The Hippo with Toothache (34 page)

As our driver navigated the streets of San Salvador, the reality of the situation hit me. Here we were, in a foreign country, full of political strife, getting ready to immobilize their only hippo, an animal that was obviously beloved by all. Though I tried not to notice, there were indeed huge green army-style tanks at almost every corner. We passed many damaged buildings riddled with bullet holes. We frequently heard gunfire. Our hosts were apparently used to this sound: they didn't jump as I did every time it occurred.

The next day I came to understand why Alfredito was such a star. Children and adults crowded around his exhibit to watch while his keeper placed whole heads of lettuce and cabbage in Alfredito's huge, open mouth. This species can be quite temperamental and dangerous. I'd never seen a keeper go into an exhibit with a hippo. But Alfredito and his keeper both seemed quite relaxed. So Michael and I went into the exhibit with them.

While the keeper scratched the hippo's chin, we were able to get a close look at the broken tooth. We stood right next to our patient and watched him eat a few more heads of cabbage. Although Alfredito was eager for the treats, it was clear he was in pain. The keeper was careful to place the offerings on the good side of his mouth. Watching them, I too became enraptured by Alfredito. He was adorable—and quite the showman. He seemed to enjoy the attention. It was clear why he had so many admirers. Now I was one of them, and tomorrow his life would be in my hands.

We met with Dr. Suazo and the zoo staff that afternoon to plan the procedure for the next morning. Alfredito would need to be fasted, a routine step for any large herbivore, as they sometimes regurgitate while under the effects of
anesthesia. The sloped entrance to the pool was also particularly dangerous. If the hippo succumbed to the effects of the anesthetic while attempting to get back into his pool, he would go down with his head below the rest of his body. In such a position, the sheer weight of his abdominal organs pushing up against his diaphragm could cause his lungs to collapse. We would need to drain his pool and build a fence around it. We would also start early to avoid the hot sun, which could cause Alfredito to overheat. Dr. Suazo translated as we discussed the procedure and our requirements.

The procedure began at seven the next morning. I carefully loaded the narcotic anesthetic, known by its trade name M99, into the dart, then loaded the dart into the rifle. I walked slowly up to Alfredito and fired. The dart hit the back of his right thigh, but the needle bounced. It was impossible to know if he had received the full dose. Hippo skin is very thick and difficult to puncture. If the dart does not hit exactly perpendicular, it will do what this one did: bounce. We watched Alfredito, waiting to see signs of the anesthetic taking effect, but nothing seemed to be happening. Alfredito lumbered slowly around his exhibit and, after an hour, it was clear that although he was sedated, he wasn't ready to go to sleep.

I loaded another dart with great care. M99 is a very good drug but quite dangerous to handle: as little as one-tenth of a milliliter can be fatal to humans. I fired the dart, and this time it stuck. But Alfredito continued to amble around, and after twenty minutes, we decided the M99 had not injected. The needle I'd used had a large diameter opening, or bore. It must have been blocked by a small skin plug, just enough to
prevent the drug from injecting. By this time, it was beginning to get hot; I instructed the zoo staff to prepare a tent to place over Alfredito to protect him from the hot sun. With the tent in place, the third time turned out to be the charm. Alfredito finally succumbed to the effects of my next dart.

Luckily, the hippo went down in a good position on his sternum and near the back of his exhibit, away from the gathering crowd. Michael jumped into action and began cleaning and preparing the tooth while I monitored Alfredito's respiration and heartbeat. About fifteen minutes into the procedure, the hippo's breathing began to slow. Then it abruptly stopped. I held my breath and for a brief second I felt my own heart stop.
Oh no
, I thought,
I cannot let this animal die
.

With the narcotic reversal agent in hand—the only option I could think of at that point—I searched unsuccessfully for a vein. Almost simultaneously, Dr. Suazo handed me a syringe of doxapram, a respiratory stimulant, and said, “In his tongue.”
Good idea
, I thought. I quickly injected the doxapram and leapt over the sleeping Alfredito to search for a vein on the other side of his body. Luckily, I found one and was able to inject the reversal agent into Alfredito's vein while the adrenaline rushed through my own. The silence of the crowd of zoo staff and visitors hugging Alfredito's exhibit added to the tension. Suddenly a cheer arose: Alfredito had taken a long, deep breath.

While all of this was going on, Michael had continued to work on the tooth and miraculously had managed to finish the procedure before the full effects of the anesthesia were reversed. We gave Alfredito his antibiotic injection and then Guillermo, the child who'd handed me the flowers, was
allowed a special close-up visit. With cameras flashing all around us, I assured him that his favorite animal was going to be all right.

But our worries were not over. Difficult anesthetic procedures can predispose to a serious condition called capture myopathy, a painful muscle problem that can be fatal. It is caused by the pressure on the downside muscles produced by the hippo's weight while it sleeps under anesthesia combined with changes in blood flow and blood pressure produced by the drug.

For the next twenty-four hours, we observed Alfredito for any adverse signs.

To our huge relief, everything seemed okay. The next day there was a picture of Michael and me on the front page of the newspaper, accompanied by a very long story of what had transpired. The reporter had written about Alfredito in detail, with dramatic descriptions of the action, so that the story read more like a novel than a news report. We were quite impressed.

When we returned to the zoo to check on our patient, the hippo seemed to be back to his old self. Children crowded around his exhibit, watching joyfully as Alfredito chomped down on whole heads of lettuce and cabbage—pain-free.

Three months later, we were invited back to the zoo to re-examine Alfredito. Our patient was doing fine, so they put us to work. Over the course of three days, we anesthetized and treated a grizzly bear, a lion, and four leopards. Michael performed seventeen root canals!

Susan K. Mikota's career in wildlife medicine began the year she graduated from the University of Illinois College of Veterinary Medicine. She says, “I was simply in the right place at the right time when the Audubon Zoo in New Orleans was transitioning into a world-class zoo. I'd had only two weeks of on-the-job training when attending veterinarian Dr. Andy Gutter was offered a trip to Africa. He left me the phone numbers of two other zoo veterinarians and gave me these instructions: ‘Don't kill the gorilla.' Luckily, the gorilla and I both survived.” In 1985, Dr. Mikota became the zoo's first full-time veterinarian. In subsequent years, she has served as president of the Association of Avian Veterinarians, chairperson of the Zoo Conservation Outreach Group, director of veterinary services at Audubon Zoo, director of veterinary research and animal health for the Audubon Center for Research of Endangered Species (ACRES), and chair of the National Tuberculosis Working Group for Zoo and Wildlife Species. Dr. Mikota is currently director of veterinary programs and research for Elephant Care International, a nonprofit organization she cofounded.

Few of us thought about cancer therapy, vaccinations, or intensive care for free-living wild animals until their numbers began to plummet. Even ten years ago, most zoo vets could easily distinguish in their minds what was appropriate care for a wild animal living in captivity versus one living in its natural habitat. Vets who worked in aquaria treated only the aquatic animals within their own and similar facilities. The title “wildlife vet” signified someone who worked exclusively with free-living wild animals. As we pointed out in the introduction to this book, the distinction is less important now.

There are only so many poison dart frogs, saltwater crocodiles, giant pandas, sea dragons, beluga whales, and mountain gorillas left on earth. Populations of lions, tigers, bears, and many other species that could once withstand a disease outbreak or natural disaster now need our help. The health of each individual wild animal matters, whether it's free-living or captive.

As natural habitats are damaged or destroyed, the words “endangered species” have become a household phrase. Even
in remote places, wild animals are exposed to polluted air, water, and soil. They also face a higher risk of disease because of increased contact with people and domestic animals. Most, if not all, of these changes are the result of human activity.

Modern zoos, aquaria, and wildlife parks now invest in conservation programs, and many have updated their exhibits and education programs to reflect the importance of protecting entire ecosystems. Protected areas and national parks are also hiring more vets to monitor the health of rare species and intervene by treating individual animals when necessary.

In the course of our careers, we zoo vets now have the opportunity to practice medicine in a variety of settings. We possess a unique set of skills that allows us to treat the individual animal while also considering the population as a whole. We know how to explain the science behind the medicine, and why some medical decisions are more problematic than others. Our challenge is to take these efforts one step further.

On a world scale, the health of all living things is connected. From a holistic point of view, a wild animal can remain healthy only if the humans and other animals in its ecosystem are also healthy. The negative corollary is that there's a chain reaction when something goes wrong.

Even the king of the jungle, the African lion, has succumbed to diseases like dog distemper, an infection spread by village dogs in the Serengeti to free-ranging jackals and wild dogs. The lions were infected secondarily. In the suburbs of Los Angeles, raccoons picked up distemper from feral dogs,
as they often do, and spread it to a wildlife sanctuary, where it killed lions and other big cats.

A similar domino effect continues to affect sea otters off the coast of California. Every year several die from a brain infection caused by a parasite that originates in two species, the feral cat and the Virginia opossum. Soil erosion and clogged tributaries contribute to excess runoff of rainwater that flows into the ocean, carrying with it the scat of these animals. Once in the food chain of kelp and abalone, the disease can be picked up by the sea otters—and potentially by seafood-loving humans as well.

Zoo vets have begun playing an active role in restoring the balance of nature, though the workload ahead seems to stretch to infinity. In cooperation with other scientists, we have managed in recent years to restore a handful of endangered species to the wild. Clearly, the chain reaction of ill health can be reversed if we work together. By taking advantage of the fact that everything
is
connected, zoo vets can make a positive difference.

When a doctor heals a patient, human or animal, the entire ecosystem benefits. When public health officials eradicate measles and polio, the world will become a healthier place for wild animals too. Health professionals, decision-makers, and ordinary citizens can set policies that protect existing healthy ecosystems and target those that need our help. If we act quickly, wisely, and collaboratively, we can even contain emerging diseases.

It's essential that vets who work with wild animals find ways to integrate their expertise into the broad scheme of things. We need to share what we know and how we feel
about wild animals and their health, and do our best to promote healthy ecosystems in the places where we work. The stories in this book reflect the willingness within our profession to do just that—to talk to people as well as animals.

Lucy H. Spelman, DVM

We thank our contributing authors for their enthusiastic participation in this project from the beginning, as well as the many veterinarians who directly or indirectly contributed their expertise to help the wild animal patients in each story. In other words, we thank all vets who work with wild animals!

We are also grateful to keepers, animal caretakers, biologists, trackers, and rangers—paid and volunteer—for their tireless efforts on behalf of the animals under their care.

We thank Jody Rein, our literary agent, for her support, encouragement, constructive criticism, expertise, timely advice, and fascination with wild animals. Without Jody, this book would still be a good idea in the backs of our minds, and we would never have found Danielle Perez, our equally terrific editor at Bantam Dell.

For their encouragement, we are grateful to our many friends and colleagues. Special thanks go to: Bill Adler, Clark Bunting, Alan Cutler, Jackie Jeffers, Jo Gayle Howard, Franchon Smithson, Diane McTurk, Roy Mashima, Julie Mashima, Athena Mylonas, Jennie Rice, Trish Silber, and Mary Tanner.

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