Nora the polar bear has led a rather dramatic life for a four year old, and 2019 was the most eventful chapter yet. Born at the Columbus Zoo and Aquarium in 2015, she was abandoned by her mother when she was just six days old. Nora started out by beating the odds – despite the dedicated work of keepers, hand-raised polar bear cubs have only a 50% survival rate. But she thrived, and her story attracted fans all over the world who fell in love with the little bear through videos showing her being bottle-fed, learning to walk, and growing up.
Supporters followed Nora's story as she was moved to the Oregon Zoo in 2016. Sadly, her intended companion there, an older bear named Tasul, died shortly after she arrived, so Nora had to pack up and move again. In September 2017 she arrived at her new home at Hogle Zoo in Utah, where she would live with a young bear with the promising name of Hope.
All was going well until January 24 of last year, when keepers noticed that the rambunctious young Nora was not moving around normally. It turned out that she'd broken the humerus in her right front leg – the long bone between the shoulder and the elbow.
This was an injury that has rarely been treated in a polar bear, so the zoo was going to need to break new ground. This is fairly typical of zoo medicine, where vets have to deal with so many different species. "I'm always doing things I've never done before," says Erika Crook, Associate Veterinarian at Hogle Zoo. "We're going into uncharted territory on so many cases, but luckily we have great colleagues who'll say, 'I haven't done it on a polar bear but one time I did it on a lion.'"
Dr. Jeffrey Watkins hadn't actually done it on a lion, but he was an expert in treating similar injuries in horses. Watkins, professor of large animal surgery at Texas A&M University College of Veterinary Medicine & Biomedical Sciences, had developed a device called an intramedullary interlocking nail that can be inserted into the bone to stabilize it. He agreed to help.
"There were many unknowns," he says. "Almost all of my experience with this bone and this fracture was in foals. But that's part of being a veterinarian - it's not always completely worked out."
Watkins would supply the nail, but additional specialized equipment would be needed. He arranged for donations of a surgical drill and a set of steel plates and screws from DePuy Synthes, and sutures and a topical skin adhesive made by Ethicon, both part of Johnson & Johnson Medical Devices Companies.
Watkins and a team of experts assembled at the zoo on February 4th. He found that the surgery was unlike working on a horse in a number of ways, starting with just the sheer size of the leg and how much longer it took to remove the hair at the incision site. "Some potential challenges that I anticipated did turn out to be challenges," he says. "At every step of the way we had to adapt." But adapt they did, and the six-hour operation was deemed a success.
Surgery was just the first step: next came rehab. At first, Nora was confined to a small safe space, but she had to gradually get moving, so the expertise of her keepers was essential. They trained her to do various movements, much like a physical therapist teaches a human patient exercises to help them regain function after an injury. One involved reaching into a special metal box attached to the bars of an enclosure. "This would force her to reach out and grasp with her paws," says Crook. "We would put a 2x4 underneath that her paw could rest on and she would flex and extend her toes." To Nora, this all just seemed like good fun, because as a reward for an exercise, she'd get a favorite treat.
She was given more challenging exercises and more freedom to move around little by little, because it was important that she not do anything to reinjure the leg. Fortunately, the usually boisterous bear seemed sensible about protecting it. Coming down from a stand, for example, she was careful to make use of the uninjured leg. "She never really limped, but when there was a chance to avoid putting 500 pounds of weight on that leg, she would always put the left one down first," says Crook.
The team had originally guessed that rehab might take four months, but x-rays taken in June showed that the bones needed more time to heal. When Dr. Watkins returned for another follow-up in October, the exam showed that she was finally ready to go. "She has a full range of motion in the shoulder joint and the elbow joint," says Watkins. "Her muscle development seems to be normal, which is a good indication that she's comfortable using the leg like her other leg." You can still see where the break was on the x-ray, but Watkins is pleased with the progress of healing. "I think she's going to have a fully functional healed limb long term and be able to make a full recovery."
So the next big step came on December 1st: reuniting Nora with her companion Hope. Introducing two animals to each other is never routine - if you've ever been nervous about bringing a second cat home, imagine how you'd feel if it were two large carnivores that weigh hundreds of pounds. Although they had been physically separated, Nora and Hope could smell and hear and sometimes see each other the whole time, which was expected to make the reintroduction easier. Still, the team had to be on high alert. But it turned out to be no big deal to the bears.
"The keepers just opened the doors to everywhere - the exhibit, the pool, the back areas," says Crook. Then they stood aside and watched. Nora and Hope greeted in a typical way for polar bears, opening their mouths at each other, sort of like a couple of dogs playing bitey-face. "It's a little display that they do," she says. Greetings over, they went about their business, and their relationship seems to be back to normal.
Crook attributes part of their success to having patience in giving Nora the time to heal – though it took longer than initially expected, there was no pressure to rush the process.
"We wanted to make sure we could reunite her with a bear that weighs a hundred pounds more and is more dominant, and she could hold her own," says Crook, "and she totally is."
Human teamwork was also crucial, from the mobilization to get people and equipment in place for surgery, to the ability to text photos and videos as Nora recovered.
"We were in constant communication," says Crook. "I think that made us all felt like we were in it together and like we had these experts guiding our decisions."
Watkins says, "I learned a lot about the logistics of getting things done and the importance of having partnerships with folks like J&J. None of this would have happened if we hadn't had these partnerships and working relationships to work as a team."
What's been learned from Nora's surgery will help other animals in the future.
"Every time you do surgery you learn something new," says Watkins. "When you try to extrapolate from horse to a bear, clearly you're going to learn a lot about bear anatomy and some of the challenges you face. This is certainly outside of our day to day practice, but we've learned that we can help them and I'd go into with a little less trepidation next time."
To Nora, though, it seems like it was just another chapter in a story where she's used to being the star. When Watkins was visiting, he and Crook did a video interview standing in front of the polar bear enclosure.
"Nora was sitting right behind us at the window, like we were having a three-way conversation - like, ' I need to hear what my doctor is saying about me,'" Crook says. "And as soon as we shook hands and said thank you for the camera, she just swam off."