Wednesday, January 1, 2014

“My favorite 2013 experiences”: Lets get crocking for Hope with ACES, or my first flight to the rescue.

I know blog updates have not been forthcoming. I have been too incredibly busy, chronically, to the point of exhausted. But I shall try again, I promise. When I started to think about my favorite 2013 experiences I realized there are so many to still be mentioned, like the Tamandua with skull fracture cared for amazingly by Ella Baron, or the field visit for the Peregrine Fund, and the spay and neutre clinics, especially the one on Tobacco Caye, and not to forget the amazing people I have gotten to work with this year. Definitely there are too many stories for one blog. And there is too little time in my life to write. I and BWRC will attempt to produce a biannual Newsletter in 2014 to not forget the many amazing critter stories.
So to keep it short highlighting the best of 2013 and some of BWRC’s amazing partners one at a time here another crazy wild animal rescue assistance we were able to provide. It starts as usual...
Typical "chop wound" on this problematic croc

Just as I hoped for one of the first free days on a weekend in about 3 months, I received a Facebook message „We need your urgent help, to stitch a crocodile“. So from „finally weekend mode” to emergency mode. The severely injured croc had been rescued by Vince and Cherie Rose from ACES after complaints by concerned people on San Pedro. It was far from the clinic, and it was a 7-8 foot croc by name of “Hope”. A little too big to travel, so Cherie started looking for assistance to get the doc to the croc. Looking at a picture we determined that it was an older injury, the patient was in good body conditions and had eaten so she did not require surgery that Friday night, but Sunday would be fine and give us the time to prepare for this potentially complicated procedure. Ode to the miracles of networking: Within minutes the San Pedro Sun agreed to donate my flight to San Pedro. Shortly thereafter BWCN followed with a donation towards treatment costs.

Ensuing on Saturday were many hours of research on procedures, anesthesia and options available under our conditions. Cherie had suggested on the phone „you might just have to amputate“. Reptile anesthesia is not easy to begin with. And when it comes to a crocodilian this size and the need for forced ventilation under anesthesia – imagine yourself putting a tube in? We had a piece of PVC pipe for the emergency, but needless to say that this can be unnecessarily dangerous... we were once again working under complete field conditions, without much „amenities“. Not only did I need at least one medically trained assistant for this procedure, but also did BOTH of my veterinary assistants WANT be part of the action. I could not blame them and in an animal this size we could not have too many helping hands. Thanks to individuals, supporters and the Summerlee Foundation we were able join a fabulous medical team with Drs. Angela, Jen, myself, interns Helen and Lily and the ACES team with Directors Vince and Cherie Rose and Assistant Chris. Drs Jen and Angela took a boat and I took an early flight out of Belmopan. This was my first flight in Belize in 10 years! Something I had looked forward to yet then was surprised by the bumpiness of the ride. 3 stops later on short Island runways... I happily arrived on San Pedro with my 2 boxes and a backpack.

Most of the medical teams hands in the picture
Thanks to ACES fantastic capture and restraint we were able examine and treat this severe injury under local infiltration anesthesia. A bench as surgery table and the back of a golf cart as instrument and medication table, under a tree. Once she was restrained, “Hope” turned into a perfect patient. While the images of the injury had been suggestive of a very old, infected lesion, with likely loss of limb, in reality there was only a thin layer of necrotic tissue and below was healthy bleeding granulation tissue. The injury was typical of a cutting injury as sustained by machete or similar tools with a deep straight craniocaudal cut through the hindlimb at the mid femur level. The bone was also severed, and there was a lot of dirt inside the deep wound cutting through about 1/3 of the thickness. Fortunately the cut did not sever the close by femoral artery! “Hope” was not using the leg, but she was dragging it and comparing to the photo she had progressed in basically “self amputating” by slowly ripping the partially severed limb off! But overall we gathered hope to save the leg with treatment.

Wound nearly closed!
Thanks to our many helping hands we went to work and washed and flushed and debrided, and flushed and flushed some more. Then we reunited the severed tissues from the deepest layers to the surfaces with many sutures. We were surprised to see how the leg came back together and the protruding tissues were repositioned, and minus a drain opening, the wound could be fully closed. The bone underneath was still broken. Bone surgery was not possible under these conditions. Yet there was little muscle contraction and replacing the fracture was possible manually. We opted for external immobilization and with mostly duct tape (you better Belize it...) immobilized the leg to the tail.

Penguin duct tape cast to provide immobilisation
After being very concerned to begin with and worrying about loosing the patient, anesthesia complications, failed amputations or the likes... we were able to clean up, close and cast the injury within 2 h, and after 3 h 30 min on the Island, I hopped back onto the place to go back home to spend even a couple of daylight hours with my family home on a Sunday. That was awesome! And the return flight was just me, and the pilot of course, and we went straight home. Nice!

And, the best part of the story is the continuation in that Hope first of all ate well, then kept the leg and then started using it again! Check out the last picture after removal of cast! It's so exiting when something this challenging can end this well for the patient!

2 months later: Amazing recovery for Hope!

I would like to end with a thank you to our partners at ACES for their amazing work for crocodiles. This was definitely a highlight for 2013 for me, and I am very glad to have been able to help just a little bit. 
Holding hands with Hope

Thanks to the Team!

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