Patches is an adorable Dachshund who had a big problem. She had a tumor in her head that was so large her human family nicknamed her Little Unicorn. Patches had a small bump that started several years back, but it never stopped her from chasing cows or playing with her owner’s grandchildren. Patches pet mom, Danielle Dymeck, had raised Patches since she was two months old. Unfortunately, the bump started to grow very quickly, and the family became frightened for Patches. Something wasn’t right. Patches had a visit to their veterinarian, who referred them to Cornell University. The tumor grew larger, invaded Patches’ eye cavity, and started to press inward, pushing on the brain. It was obvious that Patches needed the help of a team of veterinarians with very special skills.
That team included Dr. Galina Hayes, assistant professor at Cornell University’s College of Veterinary Medicine; who first welcomed Patches and reached out for help from Dr. Michelle Oblak at the University of Guelph’s Ontario Veterinary College, and Dr. Oblak’s team.
Patches needed a serious surgery. Her tumor was the same size as an orange. It was also a multilobular (having several or many parts) tumor of bone, or osteo (bone) chondrosarcoma (cancer). Surgeons try to remove these cancerous masses when possible, but they often spread to the point where surgery to remove them is no longer the best option. Often, the treatment recommended at this point is radiation and chemotherapy, just as it might be for human patients whose cancers cannot effectively be removed with surgery.
Older procedures for removing tumors such as the one Patches had would have required part of her skull to be removed so that the tumor could be cut out and then a piece of titanium mesh would be fit in place. The surgery was expensive, took a long time, and was not precise. But Dr. Oblak recommended that Patches have a new kind of surgery. In fact, the surgery planned for Patches was so unusual that it was the first in America of its size, and for this reason Dr. Hayes noted that the team would be submitting its work in The Canadian Veterinary Journal for peer review of the case study early in 2019. The success with Patches offered a significant contribution for in cases where there may be nothing else possible except to euthanize the ill animal.
The new surgical procedure relies on a 3D printer to make a custom-made skull cap out of titanium, which is fit in place more easily than titanium webbing. Dr. Oblak knew that only 30 percent of Patches skull would remain after the tumor was removed. Patches needed a strong and stable replacement for the 70 percent which she would lose.
The first step was making a CT scan of the tumor and Patches’ skull. The surgical team used the image with several software programs to precisely map and digitally remove the parts of Patches’ skull which were filled with cancer and the tumor. Next, the team created a map of the area where the new titanium skull would be placed, its appearance, and where screws would hold it securely. Once all these plans were created, they were sent to London, Ontario for ADEISS to make the new customized titanium cap which Patches would wear. ADEISS specializes in medical grade 3D printing.
The entire process included an industrial engineer, software engineers, and several veterinary surgeons. Dr. Oblak created the surgical cutting guide knowing that she had to be accurate within less than two millimeters so the plate would fit Patches. Two weeks after the plans were sent to ADEISS, the new titanium cap was ready. Patches had a four-hour surgery which was successful. Patches’ family gave her the new nickname of Titanium Top after the surgery and Patches began a new life free of cancer.
Just a week after her surgery, Patches slipped and hurt her back. A disc in her back slipped and now her hind legs are paralyzed. The slip and fall were not related to the surgery, and Patches gets around by pulling herself on two feet. She refuses to use the wheelchair provided for her, but Ms. Dymeck said that Patches is still the house’s boss. Ms. Dymeck added that she feels lucky to own Patches, and that Patches is in good spirits and gets around the house pretty quickly.