Two hours into a surgery to save Kyah, a 6-month-old giraffe, and veterinary surgeon Mark Rochat runs into a problem.
As he attempts to cut away a vessel that has grown around the giraffe’s esophagus, he can’t stop the bleeding. The soft tissue around the vessel isn’t strong enough to hold sutures. If the bleeding can’t be stopped, she will die.
“Remember, this is an embryological screw-up to begin with,” Rochat said. “The tissue wasn’t normal to begin with. From a surgeon’s standpoint, that’s interesting, but also infuriating.”
The planning for the operation began when it was discovered Kyah, from the Oklahoma City Zoo, suffered from a persistent right aortic arch, a three-inch vessel that had wrapped around her esophagus. As she grew, the vessel tightened, making it impossible to eat solid foods. The condition is the result of a birth defect.
The zoo veterinary staff assembled at 5:30 Tuesday morning to begin the delicate process of separating a 525-pound baby giraffe from its mother. She was guided onto a trailer on loan from the Dickerson Park Zoo in Springfield, Mo.
The zoo’s team had rehearsed the plan to get Kyah on the trailer the day before.
“We knew exactly where each person was going to be, up to where their fingers were to be positioned on the fence in case she kicked,” Zoo curator of mammals Laura Bottaro said.
The one-hour trip to Stillwater would be one of the few things that went as expected the rest of the day.
Once inside the CT room at Oklahoma State’s veterinary school, it became obvious that Kyah wasn’t even close to fitting inside the machine. The CT scan was supposed to give surgeons a pinpoint location of where the problem area was. But even for one of the most advanced veterinary schools in the United States there are limitations. Vets must make do with machines designed for humans.
“We get calls probably once a month from doctors who have patients who are over 500 pounds and they want to know if they can use our hippo MRI machine,” zoo veterinarian Jennifer D’Agostino said. “There is no such machine.”
The problem meant Rochat and surgeons Danielle Dugat and Michael Schoonover would not have the critical images of the problem area.
“We took her into surgery flying blind,” Rochat said. “But that’s the nature of zoo medicine.”
Rochat, who had performed the same operation on more than a dozen dogs and cats, quickly realized the differences in anatomy would be another challenge.
“In a dog, you can pull their legs out of the way fairly easily to get access to the chest area, but not in a giraffe,” Rochat said. “In a giraffe you can’t do that.”
Members of the zoo’s team took turns holding Kyah’s long leg in the best position possible. Once Rochat reached the chest area, he was confronted with a heart the size of a basketball. As D’Agostino watched they began looking for the problem vessel.
“The heart is beating and the lungs are inflating and it’s really challenging,” D’Agostino said. “It took a lot of effort to find that vessel because of the sheer size of her heart.”
Once the vessel was found, Rochat began the process of cutting it away. The surgeons were then confronted with the problem that would ultimately end any hope of a successful outcome.
“The tissue would just fall apart,” Rochat said. “You would think you got one area fixed and it would separate. It was abnormal tissue to begin with.”
The team of surgeons and D’Agostino began conferring about other options.
“We brainstormed different ideas and he wanted to try two more options,” D’Agostino said. “As he tried those you could tell his frustration level was getting fairly high.”
After four hours of surgery Rochat decided that enough was enough.
Saying goodbye to Kyah
“He turned to me and he said ‘I’m not going to be able to fix this,’” D’Agostino said. “By that point he literally had his finger plugging the hole in the vessel.”
The decision was made to euthanize Kyah on the operating table. She was unconscious from the moment she went into surgery. Twenty people had worked for four hours to give her a chance at life.
“As surgeons we have that competitive edge,” Rochat said. “When you lose a patient it gives you a bad feeling in the pit of your stomach. You want so badly to be able to fix it.”
As Kyah was euthanized, the hoofstock staff who had seen her take her first steps six month ago were by her side. Keepers walk a fine line between getting attached to the animals they care for and also understanding they are wild. As she peacefully slipped away, professionalism had to make room for emotion.
“I try to mentor my staff that these animals are not pets,” Bottaro said. “But when you are there from the time the animal is born and you actually see its birth, it’s not that black and white.”
What happens now?
Kyah’s body will be donated to the Sam Noble Museum of Natural History. While the operation to save her life was not successful, much will be learned from the attempt. Information about the operation will be published in veterinary journals. The experience may serve to better prepare other zoos with their animals.
Other zoos have offered support and have praised the attempt to save her life, even if it was in the face of long odds. Rochat praised the zoo staff for their willingness to try.
“People want to say this or that about zoos,” Rochat said. “But the fact of the matter is, had she been born out on the Serengeti she would have died a slow and agonizing death. Their staff put so much into this. God love them for being willing enough to take on a daunting challenge like this. My hat is off to them.”
D’Agostino said the attempt to save Kyah’s life was an easy decision and part of the environment in zoo medicine where the ability to adapt is as important as any surgical tool.
“There was no question for us that we were going to try this,” D’Agostino said. “She was an otherwise healthy giraffe. Logistically we knew it would be a nightmare, but we never batted an eye.”