If you read Diana’s blog post on Saturday, then you know that Negra recently sustained an injury to her toe that we’ve been closely monitoring. After careful consideration, we decided that we needed to intervene surgically to help speed the healing process and reduce the risk of long-term complications. Yesterday, our amazing volunteer veterinarian, Dr. Zamzow, along with two skilled and generous volunteer anesthesiologists, came out to conduct the minor operation.
Procedures like these actually begin the night before, when we isolate and withhold food from the chimpanzee being treated. In the morning, we shift all of the other chimpanzees into another area so that the patient can enjoy some peace and quiet during the anesthetic induction. Of course, these chimpanzees have been around the block a few times, so they know what’s going on. Sometimes they express concern and want to see what’s happening inside – especially the group’s den mother, Jody:
The chimpanzee being treated is given an injectable anesthetic in an enclosure designed for this purpose – it’s small and has no furniture or other things to climb on so that they won’t get hurt as they lose their coordination from the anesthetic (right now this is one of the front rooms – the same room you’ve seen in recent videos where the chimps like to watch their playroom parties being set up). Once they are fully anesthetized, we strap them on a stretcher and wheel them to the clinic where they’re put on gas anesthesia and hooked to cardiac and anesthetic monitors for their safety.
Our clinic, which is in the back of a 38-foot trailer, has served us well for the few procedures we have had to do, but part of the expansion project we hope to break ground on this year includes even better spaces for anesthesia induction, medical intervention, and recovery. The new and improved space will help the seven chimpanzees currently at CSNW as well as the new chimpanzees we expect to welcome over the next few years.
Here’s Negra in the clinic being prepped for surgery:
Anesthesia can be hard on a chimpanzee, particularly when they are older or ill. That’s why we try to do as much health monitoring and treatment as we can while they are awake using positive reinforcement training. But sometimes more complicated procedures require full anesthesia. Thankfully, Negra did great throughout the procedure, and she was soon on her way back to the enclosure where she could be monitored during her recovery. As one of our anesthesiologists taught us, anesthesiology is like flying a plane – the most dangerous times are takeoff and landing. So as a chimpanzee recovers, we have to watch them very closely. We position them on their side near the caging, propped up by blankets, so that we can monitor their breathing and pull their ET tube when they’re ready.
Once they start coming to, they feel generally crummy for a little while. But soon they realize that they are on a pile of blankets on a heated floor, and what better opportunity is there to take a nice long nap?
Negra is starting to feel better this morning, slowly but surely. It’s best for her to remain apart from the group for a little while longer to give her toe a better chance of healing quickly. So she’s been grooming with her friends through the caging and getting indulged with special treats. But more than anything, she’s been focusing on what she does best: resting. This is a chimpanzee that knows how to follow doctor’s orders.
Cheryl says
glad she is all better and doing well.
Katie says
This is fascinating and brings to my mind many questions about the many special challenges here! Though I know these chimps are “used to” some special procedures I wonder about how you get their cooperation for injections etc. and how you can be safely in physical contact with them when they are somewhat awake – etc.! And do Negra and the other chimps leave bandages. dressings etc alone for healing? I can see the need for that continued separation for awhile. How much hands on is still needed to monitor her? Is a low level of tranquilizing necessary?
Thanks for all the details and insight you share!
J.B. says
Hi Katie: Good questions. The techniques we use depend on a number of factors.
First, there’s the extent to which they are injection trained. Chimps progress through positive reinforcement injection training at different rates, depending on things like personality and prior experience. Some of the chimps here will present for and calmly accept an anesthetic injection, others will present anxiously and only for a brief moment, and others will not present at all. Given that they spent as much as 35 years being darted and injected by surprise, it is no wonder that they won’t all line up willingly for their shots.
Second, there’s the choice of anesthetic. Our preferred drug combo is ketamine/medetomidine. The medetomidine part of this cocktail is low-volume and doesn’t sting, so it’s much easier to deliver. It’s also reversible. However, it can depress cardiac and respiratory rates, which presents a danger to chimps with cardiac disease or who are older or obese. Drugs like Telazol have much higher safety margins, but the recovery can take much longer. So our choice of drug, which is always based on a balance of what is safest and least stressful for the patient, can affect which method of delivery will work best.
Depending on the chimp and the drug, we have a choice of hand injection, pole syringe, or dart. There are also some techniques being used now where the drug is administered through the oral mucosa, though some vets find this route to be too unpredictable in its effects. If we have to dart, we use concentrated drugs, purchased through a specialized compounding pharmacy, so that the dart can be as small and light as possible. We also premedicate the chimps with drugs like valium in a small bit of juice. That way, the chimps are less stressed through the procedure and have less memory of the event.
We don’t go into the enclosure until they are fully anesthetized, so any follow up treatment would require either their cooperation (e.g., presenting that part of their body through the mesh) or a repeat chemical immobilization (which we would try to avoid at all costs).
Chimps rarely leave bandages in place once they recover from anesthesia, so the vets must use techniques like buried sutures to prevent the chimps from undoing all their hard work. Thankfully, chimps heal quickly, so their recovery times seem to be much shorter than what we would require.
Francoise says
I am so glad she is well. I know you guys give her the absolute best and most compassionate care. And I thank you for that. But I admit to crying a bit when I read your chronology. Not because I was sad about the surgery, but it brings to mind the dozens of anesthetics and needles and such she and the other chimps endured in their past. I hope that she was not afraid when she knew what was coming. That would break my heart.
Kathleen says
Thank you for this update. I have been thinking about her injury and vibing her thoughts for a quick return to good health. I will admit, even though I know, without a doubt, that in your hands Negra will receive the very best care possible, I worry about the emotional experience of being put under. Can’t help but reflect on the horrific ways biomedical laboratories dealt with this aspect in chimpanzees lives. Even with the trust she holds in her heart for you, it would seem that this would be a scary process for her. Some memories are not forgotten no matter how dark. Thank goodness Negra has blossomed in sanctuary (especially last year!) under your compassionate care. Did the clicker training make a big difference and can you use it in assisting with the actual anesthesia?
Please keep us posted on her recovery. I will keep thinking (and worrying) about Negra until you post an “all clear”. Be sure to tell her I love her and I am thinking of her. Sweet healing dreams Negra!
J.B. says
Hi Kathleen and Francoise:
There’s no doubt that chemical immobilization can be a traumatic experience for the chimps. That, along with the risks involved, is why we try to do as little of it as possible. But you’d be surprised at how resilient they can be.
Here’s how I approach the issue: First, decide if the intervention is necessary for their health and/or well-being. If so, decide on the safest and least stressful approach. Then, get it over with and don’t dwell on it. Just provide as much care and support and attention as possible. The chimps will move on faster than we will. I have no doubt that Negra will be a little more suspicious of us in the short term, but she’s not mad at us. She has greeted us with her usual kisses each day.
Unfortunately, Negra is not yet injection trained (and from her records, she never accepted injections at the lab). But we gave her a nice valium cocktail. Too bad we couldn’t also give them to the staff 🙂
Kathleen says
Thank you, thank you J.B. for all of your in depth answers to all of our questions on this post! I have been so worried over Negra, I too could have benefited from one of those nice valium cocktails Negra enjoyed!! I am sorry to hear that Negra lost her toe, poor dear girl. After reading your blog post today (Friday) I was pleased to hear that she is doing much better. And it is nice to know that she has greeted you all with her usual kisses. I hope she knows how lucky she is to be in your care (I personally believe she does!). Thank you again for replying.
diane d. says
Sweet Negra. Rest well. You are in good hands and will soon be back with your chimpanzee friends.
Laurie Church says
Sweet sweet girl~!
CeeCee says
She looks so sweet while she sleeps.
Poor baby.
Arlene and Michael says
Oh how scary. We are thankful that Negra came through the procedure as well as she did and we send her love and best wishes for a speedy recovery:):):) Thank you for taking such amazing care of these chimps.
Jo says
Such a beautiful chimp!! Sending healing energies to settle on her and remain with her until vibrant good health is restored, and I am picturing it quickly returning! Blessings to you all for doing the right thing for her! Hugs to all!
Althea says
Echo Francoise and Kathleen. Negra and her friends well being are their human staffs most important priority. Speedy recovery sweet Neggie and hopefully you might get an extra special treat like a dinner roll or your beloved pineapple coconut juice. I am always loving and hugging you special one.
Kathleen Klueh says
Get well soon my beautiful Negra ????????????
Francoise says
I hope that Negra is feeling much better this morning (Friday). A good night’s rest and some yummy fruit juices does wonders when recovering from anesthesia, which of course what really knocks you fore a loop. So what exactly was done? Had her toe been completely severed and you closed it up, or was it a serious flesh wound? I (and I’m sure many others) like to be able to visualize what is happening with our blessed chimps — which is why your wonderful blog is so immensely important to us!!
J.B. says
Hi Francoise: We amputated the toe. After consulting with other experienced veterinarians, Dr. Zamzow decided that a full amputation would provide the greatest likelihood of long-term health. The last thing we want to do is put Negra through another procedure to deal with an infection. Negra walks on the outside edges of her feet with her pinky toes curled under, so we don’t think this will have any affect on her gait or mobility. Plus, chimps are very adaptable.
Karen says
Shower that girl with avocados and she will be her old self in no time! It is wonderful, after her history, she put her complete trust in those who love her and treet her with respect. We wish her a speedy recovery!
Vicki Hadley says
I hope that while she was under sedation you gave her a BIG hug and a kiss !
Elaine Reininger says
Love the last picture — someone lovingly tucked her in nice and warm and comfy in that blue blanket. Hope she will have a speedy recovery.