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A Strange Discovery and a New Surgical Procedure!

(Written by Dr Ashleigh Tordiffe for PAKO Magazine – Children’s edition)

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During the 2014 & 2015 health examinations on our cheetahs at AfriCat, the vets performed abdominal ultrasonography on all of the cheetahs. This means that they scan each cheetah using an ultrasound scanner, in order to make sure that all of the animal’s internal organs look healthy.

When it was 11-year-old Curly’s turn in July 2014, no one was expecting anything to be abnormal. She seemed perfectly healthy – she was eating well, behaving normally, and in very good condition. So you can imagine everyone’s surprise when Doctor Kirberger, the specialist performing the ultrasound scans, pointed out a strange growth on the screen. It was about the size and shape of a tennis ball . . . and it was right in the middle of Curly’s abdomen!

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It didn’t seem to be part of, or attached to, any other organ – but the scan showed that it had blood flowing into and out of it. It was definitely live tissue of some sort. There was some worry it might be a tumour, but there was no way to be sure without getting it out of Curly’s abdomen, and that would mean surgery!

Fortunately Doctor Hartman, a specialist surgeon, was part of the team during the annual health-check. He offered to use a surgical technique called, laparoscopy to get a closer look at the growth inside Curly.
Laparoscopy is sometimes called 'Keyhole Surgery' because instead of having to make a long cut in order to be able to see the area when operating, the surgeons use special instruments and a camera, which they place inside through tiny cuts (keyholes).

Curly was put under anaesthetic and the procedure began. Doctor Hartman made a tiny incision in Curly’s abdomen and through it he pushed the laparoscope. Some gas was pumped into the abdomen through another small cut. This helped move all the organs inside apart so that the team and on-looking enthusiastic guests and Okonjima guides could see clearly.

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We all watched on a large screen as Doctor Hartman moved the camera around inside Curly’s abdomen. . . . and suddenly there it was – a strange, bumpy, round pink ball of tissue. The mysterious mass.

Doctor Hartman examined the mass and the area around it carefully and decided he could safely remove it without causing any damage to Curly’s organs.

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And so the decision was made to perform a type of surgery never before performed on a cheetah. Using special surgical instruments and working only through the tiny cuts in Curly’s abdomen, Doctor Hartman cleanly wrapped the lump in a special 'extraction bag' and safely removed it from inside Curly.

Once it was out, and while Doctor Hartman was finishing up the operation, the other vets began to examine it. One of the vets carefully cut it open, assisted by Dr Sonja Boy-Steenkamp (forensic dental pathologist) and that’s where things got really interesting.
Right in the middle of it was a 'sickle-bush thorn'[Dichrostachys cinerea]! Curly did not have a tumour. What she had was something called a 'foreign body-induced granuloma'.

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A foreign body is something which is not part of an animal’s or person’s body, but that somehow gets in. Sometimes, when that happens, the animal’s body 'grows' a protective capsule (called a granuloma) around that object, in order to prevent it from causing damage. In Curly’s case the foreign body was a sickle-bush thorn.

Over the past hundred years, commercial farming has probably caused the most damage to Namibia’s natural habitat. Due to over grazing and a lack of natural fires, certain bush species were able to get the upper hand and resulted in the majority of Namibia’s open plains becoming thorny thickets.
Bush encroachment is a problem in the Okonjima Nature Reserve, as it is across most of Namibia, because of damage caused to the land. This has now become the environment where the cheetah, who is a sprinter - has to hunt to survive. The Cheetahs' speed and binocular vision gives them the ability to spot prey from afar before giving chase, which, in perfect conditions gives them an advantage over their competitors. They therefore prefer open plains without the visual and physical obstructions of thick bush/acacias.

We think Curly probably swallowed the thorn whilst eating. Cheetahs don’t chew their food, and so sometimes grass, leaves and sand are swallowed together with their meat. In Curly’s case, we suspect a sickle bush thorn went down too! The thorn then must have poked right through the stomach wall and ended up floating loose in the abdomen, causing enough irritation there that Curly’s body began to build a granuloma around it.

Curly recovered very quickly from her surgery and is still perfectly fit and healthy. She seems completely unaware that she made medical history that day!

This is the first case report of a thorn-induced abdominal foreign body removed with minimally invasive surgery in a wild African carnivore.

STUDY NOW PUBLISHED: Laparoscopic removal of a large abdominal foreign body granuloma using single incision laparoscopic surgery (SILS) and extraction bag in a cheetah (Acinonyx jubatus)

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