Chimpanzee Sanctuary Northwest

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Jamie and Foxie’s Exams

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From Dr. Erin:

The last few days have been even busier than usual at the sanctuary!

Both Jamie and Foxie had complete exams this week.  The decision to anesthetize any of the chimps is never taken lightly but when it comes to anesthetizing older chimps (Jamie is turning 48 in a couple weeks and Foxie is 49), we are especially careful and consider several factors before making the decision to perform an exam under anesthesia. These factors include what data we can get through positive reinforcement training, how long it’s been since their last exam, as well as any previous health concerns or current changes in behavior or affect that indicates there may be a health concern.

In Jamie’s case, as J.B. noted in a previous blog post, Jamie has been slowing down over the last several months and her belly has become more pronounced.  While the physical changes can certainly be ascribed to aging (ask me how I know) and the change in social structure since Jody’s passing,  we couldn’t be sure and there was something “off” enough about her that an exam was warranted.

With Foxie, we were concerned about a cough that developed this past summer and persisted in spite of various medications to address possible causes.

Both chimps did well under anesthesia and while Jamie wanted an extra day of rest before rejoining the group,  Foxie was clamoring to be back with her family before breakfast this morning.  The procedures consisted of a complete dental exam, including x rays and cleaning, abdominal ultrasound, echocardiogram, head to toe physical, full body x rays, and sample collection for diagnostic tests on blood, respiratory fluid and urine.

Jamie’s team on Friday included local professionals Dan Whitemarsh, DDS and Tanya Hebert, sonographer.  Traveling from west of the Cascades were Jaime Sheehan, echo tech, Milo Torres, LVT & the wonderful Dr. Dan Low and anesthesiology intern Pat Herndon.  Dr. Yousuf Jafarey, an experienced primate vet and dear friend, flew up from California just to participate in the exams!

Jaime Sheehan returned yesterday to perform Foxie’s echo as well. The rest of Foxie’s team consisted of Dr. Charles Dyer, the dentist from the Dental Coalition for Conservation (who performed in Missy’s dental care in July), Korey Krause, sonographer from Kittitas Valley Health, David Liston, MD and Kate Uselman, CRNA from Seattle on anesthesia, as well as Dr. Jafarey and myself.

We have some preliminary information from the exams that will help guide care for both of these amazing older ladies and are awaiting lab results, radiology, and cardiology reviews that will further inform protocols for keeping them as comfortable as possible in their golden years.

I am incredibly grateful to the professionals that lend their time, effort and expertise to these exams, it really is a team effort to ensure the chimps have the safest and most thorough exam possible. I am so appreciative and impressed by the staff and volunteers who rearrange schedules, take on extra work, come in early, deal with clinic equipment spilling into the foyer and all support each other as well as the chimps. I work with the most wonderful people!

And we are so fortunate to work with the incomparable Dr. Erin!

The team prepares blood samples:

Jamie’s teeth are examined and cleaned while she is given an abdominal ultrasound:

The team monitors Jamie during recovery:

Jamie sleeps off the events of the day:

Foxie receives a dental cleaning and abdominal ultrasound:

X-rays are taken of Foxie’s teeth:

Nothing speeds up recovery like some pudding in a cup:

Jamie and Foxie enjoying a lunch forage on the hill this afternoon:

Medical Mysteries and Miracles

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Did we ever tell you about the time Willy B went blind?

Caring for chimpanzees is an endless parade of difficult choices, but no decision is more wrenching than choosing when to intervene when a chimp becomes ill. Veterinary care for chimpanzees falls into two distinct categories: those procedures that we can do through the mesh with their cooperation, and those that require anesthesia. Positive reinforcement training broadens the range of diagnostics that can be performed cooperatively, but when a chimpanzee is really sick, its limitations quickly become apparent. If the tests than you can do cooperatively are insufficient or inconclusive, what’s next? How sure are you that the condition is serious enough to warrant further action? Are you willing to dart and sedate a chimpanzee for what could be a bad case of gas?

We find ourselves in these situations far more often than we would like. Like this past January, when Willy went blind.

I remember getting called on the radio a little after 8am. In the course of their opening rounds, the staff had noticed that Willy’s eyes were closed tight and he was having trouble navigating his enclosure. Rayne, Mave, and Gordo were all inspecting his eyes and showing concern for their friend who was in obvious distress. The staff immediately notified Dr. Erin and isolated Willy in the Front Rooms.

Were his eyes irritated? Could he open them at all? Was he hit in the face? Was it neurological? Other than some very slight discharge from his left eye and some understandable anxiety, he appeared otherwise healthy. We checked the overnight security camera footage, which showed Willy B making his nest as usual the previous night. And as we had thought, the evening was calm and peaceful, with no fights or falls that might have provided the opportunity for a smack to the face or a knock on the head. After he awoke in the morning and descended from the catwalk, however, he could clearly be seen groping his way across the playroom floor. Something had changed while he was asleep.

Dr. Erin was instrumental in creating a working group for veterinarians within the North American Primate Sanctuary Alliance. She queried her colleagues to see if anyone  had ever encountered something like this. Besides their concern and offers of support, the most common response was something to the effect of, “Wow, that’s really weird.”

Willy remained in isolation for the rest of the day while Dr. Erin and the team continued with what tests they could and prepared for everything from neurological consults to a CT scan. Willy went to bed that night without having opened his eyes once.

I went up early the next morning, hoping that his condition would have miraculously improved overnight. But his eyes were still closed and he could only orient towards me by the sound of my voice. He showed no reaction to a floodlight being shined directly at his eyes at close range.

Later, I offered to serve breakfast to Willy. His anxiety had subsided, and was calmly taking his fruit from me through the mesh when I placed it directly in his hand. I left Willy for a brief moment to speak with the staff serving breakfast to the rest of the group, and when I returned, Willy was patiently waiting for the rest of his fruit. With his eyes open.

He reverted to closing his eyes for brief periods throughout the day but by the following morning it was as if nothing had ever happened. He was reunited with his group and the behavior has not returned since.

The most common medical dilemmas we encounter are ones involving fatigue and inappetence. All of us get an upset stomach or cramps from time to time. Food becomes less appealing and all we want to do is lay down and rest. Nothing to worry about, right? Then again, we also get appendicitis, which requires emergency surgery. It’s good to know the difference.

Not too long ago, Burrito was displaying these same symptoms. He was showing up for meals but eating less, and he was overall less active than usual. His condition continued to worsen a bit over the course of 36 hours and the other chimps were starting to notice.

Again, there’s a lot we can do short of anesthetizing a chimp and examining them in the clinic. Dr. Erin immediately works up a differential diagnosis which guides both the things we monitor and measure and how long we wait before intervening more invasively. Food grade glitter comes in handy when you want to know if a particular chimp in the group is having bowel movements (and if you happen to like your poop festive). Remote thermometers and thermal cameras can show hot spots on the body that might indicate inflammation. Heart rate, respiratory rate, and other vitals can be gathered through observation or with devices like KardiaMobile. But sometimes everything looks normal and the chimp is still sick.

One afternoon, a few of us came upon Burrito as he was laying on the floor on Front Room 3. This is not a spot that he would usually rest. Annie and Negra were both hunched over him and Annie was very deliberately pressing on his abdomen with her hands like an doctor testing for abdominal tenderness. While I was grateful to Doctor Annie for investigating his symptoms, the scene was not encouraging. In cases like this, we have a plan put together and ready to implement should we feel the need to intervene with more invasive tests; it seemed like this might be the trigger.

But Doctor Annie was persistent. She turned it into a game and soon he was up and moving around. The two continued to play. Notably, Annie did not take her focus off of Burrito’s belly, which she continued to gently pat as the two hugged and wrestled.

Over the next few days, Burrito’s appetite returned. And like Willy B, he was not inclined to look back. There were meals to be eaten and games of chase to be played.

Every great ape caregiver has dozens of stories like this, because there will always be times when the wisest course of action is to wait and see. Spontaneous recoveries don’t necessarily preclude further action, as veterinarians may have legitimate concerns that an underlying illness or disease, such as a stroke or a partial bowel obstruction, warrants further investigation, even if things appear resolved. But in many cases, we simply thank the chimp gods and move on.

Cooperative Veterinary Care: Rayne’s X-Ray

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As avid CSNW blog readers know well, most veterinary procedures for chimpanzees are traditionally carried out while they are under anesthesia, and we don’t like do anesthetize any more than we have to. So we, along with many of our colleagues, try to find ways for chimps to willingly cooperate in their own care. That can take the form of positive reinforcement training, the use of specialized devices for diagnostics and treatment, or, in some cases, both. Take a peek at our team snapping some x-rays of Rayne’s finger in an effort to rule out a fracture and direct the course of treatment.

A Trip to the Clinic for Willy B

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Willy B took a trip to the clinic this morning. The main purpose of the procedure was to investigate some swelling in his scrotum. As usual, Dr. Erin assembled a great crew to ensure that Willy would have the best care possible.

Dan Low, MD and Leah Bezzo, CRNA, both with Seattle Children’s Hospital, kept Willy safely under anesthesia. Tom Lendvay, MD, a urologist with Seattle Children’s, performed the initial evaluation with ultrasound assistance from Korey Krause, RDMS.

Willy also had a full cardiac workup, including chest radiographs and an echocardiogram by Marneye Driesen, RDCS, since some forms of heart disease can cause fluid to begin backing up in cavities such as the scrotum.

While he was under, Willy was also given a complete abdominal ultrasound.

Echocardiograms require a more powerful ultrasound machine than the one we own, so we are very grateful to the Woodland Park Zoo for once again allowing us the use of their machine. The machine was delivered to the sanctuary by Barbra Brush, LVT, who also participated throughout the procedure, including giving William a thorough dental cleaning.

The results of the echo and samples from his scrotum will have to be sent off for analysis but based on what we’ve seen, Dr. Erin has reason to believe that Willy B will benefit from some cardiac medication, just like his buddy Cy and like good ol’ Burrito across the way.

Willy did great throughout the procedure and is recovering quickly – due in part to the fact the we have kept his feet nice and warm and fashionable. We think it’s also due to the fact that he has a standing 2:30pm appointment to display and cause chaos in his group, to which he has never once been late.

Thankfully, he also seems to understanding the importance of getting rest after a clinic visit, so we’re hoping that he’ll take an afternoon off just this once.

Many, many thanks to this amazing team of medical professionals who traveled great distances to join us this morning and of course to our own Dr. Erin and Grace! We will continue to seek the donation of a portable cardiac ultrasound machine but if that is not in the cards, be on the lookout for a fundraiser sometime next year 🙂

We’ll share updates about Willy B when we know more.

Heart Week

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Cardiovascular disease is a major cause of illness and mortality in captive chimpanzees. As many of you know, we’ve been treating Burrito since 2012 for hypertensive heart disease. What you may not know is that Cy also suffers from cardiovascular disease – in his case, dilated cardiomyopathy. To better manage his symptoms and slow the progression of the disease, Dr. Erin arranged for a cardiac exam from Dr. Lynne Nelson, lead cardiologist at Washington State University’s veterinary hospital. Dr. Nelson has been a great friend to the sanctuary for many years and has helped oversee Burrito’s care.

Dr. Nelson’s expertise was also called upon this week to assess Lucky. While Lucky has appeared to be in good health overall, her pre-transport exam from Wildlife Waystation suggested the possibility of an enlarged heart. We knew that further diagnostics would be required once she and her friends settled into their new home and social group.

And then there’s Terry. Terry has not shown any signs of cardiovascular disease, but he was due for a re-check of his fractured canine tooth, and any time a chimpanzee is anesthetized in the clinic, we want to obtain as much information as we can to help manage their care. Dr. Erin thoughtfully scheduled Terry’s re-check at a time when he could also receive a thorough evaluation from Dr. Nelson.

Three chimps in three days. Heart Week, you might call it. Or Hell Week, if you are a member of the staff responsible for getting the chimps into the right enclosures at the right times so that we could make this all work. We are incredibly grateful to all of the staff and volunteers for all the effort that went into making these exams possible while keeping the rest of the chimp house humming along like usual.

Before I share more of the week’s events, I’m sure you want to know what we found. Lucky has a healthy heart for her age, thankfully. Ultrasound revealed a few things that we’ll want to keep an eye on, but she does not suffer from any significant cardiovascular disease. Cy’s echocardiogram showed some improvements from his last exam—likely from the medications he has been on—but also some disease progression. Dr. Nelson was able to recommend changes to his medication regimen that should help. Terry’s exam showed good news on both fronts—his fractured tooth is healing nicely and his heart is healthy for his age, though he shows some mild cardiac changes that warrant monitoring every few years. Thankfully, he doesn’t have any signs of heart failure and requires no medication at this time.

It’s not fun for us to have to bring the chimps into the clinic, but it is at times necessary. One of the ways that we can reduce the trauma associated with exams under anesthesia is to work with the chimps so that they will take an injection by hand, rather than by dart. Our positive reinforcement training team, and the work of others before us at the Waystation, made it so that all three chimps willingly presented their arms and legs for their anesthetic injections. According to Jenna, who has been training with Lucky, Lucky was downright nonchalant about being poked. The Valium-spiked sip of juice probably helped a little, too.

As is often the case here, Dr. Erin, Sofia, and Dr. Nelson were aided by a number of other medical professionals who came to volunteer their time and talents. Mekensie Kmack, CRNA, who has helped many times before, oversaw Lucky’s anesthesia. New to the team this time was Marneye Driesen, who assisted with the echocardiogram.

Some of our procedures, such as abdominal radiographs, are performed outside of the clinic while the chimps are in recovery (but still anesthetized) to minimize time under anesthesia.

It’s important to keep the chimps warm during recovery – these socks are not just for fashion.

The same team assembled again the next day to examine Cy’s heart and perform routine diagnostics and cleanings.

We’ve found that there’s no use hiding what is happening from the other chimps. Once someone is out of the clinic, they are laid in the recovery room while their friends look on through windows or neighboring enclosures. This reassures them and provides a comforting presence when the chimps wake up from anesthesia.

Cy was groggy, as is to be expected, but he perked right up as soon as Kelsi put on one of his favorite movies, Must Love Dogs.

It was unfortunate that Terry had to return to the clinic so soon after having his fractured tooth repaired, but it was important to get x-rays of the tooth and underlying bone to ensure that he had healed properly. Dr. Whitemarsh, DMD, was on hand again to help.

Sonographers Korey Krause and Tanya Herbert, also new to the team, performed an abdominal exam while Michelle DiMaggio, LVT, monitored anesthesia and otherwise assisted Dr. Erin.

As I write this, Lucky and Cy have been reunited with the group. Terry, who had his procedure this morning, will remain apart for the night while he recovers. Hopefully the others let him get some rest.

As usual, the information we collect to help the chimps in our care will also be shared with the Great Ape Heart Project, so that we can help other captive apes suffering from cardiovascular disease.

Many thanks to Dr. Erin, the staff, and the amazing team of medical professionals that came to care for Lucky, Cy, and Terry this week. Thanks as well to all of our donors that make this level of care possible. If you’re interested in the veterinary care we provide at Chimpanzee Sanctuary Northwest, why not register for our upcoming Virtual Visit on Saturday, April 15th at 2pm? To learn more, click here.

An Appointment with the Dentist

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Well at least it wasn’t a rattlesnake this time…

Yes, poor Burrito was back in the clinic today to have an infected tooth extracted. Dr. Erin and Sofia were accompanied by Dr. Cristina Bender and her husband, Matt, from Pearl Care Dental in Ellensburg, Dr. Dan Whitemarsh of Cle Elum Dental Clinic, and veterinarian Dr. Austin Hardegree, who ran anesthesia and performed ultrasounds. Our friends at Valley Veterinary Hospital were also kind enough to lend some specialized dental equipment for the afternoon.

Since Burrito would be under anesthesia for the extraction, Jim Repsher, PA-C came to give him injections in both knees to help alleviate his arthritis.

Burrito has been through a lot in the last few years but he seems to somehow bounce back stronger every time. We have no doubt he’ll be up and running again very soon. For now, though, he is going to get some rest under close supervision from Dr. Erin…

…and a his chimp family, of course.

We’re so grateful to all the folks who give their time and energy to help care for Burrito and his family and friends. How fortunate are we to have such an amazing team of people looking after them.

Feel better soon, Bubs.

A Trip to the Clinic for Negra

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The group of seven got into a fight yesterday and poor Negra sustained a significant laceration on her back side that required stitches. The staff got her isolated and Dr. Erin began mobilizing for the procedure. We are grateful to have been joined by Jim Repsher, PA-C, from Kittitas Valley Hospital who, with his background in surgery and emergency medicine, was able to tend to her wound while Dr. Erin, Sofia, and other staff gave Negra a full workup.

Negra handled the procedure well and got an ultrasound of her heart, x-rays, blood work, and a dental exam while receiving her stitches.

Diana ensured that Negra’s IV remained in place while Negra was repositioned for various diagnostics.

Sofia examined Negra’s teeth and gums.

Identification tattoos on each of Negra’s thighs serve as a stark reminder of her decades spent in various laboratories.

Negra’s caregivers often have to hold her arms to ensure that the various cuffs and catheters stay in place. These moments bring us some comfort, even if Negra is unaware of our presence.

Getting sutures to remain in place, especially in fragile tissue, can be a challenge with chimpanzees, who are prone to pick at them and pull them out. For this reason, we often employ distraction techniques so that they will direct their attention elsewhere while they recover. In some cases, we place shallow “distraction sutures” in areas away from the injury. Here, Sofia paints Negra’s fingernails so that she will have something else to pick at while she recovers. It’s a tip we learned from colleagues at another sanctuary and it certainly can’t hurt to try.

Before long Negra was back in the recovery room in a pile of blankets and stuffed animals, with her team of caregivers monitoring her closely.

By morning she was alert and ready for some juice.

She made a nest next to the caging and gave kisses through the mesh before eventually falling back to sleep.

That is, until Annie started spitting water on her to get her attention and make sure she was OK! Once Negra sat up, Annie was satisfied and let Negra go back to bed.

We’re pretty confident that Negra will have an uneventful recovery – after all, she lives her whole life on restricted activity! But she will remain isolated, with her caregivers watching over her and her chimp family next door, until Dr. Erin is confident in her healing.

The life of a chimp vet is never dull. For the last month, the staff have been taking turns doing overnight duty, sleeping on a cot in the chimp house foyer to monitor the newly integrated group of nine and respond in the event of a serious conflict. Friday night was Dr. Erin’s night, and I’m sure she was looking forward to a day of rest following her shift. The chimps had other plans, though. As always, we are grateful to have Dr. Erin caring for these sixteen chimps and four cattle and we hope she can get some rest today.

If you’d like to contribute towards the veterinary care of Negra and her friends, we have had (thanks to the folks who purchased these so quickly!) a dental scaler and a polisher on our Amazon wish list that would be a huge help the next time one of the chimps finds themselves in the clinic.