Dog Blog

Poised breathlessly, a half a dozen news cameramen from practically every newspaper and television station from Denver to Wyoming trained their lenses toward the door, eyeballs jammed tight against the viewfinders, each hoping to get the first footage of the eagerly awaited guest of honor.

It wasn’t a red-carpet, Hollywood affair.

“Come on, Sally,” a voice coaxed from the hallway. Sally the Saluki, a lithe white-haired dog who was the star of the show, shyly hobbled into the room. Cameras clicked and flashed. Unsure about the brouhaha unfolding, Sally followed her owner to the front of the room and jumped up on her designated chair.

This is not an ordinary pup. Sally is missing a back foot, and in its place is a high-tech metal rod with a cushy nub at the end, a space-age prosthetic leg that, while allowing Sally the sort of four-legged mobility enjoyed by other dogs, could eventually have applications for humans.

Sally cuddled up on a blanket in between her new owners, Dr. Erik Egger and his wife Sue, a long way from the side of a dusty highway in the Middle East where she began her journey a year ago.

No one knows what happened to Sally’s back foot. It was gone when she was found by PAWS International, an animal welfare agency.

The Saluki breed is known as the official royal dog breed of Kuwait, and the American Kennel Club claims it may be the oldest known breed of domesticated dogs.

Sally was found by a volunteer who happened to be a Colorado State University alum. The volunteer contacted Egger, a well-known small animal orthopedic expert at the James L. Voss Veterinary Teaching Hospital at CSU. Because of her injury, Sally provided Egger the chance to experiment with advances in animal-prosthetic technology.

Dogs can ably adapt to having only three legs, and dealing with an injury like Sally’s often meant amputation. If a prosthetic limb were used, it would be one that was strapped on. Those have their drawbacks; they can irritate the skin and cause sores. Dogs tend to chew at them and they don’t always stay in place very easily.

What Egger had in mind was something different entirely: a permanent implant.

Sally underwent a series of surgeries. About an inch of the bone in her leg was removed and the implant was designed in such a way that it was surgically attached directly to the bone with a screw. The permanent implant was designed and manufactured by Kyon, a company in Switzerland.

Slobodan Tepic, the company’s owner who was on-hand for Sally’s debut, said the titanium implant was modeled after modern hip replacement surgery for humans. During those types of procedures, metal joints are surgically attached to bone, with the idea that bone tissue will grow over the implant, creating strength and permanence for the replace parts.

Egger said Sally was a challenging candidate, particularly because Salukis have thin skin. Because dogs come in all different shapes and sizes, the device is custom-made for the specific animal.

After the implant was installed, the next step was to develop a foot device to attach to the metal rod that sticks out of the skin. For this, Egger turned to Martin Kaufmann, CEO and Founder of OrthoPets in Denver. A rubber ball cut in half was used as the original foot. Kaufmann made the current foot out of a child’s Croc because he wanted to use a soft and cushy material.

A few others have attempted similar implant procedures, Tepic said, and although Sally’s procedure seems to have gone very well, there are still plenty of advancements to be made.

Egger and Kaufmann will continue to observe Sally to ensure the operation site doesn’t succumb to infection. They are interested in finding the optimal length for the prosthetic leg, and will continue to improve the foot design.

“We’re not going to solve it all in one day,” Egger said. “But I am delighted with how it is doing. … Ultimately, often when helping dogs, you end up helping people.”

As for Sally, she’s busy socializing with her new family members, both of the two-legged variety as well as the four-legged kind, the Eggers’ other five dogs. The prosthesis allows her to be as rambunctious as any other 2-year-old pup.

“She’s quite mellow in the right situation,” Egger said. “She comes to work with me and sleeps in the corner. But don’t let her fool you. She’s quite the terror at times.”

But of course there’s more to Sally’s procedure than simply giving one dog an unusually rare second chance to overcome a dramatic injury–there’s the potential that the research to be done on this lucky dog could very well benefit some lucky humans in the future.

“I don’t want to overstate what were doing,” Egger said. “But personally, I believe there are a lot of applications. Animals may benefit more from this than humans. On the other hand, there are a number of humans missing limbs.

“If this works out, it could be a tremendous benefit.”

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A common sports injury in human knees is even more common in dogs. Each year, more than one million dogs suffer from cranial cruciate ligament (CCL) deficiency, which is comparable to the anterior cruciate ligament (ACL) injury in humans. The common method of treatment by many veterinary surgeons involves cutting the tibia bone to stabilize the CCL-deficient knee in these dogs.

Now, a new minimally invasive technique with less severe complications than previous methods has been developed by a University of Missouri College of Veterinary Medicine researcher.

Unlike humans, CCL injuries in dogs typically do not occur because of a single trauma to the knee but are the result of a degenerative process that leads to early and progressive arthritis. For this reason, and the unique biomechanics of the canine knee, techniques used to repair the injury in humans do not work well for dogs. The new technique, known as Tightrope CCL, is modified from a technique used in human ankles and allows placement of a device that stabilizes the CCL-deficient knee through bone tunnels drilled using very small incisions. MU veterinarian James Cook worked with Arthrex Inc. from Naples, Fla., to develop and test the Tightrope device for dogs.

“Other current techniques require major surgery that involve cutting the bone, which can potentially lead to severe complications, such as fracture, implant failure and damage to the joint,” said Cook, professor of veterinary medicine and surgery and the William C. Allen Endowed Professor for Orthopedic Research. “This new technique is minimally invasive, relatively easy to perform and cost effective compared to other techniques. The dogs in the preliminary trial study experienced fewer and less severe complications with outcomes that were equal to or better than those seen with the bone-cutting technique.”

Cruciate ligament tears are five times more common in dogs than humans and cost U.S. pet-owners more than $1.3 billion each year. The new technique is not for every dog. Because surgeons must be able to drill tunnels in the bone, dogs must weigh at least 40 pounds for the Tightrope CCL method to be feasible. In addition, dogs that cannot follow a physical rehabilitation protocol after surgery and dogs with limb deformities are not candidates for this technique. The 10- to 12-week rehabilitation period is very important for any surgical technique for CCL deficiency in order to optimize successful return to pain-free function and reduce complications, Cook said.

“The times the Tightrope CCL technique has failed are when owners did not give their dogs the full rehabilitation period and let their dogs run, play or traumatize the joint before the knees were ready,” Cook said. “A successful operation is dependent on postoperative care so that the dog can heal well and build muscle for long term function. The Tightrope CCL technique is designed to allow this to happen with less surgery and less risk of a major problem arising, and so far, it has been successful.”

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Adapted from materials provided by University of Missouri-Columbia.

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