Sarah was not breathing right. Trainers could see the Atlantic bottlenose dolphin, who assisted therapists teaching disabled children, was having a hard time.
"Every breath she took was completely abnormal," said marine mammal veterinarian Dr. Michael Renner, who was called in to treat the dolphin. Sarah was taking several more seconds than normal to let air in and out of the blowhole on her back, the only means dolphins have of allowing air into their lungs. The doctors were worried she could have an obstruction, maybe a tumor.
As one of the stars of the therapy program at Island Dolphin Care, a nonprofit center to help children overcome disabilities, Sarah is believed to have helped dozens of children suffering from autism or cerebral palsy with her gentle touch in the water.
But her illness was getting in the way of her work. "Having trouble breathing, she could not do the things trainers were asking her to do and would it have gotten worse," Renner said.
Sarah's owner Deena Hoagland started the non-profit center after dolphin therapy helped her son Joe recover from a stroke that paralyzed his left side at age 3. Born with congenital heart disease and a 90 percent mortality rate, Joe is now almost 27 years old, healthy, and works at the center.
Hoagland and her husband Pete had fought for decades to find the a cure for their son, and now their therapy dolphin needed help, just like the animal that had helped their boy heal.
The first step was to get a CT scan of Sarah's lungs to see what was wrong. Using a CT scanner regularly used on humans, doctors discovered that one of the dolphin's airways was only letting in 20 percent of the air her right lung badly needed.
To form a treatment plan, Renner consulted with other veterinarians and even reached out to doctors who specialized in treating lung disease in humans, like Dr. Andrew Haas, a pulmonologist at the University of Pennsylvania.
"Throughout my entire training in medical school, I don't think there's a point that crossed my mind that I would be doing these procedures on animals, let alone on a marine mammal," said Haas, who soon realized that dolphins had some things in common with humans. "They like to be active as we do, so to see them struggling with breathing problems is not that much different than seeing a patient with breathing problems."
Doctors determined Sarah needed surgery, and not just any surgery — a procedure that had never before been tried on a dolphin in the U.S., only on people.
The staff at Island Dolphin Center was overwhelmed by the news, but Hoagland spread optimism. "I've been through this with my son, I get it and it's all right," she told the center's staff. "We're going to do this and we're going to do the best we can for her."
After working with trainers for months to prepare, Sarah went into surgery on May 11. A team of 22, from radiologists, to physicians, to veterinary technicians, crowded the operating room ready to help. The pulmonologists inserted a balloon into the troubled airway, and inflated it to gently force the duct open, like they had done on people numerous times before.
Then they waited to see if the opening would hold. It did.
A few hours after her surgery, Sarah was ready to go back in the water. The dolphin is now back at work with children who need her, like Oliwia Chyzynska, whose parents brought her to the center from Scotland for help with her cerebral palsy. They say the dolphin makes Olivvia more alert and easier to communicate with.
"If you cant talk with your own child, you have to do everything to communicate with her," said Oliwia's mother, Kamila Chyzynska.
On a recent sunny morning, Oliwia was strapped into a life vest and lowered from her wheel chair into the lagoon with her eyes still closed. A therapist held her while Sarah gingerly touched the girl's hands with her snout.
Suddenly, Oliwia opened her eyes and smiled.