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Last year, Patches the Dachshund received the nickname Little Unicorn after developing a large tumor that protruded from its forehead.
Now that the tumor is gone, his Pennsylvania family is calling him Titanium Top.
These terms of affection for the nine-year-old dog retrace the narrative of how patches became a case study in 3D medical printing, a developing frontier in the field of reconstructive surgery in animals.
In March, US and Canadian veterinarians removed a tumor from Patches' head that was so big that she had to cut up to 70% of her skull.
So they made Patches a new "skull" to fill the void. Team members used 3D printing to fit a titanium plate to what was left of the bone. Then they implanted the custom-made plaque in Patches' head as a puzzle piece.
"The plaque fits," said Dr. Michelle Oblak, veterinary oncologist surgeon at the Ontario Veterinary College of the University of Guelph, who worked on patches during the operation at the College of Veterinary Medicine. from Cornell University to Ithaca, New York. we had to follow the contour of the tumor.
Although the technology has existed since the 1980s, 3D printers have only been used in clinical applications in recent years, mainly in veterinary teaching hospitals, according to a 2014 article in The Journal of the American Veterinary Medical Association.
The technology is used to make 3D models from two-dimensional computed tomography before operations on animals such as horses and dogs, allowing surgeons to trace their approach even before the first incision.
"We use it for surgical planning," said Dr. Frank Verstraete, a surgeon at the University of California at Davis, whose team has done dozens of reconstructions of the lower jaw. "It saves us time in the current operating room."
3D printing has also been used to make implants replace the mandibles and bones of damaged legs, such as one placed in a young German Shepherd with a limb malformation in Cornell in 2009.
But it has not entered the current practice in surgery in small veterinary clinics. Costs associated with custom 3D surgical implants for disfigured or injured animals can be prohibitive. But some animals will not survive without such an implant.
That was the case with Patches, according to the team that was working on it.
Patches started developing a little bump on the head several years ago, said Danielle Dymeck, a Pennsylvania correctional officer who has raised the dog since the age of 2 months. The bump did not seem to bother the Patches when she chased cows or did nonsense with Mrs. Dymeck's grandchildren.
But he grew quickly, alarming the family. Their local veterinarian referred them to Cornell University, where Dr. Galina Hayes, an assistant professor, played a leading role in treatment in February.
The Patches tumor quickly became so big that she "ran out of space on the top of her head," Ms. Dymeck said. He began to invade the cavity of the eye and penetrate the brain, said Dr. Oblak.
"It was like a big orange on her forehead," she said.
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The tumor was so prevalent that veterinarians could see that they needed to cut out more than half of the skull bone. But then they had to decide how to cover the vast gap. A common plate made of titanium mesh would leave too much ink in the patches patch vulnerable to compression if it were hit by something.
"And that would be the end of the patches," said Dr. Hayes.
Although there are off-the-shelf implants, bespoke 3D implants are especially good for dogs, says Dr. Oblak, as the shape of their skull varies from the boxer's flat muzzle to the long greyhounds.
Veterinarians therefore opted for a custom 3D printed titanium implant.
On March 22, Patches entered the operating room. The team used a high-speed drill to cut around the tumor so it could be removed without damaging the brain.
"We blew the plate," said Dr. Oblak. "It was amazing, it fits me like a glove."
The operation took about four hours. Ms. Dymeck stated that she had paid the medical fees but that the implant had been provided by Adeiss, a Canadian company. The procedure was highlighted in a article from the Canadian press Sunday.
Ms. Dymeck said that Patches had an unrelated back injury and had recently had seizures, but the family does not know if the seizures are related to the skull surgery. "She's doing very well," she said.
Dr. Verstraete, who stated that the Cornell operation was an "interesting development," said his team uses commercially available implants as part of work primarily involving jaw reconstruction.
"We did not need to print our own custom plates," he said. "I think it's fair to say that as we progress, we will use more, but it will still be a small niche application."
Dr. Hayes said the team is working on the Canadian Veterinary Journal peer review as a case study.
She described the Patches operation as being "unusual" rather than revolutionary, and stated that her contribution could be for cases "where you can literally do nothing other than euthanize her." 39; animal. "
"I think it's still a technology that we're trying to incorporate into veterinary medicine," she added. But, she added, it will still be a niche application. but also because of the financial cost. "
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