The Rhino with Glue-On Shoes (27 page)

For the next few hours, there was nothing for us to do but wait and hope the capillary beds inside the sea dragons could do their jobs. As we waited, we talked with hospital staff and the patients' relatives about aquatic animal medicine. They were amazed at what was possible. We explained that we routinely take fish radiographs, perform surgery, and treat a range of different animals, from corals to sharks. We even use many of the same antibiotics and other drugs used in people. The range of success, however, is variable: aquatic medicine is still a new frontier in veterinary medicine.

When time was up, we watched anxiously as the pressure in the chamber was slowly reduced. At about thirty feet, the sea dragons gradually moved upward, but not all the way. Holding my own breath, I hoped they would hold their positions. But as soon as the pressure returned to room conditions, the animals were back on the surface, struggling once more to stay upright. The procedure had not worked.

Back at the aquarium, I went through all of the possible causes of the dragons' problem and alternate treatments. After making a few phone calls and checking the literature again, I had no new ideas. I desperately wanted to save these special creatures, and not just because of all the time and effort (and money) we'd put into bringing them to Florida. With their arrival, our aquarium had joined a partnership known as Project Seahorse, an organization designed to call attention to the endangered status of sea dragons as well as sea horses.

Before being shipped halfway across the world, our pair of dragons had been nurtured and fed in a special setting. We'd worked with an experienced collector in Australia who holds one of very few permits issued by the government to collect a limited number of specimens per year. These permits are given to discourage illegal collecting of adult dragons. Fishermen catch them not for food but as sources of “alternative” types of human medicine or as souvenir trinkets for sale in countless numbers of curio stores. It's sad to think of these animals ending up in such shops. They are so beautiful in life.

The collector is permitted to collect two types of dragons: one male weedy sea dragon, like the ones we received, and ten male leafy sea dragons. In aquarium lingo, we call them the “weedies” and the “leafies.” Sounds a bit like sports teams. The weedies have fewer appendages but tend to be more colorful, with yellows, blues, reds, and lots of decorative white spots. The leafies are the kings of camouflage, with ornate yellow and green fronds that blend in so perfectly with underwater vegetation that they can be hard to spot even when they hover right in front of you.

Like sea horses, sea dragon males carry the eggs, though they are attached to their tails rather than inside pouches, and they can carry up to 250 eggs each. The wild fish are kept in a holding facility until they give birth, and then released back to the wild. When the eggs hatch, the young dragons, only about a quarter of an inch long at birth and practically transparent, are maintained in optimal water conditions, free of predators, and fed several tasty meals a day—sort of an aquatic bed-and-breakfast arrangement. Once they grow to about four inches in length, they are ready to be shipped. This complicated step requires all kinds of permits and paperwork, special containers, and logistical arrangements to ensure the shortest flight routes and times.

___

As a last resort, I decided to aspirate the air directly. Holding a flashlight behind each animal to illuminate the outline of the bladder, I identified suture lines between the bony plates and targeted these with a sharp needle. As a precautionary step, I applied a drop of ophthalmic antibiotic liquid before and after the procedure to help reduce chances of infection. Immediately after the procedure, the fish looked better: both could dive down in the water, if very slowly. I began to hold out a little more hope.

Since the dragons hadn't been eating, we started tube-feeding them mashed-up brine shrimp, hoping to keep their energy levels up. This procedure in itself required creative thinking. We needed to find a tiny flexible tube to place directly into their stomachs while gently holding the fish out of water. I finally found a long catheter, the kind used for spinal taps in humans, that worked perfectly.

A day after the aspiration procedure, they were still alive. We continued to give them antibiotic injections and tube-feeding. Maybe we were finally on the right track. But to my frustration and sorrow, both animals died two days later.

The next step was a painstaking review of our transport procedures. Though we couldn't prove it, my best guess was that the dragons did suffer from supersaturation of their water with oxygen at some point during transport from Australia, possibly during the stopover in Los Angeles, where the animals were repackaged. In preparation for the flight to Tampa, the last leg of their long trip, a fresh supply of oxygen was added to the transport box. Though intended to help, this step may have harmed the precious dragons. We made a number of improvements for the next shipment, including sending one of our biologists to LA to help with the repackaging.

Despite losing both animals, some good things came of this effort. Although the recompression chamber did not save the fish, its use generated a lot of discussion among my veterinary colleagues about alternative treatments as well as about exhibit design. In the long run, this exchange of information increased our collective understanding of sea dragons, including their health care.

More important, the pair of sea dragons in the next shipment arrived in excellent condition; indeed, they thrived, and we were able to open the new exhibit to great reviews. Visitors were fascinated by the creatures' exotic appearance. We have since acquired leafies as well as weedies, and their protection in the wild has improved. These eye-catching fish continue to be among the most popular animals at our aquarium.

Amali's Example

by Lauren Howard, DVM

H
ello. My name is Lauren Howard and I'm calling from the zoo. I was wondering if I could speak with one of your orthopedic surgery instructors? No, I'm not a patient. You see, I have a giraffe with a leg problem. . . .”
Click.
“Hello?”

“Hi, I'm a veterinarian at the Houston Zoo. I have a giraffe with a leg problem and was hoping I could talk to one of your surgical instructors. Yes, I know you don't treat animals. I should try calling the zoo? No, I'm
from
the zoo. . . . Hello?”

Working at a zoo that's next to one of the country's leading medical centers has its advantages. At least that's what I thought when I started calling around looking for advice to help manage my current patient, a young giraffe with a front-leg abnormality. The Texas Medical Center includes two universities and dozens of medical facilities spread out over several blocks across from the zoo. As I dialed medical schools and teaching hospitals, I flipped through a stack of sports-medicine catalogs on my desk, trying to picture a fashionably colored, hinged knee brace fitting onto our patient's scrawny, three-foot-long front leg.

After enduring a variety of on-hold musical selections and repeating myself several times to several medical receptionists, I finally found the contact I was looking for. A human orthopedic surgeon called me back.

“What was this about a giraffe?” he asked kindly.

“Well, she's about four months old. Her hip was dislocated the day she was born, and while she's been recovering from that, she's developing secondary problems in her front legs. I think she needs a support brace for her leg, but nothing we have is working. I've been through dozens of sports-medicine catalogs but I don't think a human brace will fit right. I've got her leg measurements. Do you know of anyone who might be able to make a custom—”

“I've got just the guy for you,” he cut me off. “His name is John Fain; let me get you his number.”

With one more phone call, I arranged for John to come down to the zoo and join us in our ongoing efforts to get Amali walking normally for the first time in her life.

Born one cool fall morning, Amali did not stand up right away, and her mother accidentally stepped on her, dislocating the calf's right hip. Before the newborn giraffe had a chance to feel the dirt beneath her baby-soft hooves, she found herself in a veterinary specialty hospital. A team of orthopedic surgeons put her leg back in its socket. Lying on the gurney with her head up, Amali surveyed her surroundings as we wheeled her down the halls of the hospital. She seemed to take it all as a matter of course. She had no way of knowing the first few days of life should be any different.

Amali means “charm” in Swahili, a fitting name for this lanky newborn. With her large brown eyes and velvety soft muzzle, our new Masai giraffe calf charmed everyone who met her. Unfortunately, the Hebrew translation of Amali, “result of a long struggle,” turned out to be a better description of this spirited little addition to our giraffe family.

After the surgery, the giraffe's hip healed only partially. Because she needed extra support and special care, she was hand-raised on bottles of goat milk. As she grew, Amali could walk but favored her rear leg. As a result, she bore more weight than normal on her front legs, and gradually developed joint problems. Amali's right front leg, in particular, bent out at her knee joint whenever she put weight on it, angling to the side. Because this leg required extra support, we created a makeshift splint using large PVC piping, cut in half and padded with lots of bandaging material. This is a technique used routinely by equine veterinarians for young foals with similar leg deformities. Foals, however, rarely weigh more than 80 pounds and have shorter, more manageable legs. At this point, in early January 2005, Amali weighed about 170 pounds.

Each morning, Amali's keepers (and our largest veterinary technician, Grant, when we could coax him into it) would hold her as still as possible in a corner of the giraffe barn, while they sweated profusely and tried not to let her slip out of their grasp. Often we'd get the padding in place for the PVC splint, only to have our willful giraffe send the gauze and six feet of cotton wrap flying through the air like confetti at a lively New Year's Eve party. To the early morning zoo visitor who happened to catch sight of the strewn bandages through the barn window, it must have looked like quite a fun party indeed. In fact, the procedure was becoming increasingly difficult and even dangerous.

___

“Erica in the clinic to Dr. Lauren. Your specialist is here.” Our hospital clerk's voice crackled over my radio. A few minutes later I found John Fain at the zoo clinic, already deep in conversation with a member of our staff, completely at home among the cacophony of smells and sounds common to a zoo hospital. Over the phone a month earlier, John had explained that he was an orthotist and prosthetist, meaning that he designs prosthetic limbs and support braces for his human patients. A self-confessed animal lover and farm boy, John was the perfect fit for our situation. In his standard-issue blue hospital scrubs and shiny white sneakers, he made a cheerful first impression. He'd brought an assistant with him and a shoulder bag of equipment, as well as a digital camera held together with several pieces of duct tape.

At the giraffe barn, I introduced John and his assistant to the keepers and supervisors, who were all eager to help with the creation of the leg mold. The best way to design a well-fitting brace, John had told us, is to make a mold of the leg, which would be used to make a solid model of the leg; then a brace could be made to fit the model. To make the mold, the leg must be placed in a special plaster cast material and held motionless for five to ten minutes while the plaster dries. This is a fairly simple undertaking, I'm sure, when it's performed on cooperative human patients who understand what is being done and why. It's true that John's patients sometimes included small children, as well as residents of the state's prison system who may not always have been completely cooperative. Still, I'm confident that none of his previous patients measured up to Amali.

Now 180 pounds and almost six feet tall, Amali was testing the limits of our staff's ability to restrain her manually. With two people on either side of her and one in front, we pushed her back against a wall of the barn where we could control her a little more easily. It took three more people to extend her right front leg and hold it straight so that John could slide on a protective sleeve, then roll the mold plaster around her leg. Once the mold was in place, we did our best to keep Amali from kicking or bending her leg—or worse, sagging to the ground, as she often did when she realized she was trapped.

Minutes ticked by as we made nervous jokes. The sweat of the people on the top of the Amali-pile trickled down onto the backs and heads of those unlucky enough to be on the bottom. After what seemed an eternity, John snipped the mold off and disappeared into the hazy afternoon with our hard-won prize.

We'd known all along that we could not reverse the source of the problem—the damage in Amali's right hip. Even at the tender age of five months she was too heavy to undergo another hip surgery or hip replacement. Instead, we'd focused on the things we could fix: her front legs and right knee. By protecting these joints, we could give Amali a chance to walk without pain. Masai giraffes can grow up to fourteen feet and weigh 1,200 pounds. It was hard to imagine our little patient ever reaching this size; yet, if she did, the stress on her damaged hip would be severe.

A week after our strenuous efforts to create Amali's leg mold, John came back to the zoo to show us the result. I still had not quite gotten the kink out of my neck or the sawdust out of my boots when I was once again escorting John and his assistant to the giraffe barn. From the wariness with which the keepers and supervisors watched us enter, I guessed I was not the only one still suffering from the effects of our last wrestling match with Amali.

John put his bag down and fished around inside it, pulling out Amali's first brace with a flourish. Made of shiny white plastic with animal cartoons stenciled on it in bright primary colors, the brace looked more suited to a child's bedroom than to our musty giraffe barn. It was split along the sides into two long halves, and was to be held in place by four bright white Velcro straps. On the inside, the brace was padded with a soft white foam to prevent rubbing, and it still smelled vaguely of glue. From the grins on the faces in the giraffe barn, the brace was clearly a hit among the staff. But what would Amali think? Would we have to wrestle her to put it on? She was standing nonchalantly by herself in a sunny section of the giraffe yard. When she saw us coming, she started drooling, anticipating the bottle that was sure to come (and would provide a necessary distraction). While she sucked on the bottle, John and I gently placed the brace around her front leg and fastened the straps. It fit perfectly, extending from just below her elbow to just above her ankle. When Amali finished her bottle, she nosed my blond ponytail as I bent over her to help John with the fitting. Soon I felt warm giraffe saliva sliding down my neck. Amali had developed a taste for certain fruity shampoos, and often sucked on my hair as eagerly as she did her bottle.

Holding our breaths, we stepped back to watch her in her new brace. She took a tentative step forward, bore full weight on the leg, and started to walk carefully around the yard. Clearly her little giraffe brain knew there was something different about her leg. Soon she decided this new thing attached to her wasn't such a big deal. After all, it was a nice, sunny day—and hey, aren't those yams you're holding?

Reaching up to hand Amali a thin slice of yam, I silently congratulated my patient—the first giraffe in Texas to have her own custommade leg brace. Then I thanked John, who had generously donated his time, that of his assistants, and all of the materials for the brace. Grateful handshakes and the occasional soggy giraffe kiss were all he required for services rendered.

Thanks to the design of the brace and Amali's enthusiasm for her bottles, we never had to restrain her in order to put the brace on or take it off. With the leg straight and protected from further damage, the next step was exercise and rehabilitation, a challenge taken up by Dr. Mark Haugland, a local equine surgeon. He had years of experience treating horses with leg problems very similar to Amali's. I knew the basic principles of managing limb issues in hoofed animals (“If it's straight, make it bend; if it's bent, make it straight”), but the nuances of treating an angular versus a flexural deformity were beyond me.

Dr. Mark had an affable bedside manner and was remarkably enthusiastic about examining a patient we couldn't restrain and that he might not even be able to touch. Over several visits to the giraffe barn, he helped us define Amali's multiple orthopedic problems and focus on improving the health of her front legs and her right knee. On his recommendation, we slowly increased the length of time Amali was in the brace until she was wearing it twenty hours a day and could lie down and sleep comfortably in it. He also recommended daily physical therapy for all of her limbs, which the keepers performed religiously and without complaint.

Before long, the shiny plastic exterior of the brace was scuffed and scratched, the white Velcro straps had darkened to an earthy brown, and the pristine padding on the inside had begun smelling like a sweaty giraffe leg. John Fain and his assistants made four more braces for Amali as she grew taller and taller.

Amali's physical therapy sessions and colorful leg brace attracted the attention of our zoo visitors. We'd anticipated their questions (“What happened? Is it broken? Does it hurt?”) and posted signs around her exhibit explaining why the baby giraffe was wearing a brace. The response was overwhelming. Visitors not only expressed empathy and support for our efforts, they also shared accounts of people in their own lives who needed special braces or had lost a limb. Some told their stories directly to zoo staff; others called or sent e-mail.

One story about a little girl named Michaela touched us all. Her mother, Denise, wrote to us asking for a photograph of Amali in her brace. Michaela had suffered a hand injury when she was a premature infant. Despite multiple surgeries, she'd worn a brace on her wrist ever since. Now a willful four-year-old, Michaela had begun resisting wearing her brace, particularly at preschool and in front of her peers.

During a recent visit to the zoo, mother and daughter had turned a corner and found Amali standing nearby. The giraffe was contentedly wearing her newest brace, this one covered with purple butterflies (John felt she'd outgrown the brightly colored baby animals). Michaela had found a friend—and a role model. We happily sent Denise the photo, and learned that Michaela had carried it to school and shared it with her friends; more than that, she'd resumed wearing her own brace without complaint or argument. Denise described her daughter's transformation as immediate—and remarkable, as if a lightbulb had suddenly been turned on.