(2019) For more than a year, gorilla Alice, who turned 17 in June, has been coping with a number of medical challenges, including a complex skin picking disorder that has opened large and unsightly wounds in her skin. Similar to a condition in humans known as “excoriation disease” or “dermatillomania,” it can be a difficult condition to treat. And it’s even more complicated to cure in a young gorilla who is still nursing a 20-month-old infant, and whose complex family structure nearly defines the word “co-dependent.”
“This has been the most complicated case I’ve ever had here at Como Zoo because it involves multiple problems that have different needs for treatment, a baby that is impacted by what we do, and a family that has to be involved and accounted for every step of the way,” says Dr. Micky Trent, a large animal veterinarian and associate professor at the University of Minnesota’s College of Veterinary Medicine, which has a long-standing partnership at Como Zoo. “Treating a gorilla is not like taking care of a human. You have to consider the impact of every move you make on the outcome for the entire troop, and that’s made this very complex.”
While the condition has not been cured, Alice’s keepers and veterinarians have decided it’s time to allow the female gorilla and her family troop access to the public habitats of Gorilla Forest.
“Alice’s health concerns have been challenging, not only for her gorilla family, but also for our zoo keepers, and the wider community of gorilla health and behavior experts who are committed to caring for her,” says Como Park Zoo and Conservatory Director Michelle Furrer. “While we’ve been sharing details about the gorilla family with visitors who’ve asked about Alice and her Nyati, we also want the wider public to know about all the diagnostic care and professional collaboration that’s gone into understanding Alice’s condition.
“She may not look very pretty right now, but we’re very pleased with the progress she’s made,” Furrer adds. “The two things that we really want the public to appreciate are that Alice is doing a great job of being a gorilla, and she’s turned out to be a terrific mother.”
Diagnosing A Multifactorial Medical Problem
Como Zoo is home to nine western lowland gorillas, including a six-member family troop that includes Schroeder, the 33-year-old male silverback, Nne, a 31-year-old female, 16-year-old Dara and her daughter Arlene, born in February 2015. The top ranking female in the group is Alice, 17, who was born at the Miami Zoo and moved to Como in 2013 at the recommendation of the Gorilla Species Survival Plan, a conservation panel of gorilla keepers and other professionals that manage the health and well-being of gorillas in 51 zoos across the United States .
Recommended as a breeding partner for Schroeder, a long-time bachelor at Como Zoo, Alice delivered her first baby in 2014, an infant that died within days due to apparent feeding complications. By 2017, Alice was pregnant again, giving birth to a female that Como Zoo visitors voted to name Nyati, a Swahili word for “Unicorn.” This time, the 17-year-old female exhibited strong maternal instincts and successful nursing behavior.
Though the baby’s delivery was not complicated, Alice encountered other medical challenges just before and after delivery. While pregnant, she injured the gastrocnemius muscle located in her right calf, and still favors the leg by walking on the side of her foot. Her skin picking behavior surfaced around this time, and worsened a few months post-partum when she also suffered from a pneumothorax—free air in the chest that interferes with inflation of the lung—which required treatment by aspiration of the air while under anesthesia. During the height of her skin picking problem, Alice had opened or enlarged several large and unsightly wounds on her legs and abdomen.
“One thing that’s important to understand is that skin picking is a normal gorilla behavior,” says Hugh Bailey, lead gorilla keeper at the Woodland Park Zoo in Seattle, and a member of the Gorilla Species Survival Plan called in to consult on the case. “Gorillas can get some nasty wounds from fights, or just from being injured in their environments, and picking wounds helps to keep the injury clean. That’s why, even with really bad wounds, we often don’t treat gorillas with antibiotics because the injuries will heal on their own.”
As Como Zoo visitors may notice this summer, some of Alice’s wounds appear to be scabbed over, while others may be open and bleeding.
“You might ask, ‘Why not put a Band-Aid on her?’ and the answer is she would eat it,” says Dr. Trent. Even topical medications such as sprays and ointments pose a problem, since baby Nyati could put the medicine in her mouth as well. In fact, the close connection between Como’s gorilla mothers and babies has limited many of the treatment options available to veterinarians and keepers.
“We’ve got two babies in that troop, so whatever we do to Alice, we do to the young ones, which has been part of our rationale for the selection of drugs we use,” Trent says. “Every medicine we’ve chosen has had low penetrance into breast milk or low risk to infants if eaten. We want baby Nyati to mature normally, too, we don’t want her to be exposed to anything that would deter her neurologic development.”
To better understand both the causes and potential cures for Alice’s condition, Como Zoo turned to other gorilla keepers and facilities that are part of the Association of Zoos and Aquariums, sharing Alice’s symptoms with members of a gorilla keeper listserv, and providing regular progress reports to the Gorilla Species Survival Plan.
As Trent explains, “The first step with any of these picking disorders is to determine if there a trigger. Our initial approach was to look for anything that might make her skin feel odd.” Tests soon ruled out allergies, skin funguses, and other viruses that could be causing the skin irritation.
The zoo also sought help from psychology and neurology consultants at the University of Minnesota, looking for advice from professionals who had had success treating similar skin picking problems in humans. In May, Como Zoo also invited the Woodland Zoo’s Hugh Bailey , and Dr. Tom Meehan, vice president for veterinary services at Chicago’s Brookfield Zoo and veterinary adviser to the Gorilla SSP to observe the gorilla troop and make recommendations for moving forward.
After spending more than a week in Gorilla Forest’s behind-the-scenes animal care areas observing Alice and her interactions within the troop, Bailey and Meehan concluded that Alice’s skin picking is not due to a social or psychological problem but is instead a manifestation of various physical problems.
“This problem that she has with picking doesn’t interfere with her normal day or her ability to be a gorilla,” says Bailey. “She has a normal activity budget. She moves around fine. She eats well. She forages normally. She interacts with everyone else normally, and she takes care of her infant. None of this has been impacted by her medical condition, and it tells me that it’s not due to depression or anxiety.”
Troop Dynamics and Treatment
Visitors who have heard about Alice’s health problems often ask why the gorilla hasn’t simply been separated from the other members of her troop until she’s healed.
“But that’s just not how gorillas work,” explains Como Zoo senior keeper Allison Jungheim. “Schroeder’s job as the dominant male is to protect his troop of females and if you try and split them up, that causes a lot of stress on everyone, not just for him. If Alice were to be separated, that could also cause negative dynamic issues when you put them back together. The gorilla’s social dynamics have been a large part of our considerations all along.”
The positive bonds observed between Como Zoo’s gorillas have also reassured gorilla behavior experts that staying close to her family troop is the best medicine for Alice. While primates can experience anxiety or depression, or get picked on by higher ranking animals, Bailey says, “We just don’t see any of that with Alice. She’s part of a great group of gorillas that get along very well. They have a silverback who is very mellow and even-handed, he and the other females are great with the kids, and they settle disputes in a normal gorilla way, without a lot of aggression. The best place for Alice to recover is right here.”
In humans, skin picking disorders are usually treated with a combination of medication and behavioral therapy—an approach that’s hard to recreate for a great ape. “In people, the first line of defense is behavioral modification, and coming up with different things that a person can do when they feel the need to pick, like clenching their fists,” says Dr. Trent. Since Alice tends to pick during “down time” when she’s not eating, exploring, or engaged with her baby, keepers have created a daily schedule that includes more frequent enrichment and interaction with the gorillas, in hopes of redirecting her focus during those intervals. She is also being treated with a drug that is labeled as an anti-depressant in humans—in this case, it is being used to break a psychological feedback loop that may be giving Alice positive reinforcement from picking.
After a period of major improvement in April, Alice’s condition has remained fairly constant since May—a trend that her caregivers hope will continue when the troop returns to spending time in Gorilla Forest’s outdoor spaces this summer. “This is a very challenging disorder to overcome and Alice may never be fully cured,” says Dr. Trent. “But we know that UV light and sunshine and activity are good for many skin disorders, so we’re hopeful that she will continue to improve over time.”
“The main thing we want the public to recognize is that although Alice has a condition that doesn’t look good, it is not detracting from her ability to function as a gorilla and to take good care of her baby, and to enjoy food, and to do all the things gorillas do,” says Dr. Trent.