Injured Howler Monkey Rescue in Belize Part 2 - Surgery with surprise

Injured Baby Howler Monkey rescue in Belize – Part 2: „Mr. P’s“ surgery with surprising, human, side effect

Disclaimer for the faint of heart: this monkey had a very severe injury! Yet his story continues and we keep on hoping for the best.

About an hour after the first blog, the rescued monkey from PG, for now named „Mr. P“*, arrives in Central Farm with Paul and a volunteer.

Phew, the first step taken! Just for the ones new to the field: unfortunately in wildlife rescue we do sometimes receive animals, who do not survive transport and make sad „DOA“cases (dead on arrival). So I am happy to see him arrive alive! Yet he sits in fetal position, obviously depressed, which is a bad sign. As we gently lift him out of the tiny cardboard box, labeled with „injured monkey“from his air travel, it becomes clear that his arm is very severely injured and nearly entirely severed in the wrist. After a quick local anesthesia and further look, Paul and I ponder how to proceed.

While I often teach veterinary students, I rarely have had lay persons around in surgery and never for such a severe and gruesome injury. Usually the individuals, who deliver an animal, just wait outside, or come back later.

But, long story short: I had not really paid much attention to the third person, not from the medical field, in the tiny wildlife office, as Paul and I examine the injury and discuss the very high chance of having to amputate. Likely the reattachment of the 90-95% severed hand exceeds the possibilities of the very limited medical care available. As mentioned before, injectable anesthesia has to be used. With this risks are high; duration of anesthesia can not really be controlled well.

And did I mention that this monkey is probably barely 4.5 months old and weighs 610 grams?

Quickly the decision is made to anesthetize the monkey to assess under anesthesia if the hand can be kept and basically reattached or if it can not be saved. And just as the monkey is injected and returned to the box - so he can fall asleep without disturbance from us - and I gather all needed supplies and try to keep a handle on any possible complications fully focussed on the patient... I see, out of the corner of my eye, the volunteer, going down, to the ground, landing with an audible “thump”.

As I turn my attention to this non-medical person, who had spent the last 15 minutes in this minute space, with us discussing over the amputation of the hand of this baby while examining a gruesome injury with protruding bones and the likes... he is sitting on the ground, very dazed, yet fortunately with eyes open. I can see his blood circulation just wanted to collapse and he barely kept it going. Humans can go into shock just from the thought, or sight of things like this. Ooops to my surprise!

Fortunately the overwhelmed volunteer recovers rather quickly and we can focus on the animal patient again. Closely assessing the monkeys hand shows that, amazingly enough, all vital blood vessels on the lower (ventral) side of the arm remained intact. While the radius is fully shattered through the articulation, the ulna is mostly intact, yet the joint completely severed with one lateral tendon of the ulna remaining. The fingers are still well vascularized and the flexor tendons intact. I have seen and done a number of limb amputations. While this is definitely one of the most severe injuries to a wrist I have seen so far, it had been quickly found and brought to medical care. And the most difficult and vital structures on the lower side had remained intact and fingers still viable.

So with as little equipment as is available without a wildlife clinic I reattach his hand in two layers and stabilize the arm with a cushioned splint. As we are finishing with him we realize his temperature has dropped too much and we have to warm him back up. (annoyed/ing side note: I need a heating pad for all of my patients, who even in this tropical heat will suffer from hypothermia under anesthesia especially in major surgeries like this one). Paul lends body heat and the baby quickly comes back to normal temperature and deep post-anesthetic sleep.

We chat while anxiously awaiting for the baby monkey to wake up from anesthesia and it is a wonderful relief when he does. Then, after many tries, he lets me convince him to take some Pedialyte oral rehydration solution, first resisting, then hesitant and finally drinking with thirst, repeated droppers full!

It feels like a major battle won, but unfortunately Mr. P has many more hard weeks more to go, possibly months of recovery, before it could be attempted to reunite him with his family.

The next few days should show if the baby will survive and can keep the hand. We always hope for the best possible outcome, while we brace ourselves for a worst case scenario.

Has this tempted anybody’s curiosity enough to give a comment or ask for the continuation of Mr. P’s story? May be you are curious what this is we are talking about? Wildlife, medicine, rescue, rehabilitation and conservation in Belize? Does it matter?

Why do we do this? That is a different story!