Hey Sal how are you?
Hey Chris how you going?
Good to see you.
"Yeah, it's great to have you back here."
You got a tiger with a toothache?
Yes, we’ve got a tiger with a toothache.
"She's knocked the top off her tooth.
" Big tooth, big ache?
Big tooth, big ache.
"She's got three cubs still with her."
"I mean, the babies are actually bigger than mum now."
"One of the keepers noticed that when they fed her"
"that she was a little bit tentative and wasn't too keen to eat."
"So they did some investigating and yep."
"Sure enough, she'd cheered her tooth off."
"- Here she is down here.
- Alright."
"- Thats her there?
- This is her here."
Hey Soraya.
"I think any problem with a Sumatran Tiger is a big problem."
"But when you've got a problem with one of their biggest teeth,"
it becomes quite a challenge.
Soraya, Soraya.
Come bubba.
Okay.
Yes, you can't have anything to eat.
"She is going to be knocked down today,"
"so I can't actually give her anything to eat."
"So the others are all saying, feed me, feed me.
Hello bubbas."
Good bubbas.
Aren’t they beautiful babies?
"So she just hasn't been comfortable with the food."
"She has not been comfortable with the food no."
"And also, if you don't fix it, then the problem's"
only going to get worse.
So it does need to be fixed.
And it needs to be fixed now.
Soraya, there you can see the tooth now?
There see?
The whole thing’s sheered off.
"You see that?
Yep."
When you look inside Soraya’s mouth you can see that problem
straight away.
The top one third of her big canine tooth, a big fang
has just cracked right away.
"And that's exposed the darker bit in the middle, which is the nerve."
"That's an exposed nerve sitting right there."
That's painful.
"She's going to be a real challenge to anaesthetise."
"Well, we never do it in the exhibit."
"We always put them into the night house."
So you’ll just go in, one dart "and then we pop out
and we leave her to settle down" Because it is stressful for them.
It isn't an easy procedure.
I do dog and cat dentals but this one’s on another level I think.
Yeah, yeah.
"So I don't think she's going to go into the dentist chair willingly,"
"- but we'll give it a go.
- We'll give it a go."
Okay then, let's go up and give it a go.
"The problem with Soraya's tooth is that when it's cracked through,"
"it's exposed the pulp of the tooth but also the nerve."
So any time anything touches that tooth it’d be excruciating
for Soraya.
So what she needs is two words "that send a shiver
down anyone’s spine, a root canal."
When the animal goes down.
"The first two people and the only two people in"
until we're happy is Sam and myself.
"Just until we're sure that you know, she's nice and deep."
"Then if Chris can come through, Chris and Chorki together,"
"Chorki will be responsible for the cargo net."
"And you're responsible for the manacles."
"We always find we plan for the worst."
"Trying to get a Sumatran tiger anaesthetised,"
"trying to operate on that tooth in a very kind and humane way that"
"really causes as little pain as possible."
"All the while remembering that we don't want any pain inflicted upon us"
if she wakes up, this is hard.
So I've worked out in advance that based on her estimated bodyweight
the amount off Medetomedine we need which is 0.3 of a mill.
"So we're using the ten milligrams per mil, which is the ten times"
concentration.
"So you don't want to prick yourself with that."
And then ketamine, we're using "it's special powder
that they make up" "so we can double
the concentration as well just" "so we've got the right volume
to go into the dart."
So that's going to be 1.5 mil.
Alright great, "and then both of those
just need to be injected" into the top of the dart there.
You just can't underestimate how important getting these dosages right...
Is because "this is essentially
what is going to bring down" Soraya and keep all of us safe and...
"And really start off this whole procedure."
So...It's pretty crucial.
So this is just all of the emergency equipment in here.
"So if anything goes wrong up there, more anaesthetic,"
adrenaline, atropine All that sort of stuff, ET tubes and Anbu
bag.
So if we needed to start breathing for her suddenly.
Today always sounded like it was going to be a big day.
But now you see this stuff here, you see Nadine here
"with all her gear.
Yeah it’s starting to get very real."
"- All done?
- Yes, ready to go."
We’ll see you in a second Nadine.
Righto, see you guys soon.
With Tiger.
"The hope now is with Soraya in the night den"
"we just give her some time just to settle down, relax."
"Then we should be able to get a good shot with the dart gun."
This is just charging the dart.
"Normally, just check that that is fully pressurized."
"With this very technical piece of wire."
"The scariest part of today is, it's the whole thing."
"Because at any stage, Soraya can wake up."
And if she does that, "we're that far away from the very,
very pointy part of Soraya."
"So that anaesthetic needs to be right."
It needs to be deep enough.
"And we need to make sure "
that she, basically becomes pain free again.
A lot of challenges along the way.
I don’t know you’ve got to be nervous.
Yeah.
It’s alright Soraya, good girl.
Just looks really agitated.
"She's really pacing back and forth and doing figure eights."
"They’re going to find it really hard to get a dart into her like this."
"Sam’s going to aim for the top of her thigh, just in that back leg there."
But she flashes it then she turns away, so she's just not going
to get a clean shot.
Chorki can you go in the other side?
Just try and distract her.
"- Just pacing there is it the problem?
- Yeah."
I need her to be at right angles to the gun obviously.
She obviously knows whats about to happen?
Yes.
Sensing it.
Go out straight away, yep so she's pretty stressed.
Yeah.
It's one of the harder darties that I’ve done.
That was very hard.
"I mean, she was pacing back and forth"
"and when it hit it, she really jumped up"
"knowing that something had hit her didn't really know what it was, but"
it’s in.
We know the darts actually hit her.
It's gone in, it's injected the anaesthetic.
"We now just stand back and just make sure she goes down,"
"but also that she goes down "
deep enough that we can get in there.
She's nice and calm now.
I think she's starting to be affected which is good.
And she’s dropped, she’s down now.
It's obviously very critical "that when you go in there,
you know that she is asleep."
"Because if she’s not, she’s going to give you...
" A fair surprise.
You got a stick or something?
So they’re most sensitive, as you would know around the nose and their
ears and their eyes.
"So I’m just checking that she's got absolutely no reaction there."
So she's very slightly light.
We'll give her another minute or two.
"She's just got a slight twitch there."
Tigers are like people in one way.
"They don't go to the dentist willingly."
"So we have to bring the dentist to Soraya."
And that's what we've done today.
"A whole lot of equipment, a whole of expertise and hopefully"
we'll get the result.
I’ll get a towel for you.
Yep alright, let’s go.
"Sally and all the team here really know their animals."
"And when they see that something's not quite right,"
"there just not being themselves.
They're onto it."
"And that has really saved Soraya from what could have been"
a really serious problem here.
At the moment it's an issue,
"but it could have been a really life threatening issue."
We've not knocked her out here "before,
so haven't intubated her before."
"Most adult tigers will take a size 16,"
"but I have a 14 here just in case because she's quite small."
Do you want a light source?
Yep, well done.
That's a good fit.
She's not going to need much air.
Do you want to try that end?
So she's tubed now.
We're just now running some oxygen and anaesthetic gas into her.
"In that process, she does lighten up a little bit."
So we now need to flood the system with anaesthetic gas again.
Get it deep, and then we can start.
"A cracked tooth is always a problem."
But when it's attached "to a Sumatran tiger,
then what you're facing here" is a pretty major challenge.
"So we've assembled a specialist team,"
"including Nadine from SASH, who will be able to handle"
"what is essentially a root canal on a tiger."
Not easy.
"- 66 pulse rate.
- Great."
I'm just going to wait "till these guys have her
nice and deep" "and then we'll take a look at her
mouth."
"You don't want to get in there too soon."
So just putting some "lubricating ointment in her eyes
so that her corneas don't dry out."
"It's going to be quite a long procedure."
"So she's got a crown fracture and it's complicated,"
"which means that the pulp is exposed."
So that's very, very painful.
"I think this is a tooth that's very much amenable to a root canal."
"The interesting thing is that what you're seeing here, the crown."
"So just this crown is only about 40% of the whole tooth."
"The vast majority of the tooth is embedded in that jaw."
"So it's a pretty big deal with these guys."
What's going on under "the gum is just as important
as what's above it."
We've just been getting half "glimpses up until now,
but now we can actually see" the full extent of the fracture.
"And that’d be an extremely painful thing to go through"
and to try to live with.
So it's a very good thing for Sorayah that she’s in here today.
Let's see what we can see here.
See what that gives us.
"Between all the anesthetic gear, the darting"
"and then the little X-ray unit which can take these instant shots"
of Soraya's tooth "to really give us a good idea
about how deep this fracture" "is, whether there's any infection
involved."
"This sort of stuff hopefully will mean all the difference for Soraya."
"So this is the root of the canine itself."
This area here is all jaw.
"And if you can make out this black area right here,"
"that's actually infection and inflammation in the jaw itself."
We just want to make sure "that the area we're working in
is as clean as possible."
Cool.
Let the fun begin.
"What we'll be doing is going inside the tooth itself with some files"
"and basically scraping the inside out, getting all that nasty muck,"
the infection all out of there.
"Once that's all clean and done, what we'll do"
is we'll fill it up with a material "that is like a plastic and doesn't
really support bacterial life."
"So it doesn't allow an infection to really set up in there."
"Once all that's done, we seal it off and off she goes"
"and hopefully she won’t have an infection in her jaw anymore."
"This is lubricating agent and that just allows us"
"to get right in there and just open up the canal"
a bit.
"What we need to do now is hopefully find out"
"just how long Soraya’s tooth actually is."
Okay.
So this is a time when we need to take another X-ray.
Sweet.
Pretty loose yeah.
I wonder if we might try her down on two and quarter.
I think she's relatively stable.
"She's just giving me a little bit of grief in her breathing."
"She's breathing a bit more rapidly than lions and tigers"
"normally do and a little bit more erratically than I would like."
"So yeah, I'm just counting down the minutes."
I want her back on the stretcher and back in her den as soon as possible.
So I'm hurrying Nadine along a little bit.
"Her canal is a spectacular seven centimeters."
"- Wow.
- That’s huge!"
That means there’s that much tooth sitting beneath.
Yep that's exactly right, crazy stuff.
"Oh, so you can see all this black muck that's coming out."
"That's all the infected unhappy tissue inside the canal."
You can see that "really the damage
you see on the surface is nothing" compared to what's actually brewing underneath.
And what brewing is quite a serious infection.
"So Sorayas has been very lucky that Chalk has picked up"
this problem "early, got in there, and hopefully
" this will really be just the ticket for her.
"So what we're doing is we're actually also using bleach"
to clean out the canal.
Yeah a lot more black muck still coming out so we sort of
"have to keep on going until we're getting nice, clean, tooth."
We're making pretty good progress here we’ve almost
managed to clean out this canal here.
And once that's been done, Nadine’s happy that it’s
"sterilized and totally clean of any debris or any infection,"
then we can start to fill it.
The problem "with these is that they don't
manufacture them for tigers."
"They barely manufacture them for dogs."
"So we're going to have to get a little bit creative"
"because we do need to get this little guy all the way down"
And roll two of them together and now we’ve got an uber long one.
"- That’s amazing.
- Yeah."
Need it to get into about here.
Awesome.
So now we’ve cleaned out that canal.
The purpose of this "mixture here is to push in there
and just like putty" to fill in that gap.
"And that really gives the tooth strength"
"but also prevents any infection from occurring from here."
"Once this is done, we seal it off and hopefully we're done."
"So this is the little cone that we have pre-measured."
"What we want to do is just coat it really nicely.
Insert" that in there.
"It's actually what's used in the center of golf balls,"
interestingly enough.
She might be able to bounce a bit.
You’re just really packing that in.
Packing it as much as possible in there.
This should be a one off procedure.
"We don't have to come back and put Soraya through this again."
"So no stone has been left unturned here."
Just everything has to be right.
"So we're preparing for the cavity now just for filling really."
"We do the filling in a couple of layers"
"and it really is to increase the strength of the filling."
"That's as close to natural tooth as possible"
"and can withstand the pressures that a tooth can take.
" Alright you can go ahead.
"It’s now the last stage of the whole procedure,"
so once we're done here, her anaesthetic goes right up.
Get her as deep as possible.
"Take her back to the enclosure and let her wake up."
So can we start moving?
Alright.
Would you like to turn her up to five?
If you want to take all of this stuff off.
So we're just going to roll her towards us as we started.
Everyone's ready?
The nerve racking time is, "if she in the process of waking
up" start’s to swallow her tongue, then...
"You can't go in there and move her because"
"she's awake enough to do something about you."
"So I just normally stay here and watch her breathing."
And as soon as she starts to "move her tongue and lift her head
than we would normally go."
"So she's not stimulated, but of course"
"a bit of a catch 22 if she started to obstruct now."
This is I guess the third...
Riskiest bit.
Soraya?
"Even after we've done so much, you just can't celebrate"
"until she's totally awake sitting up"
"and looking alive because things can still go wrong right now."
Hey?
Yeah?
Me.
I know.
It's alright.
It’s okay girl, it’s alright.
It’s weird huh?
It’s alright.
That's always a worry, you know like?
"It's just like your children or your parents"
"or someone you know going to hospital"
"and having to have an anesthetic, you know?"
Oh there we go.
Looking good team, well done, "- everybody
- Fantastic, thanks very much."
Thank you, good to have you involved.
And well done you huh?
You did very well.
Thank you.
"- Thank you so much.
- It’s a pleasure any time."
And with that, it's over.
It's a massive relief to everyone "in that whole group
because everyone had their job."
"Everyone did their job and we've got the result."
"Soraya will be so much happier with that tooth all fixed up."
And thank you Sam.
"She's still a little bit woozy, I imagine"
when the local anaesthetic wears "off, it
might be slightly uncomfortable," "but she's had a good dose of pain
relief."
"She had an anti-inflammatory injection while she was under."
"So hopefully she'll be feeling really good"
"and by tomorrow, eating normally and all the rest."
Oh, and Soraya, big hugs to Soraya.
"I'm not sure who will make the quickest recovery."
Soraya goes or Sal.
They’re her babies, "and because they're her babies,
they get the best of care."
"And hopefully today, that's what we delivered."