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US Shedd’s famous otter Luna goes under the knife to prevent cancer

17:35  14 february  2020
17:35  14 february  2020 Source:   chicagotribune.com

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Luna, probably the most famous southern sea otter in America, lies on her back, out cold, nestled in a foam body support and draped in shroud-like blue sheeting in an operating room at a northwest suburban veterinary clinic.

an animal swimming in the water: Sea otter Luna at the Shedd Aquarium in Chicago on Monday, Feb. 26, 2019.© Jose M. Osorio/Chicago Tribune /Chicago Tribune/Chicago Tribune/TNS Sea otter Luna at the Shedd Aquarium in Chicago on Monday, Feb. 26, 2019.

During the first part of the anesthesia, the tail of the Shedd Aquarium marine mammal twitched between her rear legs in that kind of dream state that precedes the knockout dose. Now, she is fully under, and Dr. Mitch Robbins is almost ready to begin a new kind of treatment for captive sea otters, one that required government approval to perform, the removal of her ovaries and uterus designed to prevent later-in-life reproductive tract tumors.

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“It makes a surgeon very anxious to have this much fur,” says Robbins, an experienced animal doctor at the Veterinary Specialty Center.

In the rooms surrounding Luna at the bustling Buffalo Grove facility, dogs are being prepped for surgery with a clean shave, for sterility’s sake. A small, curly-haired pooch will wheel by on a gurney with its entire belly laid bare; a golden retriever getting an ACL tear fixed will have a hind leg similarly denuded, looking like an elongated drumstick.

Luna’s dense coat, though, demands a different protocol. With the animal’s lower abdomen exposed, the Shedd’s Dr. Matt O’Connor applies a sterilizing solution to the spots where the two incisions will be made. An assistant with a gentleman’s black comb and sterile lube carefully parts the hairs to at least allow a clean line for the scalpel.

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“You can’t shave them like you would a dog or a cat,” explains the Shedd veterinarian, who traveled to the northwest suburban clinic early Wednesday morning with about a dozen fellow aquarium staffers. “They’ll destroy a pair of clippers.”

More than that, you can’t tell an otter not to go in the water during the recuperation period, and losing even a little patch of fur would hinder the animal’s ability to maintain body temperature in the 55-degree waters of its habitat. “Even with, like, a little spot,” he says, “they would lose a ton of heat.”

But considering that the fur has to stay, Dr. Robbins pronounces himself very pleased with the tissue surface. “Look at that,” he says. “You guys did a great job prepping.”

Some 15 people are in the operating room: Shedd veterinary staff, animal trainers and PR representatives; Specialty Center surgical staff; and a visiting reporter and photographer. Video monitor towers flank the operating table so that Robbins can see inside the animal later, when the laparoscope, the camera, goes in.

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“Okay, ready?” he says. “Cutting.”

He makes the first of two small incisions, and a few drops of blood ooze onto the sea otter’s brown coat.

When Luna came to the Shedd Aquarium, rescued from being found alone and hungry and weighing less than 2 lbs. on a central California beach in Sept. 2014, she became an instant star, her fuzzy mug splashed across Internet screens and in front of the cameras of “Good Morning, America.”

Such videos as “Welcome Pup 681!” and "Playtime With Pup 681” lured the cute-seeking web hordes to Shedd’s YouTube site, and the contest that saw her named “Luna,” after her discovery site near Half Moon Bay, drew more than 10,000 votes.

Now five years old and about 45 lbs., she is just one of the Chicago lakefront aquarium’s posse of southern sea otters. Younger, temporarily cuter otters have joined the group. Meanwhile, one of the things that can happen in captive female sea otters, the Shedd and other institutions have learned, is they can develop tumors in their reproductive tract as they age.

Although the species is endangered in the wild, zoos, aquariums and the federal government that form a kind of sea otter cooperative have agreed not to breed the animals in human care. They want to be sure there is capacity to take in the pups who are found stranded every year, separated from their mothers, which is not only Luna’s story, but also the story, with slight variations, of all but one of the six southern and Alaskan sea otters at the Shedd.

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Instead of giving the females birth control — as happens in, say, captive gorilla populations, where the procedure is similar to human contraception — the institutions typically just neuter the males.

And the theory, Dr. O’Connor, the Shedd veterinarian, explains to Dr. Robbins when the latter asks in the OR, is that because the females are not going through a steady cycle of pregnancies and nursing through their lives, tumors have a chance to develop.

“The cells in their uterus can get out of whack, basically,” O’Connor says. “They’re supposed to constantly be sloughing off that uterine lining every time they give birth. When they’re not doing that, that’s what can promote these tumors to form.”

This was only discovered in older females in recent years, he explains, in animals at Shedd and at aquariums in Vancouver and Monterey Bay. “It wasn’t until recently that we determined that this type of tumor was really an issue,” he says.

Shedd specialists did a presentation on the issue a year ago at an international veterinary conference and also sought and received permission to perform preventive hysterectomies from the U.S. Fish and Wildlife department, which oversees care in animal facilities.

“To my knowledge, no one else has started spaying them yet,” O’Connor says.

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A few weeks ago, the Shedd team and Dr. Robbins did the procedure on Ellie, a 4-year-old rescued near Carmel, Calif., in 2016. The surgery and recovery went so well that they decided to go ahead with the slightly older Luna, whose age is essentially otter adolescence, and to invite the Tribune to observe.

“There were less people in the room” for Ellie’s preventive hysterectomy, says Robbins, standing over the animal. “Definitely no reporters.”

He is good natured throughout, trying to recall, for instance, the other exotic animals he has operated on through relationships with Shedd, where he is on a medical advisory board, and Brookfield and Lincoln Park Zoos.

“A sea lion, a sawfish, two electric eels, a snake,” he says. “Did they bring a shark here one time?”

“It’s 99 percent dogs and cats,” though, Robbins, 55, says. Operating on an animal like a sea otter is “fun,” he says. “It’s infrequent so it makes it very — what’s the right word? — cool.”

Veterinary Specialty Center — which does the work for the non-profit aquarium pro bono — has not only the staff expertise but the laparoscope that allows the surgery to be performed by using its camera to peer in and find and remove the organs via on-screen visuals.

That means no opening of the abdomen to look in, much smaller incisions — 12 mm and 2.3 cm, Robbins measures — and therefore almost no blood loss and much quicker recovery.

For all the people on hand, using instruments to monitor temperature and heartbeat and help the otter breathe, the procedure moves efficiently, finishing in about two hours overall, about an hour for the surgeon’s work.

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“I’ve only had one lion wake up on the table,” jokes Katie Bennett, the VSC anesthesiologist.

Before the actual surgery, though. comes an important otter bodily function. As Luna lies insensate, a liquid starts to dribble out her bottom end.

“You want urine?” says Steve Aibel, Shedd’s senior director of animal behavior and training. “Anyone want some urine? Cause we’ve got it.”

O’Connor steps in and massages Luna’s bladder to help in the expression. “Four years of veterinary school,” he says, and the urine collects on a towel placed on the floor.

At the animal’s other end, a Shedd veterinary resident takes advantage of the anesthesia to scrape tartar off of Luna’s teeth.

Once the incisions are made, and the camera inserted through a tube, or port, pushed into the animal’s torso, Robbins calls for CO2 gas to be pumped in.

This, O’Connor explains, inflates the area and makes the reproductive organs easier to find. “He’s going to look around for the ovaries and uterus, go in and grab it,” he says. A branded instrument called LigaSure lets the surgeon cut and cauterize the blood vessels in one process.

The gas is doing the job. “You can see now how nice and distended the abdomen is,” says Robbins.

Christy Sterling, a supervisor on the Shedd’s otter care team, notices, “She’s got a little more fat in her than Ellie.”

Robbins calls for the room lights to be turned off so he can better see the monitors. “There it is,” he announces. “There’s her ovary.”

He’s probing with the tip of the LigaSure, and when he finds the right spots, cuts connective tissue.

“Amazing,” he says, pointing out that the LigaSure logo is now visible on the operating-room screens — which is why, Robbins says, the company puts it there.

“Next time, we write ‘Shedd’ on it,” he jokes.

The otter gets rolled from one side to the other via the mechanical table she’s on to aid in the organ quest. At one point, the surgeon flips an organ around to “make sure it’s not a kidney,” he says, probably smiling under the surgical mask.

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“Nervous laughter,” says the Shedd’s Aibel.

“Alright,” Robbins says. “Here’s the second ovary.” Luna’s temperature is holding in a normal range, at 100.4 degrees Fahrenheit.

A few more snips and soon, the surgeon pulls the connected reproductive organs out and drops them into a sterile sample container. They’ll be analyzed for disease by a cooperative Illinois zoo pathology program, O’Connor says, and then sent to Michigan State University for study and comparison versus other otter organs.

The large incision was in a better place this time than for Ellie, Robbins says to O’Connor. “Now we know,” he says. “We can put it in out textbook chapter on sea otter laparoscopic surgery.”

The denouement goes quickly: Luna is stitched up with sutures that will eventually dissolve. Her tail twitches again as she is moved back into her travel crate and given a shot that reverses the anesthetic. Within minutes she begins to stir, very groggily.

Robbins peers in at his exceptional patient through the crate’s grated door, talking the kind of baby talk people might to their dogs or cats. “Ohmigod,” the doctor says to Luna. “Did somebody get the license plate of that truck?”

The Shedd team packs Luna back into her van for the ride back to Chicago. By the end of the day, they report, she will be back in the water, eating and otherwise doing well.

Dr. Robbins, meanwhile, steps into the operating room where the golden’s shaved leg is trussed up in the air.

“Back to the routine,” he says.

sajohnson@chicagotribune.com

Twitter @StevenKJohnson

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