Chimpanzee Sanctuary Northwest

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medical

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:

Beans, Beans the Magical Chimp

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Today, Honey B took a trip to the clinic so Dr. Erin could investigate a hand wound that wasn’t healing properly. As some of you know, chimps are notoriously good healers, which is fortunate given the frequency of wounding in this species. Most of the time, wounds heal with very little intervention- some pain meds for a few days, topical flushing or spraying with antiseptic solutions as well as laser therapy are often all that’s needed to complement their healing process.

Despite her healing and our efforts with antibiotics and laser therapy, it wasn’t enough to clear it up.  Thankfully, the inflammation remained localized at the site of the wound and didn’t spread elsewhere like it tends to in humans.

After much discussion and consideration, Dr. Erin and staff agreed Honey B should make a trip to the clinic. In superhero fashion, she assembled a team of professionals to help determine what is happening in Beanz’ hand while she was in the clinic. We are always amazed at the professionals willing and eager to assist in the chimps’ anesthetic procedures and this time was no exception: Dr. Dan Low (MD) and Leah Bezzo (CRNA) from Children’s Hospital managed anesthesia. Yousuf Jafarey (DVM) from the Woodland Park Zoo, and Jim Repsher (PA) from Kittitas Valley Healthcare, scrubbed in to help assess, culture and flush the wound and perform a regional limb perfusion to concentrate antibiotics deep into the tissues. Ian Gadbaw (LVT) from PAWS Wildlife Center, came over to get a feel for how chimp exams are done and was a great help, along with our very own caregiver Krissy, in assisting with what we needed throughout the procedure and exam.  While being treated for her hand, Honey B also got a good checkup, including a full dental exam, cleaning and polishing, abdominal ultrasound, and blood and urine samples.

We also have to give a huge thank to our positive reinforcement training team, which includes caregivers Sabrina, Jenna, and Ellen. With their tireless effort and dedication to training, Honey B was able to be anesthetized with relative ease.  This is a perfect example as to why PRT is an important part in the chimps’ care. Honey B was willing to present her hand for the anesthetic instead of the use of a dart gun, which as you can imagine, can be a traumatic experience; both for chimpanzees and caregivers.

Beezle (my nickname for Honey B) has recovered from the anesthesia and currently resting in the recovery room and is expected to be reunited with Gordo in the morning, just to make sure all the anesthesia has worn off.

Technicians take an x-ray of Honey B’s hand before entering the clinic
The amazing care team monitoring Honey B after the procedure.

All of Honey B’s friends were curious as to what was happening to their friend. Each rotating around different viewpoint to check in on Honey B.

Terry had the “best seat” in the house to check in on his friend.

Since we are on the subject of Honey B, I will share a fun little story. My watch band had recently broke. The new one I purchased has Van Gogh’s The Starry Night design on it and came with a free background of the famous painting.

As you may know, the chimps are very attune with any changes regarding the caregivers. Even the most minuscule change doesn’t go unnoticed. Honey B immediately caught site on the new watch band the other day, even though a majority of it was covered by my sleeve. When I showed her the watch, the screen lit up with the Starry Night painting on it. She stopped what she was doing, even in mid-chew, and seemed memorized by it.

What was she thinking while staring at my watch? I can’t definitively say, but I will say she has some good taste. Cy and Lucky had a similar response when I showed them. This probably won’t mean anything as the novelty of something new wears off, but I’m just going to pretend.

Here are some bonus photos from the day!

Today’s food puzzle for the rest of the chimps was boomer balls! And Rayne seemed to win this race of collecting as many as she could.

Tough decision of which boomer ball to begin with
Obvious choice for someone like Rayne is to tackle the most challenging kind first

EKG Training

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I love watching the chimps learn new ways to participate in their own healthcare. We’ve had a KardiaMobile device for a little while now, thanks to a generous donor who purchased it from our wish list, but only after making sufficient progress with other medical behaviors was our PRT team able to begin setting their sights on training everyone for cooperative EKGs. In theory it’s a simple behavior to train, since it doesn’t involve any pain or discomfort, but getting a chimpanzee to sit still for 30 seconds straight, while at the same time getting their friends to wait their turn, can be a challenge. Kudos to our training team and to our current EKG champion, Willy B. But watch your back, Willy—once we adjust the platform to accommodate ol’ stubby fingers (aka Terry), you may have some competition!

Hey, speaking of wish lists and generous donors…if you’d like to help supply the sanctuary with food, enrichment, medicines, supplies, and other necessities, please check out our Christmas in July drive and help empty our wish lists!

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.

Teamwork

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Bite wounds are probably the most common injuries we see in chimps. Our treatment protocols for these wounds tend to be fairly conservative: administer analgesics for pain, clean frequently with antiseptic spray, and monitor closely. There are a few reasons for this. First, chimps have a superhuman (literally) ability to heal. Wounds that would send me racing to the ER for stitches will close up on their own in chimps with little to no treatment in a matter of days or weeks, remaining uninfected and leaving no visible trace once healed. Second, because of the frequency of wounding in captive groups, there’s always a risk of antibiotic resistance if antibiotics are over prescribed. And third, many forms of diagnostics and treatment require the chimps to be anesthetized—something we avoid whenever practical out of concern for their overall safety and well being.

Once and a while, though, there are wounds that require a bit more than the typical conservative approach—like recently, when Rayne received a bite to her third digit (middle finger) that resulted in some swelling. When the swelling persisted even as the wound appeared to heal, Dr. Erin wanted to rule out an underlying fracture. Thankfully, our Positive Reinforcement Training (PRT) team was able to train Rayne to hold her hand in the x-ray box so that we could get some images without the need for anesthesia.

Here, Jenna asks Rayne to hold her hand flat in the box so we could get the first in a series of shots.

Jenna then withdraws her hand and Rayne holds hers still (while that other hand is trying to investigate the x-ray generator!).

The good news is that Rayne did not have a fractured digit. Interestingly, you can see an old healed fracture on her 2nd digit (index finger).

Though the swelling soon began to subside, PRT also made it possible to treat Rayne’s finger with a therapeutic laser to help encourage the healing process. For this, Rayne needs only to sit at her station marker and respond to Grace’s command to present the fingers of her left hand through the mesh. It was Rayne’s choice to pull up the orange ball and sit on it.

Sabrina is then able to program the laser, at Dr. Erin’s direction, and apply it to Rayne’s finger.

The only problem? Everyone wants a turn!

Positive reinforcement training requires a lot of staff time but these little opportunities to apply all that effort can really add up in the form of improved diagnostics, more effective therapies, and fewer trips to the clinic. Even if we learn that a chimp will require a more complex exam or treatment under anesthesia, we can often go in with a head start given the information we are able to obtain.

For her part, Rayne seems pretty happy to participate.

You want me to rotate my hand 90 degrees for a lateral view?

Here, you can laser my feet, too!

Just keep that juice coming.

 

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.