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Saturday, January 23, 2016

A jaguar visits the dentist

Posted by Kirsten Pisto, Communications

Photos by Jeremy Dwyer-Lindgren

Providing terrific animal health care is one of the benchmarks of the zoo's mission and that includes dental care. Just like in humans, a healthy mouth is tantamount to the overall wellness of an animal. If you've ever wondered about how we provide that care, here is one detailed look at a jaguar's visit to the dentist.

Its 9:30 a.m. on Friday, January 15, and the hustle and bustle of the Woodland Park Zoo Animal Health building is well underway. The Animal Health team has prepped the procedure room for a special patient this morning, a 16-year-old male jaguar, Junior. He is here for an endodontic tooth repair on one of the biggest teeth in this big cats mouth, the right maxillary canine. The upper dental arcade of teeth are termed maxillary and the bottom teeth are the mandibular teeth. In the wild, jaguars use their canines to apprehend and potentially pierce the skulls of their prey. This tooth is really big, very strong and kind of terrifying, but one that needs a dentist nonetheless!

Curators are not sure how Junior broke his canine, but it was most likely due to old age. In the wild, jaguars live about 11 years, while in zoos they can live up to 22 years. Junior, at 16 years old, is well passed middle aged, and both his teeth and claws show typical signs of aging. Photo by Dennis Dow/WPZ.
A little backstory:
When keepers noticed Junior’s tooth didn’t appear normal and that his upper right canine was partially broken, veterinary staff called on the expertise of a local veterinary dentist consultant, Allen Matson, DVM, DAVDC of Eastside Veterinary Dentistry in Woodinville, one of only a few board certified veterinary dentists in the country. Lucky for the zoo, Dr. Matson is fairly close by and generously offered to volunteer his time to take a look at Junior’s broken tooth.

Dr. Matson visited Junior behind-the-scenes for a preliminary consultation. Keepers regularly work with both jaguars in open-mouth training to facilitate oral exams so that they can visually check for any dental health concerns. In circumstances like this, Dr. Matson was able to diagnose the problem. After visually examining the tooth each time Junior snarled, lifting up his lip and exposing his gum line, Dr. Matson saw that the break was rather large and the pulp cavity of the tooth was exposed. Because of this, the tooth would have to be treated to prevent infection and painful nerve damage inside the tooth root canal. After the visual exam, an appointment was made for Dr. Matson to return to the Animal Health Complex with his veterinary assistants to attempt to repair Junior’s tooth.

The set up:
On Friday morning, Junior is called into his holding area where veterinary staff carefully inject him with an anesthetic before safely moving him to the zoo’s Animal Health facility in a specially equipped zoo ambulance. After arriving at Animal Health, Junior is quickly lifted onto a stretcher using a cargo net. It takes five or six people to safely lift the 159.5 lb. cat. As soon as he is placed on the procedure table the zoo’s veterinary technicians place the anesthesia breathing tube into his trachea and secure it with a small string around his head to ensure he is getting the proper amount of oxygen and gas anesthesia. 

Veterinary Technician, Linda Moneymaker, expertly draws a blood sample, adjusts the breathing tubes and monitors the anesthetic depth during the dental procedure. Junior’s body relaxes and,  as soon as this happens, everyone in the room jumps into action. 
Junior’s enormous paws are draped delicately over the exam table. His regal-looking spots stand out against the insulated blanket that maintains Junior’s body temperature during the procedure.  
All hands on jaguar

Dr. Darin Collins, director, Animal Health Programs at Woodland Park Zoo is orchestrating the procedure today. The team shaves off a few patches on Junior’s legs to place an indwelling catheter for intravenous fluids. A blood pressure cuff is placed on Junior’s right front paw to assist with monitoring his vitals during the anesthesia. Dr. Collins signals to veterinary tech Kim Dawson to start the blood draw and IV drip. While Kim begins the blood sample collection, volunteer veterinary tech Janna O’Conner holds Junior’s legs and forms enough pressure to assist Kim in finding the veins.

Dr. Collins listens to the heart and lungs, while closely monitoring Junior’s  level of anesthesia and watches for any signs of discomfort or agitation.
Between inoculations, blood draws and monitoring the anesthesia machine, the veterinary technicians give Junior’s back and legs some reassuring pats. Standing off to the side are Junior’s keeper, Jamie Delk and collection manager, Erin Sullivan, who will stay with Junior through today’s procedure until he is safely back in his den.
Junior receives a cozy blanket inflated with warm air to keep his body temperature at the right levels during the procedure.
Dr. Darlene DeGhetto , a volunteer veterinarian, sets up the electrocardiogram that allows the vet team to monitor Junior’s heart activity during anesthesia. Linda continues to oversee the anesthesia and throughout the almost three hour procedure she will monitor the jaguar’s vital signs. All of this safeguarding and monitoring serves a purpose, and that is to allow Dr. Matson and his veterinary assistants to work on Junior’s tooth with safety in mind for both the jaguar and the humans in the room.

Dr. Collins checks Junior’s eyes in a blink test, the last step to be sure the anesthesia has taken hold. Then he gives the go-ahead to the veterinary dentistry team. It’s time to fix that tooth.

The tooth

Dr. Matson lifts up Junior’s lip and takes a close look at the tooth while his assistants, Kim Heilbrunn and Trisha Romanosky, prepare the workspace. They wheel over a tray of instruments like you might see at your own dentist’s office; a table with many different dentistry instruments laid out, a large overhead light, a dental x-ray machine and the familiar air and water syringe. Dr. Matson begins right away on the problem tooth, first cleaning and disinfecting the area. 



There are eight veterinary staff, each performing a task, a bustling of activities coupled with the whir and beeps of the machines while quiet directives are being given which prompt the delivery of larger tools or more gauze. While most hearts might skip a beat when staring into Juniors propped open mouth, the veterinary dentists trust the anesthesia. This is all quite routine for them.

A series of x-rays are taken from different angles to get a detailed look at the fracture. Junior’s tooth is so large that the team has to try a few x-rays for the right angles. 

For the next hour and a half, Dr. Matson will work on Juniors tooth. He will file off the canal, remove the nerve and clean the canal out. The tooth itself is dead, but if Dr. Matson can replace the soft tissue inside the tooth with this inert filler substrate material, then Junior wont likely lose this large canine during a possible extraction procedure in the future.

This team of veterinary technicians are pros at working with dogs and cats, but a cat this large offers a few new challenges. Dr. Matson remarks that the largest tooth he had worked on previously was a large dog canine that measured maybe 45 millimeters long. Junior’s tooth is 70 millimeters long, so special tools and resourcefulness are key for today’s success.

That’s a wrap
Dr. Matson tells Dr. Collins that there is a little bit of persistent bleeding right at the tip of the tooth where the blood vessels come in. Since that could not be stopped today, Dr. Matson will put a dressing called calcium hydroxide in there which will cauterize the area and then he will place a temporary filling on the tooth. Then in two months Dr. Matson and his team will come back to open up and clean out the tooth. Afterwards, the dentist will use permanent material to fill up the canal just like a human root canal.

With Junior’s tooth in good shape for now, the veterinary technicians prepare the jaguar for transport back to Jaguar Cove. Kim hooks Junior up to intravenous fluids to make sure he is fully hydrated. Radio calls are made by the collection manager to alert staff at the receiving end that Junior is almost on his way home.

The lift-net is draped carefully  under Junior and then he is rolled onto his side while the net is tucked underneath him. Then, with an “on three,” command the vet staff has whisked him out the door and into the ambulance. 
After a few minutes the radio buzzes and we hear confirmation that Junior is back in his den. Keepers will keep a close eye on him as he begins to wake up. They’ll make sure he is hydrated and that his appetite returns, a healthy cue for any animal.

The veterinary dentist and his team collect their tools and unplug the special dental x-ray machine they have brought with them. I ask Dr. Matson about this experience and what makes this patient different than others. He tells me, “The thing is that this is just beautiful. You know, he’s such a beautiful animal; it’s awe-inspiring being next to him. That’s the biggest thing. I just feel privileged to be that close to him.”

Huge thanks to Dr. Allen Matson and his veterinary assistants Kim and Trisha for volunteering their time and professional expertise at the zoo. Junior may not remember their loving hands, but his tooth is already looking better! 
Special thanks to our entire team of Animal Health experts who are the absolute best at providing top-notch, excellent patient care to all of the animals here at the zoo.

3 comments:

  1. Just so impressive! Kudos to a great staff and all the volunteers who contributed their time and outstanding expertise to assure this magnificent animal continues to live a happy and pain free life.

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  2. Just outstanding! Kudos to a top notch staff and volunteers who assured a continued happy and pain free existence for a most magnificent animal.

    You guys are truly special!

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  3. Thanks to Dr. Matson and his staff for providing wonderful service to Junior! It's wonderful to have a community of health care professionals that donate their time when needed!

    ReplyDelete