{"id":73066,"date":"2023-12-12T14:34:46","date_gmt":"2023-12-12T21:34:46","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=73066"},"modified":"2023-12-12T18:26:49","modified_gmt":"2023-12-13T01:26:49","slug":"assisted-by-ob-gyns-denver-zoo-mandrill-undergoes-hysterectomy","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/assisted-by-ob-gyns-denver-zoo-mandrill-undergoes-hysterectomy\/","title":{"rendered":"The patient weighed just 30 pounds and needed a hysterectomy. How OB-GYNs assisted a mandrill at Denver Zoo."},"content":{"rendered":"
<\/div>
\"The
UCHealth OB-GYNs, Dr. Amy Markese, left, and Dr. Shawna Tonick, at the mandrill habitat at Denver Zoo. Peering at them is a mandrill named Rosa. The doctors performed surgery on a different mandrill, Saba. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n

The female on the operating table was under anesthesia and prepped for the procedure, while the two attending UCHealth obstetrician-gynecologists had scrubbed up and were ready to proceed.<\/p>\n

Their patient was suffering from perimenopausal symptoms, including prolonged periods with heavy bleeding. The hormone therapy she had been undergoing had helped but had not resolved her issues or discomfort.<\/p>\n

\"Denver
Saba is feeling much better after two doctors who typically operate on humans performed a hysterectomy on Denver Zoo mandrill in April. Photo courtesy of Denver Zoo.<\/figcaption><\/figure>\n

An ultrasound of her uterus had shown a worrisome mass. So, after weeks of planning and consultation among various medical colleagues who were dedicated to her care and well-being, the team decided that the best option was a hysterectomy.<\/p>\n

Despite having performed many such procedures, the two physicians from the UCHealth Women\u2019s Care Clinic \u2013 Anschutz Medical Campus<\/a> were in uncharted territory.<\/p>\n

For starters, she was a little smaller than their typical patient, at about three feet tall and weighing 30 pounds, and a bit younger, at 20 years.<\/p>\n

And there was another big difference.<\/p>\n

Pressed against the glass of the hospital where the surgery was taking place were the faces of parents and children, wanting to see what was going on with one of their beloved friends:<\/p>\n

It was Saba, a 20-year-old African mandrill<\/a>, who was born and raised at Denver Zoo.<\/a><\/p>\n

The Zoo partners with experts in obstetrics and gynecology (OB-GYNs) who treat humans for surgeries like Saba\u2019s to blend the expertise of both physicians and veterinarians, especially when the patient is a primate whose anatomy so closely resembles that of a human.<\/p>\n

\u201cPart of the reason the Zoo reaches out to GYNs is that the primate anatomy is essentially identical to the human female anatomy since we are primates as well,\u201d said Dr. Shawna Tonick<\/a>, who typically does surgeries at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus<\/a>, where she is an assistant professor<\/a> of OB-GYN and obstetrical health at the University of Colorado School of Medicine<\/a>.<\/p>\n

When Tonick was asked whether she wanted to be involved in the surgery, her answer was quick and firm.<\/p>\n

\u201cI said, \u2018Absolutely.\u2019 I love primates, especially African primates. I\u2019ve been on safaris a few times, and I just find them fascinating.\u201d<\/p>\n

She asked her OB-GYN colleague, Dr. Amy Markese<\/a>, to join her in the procedure.<\/p>\n

\u201cI am an animal lover too and was excited to be involved,\u201d said Markese, who is also an assistant professor<\/a> of OB-GYN and obstrectical health at the CU School of Medicine.<\/p>\n

Both women donated their time.<\/p>\n

Threatened in the wild, Saba faces another challenge<\/strong><\/h2>\n

Typically inhabiting the rainforest of west central Africa, mandrills are one of the largest and most colorful of the monkey species, with wonderfully expressive faces that can look wise, playful, inquisitive and irritated within moments.<\/p>\n

\"Dr.
Dr. Amy Markese, left, and Dr. Shawna Tonick, right, volunteered their time to do surgery on Saba, one of Denver Zoo’s mandrills. Photo courtesy of Drs. Markese and Tonick.<\/figcaption><\/figure>\n

Mandrills face many foes in the wild and are a vulnerable species. Their habitat is being destroyed through deforestation and logging. They are also killed by hunters for bushmeat and to fuel an international export market.<\/p>\n

Saba was born at Denver Zoo and lives with a group of other, mainly female, mandrills. Last winter and into early spring, her caretakers noted her worsening bleeding issues. They conducted a series of tests, including a CT scan, an ultrasound, hormone analysis, and vaginal and uterine endoscopy, which led them to seek out the assistance of UCHealth doctors to perform the necessary hysterectomy.<\/p>\n

To prepare for the procedure, Tonick and Markese collaborated with their OB-GYN colleagues, including one who had previously performed a hysterectomy on a white-cheeked gibbon from Denver Zoo. In the days leading up to the surgery, they visited the facility, toured its Helen and Arthur E. Johnson Animal Hospital<\/a>, which opened in 2020, spoke with the vets and other staffers who knew and cared for Saba and looked over the surgical supplies they would be using.<\/p>\n

\u201cA lot of planning and discussion took place before the surgery,\u201d Tonick said. \u201cAnd it ended up being very similar to what we are accustomed to.\u201d<\/p>\n

For Dr. Spencer Kehoe, a clinical veterinarian at Denver Zoo, working with UCHealth physicians makes a lot of sense, especially if other medical complications arise during the surgery that they would be more familiar with, such as endometriosis.<\/p>\n

\u201cWe combined our expertise with their expertise,\u201d he said. \u201cIt was a great collaboration and a good example of two fields coming together to give this species the best care possible.\u201d<\/p>\n

\"Dr.
Dr. Amy Markese, left, Dr. Spencer Kehoe, center, and Dr. Shawna Tonick, right, performed surgery on Saba, a Denver Zoo mandrill. Photo courtesy of Denver Zoo.<\/figcaption><\/figure>\n

Patient is different; surgery is the same<\/strong><\/h2>\n

Saba was anesthetized and brought into the Zoo\u2019s hospital operating room. The surgery, which took about 90 minutes, included the removal of her ovaries, uterus and fallopian tubes. An endocrinologist who works with Saba to help manage her diabetes was on hand. (She receives daily insulin injections.) Also there for the surgery were human and veterinary radiologists and a veterinary dental specialist.<\/p>\n

A lot of thought went into Saba\u2019s post-operation recuperation. Kehoe, who assisted with the procedure, used an \u201cintradermal\u201d suture pattern where the stitches are hidden under the skin. This was important so Saba wouldn\u2019t be able to pull them out.<\/p>\n

To keep her attention even more diverted from the incision, he placed \u201cdistraction sutures\u201d in random places, including on her arm, which would be harmless when she poked or pulled them, along with tabs of tape attached to her hair to keep her busy. Saba also got a manicure and pedicure \u2013 in neon green nonetheless \u2013 as another way to keep her focus away from her healing wound.<\/p>\n

The entire procedure went off without a hitch. Saba spent one week in her own habitat (away from the prying fingers of her family) and then re-joined the group. Aside from some pain medication, she has convalesced without any complications.<\/p>\n

\u201cShe recovered great. She seems very comfortable,\u201d Kehoe said. He added that pathology results showed that the mass was of a pre-cancerous nature, underscoring the importance of Saba having the hysterectomy.<\/p>\n

\"Dr.
Dr. Amy Markese, left, and Dr. Shawna Tonick, right, watch as baby mandrill, Zola, checks them out. With Zola is her mom, Kumani. The UCHealth doctors were on call to assist with Zola’s birth, but everything went well and Zoo veterinarians didn’t need the doctors’ help. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n

Both Tonick and Markese agreed that the day\u2019s collaboration between the Zoo and UCHealth was a great success.<\/p>\n

\u201cEveryone involved at the Zoo was so caring and took such care with Saba. It was a high-achievement moment for us,\u201d Markese said.<\/p>\n

For Tonick, the day was one she will always remember.<\/p>\n

\u201cWe were so happy to help,” Tonick said. \u201cIt\u2019s such an amazing thing to have lent our expertise. Both of us were in awe. She was so beautiful. It was one of the best days of my life,\u201d Tonick said.<\/p>\n

In the months since her operation, Saba has thrived.<\/p>\n

\u201cShe\u2019s a really independent, smart and wonderful animal,\u201d Kehoe said. \u201cShe\u2019s very much her own lady.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The female on the operating table was under anesthesia and prepped for the procedure, while the two attending UCHealth obstetrician-gynecologists had scrubbed up and were ready to proceed. Their patient was suffering from perimenopausal symptoms, including prolonged periods with heavy bleeding. 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