# A Multimodal Approach to Treatment and Management of Rumination Syndrome in a California Sea Lion (Zalophus californianus)

## TL;DR

A California sea lion with chronic rumination syndrome was successfully treated using a combination of medication, feeding changes, and behavioral strategies, improving its health and quality of life.

## Contribution

The study demonstrates a successful multimodal treatment plan for rumination syndrome in a sea lion with comorbid medical and behavioral issues.

## Key findings

- Rumination behavior decreased and eventually ceased following multimodal interventions.
- The animal showed improved health, training engagement, and social interactions.
- No visible regurgitated material was observed five months post-intervention.

## Abstract

This case study describes the treatment of a California sea lion with chronic rumination syndrome. The condition involves repetitive regurgitation and re-ingestion of food, which can cause serious medical issues and poor welfare. The animal also presented with an enlarged esophagus and low thyroid function, complicating management. We developed a multimodal plan combining medication, feeding changes, and behavioral strategies. Treatments included thyroid medication, naltrexone to reduce repetitive behaviors, smaller meals delivered in an upright posture, and structured enrichment after feeding. Rumination decreased and eventually ceased. The animal’s health, training participation, and social interactions improved. This case highlights the value of individualized, integrated approaches to complex medical and behavioral conditions in professional care.

The management of chronic rumination syndrome in professionally cared-for animals requires a comprehensive and individualized approach. In this case study, a multimodal approach incorporating pharmacological treatment, feeding modifications, and behavioral management was applied to a California sea lion (Zalophus californianus) with rumination syndrome, megaesophagus, and hypothyroidism. Behavioral observations were collected through video recordings both prior to and post-intervention. Interventions included oral naltrexone and contingent reinforcement post-feed to provide alternative enrichment activities after feeding sessions to reduce rumination syndrome, as well as levothyroxine for hypothyroidism. Additionally, dietary modifications involved offering smaller food portions, spreading meals across longer time periods, and feeding in a more upright position to facilitate esophageal passage. Results showed a reduction in the frequency of rumination syndrome, with no visible regurgitated material observed five months post-intervention. The sea lion demonstrated improved engagement in training sessions, voluntary husbandry tasks, and open-water activities, as well as improved interactions with conspecifics. The combination of pharmacological, dietary, and behavioral strategies reduced rumination behavior and improved the animal’s overall quality of life, reinforcing the value of individualized care strategies and multimodal treatment plans in addressing complex medical and behavioral comorbidities. These findings show the importance of individualized, multimodal care plans in managing complex behavioral and medical conditions, and they contribute to advancing animal-welfare practices across species.