Two-year old Alizeti is a ball of energy. One of the youngest members of the chimpanzee troop at the Sedgwick County Zoo, her rambunctiousness is perhaps only matched by her independent streak.
Earlier this month, Alizeti did what all independent toddlers sometimes do: she went her own way.
While members of the zoo’s chimpanzee troop were headed outside for the day, Alizeti decided to hang back in her room. The troop’s alpha male Moshi went back to the room to move young Alizeti along.
“Unfortunately there was a conflict between the alpha male, Moshi, and Alizeti and sometimes parenting can get a little rough,” said Dr. Heather Arens, the zoo’s director of animal health.
Arens said that Moshi is considered more of a “chill” chimpanzee and that it’s not out of the ordinary for an altercation to happen within chimpanzee groups. It is unusual for those altercations to lead to major injuries.
Alizeti and Moshi were separated right away. Zoo staff moved Alizeti and her foster mom Bea into one of the chimpanzee dens to cool down. When staff noticed that Alizeti was limping a bit, they gave Arens a call.
During a checkup, Arens noticed Alizeti was missing her two front baby teeth and that she had a major injury to her fourth right toe. In the wild those injuries would have made a detrimental mark on Alizeti’s development. Arens said that if the wound healed on its own, Alizeti might have been left with a club foot. She likely would have fought serious infections as well.
Arens cleaned the wound and patched up Alizeti’s foot. Then she decided to make a call.
“Because she’s so young, we wanted to give her the best chance possible,” Arens said. “It was above my skill set and if there's somebody who can do it better than us to give her the best chance, it's somebody who does surgery on hands multiple times a day.”
Arens called Dr. Chad Corrigan, the director of orthopedic trauma at Wesley Medical Center. Corrigan helped zoo staff about a decade earlier, when another chimp dislocated her elbow. That “house call” helped cement a relationship with the orthopedic surgeon.
“I was able to make that phone call and I’m pretty sure that a surgery was interrupted to say that the zoo needed help,” Arens said. “Once they finished their surgery, we got a call back right away.”
Corrigan told Arens that he didn’t operate on hands, but that he thought he could help assemble a surgical team for Alizeti’s case. Corrigan put out his own call to Dr. Zachary Hanson, an orthopedic surgeon at Advanced Orthopaedic Associates, and Dr. Matthew Louis, a plastic surgeon at Thrive Reconstructive Surgery.
Neither of the doctors had operated on chimpanzees before, but they both instantly said yes to the request.
“My daughter thought it was very cool,” Hanson said. “She was at home telling my wife that ‘daddy’s working on the monkeys at the zoo,’ which was very cute.”
The team took a little more than a day to study up on chimpanzee anatomy.
“Their hands and their feet are kind of similar — obviously they’re a little bit different in size — but they’re pretty similar to a human’s [hand],” Louis said. “We didn’t necessarily feel too out of our element. Everything’s thicker. The tissue is much thicker, they heal a little bit quicker.”
When it came to creating a plan for Alizeti’s surgery, Hanson said the team had to think about working with “a chimpanzee who’s not going to be able to necessarily follow post-operative instructions, be compliant with post-operative restrictions.”
“We essentially treated this like we would a similar injury in a young child who would not be able to follow any instructions,” he said.
Corrigan, Hanson and Louis and nurses Emily McKenna and April Gulley and nurse practitioner Abby Mercado met at the zoo’s Oliver Animal Hospital to perform the surgery.
Alizeti received anesthesia for the roughly hour-long surgery. Hanson said that when the doctors got a chance to look at her foot, they found that the metatarsal — the bone that runs from the palm of her foot to the base of her toe — was broken in several places.
“In humans, we would try to salvage it by putting the bone back together and reconstructing the tendons,” Louis said. “But it's not fair to do that to a chimpanzee, because you kind of want to get them back climbing and whatnot as quick as possible.”
The surgical team decided to do a ray amputation, which removed the broken metatarsal bone, several of the tendons connected to it and amputated the rest of the toe. The doctors used one of the toe’s intact tendons to move over Alizeti’s pinky toe into the open space in what Louis called “spare-parts surgery.”
The tendon transfer should allow Alizeti to keep some grip strength in her foot, Hanson said.
While Alizeti was under anesthesia, the zoo brought in Dr. Doug Winter, a veterinary dentist with Midwest Animal Dental and Oral Surgery Services, to her teeth. Winter found no major root damage, meaning that apart from a toothy grin for a while, Alizeti’s adult teeth will grow in normally.
Once the team closed up the wound on Alizeti’s foot, they set about to their next task: deciding on a chimpanzee proof bandage.
Hansen said there was an obvious choice.
“A pink cast,” he said. “It’s very cute.”
And just like a child’s cast, Hanson said he made sure to sign Alizeti’s cast as well.
In the days since, Arens said Alizeti’s been busy recovering in her room under the watch of Bea. The mother and daughter pair are getting some time separate from the troop so that Alizeti can heal and keepers can manage the reintroduction to the other chimpanzees.
Recovery isn’t a fully boring task for Alizeti. She’s been prescribed similar pain medication to human patients and zoo staff are making sure to keep her busy. Arens said the keepers are playing Alizeti videos, giving her puzzles, children’s toys and zippers.
“We initially put some surgical glue in her hair so she’d be like ‘oh, what the heck is this,’ and pick at her fur,” Aren said of how zoo staff are keeping Alizeti from messing with her cast. “But really it’s distractions, distractions, distractions.”
Arens said even with all the toys and distractions, Alizeti is proving to be a resilient patient who at the end of the day just wants to keep being a chimp.
“She's actually bouncing back way faster than we want her to,” Arens said. “They just showed us a video of her, kind of scaling the wall and then bouncing down with her cast. And, you know, it makes every medical person cringe a little bit, so she wants to play.”
This week, Hanson and Louis will return to the zoo to remove the cast and see how Alizeti’s healing. Hanson said his daughter, Blake, is anxiously waiting on the results.
“My hope is that we'll be able to come back and see her fully recovered,” Hanson said. “That’s she’ll be doing well, playing on the jungle gym, hanging from the trees, and functioning normally.”
Editor's note: An earlier version of this article misstated the name of the Sedgwick County Zoo director of animal health, Dr. Heather Arens.
