When Leon, an 11-year old Lakeland terrier, was diagnosed with a tumor on his cervical spine, his owner was given two options – euthanize Leon or take him to Colorado State University. His owner chose CSU. The result? A collaborative surgical procedure at the intersection of human and animal medicine that is now helping to advance the practice of veterinary neurosurgery at the James L. Voss Veterinary Teaching Hospital.
Leon’s story begins in early February, 2013, when his owner noticed that Leon was having weakness in his hind legs and troubles with muscle coordination. Given Leon’s age, osteoarthritis seemed a possible culprit and Leon was given a prescription medication that seemed to improve his condition, but only briefly. In a matter of days, Leon had deteriorated to the point where he became tetraplegic – unable to move any of his legs. In simple terms, Leon became what veterinarians call a “down dog.”
“Leon had a spinal cord meningioma, a type of spinal cord cancer that grows inside the meninges but outside of the actual spinal cord tissue,” said Dr. Peter Maguire, with the VTH Neurology Service and a member of the CSU veterinary team caring for Leon. “These are typically slow growing tumors and behave benignly, in that they do not spread elsewhere.”
In Leon, the tumor (only 12-mm-by-8 mm in size) was elevating, displacing, and compressing his spinal cord causing his paralysis. Humans with spinal cord meningioma are successfully treated with surgery. In dogs, though, the tumor is usually a death sentence. For Leon’s owner, that was not an option. He contacted a friend who is a neurosurgeon, and the collaborative mission to save Leon’s life began.
“We take these types of tumors out of humans all the time,” said Dr. Mark Reichman, Director of the Neurosciences Institute with Intermountain Healthcare in Salt Lake City. “I thought, if I can cure this in a human, why can’t I cure this in a dog? The anatomy is very similar. The main challenge was equipment. In human neurosurgery we have access to highly specialized equipment that typically isn’t available in veterinary hospitals. That equipment, and some of the techniques we use in human neurosurgery, is the difference between life in humans and death in dogs.”
Dr. Reichman worked with Stryker, a medical technology company, and representative Julia Wilder to have an ultrasonic aspirator delivered to the VTH for Leon’s surgery. Then he and the CSU team, which also included Dr. Bernard Séguin with the Animal Cancer Center, went to work.
“It was interesting to see a human neurosurgeon's techniques, perspectives, and use of specialized equipment which we do not have,” Dr. Maguire said. “Every opportunity to learn and advance in the help of patients, human or canine, is a good thing. I think collaboration helps us all advance in medicine.”
Following surgery, Leon was moved to the Critical Care Unit where his post-surgical needs were managed by Dr. Lauren Sullivan. Leon’s owner had been prepared for the possibility that Leon might not survive the surgery, or may need a ventilator after surgery, with the inherent risk of not being able to breathe on his own again – meaning euthanasia.
“There are important nerves that come off that location on the spinal cord,” said Dr. Sullivan. “If there was any significant swelling or bleeding, Leon would need a specialist to put him on the ventilator until that swelling went down. As it turned out, he had no issues breathing post-operatively, so we were mainly focused on caring for him as he recovered from normal surgical trauma to the spinal cord. After a week, we released him back to his owner who was able to provide comprehensive follow-up care back home in Salt Lake City.”
Leon’s collaborative surgery helped create a connection between human and animal medicine that may now blossom into a center of veterinary neurosurgery excellence at CSU. Dr. Reichman and Leon’s owner are interested in establishing a partnership with the VTH for creating a world-class neurosurgery center, and training the next generation of veterinary neurosurgeons. Leon’s owner, a neuroendocrinologist, also is interested in working with CSU veterinarians to help advance the practice of veterinary endocrinology as well as collaborate in biotechnology ventures.
Today, Leon continues to recuperate though a full recovery will take several months. He is doing physical rehabilitation and, while still a little wobbly, is walking again. Given the choice between life and death, Leon’s owner chose life and in doing so may have helped usher in a new day for veterinary neurology.