Collaboration, Innovation Key to Team's Success
Posted February 04, 2015
College of Veterinary Medicine &
Biomedical Sciences (CVM) Guidewire Group
The Guidewire Group doesn’t believe in hopeless cases. Made up
of practitioners from across the Texas A&M College of
Veterinary Medicine & Biomedical Sciences (CVM) to evaluate
rapidly evolving medical techniques and to collaborate on
challenging veterinary cases, the group harnesses the diverse
skills of its members to develop and provide new treatments for
animals that might appear to be out of options.
Formed in 2014, the group has members that include
cardiologists, surgeons, criticalists, and internists. Their focus
is on improving animal care through creativity, innovation,
and—most of all—collaboration.
“It’s an incredibly collaborative process, because it pulls
skills from different specialties in this really integrated
system,” said one of the team’s founders, Dr. Audrey Cook,
internist and associate professor at the CVM. “We’ve got great
facilities here and a great team, but this is the first time that
we’ve sat down and thought, ‘Let’s actually get a formal group of
people from different fields and with different areas of expertise
to work together on challenging patient problems and be really
integrated.’” This culture of collaboration is not only embraced
for practitioners in the immediate area but also extends to
veterinarians at training facilities or practicing in other
The practice of veterinary medicine evolves rapidly, and the
Guidewire Group aims to be at the forefront of effective treatments
for patients with seemingly little chance of survival and to lead
the way in innovative animal care by providing help, hope, and a
better quality of life.
The group is offering solutions for kidney, bladder, liver,
heart, and airway problems that were unmanageable as recently as 10
years ago. These new treatments can often make a huge difference,
such as sparing the kidney in patients for which the only other
option would have been removal of the organ.
Many of the patients the Guidewire Group sees have been
diagnosed with cancer. Cook points to the example of dogs with
transitional cell carcinoma of the urinary bladder, which often
makes the animal unable to urinate. The Guidewire Group works
together to insert a small device called a stent into a dog’s
urethra to open a way for the urine to escape.
“In the old days, we used to place tubes through the body wall
into their bladders, and it was just awful,” Cook remembered. “Now,
we put in these little tiny devices that hold the urinary tract
open. The dogs go home, and they can enjoy 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
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 three-year-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).
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
“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 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
Dr. Jordan Vitt examines an echocardiogram
after Newfoundland Rachel’s surgery.
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
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 today,” Cook said. “Even if you’ve
never heard of it or ever seen it doesn’t mean that it’s not
Cook said she hopes that all veterinarians will think that
“nothing can be done” less often, even when that may have
previously been the case, as the Guidewire Group could hold the key
to a cure.
“I hope they will say, ‘Let me call the Guidewire Group first,’”
Cook said. “‘I want to make sure there’s not a method I’ve not
heard of,’ before they say, ‘It’s hopeless. I’m sorry.’ I hope they
will take two minutes to shoot us an email or pick up the phone and
find out what options there might be.”
The Guidewire Group has a short slide presentation that its
members are eager to present to as many practitioners as possible.
“If I’m going somewhere to talk about endocrine disease, for
example, and everyone is just digging into their chicken and
coleslaw, I’ll say, ‘Just for six minutes, I’m going to tell you
something really cool that we’re now able to do,’” Cook said.
If there are even a few veterinarians in a room for a continuing
education event, for instance, Cook and her team members always
speak to the coordinator and ask for five minutes. They show
pictures of the procedures and before-and-after shots. “We’re
trying to catch people when they’re in a chair and they can’t get
away,” Cook said.
Ultimately, Cook and the rest of the team want veterinarians to
know that advances in medicine are creating new options for
patients that would have been considered hopeless in the past.
“These techniques have solved problems,” Cook said. “We actually
have solutions now for previously devastating diseases, and that is
the best news for everyone.”
To contact the Guidewire Group, send an email to
email@example.com or contact the Small Animal Hospital at
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