This is Zena, a spirited dog who found herself going through a bit of a rough patch in late 2016. As many of us know, the best prescription for climbing from our lows in life is a heavy dose of personal fortitude, plus a little bit of luck, and help from those around us. Luckily, Zena has both a warrior’s spirit and some very resourceful friends. This is the story about Zena’s struggles, the people who worked together to get her back on track, and how 3D printing technology helped them along the way.
Welcome to SAHS
Zena arrived at the San Antonio Humane Society (SAHS, www.SAhumane.org) with some obvious physical ailments. “When Zena came into the shelter we immediately noticed she had an issue with her mouth/jaw,” said Samantha Delicati, Specialty Case Manager at the SAHS. “She was unable to open her mouth and could only get her tongue out of a little gap on the left side, to eat and drink. After speaking to the owner who was surrendering her, we gathered that her jaw had been locked shut for almost a year.” As is to be expected, these physical issues took an emotional toll on Zena. “She was very stressed and uncomfortable and did not want her face being touched,” Delicati said. With Zena’s previous owners unable to continue caring for her, the staff at the SAHS decided to take her in, unclear about what was wrong with her or the extent of the damage. “Our initial thoughts on what may be causing the lock jaw were tetanus or a rare inflammatory muscle disease found in dogs. The other option was that the dog had an old jaw injury/fracture that healed incorrectly, causing the bones to fuse and lock the jaw.” Delicati and staff decided to focus on the latter, consulting with a few specialists in the San Antonio region to help formulate a specific diagnosis. This is where Dr. Justin Harper comes in.
Dr. Harper is the owner and lead surgeon of Texas Specialty Veterinary Services (TSVS, www.tsvs.net) which provides small animal surgical services to veterinary clinics, allowing practitioners to offer their clients an additional option for select surgical services within their very own veterinary practice. Basically, TSVS is a team of mobile veterinary surgeons and surgical technicians who provide much needed services for overloaded clinics. TSVS partners with the SA Humane Society just as they do with many veterinary clinics in San Antonio and the Hill Country, though with the more specific goal of working with, “non-owned animals…to provide better care for them so that they can become adoptable and placed back into family homes.” Working together, Delicati and Dr. Harper determined that Zena indeed had a previous injury that healed poorly. “Radiographs revealed she had previous trauma to her left zygomatic arch and maxilla that created a exostosis or bridging of the maxilla and mandible at the location of the original trauma.” In other words, improper healing of trauma to the left side of Zena’s face caused a benign growth of new bone between her maxilla and mandible, locking her jaw shut. It became clear that surgery would be challenging but necessary. Dr. Harper’s extensive background helped him foresee these challenges and he decided to employ a few technical resources to help give him a clearer definition of the injury prior to making any cuts.
Zena in 3D
Luckily, due to a medical donations fund provided to the SAHS, Dr. Harper was able to pursue more advanced imaging technologies to gain further insight into Zena’s case. Zena was referred to Dr. Gary Norsworthy, owner of The Alamo Feline Health Center (www.alamofeline.com). The Alamo Feline Health Center is one of the only clinics in the San Antonio area that owns and operates a Computerized Tomography (CT) Scanner and, although the center is a dog-free hospital environment, the Alamo Feline Center does allow canine companions to be imaged at the facility due to limited availability of CT scans in the San Antonio area.
Dr. Norsworthy graciously helped perform a CT scan of Zena’s skull which was instrumental in providing a wealth of information for surgical planning. “This imaging exam allowed us to reconstruct Zena’s skull in 3D in order to visualize and determine the extent and location of the cause of her injury.” But Dr. Harper didn’t stop there. In 2015, prior to performing a complex surgery on a dog named Moose, Dr. Harper utilized 3D printing technology to better visualize Moose’s injury and practice the surgery on a reproduction of Moose’s actual leg bone (Check out https://www.youtube.com/watch?v=aAf-cYVIzJE for Moose’s story). For Zena’s case, Dr. Harper approached me at DiFi3D to help take the images from the CT scan and provide him a 3D printed model of the region of interest. Working with the scanned images (or DICOM files), open-source medical image processing software, and 3D mesh sculpting software DiFi prepared the 3D image of the damaged region of Zena’s skull and printed a highly accurate 3D model for Dr. Harper to inspect prior to going into surgery.
A few weeks after Zena’s surgery I was lucky enough to accompany Dr. Harper and his team for a day of surgeries at various clinics. Up to that point, I had never been in a surgical environment other than my own (if you take a look at my left hand you’ll see I’m not very proficient with a chef’s knife). It turned out to be one of the more rewarding things I’ve experienced, partly because I got to meet Zena and interview the staff at the SA Humane Society. * After almost a year of dealing with a locked jaw, she could open her mouth within only 24 hours of the surgery. She has since recovered nicely with a complete transformation of her personality. I spoke with Felicia Niño, Director of Communication at the SAHS, who said, “Zena has been living in my office pretty much since she was surrendered to the SAHS. I’ve been playing with her, showing her love, and monitoring her progress with food, water, toys, treats, etc. She even kissed me for the first time ever last week. Her personality has flourished and progression has been absolutely amazing!” (To see more about Zena’s transformation, check out her adoption video on the SA Humane Society’s YouTube channel: https://www.youtube.com/watch?v=1RCfet51f9s).
Thanks to so many individuals and organizations working together, Zena’s surgery this past November was a success. The 3D services DiFi provided for Zena’s case pales in comparison to the work of the SAHS staff, Dr. Harper and his team at TSVS, and Dr. Norsworthy. But, when asked if 3D printing technology had a positive impact on the outcome of the surgery, Dr. Harper answered with a definite yes. “3D printing allowed us to see the real problem or bone issues at hand without all the soft tissues (tendons, ligaments and muscles) present. We were able to plan ahead accordingly and create a favorable environment for success for the patient. Had it not been for 3D printing we would literally have gone into surgery blind. We are thankful for the relationship and willingness DiFi was able to provide us in allowing a successful outcome for Zena.”
Thank you so much to Felicia Niño, Samantha Delicati and the rest of the SAHS staff for protecting and improving the lives of dogs and cats by providing shelter, care, adoption, rescue, spay and neuter programs, and education for the San Antonio community. Thank you to Dr. Justin Harper, Dr. Curry Keoughan, and the rest of the TSVS staff for your work and for giving me a firsthand look at what you do. You’ve helped open my eyes to another rewarding service that DiFi can provide. Lastly, thank you to Zena for showing us that even after years of painful experiences we can bounce back to fight another day. In my opinion, Xena:Warrior Princess has nothing on you.
For more information about the San Antonio Humane Society’s mission and provided services visit www.SAhumane.org
To read more about the Texas Specialty Veterinary Services team and the services they provide visit www.tsvs.net
* To download the questions and answers from our interviews with the SAHS staff as well as Dr. Justin Harper click here.