A 21-year-old male orangutan was acquired with a history of pneumonia at 16 months, airsacculitis at 6 years, and stereotypic behaviors. He was treated with marsupialization of the airsac at 7 years, followed by airsac ostia closure, intermittent antibiotics, nebulization, and bronchodilators.2-4 Quarantine examination revealed nasal and airsac discharge, chronic cough, persistent bronchopneumonia, bronchiectasis, and pulmonary bullae. He was considered stable and continued bronchodilator therapy.
One year later he became lethargic, anorexic, and depressed. Examination showed progressive pneumonia and airsacculitis. He was stabilized with antibiotics and airsac removal performed one month later.1 Surgery took 6 hours due to extensiveness of the airsac which extended over the chest wall, pectoralis major, into axillae, and invagination around the clavicles. The airsac ostia were 1 cm diameter, with fat and muscle layers that were oversewn twice. The cavity was infused with tetracycline and lidocaine to sclerose the dead-space. The wound was closed without skin resection. A small opening was left to allow serosal drainage and residual air venting. He was managed postoperatively with opiates, antibiotics, and an antidepressant (Remeron®) for stereotypic behavior, depression, and anorexia. He was considered medically stable 9 months later and epithelialization of the surgical site had occurred.
His bedroom was fitted with a negative pressure air purification system (IQAIR®). He has been managed 5 years postoperatively with periodic exams and antibiotics when necessary. His medical behaviors now include nebulization, IM injections and IV blood draw. His stereotypic behaviors resolved, antidepressants were discontinued and he has sired an offspring.
1. Herrin KA, Spelman LH, Wack R. Surgical air sac resection as a treatment for chronic air sacculitis in great apes. In: Proceedings of the American Association of Zoo Veterinarians. 2002:369–371.
2. Lawson B, Garriga R, Galdikas BMF. Airsacculitis in fourteen juvenile southern bornean orangutans (Pongo pygmaeus wurmbii). J Med Primatol. 2006;35:149–154.
3. McManamon R, Swenson RB, Lowenstine LJ. Update on diagnostic and therapeutic approaches to airsacculitis in orangutans. In: Proceedings of the American Association of Zoo Veterinarians. 1994:219–220.
4. Wells KS, Sargent EL, Andrews ME, Anderson DE. Medical Management of the Orangutan. New Orleans, LA: Audubon Institute; 1990:81–86.