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Operation Mufasa Smile

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Feb 23, 2012

From the Recovery Room
Ryan Rothenbuhler DVM, MS
Diplomate ACVS

A few weeks ago, I got an email that I was not really prepared for. I had been communicating with the executive director of Black Pines Animal Sanctuary, Lori Gagen, regarding donations to the park for animal feed. I was now being asked to come help them x-ray the jaw of their resident male lion Mufasa because he had a draining tract. They had established a team of people from all around Indiana and Ohio to work on Mufasa, but they needed someone with portable x-ray equipment .

Teamwork at Black Pine

Immediately I was very excited. I had been to the Indianapolis Zoo and performed surgery on a walrus during my surgery residency and have always hoped for another opportunity to assist with exotic animal surgery. I responded quickly in my email with YES, I would love to assist with imaging Mufasa.

Lori had put together an amazing group of volunteers consisting of medical doctors and veterinary doctors. They had a dentist, an oral surgeon, a DVM from Ohio, and their two local DVMs. In addition to the medical and veterinary personnel, there were going to be some of the biggest advocates for exotic animal rescue around the country. A group of volunteers who work with FEMA regarding moving exotic animals and rescue attempts were going to be in attendance as well. Tim Harrison, star of the movie "The Elephant in the Living Room", was joining the effort as well. This was going to be an experience.

Mufasa had been rescued earlier in 2011 and had a history of having a draining tract in his jaw for the last 6-7 years. They suspected a bad tooth. Immediately "What Ifs" started rolling through my head. The procedure was weeks away and I had a ton of questions. Not that I don't think oral surgeons, dentists, and medical doctors were qualified to be participating, but what did they know about working on animals. If you have a bad tooth or an abscess, they open it up, debride it, remove the tooth and send you home with antibiotics and instructions to call if you had problems. We were going to be working on a lion who could not talk and more than likely wasn't going to just let them peak at it daily and make sure everything was healing ok. What kind of antibiotics were they going to put him on? If there was a major defect in the mandible would they pack it with antibiotic impregnated plaster of paris? Was he going to need multiple anesthesia's and surgeries for debridement? Follow-up exams? More radiographs?

While I was super excited to be volunteering my time, Dr. Koontz had concerns about having his head of surgery working on a lion that could eat me in one bite. I assured him that I had no fear and that the appointed group of veterinarians was fully qualified to anesthetize Mufasa, we had nothing to worry about. 

A few days before we were scheduled to be working on Mufasa, Lori informed me that some of the veterinarians would be unable to participate, and that I was going to be lead surgeon. Dr. Taylor would run anesthesia and Dr. Kumaran would be available as well, but we were it. The team of so many different people was now three strong. I also learned that Tarzan, their resident chimpanzee, had swollen gums and was not eating. We were going to have to start earlier and work on him first. I decided at that point that I was bringing along Dr. Couture from our hospital. We needed as many veterinary hands there as possible. None of us knew what we were going to find.

Transporting Tarzan to surgery

We arrived Saturday morning at our predetermined time to meet Dr. Taylor, Lori, and everyone else. I was told that Dr. Kumaran may not make it because he had been sick. The sanctuary was buzzing with excitement and a little fear. Dr. Taylor had never fully intubated and anesthetized a chimpanzee or an african lion. We discussed the anesthesia protocol and I felt like he was prepared and ready to go. The first couple hours were spent with Lori trying to get Tarzan to take his oral sedative. I was told that chimpanzees have impeccable memories so he would be hard to trick into taking the medication. After a couple of failed attempts, Dr. Kumaran blessed us with his presence. He would be able to give Tarzan a shot - but Tarzan's memory of Dr. Kumaran would not be pleasant. After a little while we got the call that Tarzan was anesthetized and we were all to meet in the clinic to start the procedure. 

Once we got started all of my fear vanished. Tissue was tissue and this was not going to be any different. We got Tarzan intubated and on gas anesthesia. Once he was under anesthesia and the fear of a sedated pissed off chimpanzee had vanished, I had a minute to reflect on what I was working on. I was working on a chimpanzee, the animal that most closely resembled humans. To touch his hands was almost creepy. They looked amazingly similar. The technician, Kelly, and Dr. Taylor worked on collecting bloodwork and lab samples for testing. I grabbed the dental instruments and with the help of Dr. Kumaran we went to work on his mouth. We immediately found a broken canine which I removed and cleaned out the socket. The surgery was done within minutes. We helped finish up the diagnostics before moving Tarzan back to his enclosure. 

Oral surgery on Mufasa

The first surgery was done and now we had to wait on Mufasa. He was not so sure about everything that was going on at Black Pines that cool Saturday morning. He was not about to leave his enclosure and get into the transport cart. It was decided that he would have to be sedated at his enclosure using the syringe pole and then brought up to the clinic. After a short time, Mufasa arrived in the back of a ford ranger ready for surgery. He weighed in at a very large 550#. It took about a dozen people to carry him to the table for surgery. We immediately got him intubated and placed on gas anesthesia. Once he was stable, we quickly went to work on his infected mandible. We took many different views with the x-ray machine, but could not find an infected tooth. Once again, I took the "tissue is tissue" approach and started cutting out the pathology. Once I got down to his mandible I found a 1-2 mm hole in the mandible. He had a draining tract in the bone. I debrided the bone to find an abscess which promptly oozed pus as I entered it. He had surgery 6-7 years ago to remove a canine. It appeared as if they had left behind a piece of bone or tooth and it had formed a sequestrum. You ask, What is a sequestrum? A sequestrum is a piece of non-viable infected bone which becomes incased in bony proliferation called an involucrum. Once I opened the involucrum, it drained a significant amount of pus. I remove the lining and debrided the bone back to healthy bone. Once again, we were done within minutes. Dr. Taylor and his technician had once again done an amazing job collecting lab specimens and keeping him anesthetized.

Once we were all done, the room's atmosphere completely changed. It went from excited with a little bit of fear, to a room full of joy and happiness. Everyone had to take their picture with Mufasa because where else did you get an opportunity to place your hands around the neck of an African Lion and not have the fear of being eaten? Where else could you place your hand next to a paw that was close to the size of your head? At one point I had to remind the room (now with approximately 20-30 people) that we had a recovering lion in the room that was going to wake up with a very big headache and we really needed to keep things quiet. Everyone was ecstatic that it had gone so smoothly. Both surgeries had been completed with little consequences.

All from a simple email and a shot in the dark, I got to have one of the best days in my life as a veterinarian. I had worked on horses my entire veterinary career and in a few short hours I had worked on Tarzan and Mufasa. To top it off, the best part of this whole story is the fact that a group of volunteers and professionals that had never worked together became a team on this weekend and successfully treated Tarzan and Mufasa.