MCW and Children’s Hospital of Wisconsin Collaborate to Help Sick Bonobo

On a Friday this past November, Dr. Rainer Gedeit, a professor of pediatric critical care at the Medical College of Wisconsin (MCW), was on his way to pick up his mother to run some errands when he got an unusual call. The Milwaukee County Zoo needed help with a sick animal.

The zoo needed help with a young bonobo that was in critical condition. The entire bonobo troop--nearly 25 animals--at the Milwaukee County Zoo had fallen ill. Several animals had developed pneumonia, and one adult animal had died the night before.

That morning, zoo keepers found Noelle, an almost 3-year-old bonobo, listless in her mother’s arms. She was in significant respiratory distress, and the zoo staff had inserted a breathing tube. They called Dr. Gedeit for treatment recommendations, but with the blessing of his supervisor, Dr. Gedeit knew they could do more. With the help of Children’s Hospital of Wisconsin’s respiratory care service’s Khris O’Brien and clinical engineering department’s Joe Kau, they obtained a retired Children’s ventilator and brought it over to the zoo.

What they found was a very sick animal blue from lack of oxygen and in septic shock--a medical emergency. As the pediatric critical care clinical director and respiratory care services medical director at Children’s Hospital of Wisconsin, Dr. Gedeit is used to having all sorts of technology to assist in monitoring a patient, but that was not the case at the zoo. “I really had to rely a lot on the physical examination to evaluate,” he says. “It was an opportunity to get back and use the skills you have as a physician.”

Physically, bonobos are close in stature to humans. Noelle was about 16 pounds, a little smaller than your average 2-year-old human child. “It’s amazing,” he says. “The anatomy and physiology of these animals are very close to humans. Doing a physical exam was not a challenge. You’re looking at the same thing as a child--but a little hairier.”

The team had an obstacle to overcome even before getting Noelle on a ventilator. A ventilator needs both oxygen and air flow to operate, but the zoo didn’t have the required equipment to deliver the air portion of the equation. They looked into ordering air tanks from a medical gas supplier, but they needed quite a few, so Khris O’Brien came up with another idea.

The zoo did have a nebulizer, a piece of medical equipment usually used to deliver medication through an inhaled mist. The team got creative, hooked the nebulizer up to the ventilator and got Noelle on the ventilator. “It’s a neat thing to do, to look at your troubleshooting skills,” he says. “It’s great to use the knowledge of the people we have here at MCW and Children’s to get what we need and adapt what we had to make the equipment work.”

Noelle needed pretty significant support that first night, but she was stabilized. She was on the ventilator until Sunday morning, fewer than 48 hours. And the nebulizer, which usually was in operation for fewer than 15 minutes, never broke down and gave Noelle the air she needed.

Bonobos heal more quickly than humans, and Dr. Gedeit was surprised at how soon they were able to get Noelle off the ventilator, much faster than a human child who was that sick. “She was very blue before we got her on the ventilator,” he says. “I was worried she was going to be on there for days.”

Within six hours of having her breathing tube removed, Noelle was eating and looking much better. Although she still required antibiotics for several days, Noelle was on the mend. When Noelle was allowed to rejoin her troop, her mother--who had also been sick--grabbed her, picked her up and ran to the other side of the enclosure.

When Dr. Gedeit went back to the zoo just a few weeks ago, the zoo keepers had to point out which bonobo was Noelle. She was running like any other young bonobo, and he couldn’t pick her out. All signs of her severe illness were gone.

What Dr. Gedeit really takes away from the experience is how everyone at MCW and Children’s was willing to pitch in, from the respiratory care staff running around to find a replacement for a broken piece of equipment at 2 a.m. to the clinical staff offering advice. “It was really a team effort,” he says. “We have a great group of people who are willing to take the time to answer the call.”

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