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Elephant Tusk Extraction in Poland (2013-06)

 

Copy of article written by Dr Gerhard Steenkamp for www.vets4wildlife.co.za 

Dr Gerhard Steenkamp BSc, BVSc, MSc Senior Lecturer, Dept. of Companion Animal Clinical Studies, Faculty of Veterinary Science University of Pretoria, Onderstepoort

Elephant tusk extraction is a procedure that has been described in the literature but something that is infrequently done in wildlife/zoo practice. Over the past few years I have performed several of these procedures and when I was asked by a zoo in Poznan (Poland) to extract the diseased tusk of a 13-year-old elephant bull, I was naïvely confident and accepted the invitation. What follows is a diary of what transpired and how an anaesthetist and I aged significantly in 5 short months!

Ninio is an African elephant bull housed in a wonderful, purpose-built facility in the Poznan Zoo in Poland. He arrived at the facility when he was 5 years old and is the offspring of the largest elephant bull in captivity in Europe (a fact we only discovered later).

In 2010 he fractured his tusk for the first time and a human stomatologist (dentist) was called to assist. According to the zoo keepers this person was horrified at the amount of bleeding as he tried to do a partial pulpectomy (removal of part of the pulp – a type of root canal procedures) and so applied some medication and a filling and left it at that.

In February 2012 a human dentist in the UK (who also had wildlife experience) was contacted and agreed to help Ninio in late 2012. Unfortunately the dentist subsequently suffered a serious heart attack and could no longer assist them. A cry for help from Poznan was directed to me via Ireland and then via a colleague of mine, Dr. Cedric Tutt.

After making contact with the zoo, it was clear that they did not know anyone confident enough to anaesthetise an elephant bull for a 3-hour procedure. I thus proceeded to call in the help of Dr. Adrian Tordiffe of the National Zoological Gardens. Together we have worked on several elephants before and I knew he was the right person for the job.

The next few weeks were rather intense as we finalised our travel arrangements. To add to the usual red tape, Adrian had to obtain the necessary permits for us to carry M99 with us to Poznan as the only etorphine available in Europe is found in a combination drug together with acetyl promazine (ACP) and not suitable for elephant anaesthesia. We had other "unusual" luggage too. Karl Storz (the endoscopy manufacturing company from Germany) has manufactured a purpose-made endoscope for elephant vasectomies and this is also the ideal instrument for evaluating the pulp on such a tusk. This instrument was thus first to be packed. (Karl Storz in Poland was more than willing to assist with equipment but since only 2 of these endoscopes exist in the world, I had to take ours with us). Carrying this piece of equipment as hand luggage caused me to be detained at many a security check point, as it very much resembles something more dangerous and sinister!

We flew to Warsaw and were met by the veterinary technician of the Poznan zoo. The vehicle he came to fetch us with, though, would not start (and Poznan is still a 3-hour journey from Warsaw). This afforded us the opportunity to spend a whole afternoon in the Warsaw zoo. For both of us it was our first sighting of a greater one-horned rhinoceros, since Warsaw zoo has two of these magnificent animals. We also got to see Ninio’s half-brother at this zoo and began to get an inkling of the scale of the task ahead of us. He was enormous!

We had chosen to stay in the zoo at their administration building, rather than at a hotel, so that we could be close to Ninio all the time as the staff was very concerned about him and what would be expected of them. Most of the keepers could not speak English and we used an interpreter (the head elephant keeper’s wife) to help us communicate with them.

The first anaesthetic of Ninio went exactly the way we did not want it to go. The darts did not discharge completely and after careful recalculation Adrian had to give more drugs, but again there were issues with darts failing. When Ninio was eventually affected to the point that he could no longer stand steadily, he still refused to go down and with the shuffling of his hindlegs splayed completely. This was the first time ever either of us had seen something like this and it was very concerning. Quickly manipulating a 5-ton animal is out of the question and it didn’t help our cause that the elephant quarters were not equipped with a hoist. Neither was there access for a vehicle to help manipulate this monster. Everything had to be done by hand. Fortunately they had a manual hand winch and many helping hands which saved the day.

Once the animal was correctly positioned I inspected the tusk and could immediately see that my purpose-made equipment from SA was going to be too small.

Due to the chronicity of the pulp infection, ivory pearls had started to form within the pulp canal which prevented good drainage. There were also pockets of abscessation within the pulp and its cavity. During this first anaesthesia I was at least able to amputate the affected tusk and start with the loosening of the tusk as well as cutting lengthwise grooves.

We decided to wake Ninio up and reschedule a second procedure 5 days later. This meant we had to postpone our flights, which pushed the return date for us beyond the date on which Adrian’s visa expired. This required a trip to the local bureaucracy in Poznan. While Adrian was off to find a legal way to stay until the next week, I was off to a local hardware store to try and find components for new equipment.

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