This spring, two of Wisconsin’s largest AZA-accredited zoos successfully completed innovative and exciting veterinary procedures, both of which found representatives from the UW School of Veterinary Medicine (SVM) and UW Veterinary Care (UWVC) collaborating to address unique needs and complex situations as part of large, multi-disciplinary teams. The efforts garnered local and national headlines and brought together some of the best veterinary specialists in the region, highlighting Madison’s and Wisconsin’s reputation as a leading center of veterinary excellence.
KENDI’S STORY
Kendi, a 4-year-old male reticulated giraffe at the Milwaukee County Zoo (MCZ), show signs of making a full recovery after successfully undergoing a complex surgery that has never been performed on the species. This historic achievement was the result of intense planning and a large, collaborative effort across multiple institutions and veterinary disciplines. Several veterinary professionals from SVM and UWVC who work in large animal, anesthesiology and zoological medicine were involved in the significant planning efforts and were on hand for Kendi’s procedure on April 11.
In early April, MCZ’s animal care team noticed a laceration of the prepuce (the moveable sheath of skin that covers the predominant male reproductive organ) that became infected. Kendi was attempting to breed with female member of the herd, 6-year-old Maya, a recommended pairing by the Association of Zoos and Aquariums Giraffe Species Survival Plan® (SSP; note that reticulated giraffes are listed as Endangered by the International Union for Conservation of Nature Red List). Veterinary advisors from SSP say that, while minor breeding injuries do occur in giraffes, they don’t typically require intervention — Kendi’s injury is believed to have been a first.
After initial attempts to medically manage Kendi’s injury through pain medication, antibiotics and topical treatment proved unsuccessful, MCZ began significant outreach, planning and preparation to determine how to best proceed. A first step: Kendi would need to be immobilized (anesthetized) to complete the most accurate assessment of his case and needs.
Giraffes are the tallest land mammals in the world, and Kendi stands nearly 14 feet tall and weighs almost 2,000 pounds, making immobilization and subsequent evaluation no easy task – especially given the risk of injury due to a fall while anesthetized and the need always maintain proper support of the giraffe’s famous long neck, which can make blood pressure management and appropriate ventilation challenging when under anesthesia. To mitigate all these risks, the full care team needed to be prepared for possible complications, with a plan to address those complications if they arose.
The team that came together to support MCZ and treat Kendi included veterinary professionals from the SVM and UWVC (a large animal surgeon, anesthesia team and veterinary technicians – see sidebar), Henry Vilas Zoo, Kettle Moraine Equine Hospital and Regional Equine Dental Center. In addition to a complete procedure plan, the team – including MCZ’s Grounds, Forestry, and Maintenance crews – prepared the zoo’s Giraffe Barn to ensure the safest place for immobilization and recovery.
SVM’s Dr. Paul Merkatoris (DVM ’16, DACVS-LA), who was one of the large animal surgery leads to support on the procedure, says the leadership of Dr. Christy Rettenmund (DVM ‘09), senior staff veterinarian for MCZ, helped bring the best team together to do the best job for Kendi. “There were more than 40 people present to help, representing a number of different teams, including anesthesia, surgery, positioning, recovery and more,” he says. “Under Dr. Christy’s leadership, everyone knew their job and was able to perform it efficiently, which is critical when anesthetizing such a large animal. Kendi’s care team that day was made up of many different veterinary specialists, all working together to ensure a successful procedure.”
Once the team was able to immobilize and assess Kendi, they determined that a reefing — removal of a portion of the damaged prepuce with subsequent repair of the remaining prepuce — was needed, and it was performed without incident. Although commonly performed on horses and cows, it is believed that a reefing has never before been performed on a giraffe.
Dr. Elizabeth Pollack, Anesthesiology Resident, pointed to how the opportunity to work with high numbers of cattle has helped SVM residents be prepared for opportunities such as the one with Kendi. “It’s so helpful to take everything we learn and relate it to other species that may not be anesthetized as frequently. How we intubate, how we place catheters – everything can be extrapolated and super-sized.”
“From a veterinary perspective, giraffe anesthesia is one of those bucket list items,” adds Dr. Carrie Schroeder, DVM, DACVAA. “We were really lucky to have the zoo med outreach program here, led by Dr. Shawna Hawkins, so I had the opportunity couple years ago to anesthetize the same giraffe twice for two different procedures. While Kendi’s case was incredibly challenging and risky, that previous experience made it far less worrisome than the first time around.”
Post-surgery, Kendi was treated with pain medications and antibiotics. And, after being separated from the female members of the herd for about three months – aside from socializing over a wall in their indoor habitat – he is expected to be able to resume breeding. He will be monitored closely and it isn’t immediately known whether Kendi’s ability to reproduce will be impacted but the team is optimistic.
At the end of the day, while Dr. Schroeder is proud of the procedure and its success, she cites the incredible collaboration and teamwork as the real winner. “It was an incredible opportunity for everyone, especially our residents, and truly each member of the team had a specific and important role to play which they did incredibly well to give Kendi the best outcome.”
And, as an added bonus, Dr. Schroeder took her family on a trip to the MCZ a short time later, where she was able to introduce her family to Kendi and see him well on the road to recovery.
SVM and UWVC alumni and team members who participated in Kendi’s care include:
- Paul Merkatoris (DVM ’16; Large Animal Surgery Faculty)
- Emma Brennan (Large Animal Surgery Veterinary Assistant)
- Carrie Schroeder (DVM ’06; Anesthesiology Faculty)
- Emmett Swanton (Anesthesiology Resident)
- Elizabeth Pollack (Anesthesiology Resident)
- Kara Hiebert (Zoological Medicine Resident)
- Chelsey Tournade (Zoological Medicine Resident)
- Kate Lafferty (representing Henry Vilas Zoo)
- Mary Thurber (DVM ’14; Henry Vilas Zoo veterinarian)
- Jeff Zuba (DVM ’87; Board of Visitors; San Diego Zoo Safari Park)
DATU’S STORY
A resident of Madison’s Henry Vilas Zoo (HVZ), Datu – a critically endangered male Bornean orangutan – recently underwent echocardiogram as part of a comprehensive routine exam. Under general anesthesia, Datu also received bloodwork, TB testing, and an upper and lower GI endoscopy. In addition, he was able to have a small benign mass removed from his back during the procedure. Datu’s echocardiogram was conducted in collaboration with a Great Ape Heart Project (GAHP) ultrasound advisor and the SVM Cardiology Service. SVM anesthesiologists were on hand to assist with his anesthesia.
Findings of Datu’s echocardiogram were shared with GAHP. Formally established in 2010 by several zoos and veterinary medicine colleges, the GAHP focuses on identifying and monitoring heart disease in great apes, including orangutans, and developing a comprehensive and accessible reporting system for related ailments.
Dr. Mary Thurber (DVM ’14) is the veterinarian at HVZ and an adjunct Honorary Fellow in the SVM Department of Surgical Sciences. “Zoo veterinarians are the ‘ultimate generalists,’ trained to implement preventive care programs and address emergency medical situations for a huge range of species – from tiny amphibians and birds to huge megavertebrates such as giraffes and rhinos,” she says. She cites how important collaboration between veterinary and animal care staff is to accomplishing such important procedures. For example, keepers had been working with Datu on voluntary medical behavior training in advance, so when the time came he willingly presented his hand for an injection for his anesthesia.
Thurber adds, “The UW vet school provides students with amazing opportunities and fantastic mentorship in the field of zoo and wildlife medicine. Along with a diverse caseload, rigorous didactics and great mentorship, I had early exposure to and learning opportunities in zoo, wildlife and aquatic medicine. These opportunities allowed me to build a foundation for my career as a board-certified zoo veterinarian, and continued collaboration with SVM helps us achieve our mission of providing exceptional care to every animal at HVZ.”
SVM and UWVC alumni and team members who participated in Datu’s procedure include:
- Daria Hinkle (SVM Zoo Medicine Intern)
- Lindsey Snyder (UWVC Anesthesiologist)
- Kyle Bartholomew (UWVC Anesthesiologist)
- Elizabeth Pollack (Anesthesiology Resident)
- Heidi Kellihan (UWVC Cardiologist)
- Sonja Tjostheim (UWVC Cardiologist)
- Lisa Murphy (Cardiology Resident)
- Graham Rossi (Cardiology Resident)
- Sydney Fultz (Cardiology Resident)