It's hard to keep a good dog down, and Andy, a dachshund with Yoda ears and boundless energy, was as good as they get. Ever since he joined Lorraine and Robert Young’s Woodstown, New Jersey, US home as a pup seven years ago, the little long guy had been a tireless source of laughter, licks and doggy love.
This was especially valuable to Robert, who had a rare degenerative neurological disorder, multifocal leukoencephalopathy, that was increasingly limiting his mobility. As Robert’s condition declined, Andy’s favourite place to lounge became the spot right next to him on the recliner.
Basically, Andy was wherever Robert and Lorraine were, with a wagging tail and an eager heart. But one morning in July, when Lorraine had to call for Andy to come to her, she realised something was wrong. “When he tried to come to me, he was dragging his legs,” Lorraine said.
Alarmed, Lorraine brought Andy to St Francis Veterinary Center in Woolwich Township, whose chief vet, Mark Magazu, had been caring for the Youngs’ pets for 30 years.
The diagnosis: Andy was suffering from intervertebral disc disease, a dangerous condition in which the cushioning discs between the vertebrae of the spine push into the spaces between the discs. Overnight, the disease had paralysed Andy’s hind legs.
“The longer pressure is put on the spine, the faster permanent lesions can develop,” said Magazu. “You have a better probability of success the faster you get” into the operating room to repair the damage.
But if time was of the essence, so was precision in the tricky surgery, which required minute manipulation and cutting around nerves.
Lucky for Andy, St Francis is taking part in a pilot programme with Thomas Jefferson University’s Health Design Lab, which is exploring the clinical use of 3D printing for veterinary patients.
Jefferson’s staffers quickly created a 3D replica of Andy’s damaged spine based on data from his CT scan that was then used to guide and inform his surgery the next morning. Andy’s procedure was the first surgical application of the pilot programme.
The technology to create models like Andy’s has been around for a few decades, but it has been extremely costly and not in widespread use. In recent years, however, 3D printing is being increasingly explored as an aid in surgeries and other procedures, especially those that are highly individualised.
Kristy Shine is associate director of Jefferson’s design lab, which is funded largely by institutional support, private grants and donor contributions. Shine said Jefferson’s human 3D models have helped doctors with complicated surgeries.
In the case of a high-risk pregnant patient whose uterine fibroid growths would complicate her delivery by Caesarean section, the lab created a 3D model of her uterus to assist her doctors in determining the best way to deliver her child.
The lab’s work with animals is another way of using the technology to help with individualised health needs. “Anything we can do in human 3D printing can also be applied in veterinary space,” said Shine, who is also an assistant professor at Jefferson’s Sidney Kimmel Medical College.
The University of Pennsylvania’s Matthew J. Ryan Veterinary Hospital has been exploring the use of 3D models for several years, from creating a model skull of a dog with a suspicious mass to making a prosthesis for a parrot.
“There’s a lot you miss when you’re looking at two dimensions” – which a CT scan provides – “and trying to build the three dimensions in your mind,” said Evelyn Galban, an associate professor of clinical neurology and neurosurgery at Penn’s vet school, who is working on further developing 3D printing for surgical use.
“When you can see it and touch it, there’s a tremendous amount of knowledge you wouldn’t get from just looking at a screen.”
Jefferson’s partnership with St Francis helps make the technology available to a community practice. Since it is still research in progress, though, the cost of the 3D printing, so far, has not been passed on to its human patients or the owners of its animal patients.
Andy’s surgery represented a first in the Jefferson/St Francis partnership. But there was another reason everyone hoped dearly for its success: Robert had been under hospice care at home for months, and his caretakers knew his end might be near.
“I knew what Lorraine was going through,” said Magazu, the St Francis vet. “I couldn’t imagine her losing her husband and her dog at the same time. We were going to try the best we could to not let that happen.”
Andy, in that stoic, canine way, seemed to sense the stakes. “He had that look,” Magazu said. “’Do a good job, doc. Get me better.’ He wasn’t fearful. Andy’s not that type of dog.” The outcome of spinal surgeries like Andy’s can vary greatly. Some dogs don’t show improvement for six weeks. Others never do.
But Andy wasn’t just any dog. “He started showing small, little responses almost the day after surgery,” Magazu said. “He started wagging his tail. He started being able to go to the bathroom on his own.”
Hannah McLean, the St Francis vet who has been working with Andy on his rehabilitation, believes the 3D assist made a difference. “The technology provided a faster, more efficient, more complete surgery, which in turn led to a faster, more complete physical therapy afterward,” she said.
Lorraine was heartened by the updates she got from St Francis staff, who were taking care of Andy at their Woolwich Township hospital. At home, however, Robert, a retired DuPont chemical operator, was weakening. After midnight on Aug 6, with his family gathered around him, he died at age 73.
Several hours later, St Francis’ staff sent Lorraine a video clip: Andy had taken his first post-operative steps. A couple of days later, Lorraine, 72, a retired medical lab technician, went to visit him with some family. To everyone’s delight, Andy ran to them – wobbly, but wagging his tail and giving kisses.
“It was a little bit of a bright spot in my day because I know he’s doing better, he’ll be coming home,” Lorraine said. “It won’t be quite the same, not having my husband here with us. But at least I’ll have Andy back. And we can kind of move on together.” – Tribune News Service/The Philadelphia Inquirer/Rita Giordano