A veterinary team from the University of Pretoria’s (UP) Faculty of Veterinary Science recently gave four-year old white rhino bull Houdini a breath of life after performing fully invasive surgery for more than five hours to remove a severe obstruction from his nasal passage.

Years ago, Houdini was shot through the nose in a brutal poaching incident. He survived the trauma and began his recovery at The Rhino Orphanage in Limpopo under the watchful care of veterinarian Dr Pierre Bester. Despite healing well at first, months later, the team noticed something troubling – Houdini was struggling to breathe through one of his nostrils. Over time, the problem worsened. Concerned, Dr Bester performed a nasal endoscopy and found pink coloured tissue obstructing the entire right nasal passage.

“This is a major problem for rhinos,” Dr Bester says. “Unlike humans, they can breathe only through their nose. Also, their sense of smell plays a vital role in their interaction with the environment. For Houdini, the obstruction didn’t just threaten his ability to breathe – it threatened his quality of life. So it was crucial that we attempt to correct the nasal passage.”

Recognising the severity of the case, he referred Houdini to Professor Gerhard Steenkamp, a veterinary specialist in dentistry and maxillofacial surgery, at UP’s Onderstepoort Veterinary Academic Hospital for further evaluation and potential intervention. A CT scan of Houdini’s head was performed, revealing a grim picture: the lesion was so extensive that not only was the right nasal passage completely blocked, but the growth was beginning to encroach on the left nasal passage, too. It appeared as if new bone was beginning to form in the nose where the bullet had destroyed all the existing bone. These changes in bone growth was causing a total blockage of the right nasal passage, which meant the animal could not breathe normally on that side.

While low-invasive laser surgery was initially considered, the lesion’s size rendered this approach unfeasible. A decision was then taken by Prof Steenkamp and specialist equine surgeon Dr Elza Hollenbach to perform fully invasive or open surgery.

“We knew we had to act fast,” Prof Steenkamp says. “This wasn’t just about clearing a nasal passage; it was about giving Houdini back his ability to live a normal life.”

Houdini spent a few days recovering from the long CT scan procedure in the wildlife clinic’s specialised bomas. Recovery was vital to ensure that he was in the best shape for the surgery, which was expected to take several hours. Once Houdini was deemed fit and recovered, specialist wildlife veterinarian Dr Jacques O’Dell administered a combination of anaesthetic drugs before the rhino was “walked” to the theatre complex.

Performing surgery on a white rhino is always a daunting task, especially because of the anaesthetic risks involved.

“These animals – even healthy ones with fully functional airways – often suffer from severe cardiopulmonary complications under sedation,” Dr O’Dell explains. “In Houdini’s case, with compromised breathing capacity, the anaesthesia posed a significant challenge.”

As such, the veterinary team proceeded with extreme care. According to Prof Steenkamp, the surgery itself was challenging.

“We had to access the area from the side of the rhino’s face,” he says. “We couldn’t enter from the top, because of his horns, so we had to enter surgically from the side, just under the horns, where a paranasal sinus is located, in order to access the nasal passage.”

Although a vast body of research on rhino anaesthesia and immobilisation protocols has been published over the past few decades, these have focused on relatively quick field procedures that last less than an hour in healthy animals. Therefore, data from horse anaesthesia had to be extrapolated for this case.

“We know that anaesthesia that lasts for longer than two hours in horses increases the risk of mortality two-fold, with the risk doubling for every subsequent hour,” said Dr Abdur Kadwa, a specialist veterinary anaesthesiologist at the faculty who led the anaesthetics team during the procedure. “These risks stem from the rhino’s own body weight compressing blood supply to vital organs and muscles; so we had to strike a delicate balance between ensuring the stability of his blood pressure and keeping a wild animal safely asleep and pain free.”

Ironically, the rhino had to undergo a rhinotomy (cutting into the nasal cavity), a procedure that could cause significant bleeding.

“Unfortunately, no fresh whole blood that is typed and matched was available, so we employed a technique called haemodilution,” Dr Kadwa says.

He explained that haemodilution involves collecting a significant proportion of the patient’s own blood which was then replaced by intravenous fluids. “So if Houdini bled, he would have lost a smaller proportion of actual blood and have had his own blood for transfusion, negating the risks of transfusion reactions," Dr Kadwa says.

The use of the haemodilution technique to manage blood loss in rhinos has not been reported in veterinary literature, however, it has been applied in horses, cats and dogs. As far as it is known this is the first time it has been applied in South Africa and probably the world.

"All in all the anaesthesiology team, including fellow anaesthesiologist Dr Chris Blignaut and resident Dr Cizelle Naude were quite thrilled at successfully kept Houdini asleep for 5 hours and 55 minutes, without any major complications,” Dr Kadwa concludes.

After the marathon operation, Houdini was moved to a specialised boma in the faculty’s wildlife clinic, where he was closely monitored for post-operative complications under the watchful care of Dr O’Dell, his colleagues and students. The recovery went smoothly and within a few days, Houdini was up and about; by the end of the week, he was ready to return home, where he is reportedly doing very well.

“Seeing him walk out of the boma, breathing freely again was an emotional moment for all of us,” Prof Steenkamp says. “He’s a fighter, and he’s earned every breath.”

For pictures and videos of the surgery, click here.