Saturday, June 14, 2014

An Unusual Hippo Case

It has been a couple of months since I posted to this blog. This was not by intention but due to unexpected, and un-wished for events in my life that seem to have been resolved. This post takes me back thirty six and a half years to an unusual “consult” that I got involved in.   


The most unusual case I have ever dealt with came not from the Forestry Farm zoo where I did the veterinary work as part of my duties at the Western College of Veterinary Medicine, but after a 1978 January Monday morning call from Calgary. 

         “Hello Dr. Haigh, this is Greg Tarry from the Calgary Zoo. We met in the fall two years ago when you came to work with Dr. Bim Hopf on that elk we got from Banff.” I at once saw in my mind’s eye a dark-haired slim man who towered over my six feet. Dr. Hopf had been the zoo veterinarian at that time.

“What can I do for you?” I asked.

         “We have a problem. Our hippo Foggy needs some attention and Dr. Hopf is no longer here. Foggy’s canine teeth do not meet properly. The lower one on the left has not worn as it should. It has grown so long that it cuts into the inside of his upper lip and he has quit eating. He can’t even close his mouth properly and the lip has a big nasty looking ulcer on the inside. The ulcer is bleeding. We think the tooth needs cutting off, but of course we can’t do that without sedating him. Can you get here and see if you can do anything please?” 

“I guess his canines are not wearing each other down as per normal,” I replied. “Of course I’ll come – I assume you will cover my expenses.”

I was able to get away the next morning, but before that I headed to the well-stocked vet college library to put on my thinking cap about the “how to” and dig into the scientific literature to see what I could find. My results were not encouraging. Three reports mentioned a variety of drugs but all cautioned that this was a species that is difficult to deal with. If they are in water the difficulty is greatly increased because they are likely to drown as the drugs take effect. One even mentioned the use of a road grader to be driven into the water to push the patient out on to dry land before it becomes fully immobilized. Another suggested the drug fentanyl with which I was very familiar. I had that drug in my lock-up safe. I had immobilized over a hundred rhino with it and a few dozen young elephants, dozens of African antelopes and quite a number of Canadian animals. In almost all of those cases I had used a well-known sedative to enhance the effects of the fentanyl. This fellow weighed half as much again as my rhino patients at something over two tonnes, so I adjusted the dose accordingly. 

The other important tip was that long needles are essential.

No report mentioned anything about teeth and that would prove to be as interesting as the drug issue.

         The flight to Calgary was uneventful and I soon found myself looking over a high wall at the hippo, which had been locked out of his pool and was standing quietly in a passage between his daytime and night quarters and mouthing but not munching on some lettuce. A stout steel gate confined him at either end of the passage. 

         My first worry had been dealt with. The patient was not going to be able to get to water at any time until we deemed it safe. Next we descended and went to the front of his pen so that I could see his mouth. This was not so successful, even with the aid of a flashlight, but the keepers assured me that he needed help and I would find his left canine tooth embedded in his upper lip.

         After my blowgun system failed because the dart simply bounced off his hide as if was a tractor tire I had to work out an alternative. 

Two bulls duke it out.
Given hippos’ fearsome reputation for aggression I certainly was not going to stick my arm through the cage bars to give a hand-held injection.

My wife and I had witnessed this temperament when paddling on the Zambezi. Before we set out our whiplash thin guide, named Christmas, admonished us to follow him carefully to avoid the home territory of a known bad-tempered bull. 
Hippos can bite. Not good if you are in the canoe!
To emphasize this he then took us past a canoe lying on the bank that did not look exactly sound. Two jagged holes, each at least half a metre long, had been ripped through the hull on one side. Christmas explained, “One of my guests did not listen to me and went too close to a bull we know is bad. The bull came up out of the water and bit the canoe. The man was very lucky. The teeth went through the boat and missed his leg which was between those two big teeth.” We had not needed a second warning.

         For my challenging patient I rigged up a syringe with a four-inch needle at its business end and attached it to the end of a broom handle. I taped it in place with some duct tape, then climbed back up to get a bird’s eye view of him. With a single thrust I pushed the jab stick directly down into the back of his neck just right of centre.

         Five minutes later I was at the front of the passage, where Foggy had obligingly dropped to his haunches close to the stout bars. It took only a moment to lift his lip and see the ugly infected mess in his mouth and the spreading inflammation that readily explained his lack of appetite. 

         Because the bull remained somewhat aggressive, we waited ten minutes. I realized that he was not going to become fully anaesthetised but was sufficiently sedated that we could proceed as long as we got a rope onto his head to control him. All seemed well, so I asked the keepers to fill up another big syringe with penicillin, which we stuck into his shoulder region, again using a long needle.

       I began to saw his tooth.

Angle grinders had not yet been invented. If they had, it would have been the work of a few short moments to chop off the top few inches of the offending tooth. In anticipation of the task ahead I had packed a flexible wire used by veterinarians all over the world when they have to do emergency obstetrical work to cut up a dead calf that is stuck in a cow’s body. 

The Gigli saw was named after its inventor, Italian obstetrician Leonardo Gigli, to make bone cutting easy.  The Gigli was also carried by British secret agents during WWII. Its main feature is the very rough surface, a bit like a coarse file, that allows it to cut through bone quickly and efficiently—a great asset when doing amputations.

         Dr. Gigli had surely never tried to amputate a hippo tooth and I only just managed it. I used up the whole roll of wire, all three metres of it. A few strokes back and forth and the wire broke, naturally right in the middle where it had been grinding on the tooth. This left two short pieces that I could not use. I quickly discovered that hippo tooth is the hardest substance I had ever worked on. Thirty-six years later it still is. 

         Eventually, by using ever-shorter pieces of wire, and holding the ends in my hands, rather than attaching them to the handles that come with the equipment and require extra lengths for attachment, I was able to get the job done. It took almost an hour. 

         All along I had been trying to keep an eye on his breathing to see if my anaesthesia was working properly. I did not want him to wake up prematurely or or perhaps to not wake up ever again. One of Greg’s staff helped me by calling out the breathing rate and writing it down on the medical record every now and again. Those papers I had read in the vet college library had not filled me with enormous confidence.

There was one more potential problem. The scientific articles had all warned that veins are difficult to find due to the layers of fat all over a hippo’s body.  Either luck or instinct kicked in because the first place I tested was his foreleg just below the bend of his elbow. That is the spot where nurses and doctors, whether of humans or animals, have drawn blood from me and millions of other patients.  I located a nice fat vein, as big around as a ballpoint pen. It was an easy hit.

A minute after the antidote began to circulate in his body the hippo was standing and seemed none the worse for wear.

         We agreed to keep Foggy out of his pool overnight and I headed home on the evening flight. 

         Dr. Doug Whiteside who very kindly sent me medical records to refresh my memory, confirmed that after this event the zoo staff took the very wise step of training Foggy to come to the cage bars to trade goodies for good behaviour —in the form of lettuce and other favourite foods. This enabled them to spend a few minutes every day gently grinding down the other lower incisor tooth that threatened to create the same problem. This was surely a much more elegant and risk-free approach.

         Foggy lived on until 2010 when the zoo staff took the reluctant but humane step of euthanatizing him because his advanced arthritis no longer responded to treatment. He was 47 years old when he died.


Jerry Haigh said...

Thanks Denise,
You are quite right about teh surprises that our profession can bring. In 1978, when this case took place, there was only s very thin network of folks to consult, no email, no internet, etc etc. That has changed a great deal. There are listservs devoted to wildlife med and so many more things, plus a large body of specialists that did not exist 36 years ago.

Denturist said...

Today I astonished that a hippo could be this much dangerous. It is really scary that he torn apart the canoe this much.