The 61-year-old patient broke every clinical mold. At nearly 400 pounds and with a bite force exceeding 3,000 PSI, Bill, a Siamese crocodile at Utah’s Hogle Zoo, doesn’t fit a routine veterinary playbook. So when he began showing signs of sickness last fall, his care team knew standard diagnostics would only go so far.

“Bill was showing decreased appetite, loss of body condition, and bloating on the left side of his abdomen,” says Lauren Smith, DVM, Dipl. ACZM, a board-certified specialist in zoological medicine and clinical veterinarian at Hogle Zoo. But Bill’s bloodwork came back normal, stumping his clinical team.

Radiographs are typically the first line of imaging, Smith says, but in Bill’s case, size and anatomy created clear limitations. “While X-rays are a great diagnostic tool, they were very unlikely to provide the answers we needed,” she says. CT imaging offered a more complete path forward—but it required leaving the zoo.

Fortunately, Hogle Zoo knew exactly who to call, thanks to a prior partnership with University of Utah Health. The question wasn’t just whether 10-foot-long Bill could be scanned, but whether he could safely enter a human radiology suite. What followed was weeks of coordination involving more than 20 people, specialized restraint systems, and sedation protocols designed to manage risk at every step.

Transport was anything but routine. Under veterinary supervision, Bill was lightly sedated, secured to a custom transport platform, and moved into University of Utah Health’s radiology department for a full-body CT. Erika Crook, DVM, Dipl. ACZM, a board-certified specialist in zoological medicine and director of animal health at Hogle Zoo, says the zoo’s maintenance team built a heavy-duty board compatible with CT imaging, allowing Bill to remain on the same platform for both transport and scanning.

Safety—of both Bill and the staff—remained paramount, Smith says. “These crocodiles are incredibly powerful, and the Hogle team did extensive preparation to ensure everyone involved was protected.”

But transport was only part of the challenge. The CT exam itself introduced additional complexity. For starters, Bill exceeded the dimensions of the CT table, requiring careful positioning to scan his entire body.

Scott Ehrgott, RT (R)(CT), CT technologist at University of Utah Health, says the team also adjusted technical parameters to accommodate his anatomy. “We knew more penetration would be necessary given Bill’s tough skin and body habitus,” he says. The team used 140 kVp throughout the scan and increased mAs incrementally from the head and neck through the chest, abdomen, and pelvis.

Motion control was just as critical as image quality. Ehrgott says even small shifts can compromise diagnostic value. “If a patient moves, motion artifacts can render images non-diagnostic. Any manipulation of Bill carried the risk that he could become agitated and attempt to reposition himself. We worked to disturb him as little as possible while keeping him safely within the scanner’s field of view.”

Ehrgott also credits clear, coordinated communication for keeping the process efficient and safe. Each step was discussed in real time with Bill’s veterinarian, Crook. “I would say what needed to happen next — move him this direction, that direction, or rotate him from head-first to feet-first,” he says. “We’d talk it through, agree on the best move, and she would relay it to her team, so everyone was aligned. Then I’d count us down, and we’d execute together.”

Imaging ultimately revealed several gastroliths—stones crocodiles naturally swallow to aid digestion. Smith says they’re common in the species and likely behind his symptoms. There was no evidence of cancer or other major disease, and Bill’s bloodwork remained stable.

After the procedure, Bill returned to Hogle Zoo and recovered under close observation before rejoining his long-time companion, Hillary. Smith and Crook both report steady improvement.

“Bill continues to do well at this time,” Smith says, noting that his care team is tracking appetite, energy, and any return of bloating.

So far, so good, Crook adds. “Bill’s bloating has decreased recently, and his herpetology keepers monitor him every day,” she says. Still, Bill’s dietary preferences have shifted, prompting adjustments to his feeding regimen.

To Smith, the case underscores how diagnostic medicine continues to extend beyond traditional boundaries. “We are always grateful for what we can learn from our human counterparts,” she says. “The anatomy of a crocodile is vastly different from human anatomy, but CT imaging allows us to get answers for patients like Bill.”