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months of comfortable time that would otherwise not have been possible.” The work of the Guidewire Group is not just about treating cancer patients. They offer many new approaches for a variety of serious problems, such as a disease causing blood loss from the kidneys. In the past, veterinarians would have removed the kidney to stop the bleeding. However, for dogs with bleeding from both kidneys, removal is not an option. The Guidewire Group now has a solution. One day a young dog suffering from an invariably terminal kidney disease arrived at the hospital, and the Guidewire Group spent months developing a new approach to his treatment. “We tried this really novel procedure on the dog, where we placed catheters in and cauterized the kidneys. Six weeks later, he was completely cured,” Cook said. “A threeyear-old dog, given back his life. We were overjoyed with the results. He had a condition that was an absolute death sentence even four or five years ago. To have that kind of success is really, really exciting.”

An all-star team After graduating with distinction from the Royal School of Veterinary Studies at the University of Edinburgh, Scotland, in 1989, Cook held an internship in Small Animal Medicine and Surgery at North Carolina State University’s College of Veterinary Medicine. She then spent three years at the University of California at Davis College of Veterinary Medicine as a resident in small animal internal medicine. In 1994 she became a diplomate in the American College of Veterinary Internal Medicine, and in 1996 she was named a diplomate in the European College of Veterinary InternalMedicine. She spent 10 years in private practice in Newport News, Virginia, before joining the faculty at Texas A&M. The Guidewire Group’s all-star lineup is key to its success. Among them, the team has well over 100 years of experience in specialty veterinary care. Aside from Cook, other members of the core team include Dr. James Barr (criticalist), Dr. Jacqueline Davidson (surgeon), Dr. Sonya Gordon (cardiologist), Dr. Jonathan Lidbury (internist), Dr. Kelly Thieman Mankin (surgeon), Dr. David Nelson (emergency room doctor and surgeon), Dr. Medora Pashmakova (criticalist), and Dr. Ashley Saunders (cardiologist).

cardiac approaches to creatively treat non-cardiac organs. The Guidewire Group’s cardiologists, Drs. Gordon and Saunders, have been invaluable in bringing that knowledge to the table. Even though a patient might have a liver or urinary tract problem, some of the techniques of interventional cardiology can apply to the treatment. “It is a question of pulling skills from other areas,” Cook said. Some members of the group have worked with other leading veterinary medicine teams in their application of human medical methods to animals. A successful group in northeastern New York has been a pioneer in this practice, according to Cook. “They trained with human teams and then brought these methods to the veterinary world,” Cook said, adding that members of pioneering teams or their protégés have trained her and most of her team members in these techniques.

Spreading the word The team is eagerly working to spread the word about its research and welcomes emails, calls, and visits from veterinarians with questions about unusual or difficult cases. “That way, we can at least say, ‘Yes, we do this,’ or ‘No, we don’t, but we can make some calls and find out if anyone else can,’” Cook said. Cook said it’s always heartbreaking to learn about situations in which veterinarians were unaware of new treatment options for their patients and tried other treatments that are less successful—or worse, told their clients that nothing could be done. Getting the word out on new procedures is something about which the Guidewire Group is passionate. It’s been looking for ways to bring awareness of its new treatments. “I’ll bump into veterinarians and they’ll say, ‘I heard you did something cool on somebody else’s patient,’” Cook said. “They’ll say, ‘I had a dog like that six months ago. I didn’t even think to call.’” As veterinary treatments evolve rapidly, veterinarians— even recent graduates—need to be aware that techniques may be available that weren’t around when they were in school. “What we couldn’t do even five years ago, we can do

Drawing on other medical fields Cook said most of the group’s cutting-edge treatments actually had their start in human medicine. The techniques have to be scaled down, but they are based on philosophies developed in the human medical field. “Typically, people thought in terms of trying something first on an animal; if it works, you can use it on a person,” Cook said. “Here, we’re looking at human medicine success stories and using the same techniques on our animals. It’s tough. Things have to be scaled down and resized. In these cases, the human is the metaphorical guinea pig.” The team tweaks many procedures to fit patient needs by integrating its combined knowledge based on a “huge foundation” of medical research and practice already underway. For instance, Texas A&M’s cardiology team is known around the world for inventing devices and developing new procedures, and the Guidewire Group often uses these innovative

Dr. Jordan Vitt examines an echocardiogram after Newfoundland Rachel’s surgery.

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CVM Today - Winter 2014