Inside lifesaving operation to cease uncommon Brown bear getting seizures

In a shipping container near Canterbury, I’m watching as Boki the bear is being given a savage haircut. Fur is flying as the surgical team shaves him before a pioneering – and lifesaving – procedure.

This is Boki’s last chance. Unless the surgery is successful, the European brown bear is unlikely to recover after going into ‘torpor’ – a hibernation-like state – this winter.

Seven months ago, he began having seizures caused by excess fluid on the brain (hydrocephalus). When drugs failed to treat the condition, staff at Kent’s Wildwood Trust animal park knew there was only one person who could help their beloved two-year-old bear.

Perhaps the world’s premier wildlife vet, Romain Pizzi has travelled to 50 countries over a quarter of a century to operate on every type of creature from African elephants to Polynesian snails. If there’s a hippo with a toothache or an orangutan with a tumor, Romain is your man.

He’s also the only person to have performed the keyhole surgery that Boki so desperately needs.

Should he make it to adulthood, Boki will be a vast and powerful beast – brown bears can weigh over half a ton with jaws that can crush a human skull with ease.

But right now, he’s still a 20-stone juvenile. And it’s hard not to feel sympathy (mixed, admittedly, with a little fear) towards Boki as he lies five feet away from me with a breathing tube between his fangs.

Vet Elliot Simpson-Brown is in charge of monitoring the bear during the operation and making sure he remains unconscious for his own safety – and ours.

Fortunately Boki is, say those who know him, gentle and good-humoured and even, according to Wildwood Trust director of zoo operations Mark Habben, ‘an extremely engaging bear’. All the more touching given what he’s been through.

Because poor Boki just can’t seem to catch a break. His parents had been forced to work in a Spanish circus before they were rescued. In the wild, brown bear cubs can stay with their mothers for several years, but Boki was aggressively rejected by his mum at birth and removed from her for his own safety.

Why exactly, is unclear, but Mark has a theory: ‘The bears might have detected his illness,’ he tells me. ‘Animals can sometimes sense these things, and they don’t want to “catch” a disease.’

In December 2022 when he was around 10 months old, Boki was adopted from Port Lympne safari park in Kent where he had been hand-reared and transported to Wildwood.

He was quick to make it his home, climbing trees and entertaining the visitors who come to see the exotic and wonderful creatures here, including wolves, reindeers, bison, lynxes, various types of snakes and arctic foxes.

He was put into an enclosure with Fluff and Scruff, both in their 20s, who had suffered appalling neglect before being rescued from a bear-hunting facility in Bulgaria in 2014. They took to Boki immediately and treated him like a little brother.

Then fate took a cruel turn.

There had been no signs at first that there was anything wrong with Boki, says Mark. But earlier this year, he started having seizures that impacted his vision. Then one day he collapsed.

He was initially prescribed steroids, as it was believed he might have an infection. And that helped. The youngster stopped shaking, and his vision and mobility improved.

When the seizures returned, Boki was referred to TV vet Professor Noel Fitzpatrick’s practice in July, where he became the first bear in Britain to have an MRI scan.

The scan painted a bleak picture. Excess cerebrospinal fluid was building up in Boki’s skull, causing more and more pressure and severe damage to his brain. The condition, very rare in animals, is like having the most excruciating migraine you can imagine – all the time.

‘Our primary thought was about his ongoing welfare,’ says Mark. ‘How do we manage his condition? What can we do?’

There was even talk of having poor Boki euthanised. That’s when Wildwood Trust called upon the services of Romain Pizzi.

Growing up in Port Elizabeth in South Africa, Romain was surrounded by wild creatures. After studying at the University of Pretoria veterinary college, he came to the UK to undertake a Masters at London Zoo.

Romain specialises in laparoscopic, or keyhole, surgery, which is commonplace in humans but, until recently, rare in veterinary medicine.

A slight, bespectacled man, who now lives in Scotland with his wife and two young children, Romain is so softly spoken you have to lean in to hear him. And yet he holds the attention of everyone present, like a rockstar – minus the ego.

When Romain treats endangered or threatened species, he does so with an awareness of what its death might mean. He keeps a photograph of himself with the last living specimen of Partula Faba, or Captain Cook’s bean snail, named because it was first discovered on Cook’s expedition in 1791.

When it died in 2016 at Edinburgh Zoo where he is based, the species was extinct, in spite of conservation efforts.

During his career, Romain has repaired a Siberian musk deer’s broken leg, fixed a chimpanzee’s hernia in West Africa, extracted bladder stones from Greek tortoises, and amputated a Costa Rican zebra tarantula’s leg (in order that it could grow a new one).

There have been some highly unusual cases. Romain once even treated an Ostrich with a paralysed phallus.

‘I don’t know how that happened, maybe he got kicked by one of the females or did it jumping over a fence. But it had to be amputated! It was starting to get infected.’

He will soon be heading off to do clinical work with chimpanzees in Liberia and then on to rescued lions in Ethiopia.

‘There are things that can go wrong,’ Romain tells me. ‘The anaesthesia might go wrong. There could be a bleed in Boki’s brain. He’s been on a high dose of medication, which might have suppressed his immunity. The brain is really complicated. There are all sorts of microscopic things going on.’

But if anyone can succeed then Romain can. In February 2013, he performed the first (and thus far only) such brain surgery on Champa, a three-year-old Asiatic black bear.

Champa, who was rescued as a cub by charity Free the Bears and brought to a sanctuary in the mountains of Laos, also suffered hydrocephalus, though the condition was more advanced. The crippling pressure had deformed her skull and made her almost blind.

In another country, the recommendation would have been to euthanise her. But because of its Buddhist tradition, Laos forbids this.

And after six hours of keyhole surgery, Champa was able to enjoy a greatly improved quality of life until her death in 2019.

In the shipping container next to Boki’s enclosure, the team carefully lifts his 127kg body onto a makeshift operating table. They have done ‘dry runs’ with the anaesthesia to make sure it would go smoothly, though Boki’s paws are cuffed just in case…

Naturally Boki had to skip dinner last night so that he wouldn’t regurgitate food during the operation. But when he woke up this morning a little grumpy, the staff relented and gave him a tiny bit of honey-infused water.

The surgery involves drilling a small hole in Boki’s skull, making tiny incisions in his belly, puffing it up with air and inserting a tiny camera. Then Romain will position the 2mm thick silicon tube that will drain the cerebral fluid into Boki’s abdomen, where it is absorbed harmlessly.

It’s a procedure that was expected to start at 9am and last around three hours, but that doesn’t take into account how long it takes to shave Boki from his head to abdomen – nearly an hour. Lying there, bare flesh on display, he looks almost human.

Because of the bear’s very thick skull it takes another hour as the whirr of Romain’s drill makes a tiny hole. After that, he inserts the thin ‘shunt’, or tube, through the brain into a space called the ventricle.

From now on, when there’s an excess flare-up of pressure inside Boki’s brain, it will open a valve, releasing the fluid into his abdomen where it is absorbed harmlessly. Romain thinks there’s currently an extra 2 teaspoons CHK of fluid in there. It might not sound a lot for such a huge animal, but it causes agony.

Just before 6pm, the last few minor stitches are made and nearly six hours after it began, the operation is over and declared a roaring success. Boki can be moved to his den to recover.

‘I feel bad, it was tiring for everyone,’ Romain apologises gallantly, after removing his surgical gear. ‘I’m so sorry your day has been so long.’

Forget my day, I’m not the one who has been performing brain surgery! Romain is happy with the outcome: ‘Everything went beautifully. He didn’t have any major bleeds, though it was difficult to place the shunt in the brain and find a safe space so it wouldn’t get damaged.’

The most important part now is Boki’s recovery. ‘With a dog you can put a cone on its head. With a child, their parents can sit and watch over them. You can’t do that with a bear,’ says Romain.

‘Bears and pandas are very dextrous, they can use the tips of their nails to get inside a wound. Or they might lick it.’ And it’s not like Boki can be told to get some bed rest for several days. And then there’s the need for him to put on weight before winter.

‘If you keep him inside, he might get stressed and frustrated and do himself more harm. Imagine if you were locked up in your airing cupboard!’

Dr Pizzi has waived his fee for the surgery, but the Trust still needs £20,000 towards the operation and aftercare. Boki’s shunt alone cost £3,000 and he’ll be on antibiotics and painkillers for a couple of weeks.

Then there’s his food (he devours three buckets of vegetables, dog biscuits, and fish in a day), plus paying for vets and keepers and maintaining his enclosure.

So how is Boki feeling after becoming the first bear in Britain to undergo such a procedure?

Jon Forde (who holds the enviable title of ‘Head of Bears’ at the Wildwood Trust) said he was ‘really impressed at Boki’s rate of recovery. He came up to the bars and was letting us scratch him and wanting attention.’

And on Friday when he was let out for a walk, Boki sat in the sun, eating grass without a care in the world.

I’ll be keeping my fingers crossed for Boki’s recovery. But right now it looks as if this charming bear with a very sore head may finally be out of the woods.

Anyone who wishes to donate towards Boki’s care can contact Mark Hedden on [email protected] or visit https://www.wildwoodtrust.org/brown-bear-rescue/