Ndakasi: Small, but Strong

This week, Ndakasi was on my list for a follow-up health check. All reports were that the orphaned mountain gorilla had been doing well, taking a full bottle at each feeding and steadily gaining weight. According to Eddy, her primary vet, she'd even begun to resist her daily physical exams — a great sign that she was getting stronger.

It was hard for me to imagine her as a feisty little gorilla. The first time I met her she was very ill and weak. The second time, she was just barely able to take her bottle and needed oxygen around the clock.

I was excited during my drive to Goma and looking forward to seeing Ndakasi feeling well rather than at death's door. We'd set up an intensive-care-style schedule of health checks and Eddy had been sending us the results of her physical exams. But those were reports on paper. Today was my chance to see her recovery for myself and there were a few things I wanted to check carefully.

My main goal was to get a follow-up blood sample. It had been three-and-a-half weeks since we first diagnosed Ndakasi's pneumonia. I'd gotten a tiny amount of blood then and saved it; by taking a second sample now, I'd have what we'd need to run paired titers. This special set of lab tests might ultimately reveal which virus or other microorganism had caused the baby's illness.

She had been anemic last time I visited and I hoped we'd see her red blood cell numbers go up today. I also had concerns about her body weight -- at about nine pounds, she's small for a four-month-old mountain gorilla. She had been drinking full-strength formula for only a week before she became ill, and was underweight even then. It takes a lot of calories for a healthy infant, let alone a sick one, to maintain its body temperature, and her metabolic rate had probably doubled during the illness. This is one baby who can't afford to get sick again any time soon.

The weather made me worry about Ndakasi's hydration. It's very dry in Goma — the town is at a lower altitude than the Virungas —and now it's the dry season. Instead of a wet and misty drive, my trip to the Rwanda/DRC border was dusty. The difference was striking, almost as if I'd gone to a different country. My hair is always a good measure of humidity. Curly in the wet season, it's now almost straight. Instead of slightly frizzy, moderately short hair, I have long straight hair that keeps falling in my face.

Infants lose body fluids as easily as they burn calories. The humidified air produced by the oxygenator machine and the nebulizer definitely helped Ndakasi stay hydrated. But she wouldn't tolerate the treatment anymore. She'd learned quickly how to push the hosing away from her face with her tiny hands, diverting the moist vapor. Now that we'd gotten her through the illness, my sense was that her entire system would be better off in a natural environment. I thought I'd suggest to Eddy that he attempt the homemade eucalyptus leaf humidifier therapy only once in a while.

Lastly, I wanted to be certain that the variable blood oxygen level readings Eddy was recording were due to the baby's movements (the sensor doesn't work well with any type of motion) and not residual problems with her lungs.

Eddy had reported that Ndakasi wouldn't hold still for anything these days. It was taking him as long as 30 minutes just to complete a single "TPR" (temperature, pulse and respiration) without stressing her. When the gorilla was weak, she allowed Eddy to do these brief exams in just a few minutes. He could wrap the pulse oximeter sensor around her thumb and she’d ignore it; now she pulled it right off.

I hardly recognized Ndakasi when I walked into the room. She was bright-eyed and she'd grown noticeably since my last visit. I think Andres (one of her caretakers) could tell I was smiling, though my mask hid most of my face. Like all baby animals, she gazed back at me with an endearing expression.

The calm didn't last long, however. Ndakasi wanted nothing to do with my stethoscope or the oximeter — just as Eddy had reported. When it was time for the blood sample, she let me know exactly how well she was feeling: she squeaked, chirped, struggled and even tried to bite Andres! She was such a strong, moving target that it took me three sticks to get the complete sample.

She recovered quickly once back in Andres' arms, though she may very well remember me next time as the not-very-nice white ape with the needle.

Back in the lab, we found that her anemia had resolved. Now we just needed to get permits from the various governments to send mountain gorilla blood samples out for analysis. That's a whole separate project, but it could add valuable information to what we know about respiratory illnesses in mountain gorillas. At least we can take Ndakasi off the active patient list.

Sadly, I've just learned that there's been a tragic incident in the DRC like the one that orphaned Ndakasi. Wild mountain gorillas have again been shot to death and at least one infant left motherless — Ndakasi now has company.

To be continued. . .

[Rwanda, July 16, 2007. Pictures: Lucy Spelman/MGVP]

Comments

[Sheryl]

I don't think my original comment was successful. If it was then my apologies for the double post.

Thanks for the detailed update, Dr. Spelman. I'm really glad to hear that Ndakasi is doing so well! Hope we'll hear about Ndeze soon. Oh, thanks for the pictures, too.

s.

[Wanda Harris]

I LOVE YOUR COMMENTS AND THE DETAIL IS JUST FASINATING -- WHAT A RELIEF AND I HOPE SHE CONTINUES BECAUSE TO NOW LOSE HER AFTER ALL THAT HAS HAPPENED WILL JUST CRUSH A LOT OF US OUT HERE WHO LOVE THEM AND WANT THEM KEPT SAFE! YOU DO WONDERFUL WITH THEM -- AND NOT JUST THE DOCTORING!!!!

[Lauren]

Hi Dr. Spelman, Thank you for your terrific blog posts. They are terrific and very informative. I was wondering if the two orphaned gorillas have any chance of returning to the wild some day. Is that a possibility? Or is it impossible because of their contact with humans at a young age?
Thank you, Lauren

[Faye]

I love the one picture where she's holding on to her blankie! It's really amazing how similar they are to human beings. I really enjoy reading a doctor's perspective of working with wild animals, especially primates.