How veterinary medicine can save the world, Part 1: Curing disease - DVM
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How veterinary medicine can save the world, Part 1: Curing disease
In the next few months, we're taking a close look at how veterinary medicine benefits people, not just animals. In this first installment, we meet a 'translational' (cross-species) researcher who's in the process of revolutionizing orthopedic medicine—for people and pets.


The veterinary side of the equation

People aren't writing Cook just for the pain in their own knees and hips. They're bringing their dogs to the clinic—sometimes in a last-ditch effort—for live tissue implants and other advanced procedures in hopes of getting them back to work or back in the field.

Cook's team works with all kinds of working dogs: agility, search and rescue, military, police, hunting, service and field trial dogs. Last year Cook treated an elbow in a rescue dog using a Canine Unicompartmental Elbow (CUE) developed in the Missouri lab for Arthrex VetSystems. The dog, Lincoln, hadn't worked for more than a year when Cook implanted the living cartilage using the CUE medial resurfacing procedure. Lincoln passed his six-month checkup in early May and Cook got word he went to Moore, Okla., to help with the rescue operation after the massive tornado of May 20th. "He helped find some people and some bodies," Cook says. "That's pretty cool."

One particular field trial dog has become a staple of Cook's talks, a symbol of what can be done with live tissue and a key link to human applications. His name is Buddy and he was 7 years old at the time of the surgery. Cook opens the silver Mac on his desk, clears away clutter from his office move, and quickly finds the video record of Buddy's recovery. The first video shows Buddy unable to put his left leg down even with the buoyancy of water on the underwater treadmill. He looks nothing like the athlete who had won field trials and become a favorite of his owner and trainer. Buddy had been subjected to four knee surgeries, the last of which removed both menisci. His whole countenance, Cook says, his appearance and his mood, had degenerated. His owner read about the work Cook was doing at Missouri and decided to give Buddy one last chance.

"He was completely non-weight-bearing lame," Cook recalls. "His owner said, 'Listen, doc, I love this dog but this dog is miserable.'" Buddy had lost 15 pounds and, in Cook's estimation, was depressed. "Those dogs live to work," he says. "If they can't work, literally, they will not eat."

The owner told Cook, "I'm going to have to put him to sleep. Not because I don't care about him, but because I care about him too much. He can't live like this."

Cook explained that the procedure had been effective in research dogs and was being considered in human medicine but was not approved yet. The owner decided to give it a try. So Cook completely replaced Buddy's knee joint with cartilage, bone and menisci grown in the Missouri lab from organ donor grafts. In his clinic office today, three years later, Cook pushes the play button on the Mac and the video shows Buddy "running like the wind," in Cook's words, across an open field, cutting and maneuvering like a halfback slicing through the line. Buddy's even back to winning field trials, Cook says, and he's passed all his checkups.

"I've shown this video all over the world," Cook says. "Every time I watch it—and I've shown it literally hundreds of times—I get goosebumps."

Buddy wasn't the first dog to have live tissue implants at Missouri. The first was a dog from Minnesota who received an implant seven years ago, and the elbow is still sturdy. Dr. Cook recently had two dogs in the clinic with biologic joints, and a third, from Vancouver, British Columbia, had been discharged the day before after a cartilage graft.

The cartilage graft is interesting because that procedure originated on the human side, Cook says. "So," he says, "it comes full circle."


Source: DVM360 MAGAZINE,
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