmonary disease and healthy animals were assessed using the independent 2 sample t-test. Both the measurements done inside and outside the water were used. Null hypothesis: the two population means are equal Alternative hypothesis: the two population means are not equal P values < 0.05 were considered significant. Research project University of Utrecht: S.Gans 14 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Results Harbour porpoises Overview results In the appendix an overview of the results is shown in tables 5 and 6 Flow/Volume curves Shown in graphs 4-6 are the flow/volume curves of one healthy animal (Siepy) measured outside the water, one healthy animal (Sietske) measured inside the water and one animal (Renske) with a confirmed respiratory disorder. The remaining flow/volume curves can be found in the attachments. Graph 4: Flow/Volume curve, Siepy, 29-05-13, measured outside the water, healthy animal Research project University of Utrecht: S.Gans 15 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 5: Flow/volume curve, Sietske, 02-05-13, measured inside the water, healthy animal Research project University of Utrecht: S.Gans 16 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 6: Flow/Volume curve, Renske, 02-05-13, measured outside the water, confirmed pulmonary disorder Research project University of Utrecht: S.Gans 17 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Statistics and graphs Correlation In table 7 the results of the linear correlations are shown. VC PEF PIF Te/Ti ratio Mean Te Mean Ti Mean Vex Mean Vins Length in cm Weight in kg Age in months ρ: 0.76 P: 0.01 * ρ -0.64 P: 0.03 * ρ: 0,66 P: 0.02 * ρ: -0.61 P: 0.06 ρ: 0.35 P: 0.26 ρ: 0.50 P: 0.10 ρ: 0.66 P: 0.02 * ρ: 0.76 P: 0.00 * ρ: 0.79 P: 0.00 * ρ: -0.58 P: 0.05 ρ: 0,61 P: 0,04* ρ: -0.56 P: 0.09 ρ: 0.56 P: 0.06 ρ: 0.65 P: 0.02 * ρ 0.68 P: 0.02 * ρ 0.78 P: 0.00* ρ: 0.64 P: 0.02 * ρ: -0.56 P: 0.06 ρ: 0.49 P: 0.10 ρ: -0.38 P: 0.28 ρ: 0.17 P: 0.60 ρ: 0.28 P: 0.39 ρ: 0.52 P: 0.08 ρ 0.66 P: 0.02* Table 7: results of the correlation statistics * These values are considered statistically significant Research project University of Utrecht: S.Gans 18 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Regression The data that were proved to correlate were then tested for linear regression. Graphs 7 and 8 show the VC against the body size of the animals. A positive correlation is present in both graphs. Graph 7: VC (l) versus Length (cm) Intersept (α): -4.17 Standard error of the mean (SEM): 1.68 β: 0.05 SEM: 0.01 P: 0.01 * P: 0.03 * Graph 8: VC (l) versus Weight (kg) α: -1.50 SEM: 0.87 P: 0.11 β: 0.09 SEM: 0.02 P: 0.00 * Research project University of Utrecht: S.Gans 19 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 9 shows the VC against the age of the animals, there is a positive correlation. Graph 9: VC (l) versus Age (months) α:1,11 SEM: 0.39 P: 0.02 * β:0.02 SEM: 0.01 P: 0.02 * Graphs 10 – 12 show the maximum flows against the body size of the animals. A negative and two positive correlations are present. Graph 10: PEF (l/s) versus Length (cm) α: 6.48 SEM: 4.93 P: 0.22 β: -0.10 SEM: 0.04 P: 0.03 * Research project University of Utrecht: S.Gans 20 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 11: PIF (l/s) versus Length (cm) α: -6.45 SEM: 5.37 P: 0.26 β: 0.12 SEM: 0.04 P: 0.02 * Graph 12: PIF (l/s) versus Weight (kg) α: 1.05 SEM: 3.11 P: 0.74 β: 0.20 SEM: 0.08 P: 0.04 * Research project University of Utrecht: S.Gans 21 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 13 shows the average Ti against the weight of the animals, a positive correlation is present. Graph 14 – 18 show the mean volumes of the inspirations and expirations of the animals against body size and age of the animals. In all these graphs positive correlations are present. Graph 13: Mean Ti (s) versus Weight (kg) α: 0.17 SEM: 0.08 P: 0.07 β: 0.01 SEM: 0.00 P: 0.02 * Graph 14: Mean Vex (l) versus Length (cm) α: -2.96 SEM: 1.61 P: 0.10 β: 0.04 SEM: 0.01 P: 0.02 * Research project University of Utrecht: S.Gans 22 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 15: Mean Vex (l) versus Weight (kg) α: -0.95 SEM: 0.86 P: 0.30 β: 0.07 SEM: 0.02 P: 0.02 * Graph 16: Mean Vins (l) versus Length (cm) α: -3.44 SEM: 1.37 P: 0.03 * β: 0.04 SEM: 0.01 P: 0.00 * Research project University of Utrecht: S.Gans 23 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 17: Mean Vins (L) versus Weight (kg) α: -1.21 SEM: 0.72 P: 0.12 β: 0.07 SEM: 0.02 P: 0.00 * Graph 18: Mean Vins (l) versus Age (Months) α: 0.88 SEM: 0.31 P: 0.02 * β: 0.02 SEM: 0.01 P: 0.02 * * These values are considered statistically significant Research project University of Utrecht: S.Gans 24 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Inside versus outside the water The paired t-test was used to determine if there were differences in the measurements performed with the animals in the water versus those done with the animals outside of the water. In table 8 the results of the paired t test are shown. df is degrees of freedom. VC PEF PIF Mean Te/Ti ratio Mean Te Mean Ti Mean Vex Mean Vins SD Te SD Ti SD Vex SD Vins SD Te/Ti ratio df t P 95% confidence interval 8 8 8 4 8 8 8 8 8 8 8 8 4 0,67 0,35 0,72 -1,22 -1,25 0,33 0,48 0,30 -2,50 1,68 0,08 0,20 0,39 0,52 0,74 0,49 0,29 0,25 0,75 0,64 0,77 0,04* 0,13 0,94 0,85 0,72 -0,30 – 0,54 -1,49 – 2,02 -1,01 – 1,92 -0,82 – 0,32 -0,16 – 0,05 -0,09 – 0,12 -0,21 – 0,33 -0,28 – 0,36 -0,06 - -0,002 -0,01 – 0,08 -0,09 – 0,10 -0,12 – 0,14 -0,12 – 0,16 Table 8: results of the paired t-test of the porpoises *These values are considered significant In graph 19 the standard deviation of the expiration time of the animals is shown inside and outside the water. Graph 19: SD Te versus Location of Measurement (1:Inside, 2:Outside) Research project University of Utrecht: S.Gans 25 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Animals with confirmed pulmonary disorder versus healthy animals The independent 2 sample t-test was used to determine if there were differences in the means of the data obtained by measuring healthy (0-2) animals versus animals with a confirmed pulmonary disorder (3) In table 9 the results of the independent 2 sample t-test are shown. VC PEF PIF Mean Te/Ti ratio Mean Te Mean Ti Mean Vex Mean Vins SD Te SD Ti SD Vex SD Vins SD Te/Ti ratio df t P 95% confidence interval 21 21 21 16 21 21 21 21 20 21 20 21 14 -2,07 7,21 -2,74 4,13 2,48 -2,13 -0,85 -1,72 0,76 -2,16 -1,91 -1,73 0,01 0,05 0,00* 0,01* 0,00* 0,02* 0,045* 0,41 0,10 0,46 0,04* 0,07 0,10 1,00 -2,41 - 0,01 8,82 - 15,97 -9,10 - -1,24 0,41 - 1,28 0,03 - 0,36 -0,28 - -0,003 -1,46 - 0,62 -1,84 - 0,18 -0,04 - 0,08 -0,17 - -0,003 -0,43 - 0,02 -0,45 - 0,04 -0,23 - 0,23 Table 9: results of the 2 sample t-test of the porpoises *These values are considered significant Research project University of Utrecht: S.Gans 26 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena In graphs 20 - 25 the differences in the data from animals with a confirmed pulmonary disorder and the data from healthy animals is shown. Graph 20: PEF (l/s) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Graph 21: PIF (L/S) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 27 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 22: Mean Te/Ti Ratio versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Graph 23: Mean Te (S) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 28 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 24: Mean Ti (S) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Graph 25: SD Ti versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 29 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Bottlenose dolphins Overview results In the appendix an overview of the results is shown in tables 10 and 11 Flow/Volume curves Shown in graph 26-28 are the flow/volume curves of one healthy animal (Nemo) measured outside the water, one healthy animal (Tlisala) measured inside the water and one animal (Tsalka) with a confirmed respiratory disorder. The remaining flow/volume curves can be found in the attachments. Graph 26: Flow/Volume curve, Nemo, 30-05-13, measured outside the water, healthy animal Research project University of Utrecht: S.Gans 30 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 27: Flow/Volume curve, Tlisala, 23-05-13, measured inside the water, healthy animal Research project University of Utrecht: S.Gans 31 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 28: Flow/Volume curve Tsalka, 23-05-13, measured inside the water, confirmed pulmonary disorder Research project University of Utrecht: S.Gans 32 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Statistics and graphs Correlation In table 12 the results of the linear correlations are shown. VC PEF PIF Te/Ti ratio Mean Te Mean Ti Mean Vex Mean Vins Length in cm Weight in kg Age in months ρ: 0.44 P: 0.39 ρ: -0.49 P: 0.32 ρ: 0,39 P: 0,44 ρ: 0.04 P: 0.95 ρ: 0.04 P: 0.98 ρ: 0.14 P: 0.80 ρ: 0.18 P: 0.73 ρ: 0.22 P: 0.68 ρ: 0.23 P: 0.66 ρ: -0.21 P: 0.70 ρ: 0,02 P: 0,97 ρ: -0.32 P: 0.60 ρ: -0.02 P: 0.97 ρ: 0.19 P: 0.72 ρ: 0.12 P: 0.83 ρ: 0.02 P: 0.97 ρ: -0.10 P: 0.86 ρ: -0.04 P: 0.94 ρ: -0,12 P: 0,82 ρ: -0.66 P: 0.23 ρ: -0.39 P: 0.45 ρ: -0.14 P: 0.79 ρ: -0.02 P: 0.97 ρ: -0.21 P: 0.60 Table 12: results of the correlation statistics * These values are considered statistically significant No data were statistically significant, so no regression line statistics were done. Research project University of Utrecht: S.Gans 33 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Inside versus outside the water The paired t-test was used to determine if there were differences in the measurements performed with the animals in the water versus those done with the animals outside of the water. Table 13 the results of the paired t test are shown. VC PEF PIF Mean Te/Ti ratio Mean Te Mean Ti Mean Vex Mean Vins SD Te SD Ti SD Vex SD Vins SD Te/Ti ratio df t P 95% Confidence Interval 4 4 4 3 4 4 4 4 4 4 4 4 2 0,29 -2,98 2,78 -1,28 -3,53 -1,0 0,74 1,08 -8,40 -0,58 1,42 0,19 -1,09 0,79 0,04* 0,05* 0,34 0,02* 0,37 0,50 0,34 0,00* 0,59 0,23 0,86 0,39 -1,89 – 2,33 -23,29 – 0,82 0,01 – 6,28* -0,29 – 0,14 -0,33 - -0,39 -0,27 – 0,13 -0,75 – 1,3 -0,76 – 1,72 -0,07 - -0,04 -0,2 – 0,13 -0,22 – 0,69 -0,24 – 0,28 -0,35 – 0,21 Table 13: results of the paired t-test of the porpoises *These values are considered significant Research project University of Utrecht: S.Gans 34 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena In graph 29 and 30 the maximum flows of the animals inside and outside the water are shown. Graph 29: PEF (L/S) versus Location Measurement (1: Inside, 2: Outside) Graph 30: PIF (L/S) versus Location Measurement (1: Inside, 2: Outside) Research project University of Utrecht: S.Gans 35 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena In graphs 31 and 32 the mean and standard deviation of the expiration time from the animals inside and outside the water are shown. Graph 31: Mean Te (s) versus Location Measurement (1: Inside, 2: Outside) Graph 32: SD Te (s) versus Location Measurement (1: Inside, 2: Outside) Research project University of Utrecht: S.Gans 36 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Animals with confirmed pulmonary disorder versus healthy animals The independent 2 sample t-test was used to determine if there were differences in the means of the data obtained by measuring healthy (0-2) animals versus animals with a confirmed pulmonary disorder (3) In table 14 the results of the independent 2 sample t-test are shown. VC PEF PIF Mean Te/Ti ratio Mean Te Mean Ti Mean Vex Mean Vins SD Te SD Ti SD Vex SD Vins SD Te/Ti ratio df t P 95% confidence interval 11 11 11 9 11 11 11 11 10 10 10 10 8 3,67 -2,60 2,35 -4,96 -0,58 1,02 3,26 2,60 -0,39 0,74 0,45 2,36 0,08 0,00* 0,03* 0,04* 0,00* 0,57 0,33 0,01* 0,03* 0,71 0,48 0,67 0,04* 0,08 1,62 - 6,49 -24,93 - -2,08 0,50 - 15,05 -0,52 - -0,19 -024 - 0,13 -0,11 - 0,29 0,74 - 3,83 0,47 - 5,66 -0,08 - 0,05 -0,08 - 0,16 -0,56 - 0,83 0,03 - 0,94 -0,30 – 0,02 Table 14: results of the 2 sample t-test of the porpoises *These values are considered significant Research project University of Utrecht: S.Gans 37 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena In graphs 33 – 39 the differences in the data from animals with a confirmed pulmonary disorder and the data from healthy animals is shown. Graph 33: VC (liters) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Graph 34: PEF (L/S) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 38 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 35: PIF (L/S) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Graph 36: Mean Te/Ti ratio versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 39 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 37: Mean Vex (L) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Graph 38: Mean Vins (L) versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 40 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Graph 39: SD Vins versus pulmonary disorder (0: healthy 1: confirmed pulmonary disease) Research project University of Utrecht: S.Gans 41 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Discussion Having a respiratory system is an unique feature of cetaceans in comparison with other creatures living in the sea. It is obvious that the respiratory system has undergone major adaptations in order to function in sea mammals. Long apneustic periods, deep diving with barometric consequences and very limited time to ventilate are main features necessitating adaptations. Research has teached us a lot about the respiratory physiology of sea mammals. 3, 5, 6 This has increased our understanding of the physiologic and morphologic adaptations to a great extend. However, until now, spirometry in cetaceans has never been systematically explored. Spirometric data must be significantly altered in comparison to terrestrial animals, as large volumes must be inhaled and exhaled in a very short period of time. Morphologic changes in the conducting airways in cetaceans are obvious: the trachi-bronchial system has a large diameter and has increased rigidity due to circular cartilage, which extends until the gasexchange zone. 5 Measuring spirometric data will greatly increase our knowledge and understanding of the ventilatory system of cetaceans. Furthermore as infections of the respiratory system are common in these species 11, 13 it should be very helpful to use spirometric measurements as a non-invasive diagnostic tool in screening the respiratory system for disorders. There are no standard values of spirometry, neither is there a standardized method of performing these measurements. Spirometry was performed on harbour porpoises (Phocoena phocoena) as well as bottlenose dolphins (Tursiops truncates) both while inside the water and out of the water. Because of obvious logistic limitations this study could only be done in a small number of animals. Because measurements of the static breathing volumes could not be performed, it cannot be certain whether the measured VC (vital capacity) is equal tot the TLC (total lung capacity) or if it is a TV (tidal volume). Earlier research showed the TV of small cetaceans is approximately 80% of the TLC and therefore can be considered equal to the VC.2 There was some concern about a dead space effect because of the fact that the animals inhale some of their exhaled air through the hose between the mask and the pneumotachograph. The mask was disengaged from the animal after two or three breathing cycles. No differences were measured between consecutive breathing cycles. It was therefore assumed there was no significant dead space effect. Research project University of Utrecht: S.Gans 42 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Harbour porpoises In both species of cetaceans there was an expiratory plateau fase in the flow volume curves contrary of the situation in humans, where the curves show a downward slope in this position. 17 This can easily be explained by the absence of dynamic compression at lower expiratory volumes. The compression is prevented by the existence of cartilage up until the air exchange zones, which increases rigidity. In harbour porpoises the PEF is lower than the PIF, whereas in dolphins it is the other way around. Further more the Te/Ti equilibrium is more than 1.0 in all porpoises and less than 1.0 in all dolphins. An explanation could be found in different morphology of the upper airways. Apparently the dimensions and the shape of the flow volume curves is dependent on the species. The duration of an average breathing cycle is 0,8 seconds and is fairly constant. This means that the animals are only vulnerable to predator attack for a short period. The intra individual variation in volumes and times was low, which means that there might be an opportunity to use this kind of parameters as a personal standard value. This could be useful when screening for respiratory disorders. Correlations were found between body size parameters and spirometric data. This is easily explained as a larger animal breathes a larger volume of air using a higher flow. There were no marked differences in any measured parameter between animals inside the water or outside. The pulmonary function of one sick animal with interstitial lung disease was measured, which was seen in CT scanning and confirmed by necropsy. In this animal the PIF was lower than the PEF, and the Te/Ti equilibrium was below 1.0. The mean Te was lower and the mean Ti was higher than that of the healthy animals. The duration of the breathing cycle and the VC remained unchanged. These differences are probably due to altered mechanical properties of the lung tissue. Research project University of Utrecht: S.Gans 43 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Bottlenose dolphins The average duration of an exhalation is 0,4 seconds and of an inhalation 0,5 seconds. A breathing cycle takes therefore about 0,9 seconds. This is longer than was assumed in earlier literature. 2, 7 The quantity of data is not sufficient to say anything about the influence of gender. The measurements were very well tolerated. A complicating factor was the fact that some animals were trained in the past to exhale in a cup for obtaining microbiological material. They were used to an artificial and extremely powerful style of exhaling. These measurements were disregarded, though some effect may still be seen from the remaining measurements. Similar the porpoises, the intra individual variation was low. In contrast to the results of porpoises, a difference between values measured inside the water or outside was found. Outside the water the maximum flows were lower and the mean Te was higher, as wel as the SD of the Te. The most likely explanation is the difference in weight between porpoises and bottlenose dolphins. Lying on a rigid structure outside the water the weight of the animal will cause compression of the dependent lung zones which influences lung function measurements. This phenomenon should be considered when evaluating lung function measurements in cetaceans. This is especially true in heavier animals. Measurements were done in two animals having a pulmonary disorder. One of them had a tracheobronchitis confirmed with bronchoscopy. The other one was coughing and had an inflammatory response, and was diagnosed of having pneumonia. This was confirmed by ultrasound. The VC, mean Vex and Mean Vins of the sick animals were decreased, as well as the PEF and the PIF. The length of the total breathing cycle was not changed, but the Te/Ti equilibrium was consistently increased. The SD of Vins was lower in animals with a confirmed lung disease, suggesting a flow limitation. As all animals were about the same size, no correlations were found between size parameters and spirometric data. Research project University of Utrecht: S.Gans 44 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena In conclusion, lung function measurements by means of spirometry in cetaceans is a feasible method to obtain information about lung mechanics. The results of the measurements can be understood by studying the morphological and physiological features of cetaceans. The measured volumes are not extremely high in comparison to terrestrial mammals in correlation to body size. 5 This means that other adaptation methods are vastly more important in making prolonged apneustic periods possible. There were differences between the two examined species in the Te/Ti, as well as PEF/PIF equilibrium. This was also seen in the shape of the flow volume graphs. Results of pulmonary function measurements cannot be extrapolated from one species to another. In both species animals with confirmed respiratory disorders were measured. In all of these animals differences were observed in comparison to healthy animals. Pulmonary function testing might be helpful in screening and managing respiratory disease in cetaceans. Both species were measured in the water and on land, in the dolphins there were marked differences in the maximal flows, which can be explained by compression of depending lung zones. It must be emphasized that all results must be evaluated with great caution because of the very limited number of subjects. Studying larger number of animals of both species and of both sexes will be helpful to confirm the results of this study. Prospective studies of animals with respiratory disorders must be performed in order to confirm the usability of spirometry as a diagnostic tool. The combination of spirometry with other lung function tests may possibly enhance the clinical usefulness. For example airway resistance measurements and capnography could be added to spirometric data. Abnormality in lung function will never be diagnostic without further examining the animal with microbiological investigations or imaging techniques. Research project University of Utrecht: S.Gans 45 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Acknowledgements First of al I wish to thank the staff of the Dolfinarium for the chance to perform this study, in particular the trainers of the bottlenose dolphins and the harbour porpoises. They were very enthusiastic and very helpful. I wish to thank F.H.C. de Jongh for his help in understanding and processing the data. I would like to thank the veterinarians of the Dolphinarium, C.E. van Elk and P. Bunskoek, for their help during the study and for providing the data of the sick animals. I wish to thank M. G. van Emst, for his support during the study. I wish to thank N. Boeve-Epping for assistance with the lung function machine. I wish to thank my family for their moral support. I wish to thank Kevin van de Bergh and his team for designing and developing the mask. And last but not least I wish to thank the animals, for their cooperation and (sometimes a bit too much) enthusiasm. Research project University of Utrecht: S.Gans 46 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena References 1. Reynolds, J. E., Wells, R. S. & Eide, S. D. in The bottlenose dolphin, biology and conservation 304 (University Press of Florida, 2000). 2. Perrin, W. F., Wursig, B. & Thewissen, J. G. M. in Encyclopedia of marine mammals 1414 (Acedemic Press, 2002). 3. Ponganis, P. J. Diving mammals. Compr. Physiol. 1, 447-465 (2011). 4. Hoelzel, A. R. in Marine mammal biology an evolutionary approach 431 (Blackwell Science, 2002). 5. Kooyman, G. L. Respiratory adaptations in marine mammals. Integrative and Comparative Biology 13, 457-468 (1973). 6. Snyder, G. K. Respiratory adaptations in diving mammals. Respir. Physiol. 54, 269-294 (1983). 7. Ridgway, S. H. in Mammals of the sea, biology and medicine 812 (Thomas Books, 1972). 8. Lawrence, B. & Schevill, W. E. The functional anatomy of the delphinid nose . Bulletin of the Museum of Comparative Zoology 14, 103-151 (1956). 9. Reynolds, J. E. & Rommel, S. A. in Biology of marine mammals 578 (Smithsonian Institution, 1999). 10. Sweeney, J. C. & Ridgway, S. H. Common diseases of small cetaceans. J. Am. Vet. Med. Assoc. 167, 533-540 (1975). 11. Dierauf, L. A. & Gulland, F. M. D. in CRC Handbook of Marine Mammal Medicine 1063 (CRC Press, 2001). 12. Eo, K. -. & Kwon, O. -. Two cases of bacterial pneumonia in bottle-nosed dolphins (Tursiops gillii) at the Seoul Zoo, Korea. Pakistan Veterinary Journal 31, 260-262 (2011). 13. Jeraj, K. P. &Sweeney, J. C. Blowhole Cytology to Diagnose Early Respiratory Tract Disease in Bottlenose Dolphins (IAAAM 27th Annual Conference Proceedings, Chattanooga, Tennessee, 1996). 14. Gans, S. J. M., van Kregten, E., Marik, A. M., Boeve-Epping, N. & van Elk, C. E. Protected brush sampling of the respiratory tract of Tursiops truncatus to determine the microbial contamination in healthy animals (IAAAM 43rd Annual Conference Proceedings, Atlanta, Georgia, 2012). 15. Tsang, K. W. et al. Bronchoscopy of cetaceans. J. Wildl. Dis. 38, 224-227 (2002). 16. Gans, S. J. M., van Elk, C. E., Epping, N., de Jongh, F. H. C. & Hoogsteden, H. C. Lung function measurements in dolphins; a preliminary report (IAAAM 37th Annual Conference Proceedings, Nassau, Bahamas, 2006). 17. Ranu, H., Wilde, M. & Madden, B. Pulmonary Function Tests. Ulster Med J 80 (2), 84-90 (2011). Research project University of Utrecht: S.Gans 47 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Attachments Extra tables Name Sex Date Age in Length months in cm Weight in kg Place Health Amber Female 15-05-13 108 154 45,85 Inside 0 Amber Female 29-05-13 108 154 44,3 Outside 0 Berend Male 18-03-13 22 118 29,35 Outside 0 Ellen Female 06-03-13 93 149 50,65 Outside 0 Ellen Female 19-03-13 93 149 50,65 Inside 0 Ester Female 06-03-13 11 116 37,4 Outside 0 Ester Female 01-05-13 12 116 36,05 Inside 1 Gerhard Male 02-04-13 23 116 34 Outside 0 Gerhard Male 02-04-13 23 116 34 Inside 0 Joelle Female 06-03-13 10 127 36,85 Outside 0 Joelle Female 01-05-13 12 127 36,95 Inside 1 Jose Female 15-05-13 36 136 40,15 Inside 0 Jose Female 15-05-13 36 136 40,15 Outside 0 Siepy Female 19-03-13 70 147 45,6 Inside 0 Siepy Female 29-05-13 72 147 42,35 Outside 0 Desiree Female 13-03-13 58 149 50,8 Inside 0 Renske Female 28-03-13 69 159 76,4 Inside 3 Renske Female 02-05-13 71 159 67,5 Outside 3 Sietske Female 28-03-13 21 119 28,3 Inside 2 Sietske Female 02-05-13 23 119 30,3 Inside 0 Thom Male 02-05-13 12 105 22,7 Inside 1 Thom Male 02-05-13 12 105 22,7 Outside 1 Tonia Female 08-04-13 22 122 31,9 Inside 1 Table 5: overview of the results of the porpoises, data arranged alphabetically Research project University of Utrecht: S.Gans VC in l PEF in PIF in Mean l/s l/s Te/Ti 3 -9,74 10,78 1,19 1,9 -7,6 11,08 0,8 -4,14 4,58 1,7 -8,52 9,92 2,5 -6,79 8,28 1,18 1,2 -2,78 4,5 1,8 1,2 -4,24 5,32 1,2 2 -5,01 6,4 2 -5,05 7,19 1,42 1,4 -4,12 7,32 1,7 1,2 -3,84 6,52 1,2 2,1 -7,84 10,52 1,07 2,3 -4,84 5,52 1,07 1,7 -5,04 8,44 1,01 1,4 -7,19 9,17 1,93 4,4 -11,36 14,32 1,24 3 -16,32 13,56 0,61 3 -20,64 12,72 0,4 1,3 -6,8 7,24 1,4 1,5 -8,8 10,04 1,13 0,8 -3,6 5,24 1,52 1,5 -4,13 5,11 1,55 1,8 -6,35 9,9 - 48 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Name Sex Date SD Te/Ti Mean SD Te Te Mean SD Ti Ti Mean SD Vex Vex Amber Female 15-05-13 0,4 0,12 0,34 0,05 2,19 0,52 Amber Female 29-05-13 0,39 0,09 0,28 0,03 1,57 0,25 Berend Male 18-03-13 0,32 0,01 0,44 0,19 0,57 0,15 Ellen Female 06-03-13 0,34 0,08 0,3 0,07 1,15 0,19 Ellen Female 19-03-13 0,02 0,49 0,1 0,45 0,08 1,83 0,05 Ester Female 06-03-13 0,14 0,69 0,13 0,42 0,02 0,9 0,25 Ester Female 01-05-13 0,25 0,53 0,1 0,44 0,08 0,83 0,15 Gerhard Male 02-04-13 0,59 0,16 0,41 0,07 1,61 0,14 Gerhard Male 02-04-13 0,34 0,52 0,11 0,38 0,04 1,43 0,16 Joelle Female 06-03-13 0,11 0,54 0,16 0,31 0,04 1,08 0,16 Joelle Female 01-05-13 0,28 0,48 0,1 0,42 0,11 0,88 0,15 Jose Female 15-05-13 0,09 0,39 0,04 0,37 0,03 1,81 0,25 Jose Female 15-05-13 0,18 0,68 0,11 0,6 0,03 1,86 0,34 Siepy Female 19-03-13 0,32 0,54 0,1 0,48 0,22 1,19 0,15 Siepy Female 29-05-13 0,34 0,49 0,14 0,28 0,04 1,08 0,15 Desiree Female 13-03-13 0,18 0,56 0,12 0,46 0,08 3,67 0,64 Renske Female 28-03-13 0,21 0,3 0,07 0,48 0,17 1,72 0,44 Renske Female 02-05-13 0,26 0,08 0,55 0,14 1,93 0,38 Sietske Female 28-03-13 0,36 0,36 0,08 0,26 0,02 0,99 0,21 Sietske Female 02-05-13 0,12 0,33 0,03 0,29 0,03 1,41 0,09 Thom Male 02-05-13 0,18 0,34 0,05 0,21 0,02 0,65 0,08 Thom Male 02-05-13 0,25 0,52 0,11 0,29 0,04 0,84 0,06 - 0,52 Tonia Female 08-04-13 0,37 0,14 1,91 Table 6: overview of the results of the porpoises, data arranged alphabetically Research project University of Utrecht: S.Gans Mean SD Vins Vins 2,48 1,88 0,66 1,2 2 1,2 0,91 1,47 1,63 1,05 0,86 1,85 2 1,36 1,24 3,5 2,13 2,45 1,04 1,35 0,61 0,96 1,35 0,31 0,28 0,13 0,3 0,35 0,19 0,16 0,41 0,17 0,18 0,21 0,27 0,1 0,22 0,09 0,8 0,56 0,33 0,16 0,11 0,04 0,31 0,27 49 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Name Sex Date Age in Length in Weight months cm in kg Place Health VC in l PEF in PIF in Mean l/s l/s Te/Ti Apollo Male 07-05-13 292 285 225 Inside 0 12,8 -48,88 33,28 Apollo Male 30-05-13 292 285 225 Outside 0 10 -22,04 29,64 Juno Male 07-05-13 352 247 208 Inside 0 7,9 -34,32 24,44 Juno Male 30-05-05 352 247 208 Outside 0 7,3 -27,16 21,89 Nemo Male 23-05-13 319 262 223 Inside 0 8,1 -26,76 16,64 Nemo Male 30-05-05 319 262 223 Outside 0 9,8 -23,76 17,23 Tlisala Male 23-05-13 148 275 217 Inside 0 7,1 -30,91 25,25 Tsalka Male 09-05-13 184 274 217 Inside 0 11,4 -37,72 22,6 Tsalka Male 23-05-13 184 274 217 Inside 3 4,9 -22,99 17,41 Tsalka Male 30-05-05 184 274 217 Outside 3 4,7 -12,48 11 Tucker Male 07-05-13 388 289 232 Inside 1 8,5 -35,69 22,79 Tucker Male 30-05-05 388 289 232 Outside 1 9,3 -22,94 19,09 Maaike Female 02-11-12 360 270* 266 Inside 3 5,9 -17,08 18,12 Table 10: overview of the results of the bottlenose dolphins, data arranged alphabetically *No length of this animal was known, this value has been estimated using the lengths of the other animals. Name Sex Date SD Mean Mean SD Te/ti Te SD Te Ti Ti Mean SD Vex Vex Mean SD Vins Vins Apollo Male 07-05-13 0,22 0,38 0,09 0,68 0,33 8,4 1,9 9 Apollo Male 30-05-13 - 0,62 0,15 0,51 0,14 6,74 1,3 6,96 Juno Male 07-05-13 0,07 0,27 0,04 0,37 0,07 5,45 0,81 5,91 Juno Male 30-05-05 0,12 0,41 0,1 0,44 0,17 5,11 0,83 5,08 Nemo Male 23-05-13 0,09 0,41 0,05 0,65 0,09 6,19 0,95 6,6 Nemo Male 30-05-05 0,06 0,43 0,08 0,69 0,12 6,16 0,29 7,1 Tlisala Male 23-05-13 0,11 0,29 0,04 0,35 0,08 4,52 0,46 4,81 Tsalka Male 09-05-13 - 0,43 - 0,66 - 6,83 - 11,42 Tsalka Male 23-05-13 0,06 0,3 0,03 0,32 0,04 3,49 0,53 3,79 Tsalka Male 30-05-05 0,25 0,63 0,08 0,58 0,16 3,85 0,66 3,63 Tucker Male 07-05-13 0,05 0,24 0,02 0,37 0,07 4,82 0,46 5,95 Tucker Male 30-05-05 - 0,42 0,08 0,53 0,18 5,13 0,4 6,08 Maaike Female 02-11-12 0,42 0,38 0,14 0,4 0,1 3,6 0,86 4,06 Table 11: overview of the results of the bottlenose dolphins, data arranged alphabetically Research project University of Utrecht: S.Gans 1,78 1,57 1,07 1,2 0,9 1,16 0,83 0,62 0,57 1,47 1,25 1,1 50 0,68 0,95 0,76 0,75 0,67 0,66 0,9 1,04 1,09 0,76 1,24 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Flow volume curves harbour porpoises Horizontal: volume in liters Vertical: flow in liters per second Amber 15-05-13, inside, health: 0 Research project University of Utrecht: S.Gans 51 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Amber 29-05-13, outside, health:0 Research project University of Utrecht: S.Gans 52 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Berend, 18-03-13, outside, health:0 Research project University of Utrecht: S.Gans 53 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Ellen, 06-03-13, outside, health:0 Research project University of Utrecht: S.Gans 54 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Ellen, 19-03-13, inside, health:0 Research project University of Utrecht: S.Gans 55 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Ester, 06-03-13, outside, health:0 Research project University of Utrecht: S.Gans 56 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Ester, 01-05, 13, inside ,health:1 Research project University of Utrecht: S.Gans 57 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Gerhard, 02-04-13, outside, health:0 Research project University of Utrecht: S.Gans 58 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Gerhard, 02-04-13, inside, health:0 Research project University of Utrecht: S.Gans 59 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Joelle, 06-03-13, outside, health:0 Research project University of Utrecht: S.Gans 60 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Joelle, 01-05-13, inside, health:1 Research project University of Utrecht: S.Gans 61 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Jose, 15-05-13, inside, health:0 Research project University of Utrecht: S.Gans 62 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Jose, 15-05-13, outside, health:0 Research project University of Utrecht: S.Gans 63 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Siepy, 19-03-12, inside, health:0 Research project University of Utrecht: S.Gans 64 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Siepy, 29-05-13, outside, health:0 Research project University of Utrecht: S.Gans 65 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Desiree, 13-03-13, inside, health:0 Research project University of Utrecht: S.Gans 66 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Renske, 28-03-13, inside, health:3 Research project University of Utrecht: S.Gans 67 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Renske, 02-05-13, outside, health:3 Research project University of Utrecht: S.Gans 68 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Sietske, 28-03-13, inside, health:2 Research project University of Utrecht: S.Gans 69 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Sietske, 02-05-13, inside, health:0 Research project University of Utrecht: S.Gans 70 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Thom, 02-05-13, inside, health:1 Research project University of Utrecht: S.Gans 71 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Thom, 02-05-13, outside, health:1 Research project University of Utrecht: S.Gans 72 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tonia, 08-04-13, inside, health:1 Research project University of Utrecht: S.Gans 73 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Flow volume curves dolphins Horizontal: volume in liters Vertical: flow in liters per second Apollo, 07-05-13, Inside, health:0 Research project University of Utrecht: S.Gans 74 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Apollo, 30-05-13, outside, health:0 Research project University of Utrecht: S.Gans 75 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Juno, 07-05-13, inside, health:0 Research project University of Utrecht: S.Gans 76 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Juno, 30-05-13, outside, health:0 Research project University of Utrecht: S.Gans 77 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Nemo, 23-05-13, inside, health:0 Research project University of Utrecht: S.Gans 78 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Nemo, 30-05-13, outside, health:0 Research project University of Utrecht: S.Gans 79 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tlisala, 23-05-13, inside, health:0 Research project University of Utrecht: S.Gans 80 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tsalka, 09-05-13, inside, health:0 Research project University of Utrecht: S.Gans 81 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tsalka, 23-05-13, inside, health:3 Research project University of Utrecht: S.Gans 82 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tsalka, 30-05-13, outside, health:3 Research project University of Utrecht: S.Gans 83 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tucker, 07-05-13, inside, health:1 Research project University of Utrecht: S.Gans 84 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Tucker, 30-05-13, outside, health:1 Research project University of Utrecht: S.Gans 85 Lung function measurements using spirometry in small cetaceans: Tursiops truncatus and Phocoena phocoena Maaike, 02-11-12, inside, health:3 Research project University of Utrecht: S.Gans 86