In the spring of 1997, experts from the Cornell University College of Veterinary Medicine drove north on Interstate 81 in a rented moving truck packed with expensive and unwieldy equipment. They were on their way to see a special patient: a 3-month-old Asian elephant named Mali.

Mali was born at the Rosamond Gifford Zoo in Syracuse, New York, with an umbilical hernia, a defect in the abdominal wall where a loop of intestine bulged dangerously. These abnormalities can often close on their own, but Mali’s had not, increasing her risk of death or complication during future pregnancies. With only 40,000 of her species left, ensuring Mali’s survival was imperative.

Surgery was the only option, but it was not without risk. Twenty years ago, general anesthesia and surgical interventions in elephants came with high mortality rates. At the time, only two other cases of surgical hernia repair had been reported for this species – and both had postoperative complications. What Mali needed was anything but routine.

Fortunately, the zoo staff knew elephant expert Dr. George Kollias, then section head of zoological medicine at the veterinary college; he’s now the Jay Hyman Professor Emeritus of Wildlife Medicine. After getting the call for help, Kollias assembled a team: his zoological medicine colleague Dr. Noha Abou-Madi, large animal surgeons Drs. Norm Ducharme and Richard Hackett, and large animal anesthesiologist Dr. Robin Gleed. The group loaded an anesthesia machine, a large-animal surgical table, medicines and supplies into a truck to build a makeshift surgical suite at the zoo.

For nearly an hour, the team worked calmly and meticulously on the surgery. The zoo staff waited.

That high-stakes surgery was a success, and sparked what has become a 23-year relationship between the Rosamond Gifford Zoo and the College of Veterinary Medicine.

This partnership, formalized in a contract drawn up by Kollias and the zoo, provides world-class care for endangered species while giving veterinarians and students access and training on rare species and conditions. It has also enabled Cornell to launch a residency program in zoological medicine, forming a trifecta alongside Cornell’s wildlife health center and exotic pet clinic.

“We were traveling to the zoo one day a week to take care of medical concerns,” Abou-Madi says. “Our visits grew to two, three and now four-plus days a week. We are on call 24/7 and match our visits to their needs; the collection has grown, and we are involved in many aspects of the care of these special animals.”

Full circle

Mali has since grown into a 4-ton, 10-foot-tall adult Asian elephant. She continues to benefit from Cornell’s veterinary expertise, including ultrasound exams during her most recent pregnancy. This is no small task. Two elephant keepers stand at the patient’s head to hand apple slices to Mali’s questing trunk; a keeper holds the tail aside; and a veterinarian assists with the ultrasound machine while another operates the probe. Several other members of the team are nearby should assistance be needed.

The procedure also requires a preparatory enema – and all the accompanying effluent one might imagine.

The ultrasound provided key updates on the status of Mali’s baby, a healthy male calf named Ajay (“Ah-JAI”) born Jan. 15, 2019.

“We were so thrilled to see Mali successfully deliver her third baby,” Abou-Madi says. “It has been a tremendous privilege to have seen our work come full circle – to have had a role in helping Mali when she was young, and now to assist her in producing her own healthy offspring. For these critically endangered species, each healthy baby means so much to the survival of their kind.”

From python tears to lemur fertility

An average day at the zoo exposes the Cornell clinical team to a variety of species and requires multiple skills.

On most days, the zoological medicine service does the daily routine of procedures, rounds and paperwork. That team is led by Abou-Madi, with interns Drs. Michael McEntire and Alyssa Mones and resident Dr. Cynthia Hopf.

On one morning of rounds, McEntire and two fourth-year veterinary students check on the day’s patients. It’s a veritable zoo:

• A silkie chicken requires radiographs and blood samples to help diagnose lethargy;
• A ringed teal – a small duck – has a wing wound that’s on the mend;
• An enormous reticulated python is being treated for a blocked tear duct;
• Basil, a two-toed sloth, is recovering from an abdominal hernia;
• A Humboldt penguin has been sporting a squinty eye and a tender foot; and
• At the elephant barn, they’ll give Romani, a 42-year-old female, a maintenance laser skin treatment to prevent sores on her cheeks.

While the zoological medicine service is there several days a week, many of CVM’s specialty services will travel on an as-needed basis to lend their expertise.

One such specialty is the theriogenology (the study of veterinary reproduction) service, jump-started by Robert Hillman, D.V.M. ’55, renowned professor and large animal theriogenologist. Hillman played an essential role in helping the zoo develop its reproduction programs, while also helping to develop several alternative medicine therapies.

More recently, resident Dr. Lacey Rosenberg and her mentor, theriogenology section chief Soon Hon Cheong, Ph.D. ’12, helped perform the ultrasound on Mali the elephant, and conducted another ultrasound on a very different type of patient – a ruffed female lemur named Fiori. She had not conceived despite living in the same enclosure for more than two years with two males. With only about 10,000 of these lemurs left, Fiori’s lack of pregnancy is a major concern.

Cheong worked with zoo animals before coming to Cornell. He recalls working as a veterinary student at a zoo in his native Malaysia, where a sedated tiger woke up unexpectedly in an exam room. “The first rule of thumb with working with zoo animals? Don’t forget where the exits are,” he says.

Fortunately, Fiori was slightly less intimidating than a tiger. Anesthetized on the exam table in a jumble of black and white fur, she received a thorough checkup. The team examined old health issues, such as a nodule in her mouth, and administered vaccines. Cheong and Rosenberg then did the ultrasound and took radiographs; everything appeared normal.

To date, Fiori has still not gotten pregnant.

“Our next plan is to investigate the reproductive status of the males partnered with her,” Abou-Madi says. “We think they may have some fertility issues.”

In the near future, the Cornell team will be able to do even more for their patients of all sizes. The zoo has plans for a new $6 million to $7 million medical treatment and quarantine facility that will accommodate animals of many shapes and sizes.

A symbiotic partnership

While the animals benefit from the college’s care and knowledge, the Cornellians are just as lucky. Veterinary students get invaluable hands-on experience.

“If it’s a situation that’s appropriate to have students participate in, we will involve them in every single step,” Abou-Madi says. “This can involve outlining treatment plans, running diagnostics, helping with procedures and beyond. Not many other vet schools provide this kind of hands-on exposure at a zoo.”

Zachary Dvornicky-Raymond ’15, DVM ’19, says he relished the hands-on rotation as a fourth-year student. “I knew I wanted to work with wildlife even before I wanted to be a veterinarian,” he says. During his rotation, Dvornicky-Raymond learned how to handle, diagnose and treat zoo animals. He supplemented this experience through the college’s extracurricular programs such as Expanding Horizons and trips to the Belize Zoo to study with Kollias, who initiated a partnership between the college and the Belize Zoo in 2011.

The Rosamond Gifford Zoo partnership also advances Cornell research. The zoo animals provide veterinarians with ongoing access to physiological and behavioral data that they use in baseline studies to build up general understanding of exotic and endangered species.

“[A] lack of information can sometimes make diagnosing ailments in some of these animals very challenging,” Abou-Madi says. “So any knowledge we gather from our zoo patients, we share with our colleagues across the entire zoo community, and it creates a snowball effect of information that gets better all the time.”

For example, Abou-Madi’s data gathered from the zoo’s elephant herd have been crucial in developing a technique to collect cells from elephant umbilical cords to study elephant endotheliotropic herpes, a form of herpesvirus that is highly fatal in young Asian elephants. This technique has now been used in labs around the world.

Far-reaching impact

Among the partnership’s major contributions, Abou-Madi says, are Cornell graduates now working in the field of zoological and conservation medicine. They’ve gone on to work at zoos in Cleveland and Atlanta, and at Zoo New England, among others; graduates also teach zoo veterinary medicine at institutions such as the University of California, Davis.

Susan Bartlett, D.V.M. ’03, is an associate veterinarian at the Wildlife Conservation Society, the umbrella organization that comprises the Bronx Zoo, Queens Zoo, Prospect Park Zoo, Central Park Zoo and the New York Aquarium.

As a veterinary student, Bartlett was especially keen to work with Asian elephants. Abou-Madi and Kollias gave her a unique research project: to establish normal electrocardiogram (ECG) values in Asian elephants. “The staff of the Rosamond Gifford Zoo was very supportive of the work, allowing me to develop a novel ECG clip,” Bartlett says.

When she returned to Cornell for a three-year zoological medicine residency, she completed the project, obtaining ECGs on Rosamond Gifford Zoo elephants as well as others, and published the results. She stayed on another year, when Kollias went on sabbatical, to help cover his clinical and teaching responsibilities.

“Not every veterinary school has courses in zoological medicine, let alone offers the ability to actually rotate through a zoo as a veterinary student – it’s quite special,” Bartlett says. “Coming back as a resident and then joining for a year as a faculty member was so rewarding and made me the vet I am today. I will be eternally grateful.”

At the end of a day at the zoo, Cornell students and veterinarians are tired, stained and smelly – and face a 56-mile drive back to Ithaca. Yet they’ll go home with valuable new experience – just as Abou-Madi did more than two decades ago when she and her colleagues helped with the surgery of Mali the elephant.

“Ever since I was a child, I have been yearning to learn about nature and wild animals, and how to protect them,” Abou-Madi says. “The zoo allows me and so many others to actively make a difference in that very way.”

A version of this article originally appeared in the spring 2019 issue of ’Scopes magazine.

Lauren Cahoon Roberts is assistant director of communications at the College of Veterinary Medicine.