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.
x-ray
Teamwork
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.
A Trip to the Clinic for Willy B
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
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.
Doll Thief
Jamie and Foxie had a pretty epic play session while we were cleaning the playroom this morning. A few things to note about this video:
- Everyone was playing all morning – this is just a small slice of all the craziness.
- I love how Jamie shows Foxie how to get this game started – “Here, I’ve got your doll and you’ve got to try to get it back!”
- If you ever question whether chimpanzees are stronger than humans, try hanging from the ceiling for 10 minutes and let me know how that works out.
- Jamie employed a new move in this play session, which I have dubbed “The Motorcycle”. See if you can spot it.
- Jamie is 43 years old and seems to have unlimited energy. I am 43 years old and would like a nap. I don’t know how they do it.
Oh, and I’ve got some good news to share – we’d like to thank the Glide Foundation, and all of you who donated this past year, for helping us purchase our very own portable digital x-ray machine! As you may know, we have been fortunate to be able to borrow an x-ray unit as needed from a generous local veterinarian, Dr. Kellar, but with additional chimpanzees on the way we knew it was time to have one of our own. Not an easy decision when you are talking about something the price of a nice new car, but we consider it a necessary investment in the health of our growing family and we’re so grateful that you all made it possible. We’d also like to thank our friends at Project V.E.T.S. for sending along some gently used radiation protection equipment to keep our staff and consulting medical professionals safe!
A trip to the clinic for Jody
Earlier this year, we took Jody into the clinic to assess a lump developing on her foot. Unfortunately, the mass continued to grow after that procedure and cytology results suggested that further evaluation and testing was warranted.
We’re so lucky to have assistance from people like Dalila Fairchild, CRNA, who ensured that Jody was safely anesthetized and monitored throughout the exam.
Dr. Austin Hardegree assisted Dr. Erin with the foot evaluation and biopsy while Dr. Krystina Stadler, a veterinary radiologist, helped by imaging the foot mass prior to the procedure and following up on a suspected uterine fibroid discovered during Jody’s last exam.
While Dr. Stadler brought her own equipment, she also tried out our brand new Butterfly ultrasound unit, which we recently purchased though a grant from the Ruth Foundation. This user-friendly ultrasound unit works with an iPad (also purchased with the grant) and will help Dr. Erin with both general exams and emergency procedures. We are also grateful once again to Best Friends Mobile Veterinary Care for use of their digital x-ray – the only piece of equipment that we must still borrow. With more chimps joining our family as soon as next year we will undoubtedly be doing even more procedures, so we look forward to purchasing one of our own soon.
With the exam, biopsy, ultrasound, x-rays, and teeth cleaning done, we wheeled Jody back to the recovery room.
We’ll have to wait for these latest test results to see what, if anything, comes next. For now, Jody is sipping Coke and eating grapes in a sea of soft blankets. She will have to stay isolated for at least a few days to ensure that the stitches stay in place long enough for her incision to heal, but her friends will be able visit her regularly though the mesh.
An exam for Foxie
As I type this, Foxie is recovering uneventfully from anesthesia after a full workup.
Diana mentioned a while back that Foxie hadn’t been feeling well, and while she did get her appetite and energy back it took longer than we would have liked and thus warranted further investigation. As many of you know, we’ve long referred to Foxie as “Tiny” due to her diminutive stature. She simply can’t afford to get too much tinier.
As always, we are grateful to Dr. Erin as well as the medical and veterinary professionals that volunteered their time and expertise to help ensure that Foxie stays well.
We’ll know more once we run labs and consult with other specialists on the imaging, but so far we haven’t seen anything alarming. And her recovery from the procedure has been great – before she had even regained enough balance to walk, she managed to find and hold onto a Dora the Explorer doll. For the rest of the afternoon she’ll sip Sprite and rest up, and then hopefully get a good night’s sleep so that she can rejoin her family in the morning. Jody, in particular, did not want to leave her side this morning and will be relieved to be with her again.
