On behalf of myself and my co-authors, we are pleased to announce the 
publication of a new method for the visual assessment of freshwater skin 
disease in dolphins.

The open access publication is available here:
https://doi.org/10.3389/fmars.2026.1743541

Please see the Supplemental Materials and other resources available at this 
link for additional guidance in applying the protocol: 
https://galvestonbaydolphin.org/fresh/fresh-protocol/

Fazioli KL, Toms CN, Takeshita R, Quackenbush A, Greig D, Rowles T, Schwacke L, 
Colegrove K, Ewing RY, Fauquier D, Boyd D, Bouwkamp A, Duignan P, Fougeres E, 
Hart L, McDaniel S, Morgan T, Sinclair C, Speakman T, Sutton M, Whitehead HR 
and Mintzer VJ (2026) The dolphin FRESH protocol: visual Freshwater-Related 
Evaluation of Skin Health in free-ranging bottlenose dolphins (Tursiops spp.). 
Front. Mar. Sci. 13:1743541. doi: 10.3389/fmars.2026.1743541

Exposure to freshwater is a pressing health issue for coastal bottlenose 
dolphins (Tursiops spp.). Environmental changes, including increased 
precipitation events and future coastal infrastructure projects, are altering 
salinity within estuarine systems. Consequently, understanding effects of 
freshwater exposure on dolphins and developing tools to evaluate related health 
conditions is urgent. To address this need, a group of veterinarians, 
pathologists, epidemiologists, natural resource managers, and field biologists 
convened to create a protocol to visually assess freshwater-related skin 
lesions in free-ranging bottlenose dolphins. The Dolphin FRESH 
(Freshwater-Related Evaluation of Skin Health) Protocol guides users without 
medical backgrounds to screen and evaluate photographs by focusing on the 
visual identification of three primary indicators of freshwater skin disease: 
Overgrowth, Target-like Lesions, and Light Discoloration. By determining 
presence of the primary indicators and scoring associated characteristics, 
FRESH provides users with a relative assessment of the severity of these skin 
anomalies, and metrics to track progressive changes. The scoring rubric 
performed well during systematic testing, with evaluators correctly identifying 
freshwater cases through recognition of primary indicators and with no 
significant differences in total severity scores between field biologists and 
medical experts. FRESH is an important step in advancing knowledge on the 
effects of salinity fluctuations on dolphin health. When applied to photo 
datasets over time, this tool will enable researchers and managers to evaluate 
progression and regression of freshwater skin disease, occurrence and effects 
of multiple exposures, and the relationship between freshwater exposure skin 
indicators and health and survival outcomes.

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