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These Asian Bears Were Cut Open for Their Bile. Here’s What’s Being Done to Rehabilitate Them
Veterinarians in Vietnam perform surgeries, prepare special diets and craft recovery routines for moon bears to give them a better life
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On the first sunny day of spring, Su Su, an Asiatic black bear (Ursus thibetanus) living in northern Vietnam, is foraging for pumpkin and challenging her friends for a turn in the tire swing. Like her peers at Vietnam Bear Sanctuary, or her wild relatives in forests throughout Asia, Su Su is about five feet tall standing up, with a large, round head and broad paws. Her fur is glossy black, save a white crescent shape around the neck, the calling card that earned this species the nickname of “moon bears.”
But unlike moon bears living in the wild, Su Su is the beneficiary a lifelong rehabilitation process. In 2023, during one of her routine health checks, Su Su received gallbladder surgery and two root canals. On the same day, when her abdominal ultrasound revealed a renal cell carcinoma, she also underwent a kidney removal.
Veterinarians have performed health checks like this on Su Su every two years since she was rescued from bear bile farming in 2016. Organ damage is among the many telltale injuries of life on a bile farm that veterinary staff at the sanctuary look for in their nearly 200 bears rescued from this brutal industry. Like her new den-mates on this side of freedom, Su Su spent the years prior to her rescue in a cage scarcely larger than her body, where a needle was routinely inserted into her gallbladder to extract bile for sale in the traditional Chinese medicine market. Bear bile is used to treat a variety of conditions including gallstones and liver disease. The substance’s high concentration of ursodeoxycholic acid has proved it to be an effective remedy for some ailments, though many herbal substitutes exist today.
Bears rescued from bile farming are given a second chance in Vietnam’s sanctuaries, but their lives are often complicated by the extraordinary health consequences of the conditions they’ve lived through. The veterinarians and caretakers waiting for them after rescue have dedicated years to better understanding these bears and innovating to meet their needs. Through diligent care and research, they hope to restore quality to what remains of their lives.
“A lot of the bears have psychological and physical trauma from their lives in cages, so they’re not suitable for release,” says Brian Crudge, the Laos-based regional director at Australian bear welfare organization Free the Bears. “So we have to provide a sanctuary if we want to get these bears out of farms.”
Bear bile has been taken from wild bears in numerous Asian countries for use in traditional Chinese medicine for thousands of years, but it wasn’t until the 1970s that opportunistic individuals in North Korea developed the first procedures to repeatedly extract bile from living captive bears. The practice was quickly adopted in China, where the government claimed that farming would help preserve dwindling wild bear populations. In Vietnam, the bile farming boom followed moves by the country in 1986 to open international trade and adopt some free-market policies, spurring financially desperate people to start these makeshift bear farms. By the time bear capture and bile extraction were made illegal in Vietnam in 2005, more than 4,300 bears were already caged in basements and sheds throughout the country. They were microchipped and deemed “government property,” but were left in the care of their owners.
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Though those laws prompted the industry’s decline and helped curb the capture of new bears, they were just the beginning of what remains a slow and complicated end for bile farming. The thousands of bears already in captivity at the time of the 2005 laws were rendered unprofitable to their owners unless bile was still extracted illegally. If farmers did continue to extract bile, it was difficult for law enforcement to confiscate the bear with nowhere to put it. Too sick to return to the wild, the bile bears’ futures were in purgatory, with years left in their life spans but nowhere to go.
But in 2008, a third option was created when Free the Bears opened Vietnam’s first bear sanctuary just north of Ho Chi Minh City. Shortly after, Vietnam Bear Sanctuary was founded up north by animal welfare organization Animals Asia. With appropriate places to house rescued bears, it became possible for law enforcement to carry out those 2005 laws. They could confiscate bears that were subjected to illegal bile extraction and seize newly captured cubs. Former bile farmers could also voluntarily relinquish their bears, and many have. Today, Vietnam boasts at least four bear sanctuaries. Together to date they’ve provided homes for over 600 bears rescued from bile farming. There, aside veterinarians and caretakers, these bears embark on the journey of rehabilitation.
“Bear farming doesn’t give animals any choice. They’re in a cage, confined, fed the same thing every day, and that’s their life,” says Shaun Thomson, senior veterinary surgeon at Vietnam Bear Sanctuary, which is tucked in the mountains of Tam Dao National Park about 30 miles from Hanoi. Thomson performed the 2023 removal of Su Su’s kidney. “What we want to do is give them a life where they feel empowered to make all the choices that they can.”
When a rescued bear arrives at the sanctuary, the path to rehabilitation begins in the quarantine enclosure. Here, bears find the space to stretch their limbs and walk for perhaps the first time since being cubs. The sanctuary team begins a full assessment of the bear for the toll that bile farming took on them. While every bear presents a unique case, veterinarians know to look for a few common afflictions: malnutrition, dental problems, gallbladder diseases and skin diseases.
On bile farms, bears have been fed cheap, non-nutritious foods like rice porridge and cereals, often in inadequate quantities, as hunger and dehydration prompt their bodies to produce more bile. Once in the sanctuary, some bears take quickly to a new variety of food, which includes seasonal fruits and vegetables, as well as dog treats to give them added nutrition. Other bears struggle more with the stress of the change and require a slower-paced transition.
The sanctuary’s behavior and husbandry managers track each individual bear’s progress closely. The managers have developed their own stepped program to gently guide the bears through the transition into sanctuary life, which each animal completes in its own time. “So they come in and have their basic needs met, and then their caretakers introduce small challenges,” says Thomson.
The goal of this tiered process is to prepare the bears for entering the communal den at the end of their quarantine. Veterinarians are primarily focused on assessing the bear’s physical readiness to enter this larger space. Meanwhile caretakers are concerned with something that can be even more challenging to address: the psychological trauma resultant from years of abuse in captivity.
Many rescued bears spend their first days of freedom unable to escape learned trauma responses, termed “stereotypic behaviors,” from bile farms. This might look like rocking their head back and forth for hours or pacing in endless concentric circles. These stress behaviors are so engrained in the bears’ psyches that they sometimes take longer to eliminate than physical ailments.
As part of the sanctuary’s strategy to help the animals manage their stress, caretakers keep a meticulous profile of each bear for the remainder of its time in the sanctuary. The profiles will help the caretakers track changes in the animals’ well-being. Rehabilitators know which bears prefer condensed milk as a reward and which would rather have strawberry jam, which ones play fiercely, and which prefer to relax in solitude.
Caretakers also share this information with the facilities staff, a separate team who builds and updates the structures placed in the bears’ enclosures. They create tall structures for bears that enjoy climbing to high places, or pools for bears that love to swim.
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The facilities team also crafts and maintains constant enrichment activities, small challenges that stimulate foraging, exploration and other behaviors that these bears would exhibit in the wild. For example, the team might hollow out a log and fill it with vegetables rather than simply piling food on the ground. This makes mealtime more natural for the bears and promotes mental well-being. “We spend a lot of our effort trying to encourage natural behaviors,” says Crudge. “And in doing that, the bears spend less time on those abnormal behaviors.”
The meticulous observation of each bear also helps the veterinarians, who use the information to consistently re-evaluate their own hypotheses. They constantly improve their strategies for how to best care for the bears’ physical health.
In one instance last year, caretakers recorded that many of the bears at the sanctuary were gaining weight. Veterinarians predicted that the increase was caused in part by their system of feeding the bears different amounts depending on the season. By experimenting with a lower-calorie diet in the fall, they were able to help the bears get to a healthier weight.
Dental care is another point of focus and improvement at the sanctuary. Bears in bile farms tend to chew incessantly on the iron bars of their cages, leaving them with damaged or broken teeth. A poor diet renders them even more prone to infection. Tooth extraction has long been the primary remedy at sanctuaries to help fix bears’ teeth and relieve dental pain. But bears’ canine roots are quite substantial, meaning a sizable portion of jaw structure is removed when these teeth are extracted. Chewing can then lead to a broken jaw or other issues. So, the sanctuary began trying root canals, a procedure common in humans but rare in wildlife. In the practice, a veterinarian can clean the infected tooth without having to remove it.
Last year, Thomson performed the first successful in-house root canal on a bear named Rae, revolutionizing dental care at the sanctuary. Since then, over 100 root canals have been performed on bears rescued from bile farming, and the team is preparing to share its research on the efficacy of the procedure in bears. Because a root canal leaves the tooth and root intact, bears can recover and return to their lives much quicker.
At the sanctuary, lifelong healing is made easier by working with the bears to adopt the “cooperative care” methodology, in which bears are trained to participate in their own care routines rather than being anesthetized for every procedure. “We’ve trained many of our bears to open their mouths on command so that we can assess their teeth,” says Thomson. “It means that if they break another tooth while eating or playing, we can find it quickly.”
To consistently monitor her blood pressure after the kidney removal, caretakers taught Su Su to extend her arm through her den bars for a test, rewarding her with her favorite treats. Other arthritic and aging bears have been taught exercises for stretching and strengthening their limbs, part of the sanctuary’s pioneering physical therapy program.
A bear named Arthur was one of the first to enjoy improved mobility from this program, strengthening his rear limbs. After three years with the ability to stand and climb again, Arthur died in 2023 from gallbladder disease. This affliction is ultimately among the most common causes of death for former bile bears, as the years of cruelty can never be fully erased. Each puncture of the gallbladder for bile harvesting was a new risk for introducing bacteria or inflammation to the organ, which can result in gallbladder stones or terminal infection.
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Of those 4,300 bears caged when bile farming was outlawed in 2005, 177 remain in the cages of Vietnam’s bile farms today, kept by the industry’s most stubborn holdouts. In 2023, Animals Asia opened a second sanctuary in Bach Ma, a national park in central Vietnam, with the capacity to house and rehabilitate each remaining captive bear should they be relinquished. These bears, the last ghosts of an industry expected to reach its end in the next few years, will likely present the toughest health challenges yet. The staff at the sanctuary is preparing for bears with extreme hypertension, advanced arthritis and in need of specialized surgeries.
They’re also preparing to leave the rehabilitation of these last bears in the capable hands of the local people. Thomson and others have launched a program to train local caretakers to be qualified veterinary nurses. “Our new sanctuary in Bach Ma has no expatriate talent in it,” says Thomson. “It’s all Vietnamese-trained. By the end of this year, there won’t be expat vets at this sanctuary either.”
As his six-year tenure leading bear rehabilitation in Tam Dao winds to its conclusion alongside Vietnam’s bear bile industry, Thomson leaves behind a sanctuary where bears, once kept apart on farms and confined by design, now wrestle with each other freely. And research shows these bears are better off.
In 2018, Australian animal behavior scientist Edward Narayan conducted one of the first studies of animal stress-hormone levels over time using samples from the bears at the sanctuary in Vietnam. He examined hormones in fecal samples from 16 bears on the day of rescue, and again each week for 22 weeks. Though the data of each individual bear varied, the overall trend demonstrated that bears’ psychological stress was decreasing the longer they lived in sanctuaries. “So, you know, the bears are in very safe hands,” says Narayan about the team at the sanctuary.
For Thomson, this study was another bit of proof that, despite what’s left to learn, he and his colleagues have been doing things right. “We have to run on the mentality that every life wants to live,” says Thomson. “A faster way to end bear farming would be to just euthanize all the bears and end it. But that takes the ownership of life away from the living being, the one that wants to live.”