January 29, 2013 started as a normal day at the Racine Zoo in Racine, Wis.  Two red kangaroos were scheduled for their routine veterinary exams and keepers were busy preparing.  Suli, a 16-year-old red kangaroo, and Coing, a 13-year-old red kangaroo were in their holding stall so that the Zoo’s consulting veterinarian, Dr. Nelson could anesthetize them for their check-up.  A few minutes later, Suli was sleepy enough for us to start her exam.  During routine exams, Dr. Nelson checks the animals’ eyes, ears and mouth, listens to their lungs and heart and takes a blood sample.  A few years earlier, a routine exam had revealed that Suli has spinal arthritis.  This causes her to be a little unsteady on her feet, though she has shown no signs of pain.  Radiographs were scheduled for that January day in order to assess Suli’s spinal condition. Suli appeared to be in good health, until Dr. Nelson looked inside of her pouch.  What he found was a mass on her mammary glands. This was not a good sign.  A biopsy was taken to determine if it was cancer.  Suli recovered well that day from her exam, but a discussion was necessary in order to figure out what steps we would have to take next.

A few days later, we found out that the test results indicated it was a carcinoma.  Dr. Nelson’s first impressions of the mass were that it was possible it could be removed, though another exam would have to be scheduled so that more preparations could take place.  Dr. Nelson also contacted other kangaroo experts to consult on this unusual case.  The response was not very uplifting.  Many who have seen this type of cancer before noted that the outcome was usually not very good.

At Suli’s next exam, pictures and measurements of the mass were taken.  The mass had grown since her last exam just the week before.  We had two options: try to remove the tumor, which as far as we were aware, had never been done before; or decide that the risks were too high and do nothing.  After some tough conversations, the surgery was scheduled for the next week.

On surgery day, Suli’s keepers were nervous.  We wanted to do all we could to help her, while keeping in mind that we did not want to put her through unnecessary suffering.  Once Suli was anesthetized, things got more complicated for her, and heart wrenching for Zoo staff.  Suli’s mass had continued to grow and was much bigger than the first day it was found.  Surgery and recovery would now be more difficult.  The size of the tumor also meant that we might have to remove most of her pouch.  Keepers, curators and the veterinarian now had to decide how to proceed.   Dr. Nelson laid out our options, which included trying surgery, knowing that at any time we may have to decide the course of action while Suli was on the operating table.  If the surgery proved to be too much, we would have to euthanize her. Alternatively, we could let the cancer take its course and then make the decision to euthanize her at the first sign of discomfort. Our last option was to euthanize her right away, knowing the cancer would eventually take her life.  Her prognosis was grim, regardless of the option we chose.  After much discussion (and fighting back tears), we decided that we would fight for her.

Suli was transferred to the hospital and prepped for surgery.  Dr. Nelson removed the whole mass as well as most of her pouch.  Now we had to decide again how to proceed.  Did we want to put her through the stress of waking up, knowing her prognosis would still be grim?  Recovery from the surgery would be hard.  She would have to stay inside to be monitored and kept on medication.  The tumor was likely to return.  Would not having a pouch cause more issues?  Would her surgery site heal properly?  Were we making her suffer more than we should?  After another tough conversation–one of the hardest many of us have had in our careers–the questions that hovered in my mind were: “What if she pulled through and beat the odds? What if? What if we are taking her away too soon?  What if she is ready to fight and prove us all wrong?”

In the end, none of us could ignore the “what ifs” that lingered in our minds.  Dr. Nelson closed the surgery site, and we began the long recovery process.  The rest of that day, we sat with Suli.  We monitored her vitals and kept her warm while she recovered from surgery.

Zookeepers are often faced with these hard decisions. These animals are under our care and are our responsibility.  They can’t tell us when something is wrong or what hurts.  It is our job to pay attention to the details and be their voice.  We work closely with these animals and form deep connections.  We take pride in giving these animals, who are here to teach others, the best care possible.  We must always have their best interest in mind.  It is rare that a day goes by that we do not think about these animals.  We often spend our free time reading and learning about them.  Many of us spend our vacations traveling to other zoos to learn from other keepers.  We take pride in our jobs, knowing we are playing a part in educating the public about disappearing species. Zookeepers are oftentimes kept up at night, worrying about animals under their care.  I know the night after Suli’s surgery was a rough one for many of us.  I was up early the next morning and rushed to work to check in on her.

We took the following weeks one day at a time.  Suli was eating well and had recovered fully from the surgery.  She had weekly check-ups with the vet.  Those days were often stressful, and I was always a ball of nerves.  We all waited silently as Dr. Nelson checked on the surgery site and waited for an update.  On most days, it was good news.  Things were healing.  As we often said, “things could be worse.”  We didn’t want to get too excited and knew that at any time things could still go downhill.   Suli was on long-acting antibiotics to fight any infections that occur.  She needed one more surgery to help her now-pouchless stomach heal.  If all went well, she would be moved back down to Walkabout Creek.  On her last scheduled exam, we all held our breath.  The surgery site had healed well.  There were no signs of infection or any new lumps.

Three and a half months after first finding the mass, Suli returned to Walkabout Creek.  She would have to recover from her most recent exam before she would be back on exhibit.  On the trip back to Walkabout Creek with Suli, we fought back tears of joy, happy that she would feel the grass on her toes and the sun on her face again.

Thinking back over the last several months, we couldn’t believe how far she had come, and how far we had come.  Removing a kangaroo’s pouch had never been done before, as far as we were aware.  When this kind of cancer was found in other kangaroos, it was normally too late.  Through our great vet, the dedicated aftercare and many big hearts, Suli got a second chance at life.  She proved us all wrong and reminded us that anything is possible.  When released back onto exhibit, she greeted the other kangaroos and spent the rest of the day exploring her exhibit and grazing on fresh grass.  We couldn’t have been happier for her!

Now, one may ask if not having a pouch will be problematic for a kangaroo.  In Suli’s case, it shouldn’t be an issue.  A kangaroo’s pouch is where a joey will spend the first (approximately) 235 days of life.  To have a joey, there needs to be a male kangaroo around.  Since we do not have any male kangaroos at the Racine Zoo, Suli should not need her pouch!

We still may have some difficult decisions ahead of us.  This cancer could return.  The spinal arthritis could get so bad that it adversely affects Suli’s quality of life.  Those are all things we will deal with professionally and with her best interest in mind if and when they come up.  But for now, Suli can be seen enjoying life in Walkabout Creek!

Always have hope!

Guest blogger: Angie Kutchery, Primary Kangaroo Keeper, Racine Zoo