Other monkeys case method: 50 questions

A facility troop of three 5-year-old crab-eating macaques. During morning cleaning, watery stool mixed with mucus and blood is found in several spots on the floor, and one animal is huddled in a corner with a dull coat. It ate normally until last night. The other two look fine. You are the only keeper on duty, and visitors are scheduled today.

Which is the most appropriate first action?

1. Leave it in the same cage as the two healthy animals and watch its appetite until evening
2. Isolate the huddled animal, collect a stool sample, care for it with gloves and a mask, and see a vet the same day
3. Mix a human digestive remedy into the food and wait for the stool to firm up
4. Hose the stool off the floor and fast the whole troop

AnswerB. Isolate the huddled animal, collect a stool sample, care for it with gloves and a mask, and see a vet the same day

ExplanationMucoid, bloody stool in monkeys most likely means enteritis such as bacterial dysentery or salmonella, which also infects humans, and dehydration makes it deteriorate rapidly. Isolate the affected animal, collect a stool sample for testing, and have it examined by a vet the same day. Wear gloves and a mask for care and wash hands with soap afterward. Observing it in the shared cage lets it spread through the troop, and giving human medication on your own can mask the causative organism and make things worse. Casually hosing away stool spreads pathogens in spray and destroys the sample. Fasting the whole troop only hastens weakness and has no basis.

IssuesThere was only one keeper, with no system to isolate and seek veterinary care at the same time when something went wrong. There was little awareness of keeping abnormal stool as a sample, and the habit of hosing it away was a breeding ground for spread.

ImprovementKeep an isolation cage and stool containers on hand, and post the procedure: isolate, sample, vet on seeing bloody stool. Designate a backup staff member for emergencies and make a habit of recording stool condition before cleaning.

A 12-year-old rhesus macaque taken in from a research facility. A dry cough started three weeks ago, and the monthly weigh-in showed a 1 kg loss. It is eating but getting thin, and the lymph nodes in its neck look swollen. The keeper assumed it was a cold, but two other macaques live in the same building.

Which response should take priority here?

1. Assume dry air is the cause, set up a humidifier and increase high-calorie fruit
2. Give a small dose of human cough syrup and watch for a week
3. Suspect tuberculosis, isolate it, care for it wearing an N95 mask, consult the vet and public health center, and test the other animals
4. Let it out into the outdoor exercise area to sunbathe only while it is coughing

AnswerC. Suspect tuberculosis, isolate it, care for it wearing an N95 mask, consult the vet and public health center, and test the other animals

ExplanationChronic cough, weight loss and swollen lymph nodes strongly suggest tuberculosis in monkeys, which spreads to both humans and monkeys. Isolate immediately, do all care wearing an N95 mask and gloves, and contact the vet for a tuberculin test and imaging. Tuberculosis is also a reportable disease under the Infectious Diseases Control Act, so consultation with the public health center and testing of cohoused animals and keepers is required. Humidity and fruit do not address the cause, and more fruit raises the risk of diabetes. Human cough medicine hides symptoms and delays diagnosis. Letting it outdoors widens exposure to other animals and people.

IssuesThe tuberculin test record from intake was not checked, and the cough was self-diagnosed as a cold and left for three weeks. The objective abnormality of weight loss was recorded but did not function as a trigger for a vet visit.

ImprovementSet a quarantine period for new animals and record tuberculin tests at intake and yearly. Define numeric criteria for a vet visit, such as a cough lasting one week or a 5% weight loss, and have keepers get a yearly health check themselves.

A captive 8-year-old male crab-eating macaque. At feeding time you notice several small blisters and ulcers on its upper lip and inside its mouth. Appetite is slightly down but activity is normal. Since last week a new staff member has been cleaning inside the cage and once touched the animal's mouth area with bare hands while practicing restraint.

Which is the most appropriate first response?

1. Treat it as mouth sores, switch to soft food and watch until it heals
2. Judge it stress-related and simply stop the staff member's in-cage work
3. Dab antiseptic on the lesions with a cotton swab and separate feeding stations so cagemates do not catch it
4. Treat it as suspected B virus: do not touch with bare hands, isolate it, contact the vet, and have the staff member who touched the mouth consult a medical facility

AnswerD. Treat it as suspected B virus: do not touch with bare hands, isolate it, contact the vet, and have the staff member who touched the mouth consult a medical facility

ExplanationBlisters or ulcers on the lips or in the mouth of a macaque are seen during the shedding phase of B virus (Macacine herpesvirus 1), which is mild in monkeys but causes lethal encephalitis in humans. Isolate immediately, do all further care in goggles, gloves and a mask, and contact the vet for testing. The staff member who touched the mouth with bare hands may have been exposed and should consult a medical facility about B virus exposure regardless of whether there was a wound. Watching with soft food as mouth sores, or applying antiseptic with bare hands, increases human exposure. Merely stopping the work leaves out the response for the person already exposed.

IssuesThe new staff member practiced restraint by touching the mouth with bare hands and no protective gear, and training that macaque saliva is a lethal source of infection was lacking. There was also no habit of checking inside the mouth for abnormalities.

ImprovementMake protective gear and working through the door the rule for handling macaques, and give new staff B virus training before they start. Post exposure contacts and medical facilities, and add observation of the mouth and lips to the daily checklist.

A 20-year-old crab-eating macaque kept privately for many years. It has long been given bananas and sweets. Lately the water bottle is empty every day, there is more urine on the floor, and it is getting thinner despite eating well. Its coat is dull, and its eyes seem to be clouding white.

What should the owner do about these changes?

1. Put it down to age and give more of its favorite fruit to build strength
2. Remove the water bottle for half a day to stop it drinking too much
3. Suspect diabetes, stop fruit and sweets, and see a vet within a few days for blood and urine tests
4. Cataracts are the only problem, so buy eye drops and apply them

AnswerC. Suspect diabetes, stop fruit and sweets, and see a vet within a few days for blood and urine tests

ExplanationExcessive thirst and urination, weight loss despite eating, and cataracts are the classic signs of diabetes, common in middle-aged and older monkeys made obese by a diet centered on fruit and sweets. Left untreated it becomes life-threatening through dehydration and ketoacidosis, so see a vet within a few days for blood and urine tests. Stop fruit and sweets at once and switch to primate pellets and vegetables. More fruit worsens the condition. Restricting water is dangerous, as dehydration progresses; excessive drinking is a result, not the cause. Cataracts are a complication of diabetes and over-the-counter drops will not solve them.

IssuesYears of a fruit- and sweets-centered diet led to obesity and diabetes. It took a long time from the onset of excessive thirst and urination to the vet visit, and there was no habit of recording weight or water intake.

ImprovementMake primate pellets the staple and limit fruit to small amounts a few times a week. Keep monthly weight records and water-intake logs, and check blood sugar at the yearly checkup. Share criteria for a vet visit with the family.

A 1-year-old capuchin kept indoors. It gets almost no sunlight, its diet is mostly vegetables and fruit, and it refuses pellets. Recently its wrists have bent and its gait has become odd, and this morning it had a brief seizure. It is calm now but listless.

Which is the most appropriate first action?

1. The seizure has stopped, so start long sunbathing sessions today and watch
2. Give extra calcium supplements and massage the wrists to straighten them
3. Keep it dark and quiet without touching, carry it carefully assuming its bones break easily, and see a vet the same day
4. Treat it as epilepsy and give a small dose of human anticonvulsant

AnswerC. Keep it dark and quiet without touching, carry it carefully assuming its bones break easily, and see a vet the same day

ExplanationMetabolic bone disease from vitamin D3 and UV deficiency and a fruit-heavy diet is common in growing monkeys, causing bone deformities along with seizures from low calcium. After a seizure, avoid stimulation and keep it dark and quiet; the bones are brittle, so handle with care and see a vet the same day. Treatment requires blood tests and a planned supplementation program by the vet; self-dosing supplements can cause overdose or malabsorption. Massaging to straighten risks fractures. Sunbathing is effective for prevention but does not treat the current seizure. Human anticonvulsants misjudge the cause and are dangerous.

IssuesThere was no UV lamp or sunbathing, and the animal was raised on vegetables and fruit alone while refusing pellets. Knowledge of nutrition during growth was lacking, and nothing was noticed until the gait became abnormal.

ImprovementMake primate pellets the staple and provide a UV lamp or daily sunbathing as a source of vitamin D3. During growth, record weight and skeletal condition monthly, and consult the vet if the animal will not eat pellets.

A 9-year-old rhesus macaque housed alone at a facility. Since its former cagemate died, it paces the same route in the cage and repeatedly bites its forearm, causing hair loss and bleeding. The wound is starting to fester. The keeper has shouted at it every time it was caught doing so.

Which is the most appropriate way to handle this problem?

1. Have the vet treat the wound, change the environment daily with foraging puzzles and hideouts, and consider housing it with a companion
2. Shout at it or splash water every time it bites to stop the behavior
3. Fit an Elizabethan collar yourself so it cannot bite its arm
4. Boredom is the cause, so play a TV in front of the cage all day

AnswerA. Have the vet treat the wound, change the environment daily with foraging puzzles and hideouts, and consider housing it with a companion

ExplanationSolitary housing and lack of stimulation are the biggest causes of self-injury and stereotypic behavior in monkeys. First, the festering wound needs veterinary treatment; a deep infection can require surgery. In parallel, vary environmental enrichment daily, such as devices that make foraging take time, three-dimensional climbing routes and hideouts, and consider a companion while assessing compatibility. Scolding and splashing water heighten anxiety and worsen self-injury. Fitting a collar as an amateur carries a high risk of bite injury during restraint and does not address the cause. TV sound is stimulation, but noise can increase stereotypic behavior and cannot meet the underlying social need.

IssuesA troop-living animal was kept alone long-term, and the behavioral change after losing its companion was treated as misbehavior and met with scolding. The self-inflicted wound was left to fester, and the environment was never reviewed.

ImprovementOn the first sign of self-injury, see a vet and create and log a daily enrichment plan. To avoid solitary housing, coordinate with other facilities and look for a compatible companion; record daily behavior observations to catch deterioration early.

A facility keeping four crab-eating macaques. A week ago a staff member with fever and cough kept feeding them without a mask. Today two animals have fever, runny nose, conjunctivitis and a rash spreading from the face to the body. The other two are listless. The staff member is still coughing.

Which is the most appropriate first response?

1. Apply over-the-counter anti-itch cream to the rash, keep them warm and watch until the runny nose stops
2. Suspect an infection from humans such as measles, isolate the sick animals, bar symptomatic people from entering, and contact the vet
3. Move all four to the outdoor exercise area for fresh air before it spreads
4. Assume the rash is a food allergy and change the type of fruit

AnswerB. Suspect an infection from humans such as measles, isolate the sick animals, bar symptomatic people from entering, and contact the vet

ExplanationMonkeys are highly susceptible to human measles, influenza and the like; symptoms mild in humans can become severe and fatal across a whole troop. Fever, conjunctivitis and rash are the typical course of measles. Isolate the sick animals at once, bar anyone with a cough from entering, and contact the vet for testing and supportive care. Anti-itch cream and warmth do not address the cause, and the route of infection from humans continues. Moving them outdoors does not stop transmission if the same keeper cares for them, and increases exposure to other animals. Assuming an allergy cannot explain the fever and conjunctivitis and delays the vet visit.

IssuesA sick staff member kept having contact, and the risk of human-to-monkey transmission was not shared within the facility. There were no criteria for mask use or entry restriction, and the early stage of the outbreak was missed.

ImprovementBar anyone with fever, cough or rash from entry and place a health checklist at the entrance. Make masks and handwashing mandatory at every feeding, and confirm keepers' measles and influenza vaccination history.

A 7-year-old female crab-eating macaque. At the morning feeding it packed pellets into its cheek pouches but, unlike usual, did not take them out to eat, and sits still on the perch. By evening the pouches are still bulging and it has barely drunk any water. Stool is scant and somewhat hard.

Which is the most appropriate action for the owner?

1. Judge that it has had no appetite for a full day, contact the vet the same day and have it seen
2. Show it favorite fruit to spark its appetite and wait until tomorrow
3. Put a hand into the cheek pouch to scoop out the food and check inside the mouth
4. Assume lack of exercise and let it out to run in the exercise area

AnswerA. Judge that it has had no appetite for a full day, contact the vet the same day and have it seen

ExplanationA macaque holding food in its cheek pouches without eating is a sign of reduced appetite from mouth pain, digestive problems or general illness, and "no appetite for a day" meets the criterion for a same-day vet visit. Water intake is also down, so contact the vet before dehydration progresses. Tempting it with fruit and waiting until tomorrow delays identifying the cause, and the sugar is not good either. Putting a hand into the cheek pouch carries an extremely high risk of bite injury and B virus exposure and must never be done. Exercising a sick animal risks deterioration and falls.

IssuesFaced with the clear abnormality of loss of appetite, the owner nearly decided to wait until the next day. The very idea of putting a hand into the cheek pouch showed insufficient understanding of the danger of a macaque's mouth.

ImprovementPost criteria for a vet visit: no appetite for a day, reduced drinking, reduced stool. Record cheek-pouch condition and leftover food after each daily feeding, and make it a rule never to put hands near the mouth. Secure a vet in advance.

A facility with six crab-eating macaques. On a winter afternoon, the lowest-ranking animal, a 3-year-old female, is huddled in a corner and not joining the troop's grooming. On closer look there are small bite wounds on her back, and at feeding time she is chased off by the others and cannot eat. Her small body is shivering.

Which is the most appropriate response for this animal?

1. Troop hierarchy is natural, so do not intervene and observe until the next morning
2. Pick up the huddled animal and carry her to a warm indoor room
3. Shout at the bullying higher-ranking animals and bang on the cage to intimidate them
4. Separate the huddled animal into the adjacent section with the sliding door, keep her warm, give food and water, and see a vet the same day

AnswerD. Separate the huddled animal into the adjacent section with the sliding door, keep her warm, give food and water, and see a vet the same day

ExplanationA low-ranking animal that cannot eat, has bite wounds and is shivering is at risk of hypothermia, low blood sugar and infection. Separate her from the troop, keep her warm, secure food and water, and see a vet the same day. Separate using the sliding door, not by picking her up bare-handed, but by a safe method. Left alone, weakening and attacks continue and it may be too late by morning. Scolding the dominant animals or banging the cage excites the whole troop and intensifies attacks on the weak one. Picking her up risks bites and infection; never handle an agitated animal without protective gear.

IssuesCiting troop hierarchy, staff overlooked a weak animal being unable to eat. Feeding stations and hideouts were too few, leaving no refuge for weaker animals. Winter warmth was also left to the troop.

ImprovementIncrease feeding stations and hideouts to more than the number of animals and check at every feeding that weaker animals are eating. Record bite wounds and weight loss, and always keep a separation section free. In cold weather, manage blankets on sleeping platforms and room temperature.

A 15-year-old rhesus macaque anesthetized for a checkup in the morning and returned to the facility in the afternoon. The vet said it should be walking by evening, but at 8 p.m. it is still lying down, responds sluggishly to calls, and its hands and feet are cold. Breathing is slow and shallow. The cage has a high sleeping platform.

Which is the most appropriate first action?

1. Put it down to individual variation in anesthesia, darken the cage and let it sleep until morning
2. Rub its body vigorously to rouse it and pour water into its mouth to wake it
3. Move it to a low recovery cage, warm it with a blanket, count its breathing rate and immediately contact the vet who gave the anesthesia
4. Lift it onto the sleeping platform, turn the heating to maximum and watch

AnswerC. Move it to a low recovery cage, warm it with a blanket, count its breathing rate and immediately contact the vet who gave the anesthesia

ExplanationFailure to wake past the expected time after anesthesia, with cold extremities and shallow breathing, may indicate hypothermia, circulatory failure or delayed drug metabolism, and is highly urgent. Prevent falls with a low recovery cage on the floor, keep it warm with a blanket while counting breaths for one minute, and immediately contact the vet who performed the anesthesia for instructions. Leaving it until morning lets hypothermia progress. Vigorous rubbing or pouring water into the mouth causes aspiration or bite injuries. Lifting it onto the platform risks a fall and fracture while half-awake, and maximum heating causes overheating and dehydration.

IssuesPost-anesthesia monitoring was inadequate, and the animal was returned to a cage with a high sleeping platform. Criteria for delayed recovery and emergency contact procedures had not been confirmed with the vet in advance.

ImprovementOn days with anesthesia, assign someone to check breathing and temperature regularly through the night in a low recovery cage. Share in writing with the vet the expected wake-up time, emergency contacts and an after-hours facility.

An 18-year-old male capuchin. For several days it has dragged its right hind leg and, unable to climb to its usual high sleeping platform, sleeps on the floor. The ankle is slightly swollen but appetite is fine. Yesterday it threatened when approached and nearly fell trying to climb to the platform. The owner is considering applying a compress patch.

Which is the most appropriate action for the owner?

1. Apply a human compress patch and lay a towel on the platform until the pain subsides
2. It is eating, so assume it will heal on its own and watch for a week
3. Do not touch the swollen leg, lower the sleeping platform to prevent falls, and see a vet the same day
4. It will stiffen if not moved, so let it out to walk in the exercise area

AnswerC. Do not touch the swollen leg, lower the sleeping platform to prevent falls, and see a vet the same day

ExplanationLimping with swelling may be a fracture or arthritis, and in an elderly animal gout or a tumor, so you cannot assume it will heal on its own. Do not touch the swollen area, lower the platform and perches to prevent falls, and see a vet the same day. A human compress patch may be licked for its ingredients, applying it risks bite injury, and its benefit is uncertain. Even with appetite intact, bone lesions progress, and a week's delay makes treatment harder. Exercising on a painful leg leads to fractures and falls.

IssuesThe gait abnormality was left for several days, and the near-fall from the high platform was missed as a warning sign. There was an inclination to use human medication, and no preparation for joint and bone disease in an elderly animal.

ImprovementMake abnormal gait or swelling a same-day vet criterion; for elderly animals, lower platforms and perches and lay mats on the floor. Have blood and imaging tests at the yearly checkup and record changes in joints and bones.

An 11-year-old female crab-eating macaque. For two days she has passed almost no stool, her belly is distended and she resists being touched there. Since last night she has not touched her food, and this morning she vomited several times. There is a wooden toy in the cage, and chewed fragments are scattered on the floor. Activity is low and she sits still on the perch.

Which is the most appropriate first action?

1. Assume constipation and give olive oil or yogurt
2. Lack of exercise is the cause, so make her run in the exercise area and give plenty of fluids
3. Massage the belly to make her pass stool
4. Treat vomiting plus no stool as suspected intestinal obstruction, withhold food, and see a vet right now with photos of the fragments

AnswerD. Treat vomiting plus no stool as suspected intestinal obstruction, withhold food, and see a vet right now with photos of the fragments

ExplanationNo stool, abdominal distension, vomiting and complete loss of appetite together strongly suggest intestinal obstruction from chewed wood fragments or severe enteritis; left untreated it leads to death from bowel necrosis. Give no more food, take photos or actual fragments from the floor, see a vet immediately and have imaging done. Oil or yogurt worsens the obstruction and risks aspiration through vomiting. Abdominal massage risks bowel perforation, and restraining an animal in pain invites bite injuries. Exercise and fluids do not resolve an obstruction.

IssuesA wooden toy that splinters when chewed was provided, and fragments on the floor were not recognized as a sign of foreign-body ingestion. Stool volume went unchecked for two days, and the vet visit was delayed until vomiting began.

ImprovementChoose toys of a size and material that cannot be swallowed and inspect for chew marks daily. Record stool volume daily and consult the vet as soon as it drops. Decide in advance that vomiting plus no stool means an immediate vet visit.

A facility keeping five crab-eating macaques. A 4-year-old male has reached sexual maturity and fights with the older male have intensified. In the evening the young male is bitten deeply on the arm and blood is dripping. The two agitated animals are still threatening each other in the cage and the others are screaming. The keeper, wearing gloves, is debating whether to enter the cage.

Which is the most appropriate first action?

1. Enter the cage at once, hold the injured animal and stop the bleeding
2. Separate the two with a spray from the hose, wait for the excitement to subside, isolate the injured animal with the sliding door and see a vet the same day
3. It will settle on its own, so do nothing and check the wound the next morning
4. Bang on the cage to intimidate them all, stop the fight, then pour antiseptic on the wound

AnswerB. Separate the two with a spray from the hose, wait for the excitement to subside, isolate the injured animal with the sliding door and see a vet the same day

ExplanationEntering a cage with an agitated troop is the most dangerous option; if the keeper is bitten it becomes a serious incident including B virus exposure. Distract the two with a spray of water to separate them, and once calm, move the injured animal to a separate section with the sliding door. A deep bite with heavy bleeding needs cleaning and suturing under anesthesia, so see a vet the same day. Leaving it until morning worsens it through infection and blood loss. Banging on the cage heightens the whole troop's excitement and intensifies attacks on weaker animals. Pouring antiseptic through the cage is ineffective and the irritation makes it thrash.

IssuesThe sexually mature young male and the older male were housed together without separation, and the escalation of fighting was not anticipated. Preparation of a separation section and distraction tools was inadequate, leading to the dangerous idea of the keeper entering the cage.

ImprovementWatch for changes in rank at sexual maturity or when introducing newcomers and separate as needed. Provide multiple hideouts and feeding stations and always keep a section that can be divided by sliding door. Enforce the rule of never entering the cage during agitation.

While feeding a 10-year-old crab-eating macaque at a facility, a keeper who reached a hand through the feeding port is bitten on the index finger and is bleeding from the tooth marks. The pain is bearable and bleeding is light, and the keeper says "it's just a small wound," puts on a bandage and tries to carry on working.

Which is the most appropriate action for the keeper and those around?

1. Immediately wash the wound with soap and running water for 15+ minutes, and see a medical facility the same day, reporting it as a macaque bite
2. Put on a bandage, keep working, and go to the hospital if it swells
3. Pour plenty of antiseptic on it and write it in the facility log the next day
4. Squeeze the wound hard to bleed it out, suck out the poison by mouth, then bandage it

AnswerA. Immediately wash the wound with soap and running water for 15+ minutes, and see a medical facility the same day, reporting it as a macaque bite

ExplanationEven a small macaque bite may have introduced B virus, which has a high fatality rate once it develops. Immediately wash with soap and running water for 15+ minutes, and see a medical facility the same day, stating "bite from a macaque." This allows appropriate measures such as early antiviral treatment. Carrying on with a bandage, or merely logging it the next day, misses the window for treatment. Antiseptic alone is no substitute for washing. Sucking the wound by mouth creates a new exposure to the oral mucosa and is extremely dangerous.

IssuesThe basic prohibited act of putting a bare hand through the feeding port occurred, and the keeper personally underestimated the seriousness of the bite. Bite procedures and medical contacts were not posted in the facility, leaving it to individual judgment.

ImprovementChange feeding to a port design that does not require inserting hands, and do in-cage work with protective gear and two or more people. Post procedures for bites, scratches and saliva exposure, and keep a washing sink and medical contact information in the animal area.

During a facility patrol, a staff member gets too close to a cage and a rhesus macaque's claws reaching through the mesh leave three scratches on the forearm. Bleeding is minimal and there was no bite. The staff member thinks "I wasn't bitten, so I'm fine." The monkey's records show it tested B virus antibody-positive in a previous test.

Which is the most appropriate response for this staff member?

1. It is not a bite, so washing and a bandage are enough
2. The scratches are shallow, so apply antiseptic and see a doctor if fever develops
3. Claws are not saliva, so there is no infection. Observe for a few days just in case
4. Treat scratches as B virus exposure too: wash for 15+ minutes, see a doctor the same day and report that the animal is antibody-positive

AnswerD. Treat scratches as B virus exposure too: wash for 15+ minutes, see a doctor the same day and report that the animal is antibody-positive

ExplanationB virus can be transmitted not only through saliva but also through saliva and body fluids on claws from grooming, urine and skin secretions, so scratches are treated as the same exposure as bites. Immediately wash with soap and running water for 15+ minutes, see a doctor the same day and report "scratch from a B virus antibody-positive macaque." The incubation period is days to weeks, and by the time fever, blisters or numbness appear it is too late. Dismissing it because there was no bite, or settling for antiseptic, misses the window for treatment.

IssuesThe staff member did not understand how far claws reach through the mesh and mistakenly believed B virus spreads only through bites. The antibody-positive record was not used to alert staff on site.

ImprovementSet a no-approach line around cages and inform staff of mesh size and claw reach. Label B virus antibody-positive animals on their cages, and train staff that scratches and saliva exposure follow the same medical procedure as bites.

When a sliding partition door was closed for cleaning, the fingertip of a 3-year-old crab-eating macaque reaching through from the other side was caught and severed at the first joint. The fingertip is lying on the floor, and the monkey is screaming and running around the cage, bleeding.

Which is the most appropriate first action?

1. Catch the monkey, pour antiseptic on the wound and bandage it
2. Wait for the excitement to subside, wrap the severed part in moistened gauze, keep it cool, contact the vet and rush it in
3. The fingertip cannot be reattached, so discard it and watch until the bleeding stops
4. Tie a cord tightly around the arm as a tourniquet to stop the bleeding

AnswerB. Wait for the excitement to subside, wrap the severed part in moistened gauze, keep it cool, contact the vet and rush it in

ExplanationA severed finger carries risk of heavy bleeding and infection, and forcibly catching an agitated animal gets the keeper bitten. First use the sliding door to move the animal into a small section to calm it, contact the vet, and rush it in for treatment under anesthesia. Wrap the severed part in moistened gauze so it does not dry out, place it in a bag, keep it cool with a cold pack and bring it along to widen the treatment options. Antiseptic and bandaging require restraint and are dangerous; a cord tourniquet causes tissue necrosis. Leaving the bleeding leads to death from blood loss and infection.

IssuesThere was no call-out check of the animal's position when operating the sliding door, and the mesh and door gaps allowed fingers through. Staff did not know how to preserve a severed part, and there was no preparation for emergency transport.

ImprovementOperate doors only after visually confirming and calling out the animal's position. Modify doors and mesh so fingers cannot enter, and stock gauze, bags and cold packs in the first-aid kit for preserving severed parts. Designate a vet to accept emergencies.

An elderly 22-year-old capuchin. In the morning it apparently fell from its perch to the floor; its left forearm is bent unnaturally and it threatens anyone trying to touch it. The floor is hard concrete. Reduced bone density was noted at a previous checkup. The owner is about to apply a splint.

Which is the most appropriate action for the owner?

1. Suspect a fracture, move it to a small carrier without touching the arm, keep it still and see a vet the same day
2. Straighten the arm, apply a splint, bandage it in place and then see a vet
3. Wait for the pain to subside and see a vet once it can move
4. Give a small dose of human painkiller and watch

AnswerA. Suspect a fracture, move it to a small carrier without touching the arm, keep it still and see a vet the same day

ExplanationA fall in an elderly animal with reduced bone density very likely means a fracture. Forcing the bent arm straight or splinting it can let bone ends damage nerves and blood vessels, and risks a bite from the animal in pain. Without touching it, move it to a small carrier or transport box that limits movement, and see a vet the same day for imaging. Waiting for the pain to subside lets the bone shift and heal poorly. Human painkillers have unknown dosing and can cause gastrointestinal bleeding or kidney damage.

IssuesDespite the noted reduced bone density, the high perch and hard concrete floor were left as they were, with no fall prevention. There was also mistaken knowledge about splinting and using human medication.

ImprovementFor elderly or brittle-boned animals, lower perches and lay rubber mats or straw on the floor. If bone problems are noted at a checkup, review diet and UV, and share with the family that fractures mean no touching and a trip to the vet in a transport box.

On a winter night, a crab-eating macaque removed the mesh cover of the heater installed in the cage and grabbed the hot unit with a bare hand. Rushing over at the scream, you see the skin of the palm has turned white and hard, with some parts blackened. The monkey is moving around the cage shaking its hand.

Which is the most appropriate first action?

1. Switch off the heater, guide it so the burn can be cooled under running water for 10 minutes, and see a vet right now since white or black skin means a serious burn
2. Apply oil or aloe to the hand to cool it and see a vet the next morning
3. No blisters have formed, so treat it as a minor burn and watch
4. Apply ice directly to cool it and bandage the hand in place

AnswerA. Switch off the heater, guide it so the burn can be cooled under running water for 10 minutes, and see a vet right now since white or black skin means a serious burn

ExplanationSkin that turns white and hard or blackens is a deep burn; it looks mild because pain sensation is lost, but it is severe. First switch off the power to prevent repeat contact, run water over the burn for 10 minutes by a safe method such as through the sliding door, and see a vet immediately. Deep burns cause loss of hand function through infection and tissue necrosis and need treatment under anesthesia. Oil and aloe become sources of infection, and direct ice adds frostbite. The absence of blisters is characteristic of deep burns and is no basis for calling it mild.

IssuesThe heater was installed with a removable mesh cover that dexterous hands could take off, leaving the unit touchable. Burn severity was misjudged by the presence of blisters, and staff did not know what a deep burn looks like.

ImprovementPlace heaters out of reach or use a fixed, non-removable cover, and inspect assuming the monkey will dismantle it. Post the burn procedure: cut power, cool under running water, see a vet immediately, and teach that white or black skin means severe.

A 6-year-old crab-eating macaque kept at a private home. During indoor exercise time it chewed the fan's extension cord, gave a short scream and fell on its side. The area around its mouth looks scorched and it is convulsing. The cord is still plugged in and lying on the floor.

Which is the most appropriate first action?

1. Rush over, pick it up and start chest compressions
2. Pull the cord out with bare hands and rinse the mouth with water
3. Cut the breaker or unplug the cord before touching it, check breathing and heartbeat, and see a vet right now
4. Wait for the convulsions to stop and see a vet the next day once it has settled

AnswerC. Cut the breaker or unplug the cord before touching it, check breathing and heartbeat, and see a vet right now

ExplanationTouching an electrocuted animal electrocutes the rescuer too. First cut the breaker or unplug the cord with dry hands, and only approach after the power is off. Then check breathing and heartbeat; if there is no response, put on gloves and consider chest compressions while seeing a vet immediately. Besides mouth burns, electric shock can cause pulmonary edema and arrhythmia hours later, so a same-day vet visit is needed even if the convulsions stop and it seems fine. Pulling the cord bare-handed or picking it up while live are classic double accidents. Next-day care is too late.

IssuesAn electrical cord was exposed within the monkey's reach. The basic step of cutting the power before rescue was unknown, as was knowledge of delayed symptoms after electric shock.

ImprovementIn the indoor exercise area, run cords through conduit or cover outlets and do not use electrical appliances. Share the breaker location with the family, and post the electric shock procedure: cut power, check breathing, see a vet immediately.

While cleaning a cage at a facility, an agitated rhesus macaque threatened a staff member's face through the mesh, and saliva and fluid from its mouth splashed into the staff member's eye. The staff member was not wearing goggles and rubbed the eye. There is no wound on the skin. The monkey has a history of blisters on the lips.

Which is the most appropriate action for the staff member?

1. No wound means no infection. Apply eye drops and keep working
2. Rinse the eye with antiseptic, write it in the facility log and watch
3. Wipe the eye with a towel and see an ophthalmologist the next day if it swells
4. Immediately flush the eye with running water or saline for 15+ minutes and see a doctor the same day as a mucous membrane exposure

AnswerD. Immediately flush the eye with running water or saline for 15+ minutes and see a doctor the same day as a mucous membrane exposure

ExplanationB virus also infects through the mucous membranes of the eyes and mouth, and fatal cases from splashes to the eye have been reported. Even without a skin wound, mucous membrane exposure is serious: immediately flush the eye with running water or saline for 15+ minutes, see a doctor the same day and report "mucous membrane exposure to macaque saliva." Applying eye drops and continuing work, or waiting until the next day, misses the window for treatment. Rinsing the eye with antiseptic damages the cornea and does not address the exposure. Rubbing the eye increases contact with the mucosa, so do not touch it further.

IssuesGoggles were not worn for work in and around macaque cages. Knowledge that mucous membrane exposure is a route of infection was lacking, and danger was judged solely by the presence of a skin wound.

ImprovementAlways wear goggles, mask and gloves when working near macaques. Keep an eyewash station or saline in the animal area, and post and teach that mucous membrane exposure follows the same medical procedure as bites.

A staff member assisting the vet at a facility checkup pricks their own thumb with a needle just used to draw blood from a crab-eating macaque. Bleeding is slight and pain mild. The vet is busy with the next animal, and the staff member, thinking "I threw the needle away right away," is quietly about to change gloves.

Which is the most appropriate action for the staff member?

1. Immediately wash the wound under running water for 15+ minutes while squeezing it, report to the vet and see a medical facility the same day
2. Bleeding is slight, so change gloves, keep working and report after finishing
3. Apply antiseptic and a bandage, and consider it fine if there is no fever for a few days
4. Retrieve the needle, send it for testing yourself and see a doctor after the results come back

AnswerA. Immediately wash the wound under running water for 15+ minutes while squeezing it, report to the vet and see a medical facility the same day

ExplanationA needlestick with a needle carrying monkey blood is an exposure to blood-borne infections such as B virus and simian retroviruses. Immediately wash with running water and soap for 15+ minutes, report to the vet and facility manager, see a medical facility the same day and give details of the exposure and the animal's test history. Continuing work and reporting later, or assuming no fever means no problem, ignores the length of the incubation period. Sending the needle for testing yourself does not inform decisions on preventive treatment for humans and delays medical care. Always record exposures and provide the animal's test information to the medical facility.

IssuesThere was an atmosphere of downplaying needlesticks and hesitating to report, and exposure procedures had not reached staff. Needle handling and sharps container placement during blood-draw assistance had room for improvement.

ImprovementKeep a sharps container at hand during procedures and never carry used needles around. Make reporting mandatory for all needlesticks, bites and mucous membrane exposures and build a culture where reporting is easy. Maintain records so the medical facility and the animal's test history can be referenced immediately on exposure.

An 8-year-old capuchin. It caught the tip of its tail on a tear in the cage mesh and has a laceration; drops of blood dot the floor. Every flick of the tail sprays blood, staining the cage walls. The monkey is agitated but walking normally. The owner is about to enter the cage holding tissues.

Which is the most appropriate first action?

1. Put on gloves, move the monkey to a small section to calm it, press with gauze for 5+ minutes and see a vet the same day
2. Enter the cage, press with tissues and hold the tail until it stops
3. Darken the cage so blood does not spray and leave it until morning
4. Wrap a rubber band tightly around the base of the tail to stop the blood

AnswerA. Put on gloves, move the monkey to a small section to calm it, press with gauze for 5+ minutes and see a vet the same day

ExplanationEven a small tail laceration bleeds persistently, and flicking from agitation keeps it bleeding. First put on gloves, move it to a small section with the sliding door to limit movement, and once calm, press with clean gauze for 5+ minutes and see a vet the same day. Suturing or treatment of the tail tip is often needed. Entering the cage bare-handed and gripping the tail causes bite injuries and blood exposure. Leaving it until morning lets blood loss and infection progress. A rubber band at the base causes the tip to die and the tail to be lost.

IssuesThe direct cause was a tear in the mesh left unrepaired; facility inspection was inadequate. There was also the judgment to handle an agitated animal bare-handed and mistaken knowledge about tying off with a rubber band.

ImprovementInspect mesh and perches daily for splinters and tears and repair immediately. Stock gauze and gloves for bleeding in the first-aid kit and share that tourniquets and rubber bands are never used. Separate into a section before treating when agitated.

A 7-year-old crab-eating macaque kept privately. On waking, the owner finds the padlock on the cage removed, a window open and the monkey gone. The neighborhood is residential, near an elementary school route. The owner is about to go searching alone with food in hand. They remember locking it the day before but did not double-lock.

Which is the most appropriate first action for the owner?

1. Chase it alone until found, and carry it home in your arms once caught
2. Appeal on social media and have whoever finds it catch it
3. Wait for it to come back on its own, leaving the cage door open with food inside
4. Notify the police and local government immediately, warn neighbors not to approach, and lure it into a cage with food in coordination with experts

AnswerD. Notify the police and local government immediately, warn neighbors not to approach, and lure it into a cage with food in coordination with experts

ExplanationThe escape of a monkey classified as a Specified Animal poses risks of bite injuries and lethal infection to the neighborhood, so there is a duty to notify the police and local government immediately. With a school route nearby, call on neighbors not to approach and to report sightings, and work with experts to lure it into a transport cage with food. Chasing widens the escape range, and catching it bare-handed gets the owner bitten. Leaving the cage open and waiting does nothing to prevent harm to others. Asking the public to capture it via social media is the worst choice, spreading bite injuries.

IssuesA monkey skilled at opening locks was secured with a single padlock, with no habit of double-locking and visual checks. Escape contacts and procedures had not been confirmed in advance, and the idea was to catch it alone.

ImprovementDouble-lock and visually confirm every night, and lock windows and doors too. Post the escape procedure, do not chase, notify, with contacts for police, local government and experts. Keep a transport cage and lure food on hand.

A staff member at a facility was cleaning inside a cage alone. They thought the animal had been moved to the adjacent section, but the sliding door had been left open, and a 10-year-old rhesus macaque jumped on them from behind, biting and scratching the shoulder and neck. The staff member has no protective gear and the monkey is still agitated and nearby.

Which is the most appropriate first action for the staff member?

1. Shake the monkey off, run out of the cage and drive it away
2. Freeze, avert your eyes and take a low posture, call for help, have the monkey drawn away with food or water, then exit, wash and see a doctor
3. Shout at it and bang on the cage to drive the monkey into a corner
4. Grab the monkey, shove it into the adjacent section and close the door

AnswerB. Freeze, avert your eyes and take a low posture, call for help, have the monkey drawn away with food or water, then exit, wash and see a doctor

ExplanationRunning, shaking off, shouting or hitting makes an agitated monkey continue attacking. First freeze, avert your eyes and adopt a low, non-threatening posture to end the attack, then call for help so another person can distract it with food or a spray of water and draw it away. After exiting, immediately wash the wounds for 15+ minutes and see a doctor the same day, reporting a macaque bite. Grabbing the monkey bare-handed and shoving it invites the deepest bites. Entering the cage alone and failing to confirm the door was closed is the root of the accident.

IssuesIn-cage work was done alone, with no procedure to visually confirm that the sliding door was closed. Working without protective gear had become routine, and there was no training in how to respond when jumped.

ImprovementAlways do in-cage work with two or more people, with call-out cross-checks of animal movement and sliding door locks. Make protective gear mandatory and train the response to attack: freeze, avert eyes, call for help.

The facility's animal house has a double-door vestibule. A new staff member opened the outer door while the inner door was still open, and a 5-year-old crab-eating macaque coming out of the exercise area entered the vestibule. Staff member and monkey face each other in the narrow space, and the monkey is baring its teeth with eyes wide open.

Which is the most appropriate action for the staff member?

1. Dash past the monkey to get out and close the outer door
2. Lock eyes with the monkey and stare it down so it does not move
3. Avert your eyes, back away slowly, close the inner door to secure the monkey's escape route and call for help
4. Push the monkey back into the exercise area by hand and close the inner door

AnswerC. Avert your eyes, back away slowly, close the inner door to secure the monkey's escape route and call for help

ExplanationBared teeth and wide eyes are a clear macaque threat; ignoring it or maintaining eye contact leads to attack. Avert your eyes, make no sudden moves, back away slowly to gain distance, and if possible exit through the door behind you or secure a route for the monkey back to the exercise area, then call for help. Dashing past gets you chased and bitten, and staring back is the ultimate provocation. Pushing it by hand carries an extremely high risk of bites and B virus exposure. The iron rule for a vestibule is to close one door before opening the other; this procedural breach caused the accident.

IssuesThe double-door rules had not been drilled into the new staff member, and the basic of closing one door before opening the other was not followed. They did not know the meaning of threat behavior or how to respond, nor the danger of a confrontation in a confined space.

ImprovementPost "close one door before opening the other" on the vestibule doors and have new staff learn the procedure accompanied by a senior. Build threat signs and responses (avert eyes, back away slowly) into training, and install a help-call buzzer in the vestibule.

Summer at a facility. A staff member finds a 2-year-old crab-eating macaque floating motionless in the 60 cm deep bathing pool in the exercise area. When pulled out, water comes from its mouth; it is limp and does not appear to be breathing. The other animals are gathering around, agitated.

Which is the most appropriate first action?

1. Hold it upside down and shake it to get all the water out, then watch
2. Start mouth-to-mouth rescue breathing directly on its mouth
3. Wrap it in a blanket to warm it and wait for breathing to return on its own
4. Put on gloves, move it away from the other animals, lower its head to drain water, and if not breathing start chest compressions while contacting the vet and rushing it in

AnswerD. Put on gloves, move it away from the other animals, lower its head to drain water, and if not breathing start chest compressions while contacting the vet and rushing it in

ExplanationDrowning with no breathing is a race against time. First move it to a safe place away from the other animals, put on gloves and goggles, lower the head below the body and gently drain water from the mouth, then check for breathing. If none, lay it on its side, compress the highest point of the chest with one hand at 100–120 per minute, and rush it in while contacting the vet. Mouth-to-mouth on a monkey risks infections such as B virus and is not done; use a bag valve mask if available. Shaking it upside down causes spinal injury or aspiration from vomiting. Just warming it and waiting leaves cardiac arrest untreated.

IssuesA deep pool was placed in an exercise area with young animals, with no constant supervision or shallow design. Staff did not know the drowning procedure or the reason to avoid mouth-to-mouth, and no bag valve mask was prepared.

ImprovementMake bathing areas shallow enough for young animals to stand, with slopes or footholds to climb out. Stock a bag valve mask, gloves and goggles in the first-aid kit and train CPR yearly under the vet's guidance.

A thick rope hung in the cage as a toy has wrapped around the neck of a 4-year-old capuchin that was playing on it; it is dangling and struggling. Its feet do not reach the floor and it is making no sound. Its face is starting to turn dark red. The owner is alone and scissors are within reach.

Which is the most appropriate first action?

1. Lift its body to take the weight off the neck while cutting the rope, then check breathing once down and see a vet immediately
2. Pull hard on the rope to try to get it off the neck
3. Take a video, send it to the vet and wait for instructions
4. Wait for the monkey to untangle itself and approach once the struggling stops

AnswerA. Lift its body to take the weight off the neck while cutting the rope, then check breathing once down and see a vet immediately

ExplanationA constricted neck causes death by suffocation within minutes, so rescue without hesitation. Lift the body with one hand to take the load off the neck, cut the rope and lower it. Even if unconscious it may bite on recovery, so wear gloves if possible; once down, check breathing and heartbeat at once, and see a vet immediately even if breathing returns, since throat swelling and brain effects can appear later. Pulling the rope tightens the strangulation. Taking video or waiting for it to untangle overlooks suffocation. Time passing while it hangs is the greatest danger.

IssuesA rope that could form a loop, of a length prone to entanglement, was hung without inspection. The possibility of neck entanglement was not anticipated, and no place for a cutting tool or gloves had been decided.

ImprovementFix both ends of ropes so they cannot form loops and inspect length and wear daily. Keep a cutting tool and gloves beside the cage, and share the entanglement procedure of taking the weight off and cutting with family or staff.

At a facility open day, an elementary school child out of the parent's sight climbed over the no-entry fence, put a hand into the mesh of a crab-eating macaque cage and was bitten on the finger. The child is crying and bleeding, and the parent is about to pour water from a flask on it and put on a bandage. The staff member is unsure what to say.

Which is the most appropriate response for the staff member?

1. It is the child's injury, so leave it to the parent and explain it is not the facility's responsibility
2. Have them put on a bandage, tell them to go to the hospital if it swells, and continue the tour
3. Immediately wash at the sink with soap and running water for 15+ minutes, tell them to see a medical facility the same day as a macaque bite, and provide the animal's information
4. Prioritize isolating the biting monkey and having the vet examine it, and hand the child antiseptic

AnswerC. Immediately wash at the sink with soap and running water for 15+ minutes, tell them to see a medical facility the same day as a macaque bite, and provide the animal's information

ExplanationA macaque bite is treated as B virus exposure regardless of who was bitten. The staff member should immediately guide them to a sink, wash with soap and running water for 15+ minutes, clearly explain that they must see a medical facility the same day and report "bite from a macaque," and provide information such as the animal's test history. Leaving it to the parent or a mere bandage misses the window for treatment and fails the facility's duty to explain. Isolating the monkey can wait; the child comes first. The facility is responsible for telling visitors that exposures follow the same procedure.

IssuesThe fence was within reach of the cages, and child supervision and no-entry signage were inadequate. The facility had not prepared what to tell a bitten visitor or where to refer them.

ImprovementSet the viewing line out of reach of the mesh and block physically with double fencing or clear panels. Prepare visitor warning signs and a written medical referral to hand out after bites, and train staff to explain calmly.

While driving a rhesus macaque to a checkup, the latch on the transport cage in the cargo area loosened, and at a stop you notice the door is half open. The monkey is still inside but is pushing the door to get out into the vehicle. The keeper is driving alone, 20 minutes from the animal hospital.

Which is the most appropriate first action?

1. Keep driving and fix the door after arriving at the hospital
2. With all vehicle doors and windows closed, cover the cage with a thick blanket to darken it, secure the door from outside with wire or a strap, then contact the hospital
3. Open the windows for ventilation and drive while holding the door shut by hand
4. Let the monkey out into the vehicle to calm it, repair the cage, then put it back in

AnswerB. With all vehicle doors and windows closed, cover the cage with a thick blanket to darken it, secure the door from outside with wire or a strap, then contact the hospital

ExplanationAn escape during transport leads to bite injuries inside the vehicle and, if it gets outside, harm to the public. First close the vehicle doors and windows to prevent escape outside, cover the cage with a blanket to darken it and reduce agitation, then secure the door from outside with a strap or wire without bringing hands close. If it cannot be secured, contact the hospital for help. Continuing to drive risks it bursting out while moving, causing a serious accident. Opening windows creates an escape route. Driving while holding the door by hand doubles the risk of bites and a traffic accident. Letting it out into the vehicle is the most dangerous option, and it cannot be recaptured.

IssuesThe transport cage latch was not checked before departure, and no spare securing straps were carried. The monkey was transported by one person, breaking the two-or-more rule.

ImprovementBefore transport, have two people check the cage door, latch and lock, and keep securing straps, a blanket and gloves in the vehicle. Transport with two or more people, secure the cage so it cannot move in the vehicle, and stop to deal safely with any problem en route.

A newly renovated cage at a facility. The mesh openings are larger than before, and a 1-year-old crab-eating macaque pushed its head through to peek at the next section and cannot pull it back. Its neck is compressed, the mesh digs in deeper the more it struggles, and its cries are getting weaker. An adult in the next section is approaching.

Which is the most appropriate first action?

1. Pull on the head to force it out
2. Distract it with food and wait for it to free itself
3. Smear oil on the neck to slide it out, and call a contractor the next day if it does not work
4. Move the adult away with the sliding door, put on gloves, support the body while cutting the mesh with cutters to free it, check breathing and see a vet the same day

AnswerD. Move the adult away with the sliding door, put on gloves, support the body while cutting the mesh with cutters to free it, check breathing and see a vet the same day

ExplanationA head caught in mesh with neck compression and weakening cries is the stage before suffocation, and there is the looming danger of being bitten by the adult next door. First move the adult away with the sliding door, put on gloves, support the body to take the load off the neck, and cut the mesh with cutters or tin snips to free it. Afterward check breathing and neck swelling and see a vet the same day. Pulling the head injures the neck and ears and makes the mesh dig in further. Waiting or using oil leaves the risks of suffocation and bites. Waiting until the next day for a contractor is out of the question. The root cause is the facility defect of mesh size unsuited to young animals.

IssuesDuring renovation, no one considered a mesh size a young animal's head could fit through, and there was no safety check after installation. Cutting tools and gloves were not near the cage, and the risk of contact with the adjacent section was not anticipated.

ImprovementSize mesh so that neither the head nor fingers of the smallest animal can enter, and always observe on a trial basis after renovation. Keep cutters, tin snips and gloves in the animal house, and share the entrapment procedure of taking the load off the neck and cutting the mesh.

A plastic foraging toy given to a 9-year-old crab-eating macaque has been dismantled in the cage, and two screws and a spring are missing. The monkey is eating fine so far, but the keeper searched the whole floor and could not find them. The evening feeding is still a few hours away.

Which is the most appropriate action?

1. Contact the vet about possible ingestion, confirm by X-ray the same day, and record vomiting, appetite and whether stool is passed
2. It is fine, so watch the stool for a few days and see a vet if the screws do not come out
3. Give salt water to make it vomit and relax once they come up
4. Give plenty of high-fiber vegetables and wait for them to pass with the stool

AnswerA. Contact the vet about possible ingestion, confirm by X-ray the same day, and record vomiting, appetite and whether stool is passed

ExplanationMetal screws and springs can injure the digestive tract and cause perforation or obstruction, and the best course is to locate them while the animal still seems fine. Contact the vet and confirm by X-ray the same day whether they are in the body and where. From then on, record vomiting, appetite and stool, and see a vet immediately on any change. If perforation occurs while watching the stool for days, it is too late. Inducing vomiting with salt water causes toxicity or aspiration, and sharp objects injure the esophagus. Pushing through with vegetables does not work for sharp metal.

IssuesIt was not anticipated that a dexterous monkey would dismantle a screwed toy, and a toy with swallowable parts was provided. There was a habit of checking for missing parts, but no criteria for a vet visit.

ImprovementLimit toys to one-piece molded items that cannot be dismantled and whose parts are too large to swallow. Record the number of parts before installation and count them at daily collection. Decide in advance that a missing part means imaging the same day.

A 5-year-old capuchin kept at a private home. After a visitor left, it emerged that, finding it adorable, they had given it about half a bar of chocolate. An hour later the monkey is restless and moving about, its heart seems to be pounding, and it is drinking a lot of water. No vomiting yet.

Which is the most appropriate action for the owner?

1. Give milk to neutralize it and wait for it to settle
2. Put a finger down its throat to make it vomit
3. Note the type and amount of chocolate and the time eaten, see a vet immediately and report the course of symptoms
4. The excitement is temporary, so darken the room, let it sleep and see a vet the next morning

AnswerC. Note the type and amount of chocolate and the time eaten, see a vet immediately and report the course of symptoms

ExplanationThe theobromine in chocolate easily reaches toxic doses in small-bodied monkeys and can progress through agitation, rapid heartbeat, excessive thirst and vomiting to seizures. With symptoms already starting, record the type, amount and time eaten, see a vet immediately, and receive treatment such as induced vomiting or IV fluids at the vet's judgment. Milk does not neutralize anything; the fat only alters absorption and may trigger vomiting. Putting a finger in the mouth risks bites and B virus exposure and must never be done. Waiting until morning risks arrhythmia or seizures during the night, too late for treatment.

IssuesThe rule that visitors do not feed the monkey was not enforced, and human food was within reach. The family had not shared criteria for when to see a vet once poisoning symptoms appear.

ImprovementTell visitors in advance that feeding is prohibited and do not bring human food into the room with the cage. Post a list of forbidden foods and set the procedure: if something is eaten, note amount and time and see a vet immediately.

During cleaning at a facility, a 7-year-old crab-eating macaque reached through the mesh, knocked over a container of disinfectant a staff member had left outside the cage, and licked the spilled liquid. Minutes later it is foaming and drooling and pawing at its mouth. The container label says chlorine-based.

Which is the most appropriate first action?

1. Spray the face with the hose to rinse out the mouth
2. Do not induce vomiting; contact the vet immediately with the container label and go in, wiping around the mouth with a wet towel
3. Give large amounts of water or milk to dilute it and make it vomit
4. Wait for the foaming to stop and consider it fine if it has an appetite

AnswerB. Do not induce vomiting; contact the vet immediately with the container label and go in, wiping around the mouth with a wet towel

ExplanationWith corrosive agents such as chlorine products, inducing vomiting is contraindicated because the agent passes back through the esophagus and spreads the damage. Check the ingredients on the container label, contact the vet immediately and go in. Limit cleanup around the mouth to wiping with a wet towel; spraying the face with a hose worsens the condition through aspiration and irritation and can provoke agitation and bite injuries. Forcing large amounts of water or milk induces vomiting. Even when the foaming stops, damage to the esophagus and stomach progresses later and cannot be judged by appetite.

IssuesDisinfectant was placed within reach through the mesh during work, underestimating the monkey's arm length and curiosity. Staff did not know the basic rule of not inducing vomiting with corrosive substances.

ImprovementKeep chemicals in lidded containers out of reach of the cage and at least 1 m from the mesh during work. Post the ingredient list of chemicals in use and poisoning contacts in the animal house, and teach that vomiting is contraindicated for corrosive substances.

A 6-year-old crab-eating macaque let out indoors at a private home dismantled the TV remote, and the owner saw it put a button battery in its mouth and swallow it. The monkey seems unbothered and shows no sign of vomiting. The owner is thinking of watching for now. It is 9 p.m. and the regular vet is closed.

Which is the most appropriate action for the owner?

1. The battery will come out with the stool, so watch until the next morning
2. Scoop out the inside of the mouth with a finger
3. Give oil to help it slide through and watch the stool
4. A button battery damages the esophagus and stomach within hours, so contact the emergency (after-hours) animal hospital and go in immediately

AnswerD. A button battery damages the esophagus and stomach within hours, so contact the emergency (after-hours) animal hospital and go in immediately

ExplanationA button battery discharges inside the digestive tract and within hours chemically damages the wall of the esophagus or stomach, causing perforation. It is an emergency from the moment it is witnessed; even if the animal seems fine, contact the emergency (after-hours) animal hospital, go in immediately and have imaging and endoscopic removal. Waiting until morning is the most dangerous decision. Scooping out the mouth with a finger carries an extremely high risk of bites and B virus exposure. Oil does not stop the battery's damage, and inducing vomiting may spread esophageal injury. Knowing an emergency hospital that sees patients at night in advance is essential.

IssuesElectronic devices containing batteries were left within reach during indoor exercise. The owner did not know the danger of button batteries or where to go for care at night.

ImprovementRemove electronics, batteries and small objects from the indoor exercise room and set it up assuming things will be dismantled. Confirm the emergency (after-hours) hospital's contact and whether it will accept the animal in advance, and agree as a family that ingestion is never just watched.

The door of the storeroom adjoining the facility's exercise area was open, and a bag of rodenticide stored there had been chewed with some contents gone. A staff member saw a 10-year-old rhesus macaque coming out of the storeroom. The monkey is lively with no symptoms, but the bag says anticoagulant type.

Which is the most appropriate first action?

1. Note the product name and ingredients, contact the vet immediately even without symptoms, go in and report the possible ingestion
2. No symptoms yet, so see a vet if bleeding or similar appears
3. Put salt in its mouth to induce vomiting and give large amounts of water
4. Give vitamin K supplements on your own judgment and watch

AnswerA. Note the product name and ingredients, contact the vet immediately even without symptoms, go in and report the possible ingestion

ExplanationAnticoagulant rodenticides cause no immediate symptoms; internal bleeding, bloody stool and difficulty breathing appear days later. The best course is to note the product name and ingredients while still asymptomatic, see a vet, and receive blood tests and antidote at the vet's judgment. Once symptoms appear, bleeding cannot be stopped and it becomes life-threatening. Inducing vomiting with salt causes salt poisoning, and restraining an agitated animal risks bites. Vitamin K is used in treatment, but dose and duration are decided by the vet; self-administered supplements are inadequate and dangerous.

IssuesRodenticide was kept in a storeroom the monkey could enter, and locking the door was not enforced. Knowledge of delayed poisoning was lacking, and the mistaken judgment that no symptoms meant safety was nearly made.

ImprovementMove chemicals and rodenticides to a locked dedicated cabinet and keep doors adjoining the exercise area locked at all times. Share the list and ingredients of chemicals in use with the vet, and set the rule that possible ingestion means a vet visit even without symptoms.

2 p.m. in August, 35°C. In an outdoor exercise area with little shade, a 13-year-old crab-eating macaque is breathing rapidly with its mouth open, motionless and limp. It is drooling heavily, unsteady, and unable to get down from the perch. No misting or fans are installed.

Which is the most appropriate first action?

1. Make it drink cold water all at once to cool the body
2. Immerse the body in ice water to cool it rapidly
3. Move it to a cool, shaded indoor room, cool the body with wet towels and a fan while contacting the vet, and go in right now
4. Move it to the shade and wait for it to recover on its own

AnswerC. Move it to a cool, shaded indoor room, cool the body with wet towels and a fan while contacting the vet, and go in right now

ExplanationRapid open-mouth breathing, drooling and unsteadiness are signs of severe heatstroke, and body temperature must be lowered before the brain and kidneys are damaged. Move it to a cool indoor room, cool the neck, armpits and groin with wet towels while blowing air with a fan, contact the vet and go in immediately. Immersion in ice water constricts blood vessels, trapping heat and causing shock. Forcing water into an animal with reduced consciousness causes aspiration. Just waiting in the shade does not lower body temperature and progresses to multi-organ failure. Above 32°C, cooling is required.

IssuesThe outdoor exercise area lacked adequate shade or cooling equipment, and the monkey was let out during the hottest hours of a scorching day. Early signs of heatstroke and the response were unknown, as was the danger of rapid cooling.

ImprovementEquip the exercise area with shade, misting and fans, and bring animals indoors during the day when temperatures exceed 30°C. Prepare ice blocks with frozen fruit and wet towels, and post the procedure: at signs of heatstroke, cool while heading straight to the vet.

Late on a January night, heavy snow causes a power outage at the facility and the animal house heater stops. Room temperature has dropped below 10°C with no prospect of power before morning. Four crab-eating macaques are huddled together on the sleeping platform, but the one elderly animal is shivering. A single staff member is on night duty with a portable gas stove and blankets.

Which is the most appropriate first action?

1. Burn the gas stove beside the cage for warmth
2. Add blankets around the sleeping platform to enclose it, place hot-water bottles wrapped in towels, and check the elderly animal's shivering and responsiveness hourly
3. Put all four in one carrier and warm them with the car heater
4. Do nothing until morning and wait for power to return

AnswerB. Add blankets around the sleeping platform to enclose it, place hot-water bottles wrapped in towels, and check the elderly animal's shivering and responsiveness hourly

ExplanationBelow 10°C monkeys need warming, and elderly animals in particular become hypothermic easily. Enclose the sleeping platform with blankets to retain heat, boil water on the gas stove to make hot-water bottles, wrap them in towels and place them so the troop can huddle together. Check the elderly animal hourly for shivering and reduced responsiveness, and contact the vet if it becomes limp. Burning the stove beside the cage risks carbon monoxide poisoning and fire, and dexterous hands will knock it over. Putting all four in one carrier leads to fighting and bites, and conditions in a car are hard to manage. Doing nothing endangers the elderly animal.

IssuesMeans of warming during an outage were not organized, and there was no backup power or hot-water bottles. No night-duty procedure accounted for the elderly animal's vulnerability to cold.

ImprovementStock backup power or a generator, hot-water bottles, blankets and disposable heat packs as winter supplies. Inform night-duty staff of the outage warming procedure and vet contacts, and set an observation interval for elderly animals.

An earthquake of lower 6 on the Japanese intensity scale. Part of the facility's animal house wall has cracked, and the steel cage frame has warped, leaving a gap at the door. The three crab-eating macaques inside are screaming in agitation, and one is pushing at the gap in the frame. Aftershocks continue; there are three staff on hand, but the transport cages are in the storeroom.

Which is the most appropriate first action?

1. Catch them one at a time by hand through the door gap and put them in carriers
2. Staff evacuate until the aftershocks subside, leaving the monkeys in the cage
3. Open the cage and let them into the exercise area to calm them
4. Block the gap from outside with boards or straps, cover with blankets to darken it, bring the transport cages and lure them in with food

AnswerD. Block the gap from outside with boards or straps, cover with blankets to darken it, bring the transport cages and lure them in with food

ExplanationAn escape from a warped cage would cause secondary disasters of bite injuries and infection in the disaster zone, so first block the gap from outside with boards or straps to stop escape, and cover with blankets to darken and reduce agitation. Then bring the transport cages and lure them in with food to move them safely. Catching by hand is the most dangerous act with agitated animals and would get several staff bitten. If staff alone evacuate and leave the gap, escape is likely. Releasing into the exercise area adds escape routes while the area's own damage is unknown. During aftershocks, prioritize escape prevention in a short time.

IssuesThere was no reinforcement anticipating cage warping in an earthquake, and transport cages were not kept nearby. Disaster escape-prevention procedures and role assignments had not been decided among staff, forcing decisions on the spot.

ImprovementInspect cage anchoring and reinforcement, and place transport cages, straps, boards and blankets inside the animal house. Set and drill the disaster sequence of escape prevention, darkening, luring, with staff roles, and post local government contacts.

With a large typhoon approaching, an evacuation order is issued for the area where a private home is located. The owner is thinking of putting an 8-year-old crab-eating macaque in a transport cage and taking it to the shelter. The shelter is a gymnasium where the general public gathers, and whether a monkey would be accepted is unknown. The house is near a river and at risk of flooding.

Which is the most appropriate action for the owner?

1. Contact the local government or a facility in advance about a place that can take the monkey, or move it in its transport cage to a safe place such as the second floor of the house with food and water secured
2. Take it to the shelter without telling anyone, covering the cage with cloth to hide it
3. Leave the monkey in its cage at home with extra food and evacuate alone
4. Load the cage in the car, sleep in the car and open the windows for ventilation

AnswerA. Contact the local government or a facility in advance about a place that can take the monkey, or move it in its transport cage to a safe place such as the second floor of the house with food and water secured

ExplanationMonkeys, including Specified Animals, are not accepted at general shelters, and hiding one there is not permitted given the risks of bites and infection. Contact the relevant local government department, or a facility or zoo consulted beforehand, to secure a place to board it, or move it in its transport cage to a place safe from flooding such as the second floor of the house, with several days of food and water and warming supplies. Leaving it in the cage and evacuating means drowning in a flood or escape. Sleeping in a car with windows open creates an escape route, and the car interior is dangerous in heat or cold.

IssuesEvacuation destinations and boarding options had not been discussed with the local government in advance, and the owner did not understand that Specified Animals cannot be brought to shelters. No storage location in a flood-risk house had been considered.

ImprovementArrange a disaster boarding place with the local government or a facility in advance, and stock a transport cage, food, water and warming supplies. Decide a safe location in the house that accounts for flooding and outages, and share the evacuation plan with the family.

A February morning in the facility's outdoor animal house; the water bottle is frozen. Apparently no water has come out since the previous evening. A 16-year-old rhesus macaque is curled up on the sleeping platform, responds sluggishly to calls, feels cold and moves slowly. The other younger animals are moving normally.

Which is the most appropriate first action?

1. Give hot water to drink to warm it from inside
2. Move it to a warm indoor room, warm it slowly with blankets and a wrapped hot-water bottle, give lukewarm water if it can drink, and see a vet the same day
3. Blow hot air from a hair dryer directly on it to warm it fast
4. It will warm up once the sun is out, so just replace the water bottle and watch

AnswerB. Move it to a warm indoor room, warm it slowly with blankets and a wrapped hot-water bottle, give lukewarm water if it can drink, and see a vet the same day

ExplanationSluggish response and a cold body are signs of hypothermia and dehydration, especially dangerous in an elderly animal. Move it to a warm indoor room, warm it slowly with blankets and a cloth-wrapped hot-water bottle, give small amounts of lukewarm water if it can drink, and see a vet the same day. Rapid warming causes shock or burns, so avoid direct hot air from a dryer. Giving hot water to a sluggish animal causes aspiration and mouth burns. Waiting for the sun leaves hypothermia untreated and dehydration advancing. The habit of checking the water dispenser for freezing every morning was missing.

IssuesThere was no procedure to check water bottles for freezing every morning in winter, so it went unnoticed that water had run out the previous evening. Windproofing and warming of the sleeping platform did not account for the elderly animal's vulnerability to cold.

ImprovementIn winter, cover water dispensers with insulation, check for freezing morning and evening, and set out spare water. Windproof and blanket the elderly animal's sleeping platform, and run the heater when room temperature is below 10°C. Share the procedure: warm hypothermia slowly and see a vet.

Last week at a facility, one crab-eating macaque was diagnosed with dysentery and is under treatment. A staff member responsible for cleaning has had diarrhea and abdominal pain for three days and reports bloody stool. Saying "it has nothing to do with the monkeys," the staff member took over-the-counter medicine, came to work, and is still cleaning several cages today without gloves.

Which is the most appropriate response for the facility?

1. The staff member's health is a personal matter, so leave it to their judgment
2. Watch until the over-the-counter medicine works and advise seeing a doctor if it does not
3. Remove the staff member from cleaning duties, explain the link to monkey dysentery, have them see a medical facility immediately, and re-enforce handwashing and protective gear for other staff
4. Reassign the staff member to feeding other animals and give cleaning to someone else

AnswerC. Remove the staff member from cleaning duties, explain the link to monkey dysentery, have them see a medical facility immediately, and re-enforce handwashing and protective gear for other staff

ExplanationBacterial dysentery spreads from monkeys to humans, causing diarrhea with bloody stool. When a staff member develops bloody stool at a facility with an animal under treatment, the link must be suspected: have them see a medical facility immediately and tell the doctor about contact with monkey dysentery. Continuing to clean while having diarrhea spreads infection to other animals and staff and worsens their own condition. Leaving it to personal judgment or watching with over-the-counter medicine becomes a public health problem. Reassigning to feeding does not end contact with the source. Also re-enforce gloves, masks, handwashing and the ban on eating and drinking in the animal area.

IssuesAfter the monkey's dysentery diagnosis, staff health monitoring and enforcement of protective gear were not carried out. Understanding of zoonoses had not reached staff, and there was no system to remove someone from duty when they reported being unwell.

ImprovementWhen an infected animal is identified, check the health of involved staff daily and remove anyone with diarrhea or fever from duty and send them for care. Place handwashing facilities and protective gear in the cleaning area, and post the ban on eating and drinking in the animal area.

A facility is to take in one abandoned crab-eating macaque. Its test history is unknown. Thinking "it would be lonely on its own," the person in charge is about to put it into the cage with the existing troop of four on the day it arrives. The quarantine section is a little way off but has not been used for some time.

Which is the most appropriate response for the facility?

1. Put it in with the troop on arrival day and separate them if they do not get along
2. Put it in the section next to the troop, let them get used to each other through the mesh, and merge after a few days
3. If it looks healthy, put it in with the troop and test it if anything seems off
4. Isolate it in the quarantine section for a set period, complete tuberculin, fecal and B virus and other tests, then merge in stages

AnswerD. Isolate it in the quarantine section for a set period, complete tuberculin, fecal and B virus and other tests, then merge in stages

ExplanationAn animal with unknown test history risks bringing tuberculosis, dysentery, B virus, parasites and more into the troop. Isolate it for a set period in a quarantine section away from the existing troop, complete tuberculin, fecal and virus tests under the vet, then merge in stages after acclimation through the mesh. Same-day merging or contact in the adjacent section cannot prevent transmission via droplets or feces and can lead to losing the whole troop. Even if it looks healthy, tuberculosis and B virus persist without symptoms. During quarantine use dedicated tools and protective gear, and care for the existing troop first.

IssuesEmotional judgment took priority over the importance of quarantine, and the quarantine section had fallen out of use. The facility had no written procedure for introducing an animal with unknown test history.

ImprovementWrite a new-intake procedure and set the quarantine period and required tests with the vet. Keep the quarantine section always ready, and specify dedicated tools, protective gear and the order of care. Merge in stages after observation through the mesh.

A facility staff member with a cold sore (oral herpes blister) on the lip is about to take the feeding shift for the capuchins and marmosets. They think "I've heard monkeys can infect people, but people to monkeys shouldn't be a problem," and have no mask. The capuchins are used to taking treats directly from staff hands.

Which is the most appropriate response for the facility?

1. Remove the staff member from all contact duties with Central and South American monkeys until the blister heals, with another staff member feeding in the meantime
2. A mask makes it fine, so hand over a mask and let them continue feeding
3. Let them feed as long as they wear gloves and avoid hand-feeding
4. Human herpes does not affect monkeys, so let them work as usual

AnswerA. Remove the staff member from all contact duties with Central and South American monkeys until the blister heals, with another staff member feeding in the meantime

ExplanationHuman herpes simplex virus causes fatal encephalitis when it infects Central and South American monkeys such as capuchins and marmosets. Viral shedding is heavy while blisters are present, and the habit of handing treats directly makes it even more dangerous; masks or gloves alone cannot fully prevent transmission via saliva or fingers. The correct response is to remove the staff member completely from contact duties with these monkeys until the blister heals and have another staff member feed. All staff need to understand that transmission from humans to monkeys, not just monkeys to humans, can be fatal.

IssuesStaff did not understand the risk of human-to-monkey transmission, and there was no rule restricting duties for people with cold sores. The habit of hand-feeding treats also created a route of infection.

ImprovementWrite rules restricting duties for people with cold sores, colds, diarrhea and other symptoms, and check at the health screening before entry. Give treats via bowls or feeding ports, never by hand, and enforce masks and handwashing at all times.

In the facility's animal house, staff habitually eat lunch at a desk beside the cages. The desk shows traces of splashed monkey feces, and some people take off their gloves and eat their lunch with bare hands. Recently one staff member has had recurring mild diarrhea of unknown cause. The facility director has been asked for improvements.

Which is the most appropriate response for the facility?

1. Wipe the desk with alcohol before eating
2. Ban eating and drinking in the animal area, set up handwashing and a break area outside it, and establish the procedure of removing protective gear and washing hands before meals
3. Keep lunches in sealed containers and eat quickly
4. Have only the staff member with diarrhea eat in a separate room

AnswerB. Ban eating and drinking in the animal area, set up handwashing and a break area outside it, and establish the procedure of removing protective gear and washing hands before meals

ExplanationMonkey feces and saliva contain Shigella, Salmonella, parasites and more, and eating or drinking in the animal area leads to oral infection via hands or droplets. Wiping the desk does not prevent airborne droplets or contaminated hands, and sealed containers or eating quickly make no difference. Ban eating and drinking in the animal area, set up handwashing facilities and a break room outside it, and establish the procedure of removing protective gear and washing hands with soap before eating. Simply moving the staff member with diarrhea to another room does not cut the route of infection; also advise them to see a doctor to find the cause.

IssuesEating in the animal area had become habitual, and the risk of oral zoonotic infection was underestimated. Handwashing and rest areas existed only inside the area, making hygienic behavior hard in practice.

ImprovementClearly separate the animal area from the rest area and set up handwashing and a place to put on and remove protective gear at the entrance. Post the ban on eating and drinking, require staff to report diarrhea or fever and see a doctor, and hold yearly hygiene training.

On the morning round, an 18-year-old crab-eating macaque has fallen from the sleeping platform and lies on the floor, unresponsive to calls. The body is still warm but chest movement is not clear. Its two cagemates have approached and are touching the body. The staff member is alone, and gloves and goggles are in the vestibule.

Which is the most appropriate first action?

1. Rush over bare-handed, pick it up and check breathing
2. Judge it dead, contact the vet and collect the body
3. Separate the cagemates with the sliding door, put on protective gear, check chest movement and heartbeat, and if absent start chest compressions and contact the vet
4. Observe from outside the cage for 10 minutes and see a vet if it does not move

AnswerC. Separate the cagemates with the sliding door, put on protective gear, check chest movement and heartbeat, and if absent start chest compressions and contact the vet

ExplanationEven if unconscious, a warm body means resuscitation may be possible. First separate the cagemates with the sliding door to secure safety, put on gloves and goggles, then check breathing by chest movement and heartbeat with a hand on the chest. If neither is present, lay it on its side, compress the highest point of the chest with one hand at 100–120 per minute, and continue while contacting the vet. An unconscious animal may wake during resuscitation and bite, so protective gear is essential and picking it up bare-handed is dangerous. Declaring death outright or observing for 10 minutes loses the chance of resuscitation.

IssuesThe round was done with protective gear left in the vestibule, not ready for immediate use in an emergency. The procedure for checking an unconscious animal and the basic of separating cagemates before treatment were not habitual.

ImprovementCarry protective gear on rounds and keep each cage's separation sliding door ready for use. Train breathing and heartbeat checks and chest compressions yearly under the vet's guidance, and post emergency contacts in the animal house.

During a checkup at a facility, a 7-year-old rhesus macaque under anesthesia stops breathing and the vet is securing the airway. The assisting staff member is about to start mouth-to-mouth rescue breathing as learned in a human first-aid course. The bag valve mask is still in the drawer of the treatment table, not at hand.

Which is the most appropriate action for the staff member?

1. Start mouth-to-mouth rescue breathing as taught
2. Put a handkerchief over the mouth and give rescue breaths through it
3. Skip rescue breathing and continue chest compressions only
4. Do not do mouth-to-mouth; get out the bag valve mask, ventilate under the vet's direction and share chest compressions if needed

AnswerD. Do not do mouth-to-mouth; get out the bag valve mask, ventilate under the vet's direction and share chest compressions if needed

ExplanationMacaque saliva and the oral cavity may contain B virus, and mouth-to-mouth is direct exposure of the rescuer's mucous membranes, so it must never be done. A handkerchief lets fluid through and is no protection. A bag valve mask allows safe ventilation; during a procedure under anesthesia, follow the vet's direction and share ventilation and chest compressions. Chest compressions alone supply no oxygen and lower the chance of resuscitation, so use a means of ventilation if one exists. Leaving the bag valve mask in a drawer is a preparation failure; set it out at hand for every anesthesia procedure.

IssuesKnowledge from a human first-aid course was about to be applied directly to a monkey, and the danger of mouth-to-mouth as a route of infection had not been shared. The bag valve mask was not at hand during the procedure.

ImprovementSet the procedure of laying out the bag valve mask, gloves and goggles on the treatment table before anesthesia. Prohibit mouth-to-mouth in monkey resuscitation and agree with the vet in advance on roles for ventilation and chest compressions.

A 6-year-old crab-eating macaque bitten deeply on the forearm in a fight is in a section isolated by the sliding door, with blood spurting from the wound in pulses. A pool of blood has formed on the floor and the monkey is moving around in agitation. There are two staff, with protective gear and gauze at hand.

Which is the most appropriate first action?

1. Cover with a blanket to darken and limit movement, then in gloves and goggles press clean gauze firmly for 5+ minutes, raise the arm above the heart, contact the vet and rush it in
2. Press the wound with bare hands and wait for the bleeding to stop
3. Tie a cord tightly around the top of the arm as a tourniquet
4. Pour antiseptic into the wound and wait for the blood to clot

AnswerA. Cover with a blanket to darken and limit movement, then in gloves and goggles press clean gauze firmly for 5+ minutes, raise the arm above the heart, contact the vet and rush it in

ExplanationPulsing bleeding is arterial and leads to massive blood loss within minutes. First cover with a blanket to darken and limit movement, secure safety with two people, put on gloves and goggles, press clean gauze on the wound firmly for 5+ minutes, and keep the arm above the heart. Meanwhile contact the vet and rush it in for vascular repair and suturing under anesthesia. Monkey blood is infectious; touching it bare-handed carries the double risk of bites and blood exposure. Tourniquets cause necrosis and nerve damage in the limb and are not used. Pouring in antiseptic does not stop bleeding and damages tissue.

IssuesThe decision to separate was delayed until arterial bleeding occurred in a fight. Staff held mistaken ideas about bleeding, such as pressing bare-handed or using a tourniquet, and awareness of blood exposure risk was low.

ImprovementStock gauze, gloves, goggles and blankets for bleeding in each animal house and train pressure hemostasis and limb elevation. Make it known that tourniquets are never used, and set criteria to separate at the first signs of fighting.

At 10 p.m., a 10-year-old crab-eating macaque is limp with bloody stool and vomiting and breathing rapidly. The animal hospital that sees patients at night is an hour away by car. The owner is alone and the transport cage is in the shed. The monkey normally lets itself be held but now threatens when touched. The outside temperature is 5°C.

Which is the most appropriate method of transport?

1. Hold it as usual in the passenger seat and drive with the heater on
2. Contact the hospital in advance, lure it into a lockable transport cage with food, cover with a blanket to keep it warm and dark, and drive
3. Put it in a cardboard box sealed with packing tape on the back seat and drive
4. Wait until morning and take it when the regular vet opens

AnswerB. Contact the hospital in advance, lure it into a lockable transport cage with food, cover with a blanket to keep it warm and dark, and drive

ExplanationLimpness with bloody stool, vomiting and rapid breathing carries the risk of dehydration and circulatory failure and cannot wait until morning. First contact the hospital to confirm acceptance and arrival time, lure it into a lockable transport cage with food, cover with a blanket to keep it warm and dark, and drive. A sick animal threatens and bites even if normally tame, so carrying it in your arms invites bites while driving and escape. A cardboard box will be torn open and it will escape inside the car. Warmth in cold weather and prompt treatment on arrival through advance contact are key; transport with two or more people if possible.

IssuesThe transport cage was in the shed, not ready for immediate use in an emergency. The emergency (after-hours) hospital and how to contact it had not been confirmed, and the danger of carrying a sick animal in the arms was not recognized.

ImprovementKeep the transport cage beside the cage and practice luring it in with food regularly. Research and post the emergency (after-hours) hospital, contact and travel time, and keep blankets and a hot-water bottle in the car for warmth. Always contact ahead before transport.

At 11 p.m., a 12-year-old capuchin is not right. It ate normally during the day, but now it is breathing with its mouth open and its lips and tongue look purplish. It lies motionless and responds weakly to calls. The emergency (after-hours) animal hospital is 40 minutes away by car. The owner is unsure whether to watch until morning.

Which is the most appropriate decision in this situation?

1. It ate during the day, so darken the cage and watch until morning
2. Look up the symptoms online and treat it at home following accounts of similar symptoms
3. Open-mouth breathing and purple lips and tongue are signs to go to the emergency hospital now, so call ahead and transport immediately while keeping it warm
4. Warm the room, give water, and go to the emergency hospital if there is no improvement after an hour

AnswerC. Open-mouth breathing and purple lips and tongue are signs to go to the emergency hospital now, so call ahead and transport immediately while keeping it warm

ExplanationOpen-mouth breathing and purple lips or tongue (cyanosis) mean a lack of oxygen, indicating a serious heart or lung problem, and meet the criterion for going to the emergency hospital now. Having eaten during the day is no reassurance, and waiting until morning carries a high likelihood of death. Call the emergency (after-hours) hospital, describe the symptoms, put it in a transport cage, keep it warm with a blanket and dark, and transport immediately. Online accounts involve different animals and causes and are dangerous. Waiting an hour only prolongs oxygen deprivation, and giving water risks aspiration. At the hospital, give species, age, weight and time of onset.

IssuesThe owner did not know the signs that mean go to the emergency hospital now and nearly chose to wait based on daytime appetite. Emergency hospital contacts and transport preparations had not been arranged in advance.

ImprovementPost the criteria for an immediate vet visit even at night: open-mouth breathing, cyanosis, seizures, loss of responsiveness, heavy bleeding. Research the emergency (after-hours) hospital's contact and travel time, and keep the transport cage and blanket always ready to use.

A facility staff member was bitten on the hand by a crab-eating macaque 10 days ago, rinsed it lightly with water and did not see a doctor. Today blisters have formed at the bite site, there is numbness and pain from the hand up the arm, and a mild fever and headache. The staff member thinks it is a cold and is about to keep working on over-the-counter painkillers.

Which is the most appropriate action for the staff member and the facility?

1. Treat it as a cold and watch for a few days on over-the-counter medicine
2. Possible early symptoms of B virus infection: see a medical facility immediately, report the macaque bite history and date, and the facility provides the exposure record and animal information
3. Apply antiseptic to the bite site and see a doctor if the numbness spreads
4. Have only the blisters looked at by a dermatologist and say nothing about the monkey

AnswerB. Possible early symptoms of B virus infection: see a medical facility immediately, report the macaque bite history and date, and the facility provides the exposure record and animal information

ExplanationBlisters at the bite site, numbness, pain, fever and headache appearing days to weeks after a macaque bite are early symptoms of B virus infection, which has an extremely high fatality rate once it progresses to encephalitis. See a medical facility immediately, be sure to report the macaque bite history and date, and the facility provides the exposure record and the animal's test history to the medical facility. Early antiviral treatment separates life from death. Treating it as a cold and watching, or disinfecting and waiting, are the worst decisions. Having only the blisters examined by a dermatologist without mentioning the bite means the doctor cannot suspect B virus and diagnosis is delayed. The initial decision not to see a doctor at the time of the bite is the root problem.

IssuesWashing for 15+ minutes and same-day medical care were not done right after the bite, and the exposure was neither reported nor recorded. Staff did not know the incubation period and early symptoms of B virus, and the facility had no follow-up system after bites.

ImprovementAlways record bites, scratches and mucous membrane exposures, make same-day medical care mandatory, and have the facility follow up. Teach the early symptoms of B virus (blisters, numbness, fever, headache) and give staff a wallet card listing what to tell the doctor.