World-renowned (and NOVA local) pet prosthetist Derrick Campana explains his industry
By Joseph Grammer
Many dogs are unfortunately missing legs or unable to fully use the legs they have. What can we do for our pups when an injury or disease affects their mobility? One good option is to head to Animal Ortho Care in Loudoun County, Virginia, and let them help your canine companion walk again.
Animal Ortho is hard at work crafting custom orthoses (braces) and prostheses for dogs and other animals in need. This is a burgeoning industry we will definitely see more of in the future, but even now the world of pet prosthetics is doing some impressive things.
Dr. Derrick Campana is the brainchild of Animal Ortho. He is youthful and energetic, which, combined with his expertise, made him a great speaker for The Dodo, a popular online series that shares videos and stories about animals and the humans who help them. Derrick has gained quite a bit of visibility in his role as a hardworking guy who crafts prosthetics for animals.
It wasn’t always this way, though. Originally, Derrick went to school for human orthotics and prosthetics. He worked at a people-focused office starting in 2004, but one day a veterinarian brought a dog into the clinic and requested a prosthesis. At the time he thought it was odd, but Derrick accepted the challenge and managed to make a prosthesis that worked. This was the “lightbulb” that went off for him, so he became motivated to try making more canine prostheses.
(Just to be clear: prostheses and orthoses are different things. Orthoses brace a limb, while prostheses replace a nonexistent limb. Both are important in mobility work and recovery.)
Dr. Campana has worked in pet orthotics and prosthetics for 13 years, but he still believes the industry is in its infancy period. He says the journey was an uphill battle back then: “no one had seen dog prostheses before, and especially not orthotics.” It was hard at first making knee braces for animals, but Derrick was sure they could help pets avoid some surgeries, with the logic that the brace would stabilize an injured leg and keep it from getting worse.
Nowadays, there are multiple conferences for pet orthotics, and there is more money in the field, not to mention a wide variety of products. Animal Ortho Care has grown in scale over time, too, and by now Dr. Campana estimates that the company has helped around 15-20,000 different animals. That’s a lot of limbs to fix!
The mobility industry is using some high-tech stuff to get dogs back up on their paws. How is a canine prosthesis made? The process has changed over time, but the latest ingredients of a prosthesis/orthosis include high-temperature vacuum-formable thermoplastics, low-temperature thermoplastics, specialized foams, Velcro straps, and padding. Most of these materials conform to human medical industry standards, which means your pup will likely be getting the same treatment as you would in the same situation.
According to Dr. Campana, more plastics are used in animal braces and prostheses, compared to those made for humans. This allows for a greater degree of modification, and makes the process easier to handle from far away—i.e., via snail mail. However, the overall process of making braces and other devices is similar to the way it’s done for humans.
Animal Ortho Care doesn’t physically see the majority (~80%) of its animal patients. The first step in helping a dog involves shipping out a casting kit. Then the owner, or the owner’s vet, will cast the leg and ship the mold to Ortho Care. After that, Derrick and his team build the proper device based on that mold. Once that’s done, they ship it off and the owner tests out the prosthesis. Sometimes it fits perfectly the first time, but other times they have to work to adjust the device, occasionally creating new ones. Then it’s a matter of caring for your limb or brace, which you can learn more about on the Animal Ortho website. While the tread of a prosthesis will wear away, and the foams will need replacing, the durable shell is built to “last a long time.”
Patients local to NOVA can come directly to the clinic in Loudoun County to undergo the fitting and molding process. A facility in Minnesota handles most of the off-the-shelf production, for devices that don’t require as much customization and finesse.
With a dog, you don’t have to care as much about aesthetics in terms of prosthesis design, and you don’t have to worry about a foot fitting into a shoe. Your dog will be happy as long as the limb works properly and doesn’t hurt! This gives the prosthetist some artistic leeway during creation, but of course he does his best to make the device look like something you’d want to strap onto your pup. However, prosthesis creation is a bit more limited with dogs, according to Dr. Campana, partly because of the particularities of fur. Designing for skin, for example, lets you rely on suction systems for a good fit, but fur gets in the way. When designing canine prostheses, device makers use what they call “anatomical suspension points” instead.
A dog needs to have a partial limb of some sort in order to fit a prosthesis—in other words, a lower limb up to the joint. Without a “stump,” the dog will likely require a cart for movement. The Australian rehabilitation center Dogs in Motion says that if “40 to 50% of the antebrachium (radius/ulna) or crus (tibia/fibula) are present,” a prosthesis will work. Otherwise, it could actually hurt your pup’s body! In this case, you might also be able to apply braces to the remaining limbs, and help your dog move that way.
In addition to prosthetic limbs, Animal Ortho offers a range of braces for canine elbows, hips, spines, knees, and paws. These devices can help with sciatic nerve pain, arthritis, and even wound treatment. Here are three common injuries to dogs that often require braces:
1.) Partial cranial cruciate ligament (CCL) tears. This ligament connects a dog’s thigh and shin bones at the knee, which is called a stifle joint in canines. If a dog’s back leg starts limping, it can often signal a partial tear of this tissue. While many injuries can be stabilized with a quality brace, a full tear will usually require surgery.
2.) Achilles tendon rupture. The Achilles tendon is actually a collection of five tendons, and it helps keep your dog’s back heels elevated properly. However, some or all of these tendons can tear, which is an injury more common in large breeds or older dogs. Surgeons have been using Animal Ortho’s Achilles braces for pets during post-op recovery for tendon repair, sometimes instead of the more common “cage-like” brace. An Achilles brace is less invasive since it doesn’t require any drilling or clamping. This is an example of orthoses working in conjunction with surgical procedures.
3.) Carpal hyper-extension. This injury may occur if your furry friend jumps off a high place and lands awkwardly. Many times the first observed symptom is a dog’s hesitation to put her weight on a forelimb, since the carpus is a cluster of bones in the canine “wrist.” Excessive force can tear the carpal ligaments, and in severe cases lead to joint collapse. Surgery may be required for this issue, but nonsurgical candidates can use braces, too—even long-term.
To help create safe and affordable orthoses, Derrick teamed up with the Caerus brand to create and sell customizable leg braces off-the-shelf. Because of the low-temperature thermoplastic technology used to make them, a brace designer can reheat and modify Caerus devices more easily, accommodating changes in the patient’s limb due to swelling or other effects. And since the products can be mass-produced, it’s easier to have a wide effect on dogs with fractures and tears in their legs. (They can also be used to help cover wounds.) The braces can accommodate a range of sizes by adding or removing padding as needed to fit your dog’s limb. Don’t forget to clean and replace the padding regularly, too!
Dr. Campana stresses that contrary to popular belief, orthotics will save people money. He notes that there is a popular conception that “you have to be rich” to get your dog a quality orthotic device, yet an ACL stifle surgery for dogs, especially in the NOVA area, can easily cost $3-5,000. “A good knee brace might be able to do the job for $700.” As for artificial limbs, they cost on average around $1,000. Such devices can help extend a dog’s life by several years, which may be priceless to many pet parents. Even so, if you want your pup to run without draining your bank account, Animal Ortho works with CareCredit (a health financing credit card) to help people pay for braces and limbs. Pet insurance plans can also help.
While Derrick certainly works with dogs (they’re more than 90% of his patients), he also helps many different types of animals. Because of the diversity of these quadrupedal clients, he often needs to find creative solutions. Notably, he built prosthetic legs for two elephants in Thailand. Due to the sheer weight of the animals, there were “a ton” of adjustments he needed to make to figure out all the forces and stresses that would impact the limbs. Plus, he had to take into consideration the specific nature of the injuries, which in this case were caused by land mines. For these mega-sized devices, Derrick sourced some titanium from car parts. He had to locate companies with big enough ovens to vacuum-form custom joints and other pieces.
If all that isn’t enough, Derrick is launching another business called Bionic Pet, which handles nothing but prosthetics. These will be especially helpful for dogs with congenital limb deformities, or dogs with cancer, including osteosarcomas. He recently developed an “IPOP,” or immediate post-operation prosthesis. If Derrick knows that a vet will amputate a dog’s limb, for example, he can make the device right away. This way the surgery is performed, the prosthesis is attached as soon as the procedure ends, and the dog wakes up on all fours. Acclimating the pet to the prosthesis in this way is supposed to help boost the success rate for a finalized and well-adjusted limb.
Another useful tool is 3D printing. This technology has touched many industries, and the field of pet prosthetics is no exception. Although it’s still expensive on the vet side, Dr. Campana created the world’s first 3D-printed canine prosthesis for a Husky mix named Derby. Because of the nature of Derby’s injury, Dr. Campana initially thought he couldn’t make a viable prosthesis. Derby had an illness that left his forelimbs severely deformed at birth. However, Derby’s foster worked for a 3D printing company and encouraged Dr. Campana to try using the technology. Derrick then casted the dog’s leg, 3D scanned it, built the device, and ultimately helped Derby run on all fours more easily than he ever had before. Campana notes that 3D-printed materials break down more quickly than in traditional prosthetics, but replacing devices is much easier.
With all these cutting-edge techniques being used, what is Dr. Campana excited about right now? His answer is pulsed electromagnetic fields, or PEMF. Without using magnets, PEMF runs low-level current through targeted pain areas to reduce inflammation and promote cellular healing. According to him, “the technology has long been proven on the human side,” but Caerus recently bought a company that owned PEMF patents, bringing them to bear on the world of pets. He plans to launch new products in 2018, and he says that this technology will alleviate pain and help dogs rely less on painkilling drugs (for instance, after surgeries). It may also help with ailments like hip dysplasia and arthritis.
Undoubtedly, Dr. Campana has accomplished a few animal mobility “firsts.” In addition to helping elephants, he made artificial forelegs for the first “bionic ram” and crafted the first prosthesis for a camel. Not surprisingly, he has an Animal Planet documentary coming out in March 2018, and a possible reality show after that.
Seeing as how he can seemingly handle anything, what’s Dr. Campana’s biggest challenge? In his words, “not ever [or rarely] seeing the patient.” Because he is building his devices remotely, he really needs to hone his skills so an artificial limb or brace will fit comfortably and account for that particular animal’s unique build. If designing clothes for someone you’ve never met is difficult, imagine how hard it is to build a functional leg that will let a dog move easily, without slipping, without chafing, but never actually be in the same room as him.
Right now, there are only a handful of other people and teams who can do what Derrick does at the same level. What does it take to be a top-notch prosthetic maker? For one, you need to be very good at sculpture, with an eye for extreme details. This is definitely a skilled industry, which means practice, practice, practice at your craft. In the old days, makers would take a block of wood and make prosthetic legs from it; more recently they used carbon fiber. But now 3D printing is ushering in a completely new way of helping canine mobility. Together with high-tech thermoplastics, which are far more adaptable than carbon fiber, we will likely see a boost in the number of orthotic/prosthetic devices available on the market, hopefully with a reduction in price. Dr. Campana may soon be able to produce customized working prostheses for a larger number of dogs (and other animals) than he ever dreamed of.
The future of dog prosthetics and orthotics is “following the human model,” says Derrick. “Once we get a really big database from 3D scanning every single mold, we’ll be able to do more off-the-shelf devices, things will be faster to create, more modifiable, and even less expensive. We have a mold library now, but we’re going to start scanning every single one to really build up a huge database of limbs.” This will save quite a lot of time, since for most of his career, Derick has hand-sculpted his devices.
In terms of breeds, Derrick says he tends to see lots of Golden Retrievers and Labs. Black Labs in particular, he says, seem to come to him with cancers and osteosarcomas, and his braces and limbs have helped them stay up on their paws. With German Shepherds, CCL ruptures are more common, “in part because they’re lower to the ground in the back.” There are also fairly frequent carpal deformities in Ridgeback-type dogs.
One pup who sticks out in Derrick’s mind is Ebony, a local Chocolate Lab who had a higher-level leg amputation. Derrick says that at the time, he had never made a prosthesis for that level of amputation. It took him five or six tries to get the model right, but in the end the artificial limb “worked perfectly.” This was another wake-up moment for Derrick where he realized he could help a greater population of patients.
Surprisingly, Derrick didn’t grow up with dogs, but he has one now: a Cavachon (Cavalier King Charles Spaniel-Bichon Frise mix) named Henry. He is six years old, and he is Derrick’s first dog ever, but don’t worry—he is making up for lost time by bringing his canine to work with him. It’s comforting to know Derrick is out there with his pup, making sorely needed prostheses and braces for dogs. He’s the guy who helps our four-legged friends keep walking.
Please see https://www.animalorthocare.com/ for more information, or to find a brace, prosthesis, or other device for your mobility-impacted dog.
Joseph Grammer is managing editor for NOVADog Magazine. He lives in Alexandria, VA, but grew up in New Jersey with a bunch of adopted dogs, including a mutt (Blizzard) who he found on the street.