120 minutes.
The clock starts ticking Saturday at the Animal Medical Care clinic moments before 9 a.m. On the table is Aialik, a 12-year-old sea otter from the Oregon Coast Aquarium who for 13 months has been unable to urinate without the help of a catheter. On hand are local veterinarians Steven Brown and Dan Lewer, both who work closely with the Oregon Coast Aquarium, and Bernard Seguin , a surgeon at Oregon State University’s Veterinary Teaching Hospital. Together, they will attempt a surgery never performed before on a marine mammal.
Without it, Aialik, orphaned and rescued in Alaska when he was only days old, will face continued urinary tract infections, which could eventually critically impair his health and even lead to his death.
Already, the catheter has been in place far too long.
“Generally we’re trained in veterinary school that ideally you don’t have an urinary catheter longer than 48 to 72 hours, says Brown. There is always the risk of urinary infection. The catheter can become plugged. And the catheter is an irritant.”
But with Aialik a catheter has been the only option. His bladder has gone flaccid and he is unable to control it, leading to a persistent bladder infection. Doctors suspect the problem may have stemmed from a parasite infection — the same infection that killed a sea otter at the aquarium in the late 1990s, says Judy Tuttle, aquarium curator of mammals.
The doctors hope that surgery will free Aialik of the catheter and allow him to function more or less normally. But the operation comes with its own set of risks. The anesthesia could cause his heart to go into fibrillation or his blood pressure to drop — and there is always the unknown, the unexpected that comes with any surgery. The less time under anesthesia, the better the odds.
View full sizeMotoya Nakamura/The OregonianAialik wakes after his surgery. If all turns out the way it’s supposed to, the sea otter won’t need a catheter to urinate anymore.That’s why doctors have given themselves just two hours –120 minutes — to sedate the sea otter, perform an endoscopy of the urethra, take X-rays with dye contrast and, if all goes as planned, perform the surgery.
Sound like a lot of effort for one 87.5 pound sea otter?
Not at all, says Jim Burke, aquarium director of animal husbandry. “We have a great responsibility for taking an animal into captivity,” says Burke. “We need to care for it to the highest possible level. That goes for all animals. We are their caretakers.”
Lewer gives the famously feisty Aialik a sedative to calm him, than covers the critter’s mouth with a cone so he will breathe anesthesia and sleep deeper. Finally, he intubates the sea otter, and hooks him up to an IV. The monitor signals a steady heartbeat. Brown removes the catheter — replaced five times already in the past year — and the team races inside the clinic. It’s 9:20.
Aialik lies limp on the table, oblivious to the work going on around him. A handful of veterinary technicians and aquarium staff stand by as the doctors go to work, performing their tasks without pause. Opera plays on the clinic speakers. From somewhere a dog barks, a cat cries. The endoscopy shows the wear on Aialik’s urethra from the catheters and infection; the x-rays confirm that the procedure they plan — marsupializing the bladder — should work. In layman’s terms, Brown and Seguin will attach Aialik’s bladder to his abdominal wall, then create a hole about the diameter of a pencil in the wall from which urine can leak. The hole should heal to about the size of the tip of a pen. “I’m scrubbing in,” Brown calls.
Lewer and the vet techs wheel Aialik from the X-ray room into surgery while Brown and Seguin don masks and gloves.
At 10:09, surgery begins. Helen Diggs, director of OSU’s Lois Bates Acheson Veterinary Teaching Hospital, joins Tuttle and Burke of the aquarium staff by the surgery room window.
Brown and Seguin work in sync. They cut into the abdominal wall, then bring the bladder up to the wall and create the hole or “stoma” in the bladder. Lastly, they stitch the bladder to the abdominal wall.
“He’s getting light,” reports vet tech Roxie McGrath, who sees Aialik move. He’s coming out of anesthesia.
“Steen,” Brown yells from the room for vet tech Steen Smith. Smith races in and administers more anesthesia. At 10:47, the doctors emerge from surgery and Aialik is wheeled to recovery.
“One hundred and fifteen minutes,” McGrath calls. “Five minutes to spare.”
Moments later, Lewer clears the recovery room. Aialik is awake and already starting to act like his good old sassy self.
“We’re happy as clams,” says Tuttle, as she watches Aialik explore the new space.
At 1:30, the aquarium pickup truck pulls back up to the loading dock at the Animal Medical Care clinic. Aialik is bound for home.
To see more photos of the surgery click here
