by Jack Kelly
While Timmy always had an unusual gait when walking, it didn’t slow him down. The two-year-old goldendoodle’s steps were different than how most dogs walk around — bouncier, and at times a little wobbly — but he lived his early years like any other dog.
Until he slipped trying to get into the car one afternoon.
The fall, which occurred in June 2025, left him unable to stand up or walk and with minimal ability to move his legs. A family member caring for Timmy while his owner was out of town rushed him to UW Veterinary Care’s (UWVC) emergency department, where he arrived in significant pain. He was admitted and transferred to UWVC’s neurology service.
Clinicians started with a neurological exam and determined there was a problem with Timmy’s neck, says Starr Cameron (MS’21; Department of Medical Sciences), head of UWVC’s neurology service and assistant dean for clinical and translational research at the UW School of Veterinary Medicine (SVM). From there, advanced imaging was ordered to determine the cause of Timmy’s immobility.
Timmy’s care team was looking for a fractured vertebrae or herniated disc, Cameron says. But it’s what an MRI and subsequent CT scan didn’t show that caught the clinicians’ attention: the young goldendoodle was missing a key piece of his spine. He was born without his C1 vertebra, which connects the skull to the backbone.
“This sort of malformation has never been described before from an anatomic standpoint,” Cameron tells On Call. “Nobody’s ever seen anything quite like this.”
In the weeks immediately following his initial visit to UWVC, Timmy regained most of his pre-accident mobility. However, Cameron and Karina Pinal, a third-year neurology resident, determined that Timmy required surgery. They feared that another fall, even a minor one, could be fatal for him.
The clinicians spent several days preparing for an advanced, first-of-its-kind procedure. Cameron conducted a thorough literature review to understand how procedures in similar cases were conducted and reflected on prior surgeries she had performed to develop a strategy.
Cameron used the CT scan of Timmy’s spine to produce a 3D-printed model of his backbone. The model proved to be “critical,” Cameron says, because it allowed the clinicians to prepare using an exact replica of Timmy’s unusual anatomy.
On the day of Timmy’s procedure, Cameron and Pinal were joined in the operating room by neurologist Natalia Zidan (Department of Medical Sciences), radiologist Samantha Loeber (Department of Surgical Sciences), and second-year diagnostic imaging resident Mattisen DiRubio. Timmy was positioned on his back for the surgery, and Cameron conducted the procedure through a six-inch incision over the dog’s neck.
To begin, she cleaned away large amounts of scar tissue that had formed around Timmy’s spine. Then, Cameron inserted two pins to connect the pup’s skull to his fully formed C2 vertebra. Finally, they embedded four screws to help anchor the pins. The surgeons did it all while navigating around key pieces of Timmy’s anatomy, including his trachea, esophagus, and jugular veins.
The clinicians’ work was aided by UWVC’s state-of-the-art 3D C-arm, an advanced type of diagnostic imaging that combines regular X-ray with a CT scanner to provide detailed, three-dimensional views of the body during surgery. The technology gave the team real-time assessments of implant placements and allowed them to make any necessary adjustments. In total, the procedure took about four hours.
“Traditional imaging technology requires post-operation scans and additional operating room time to make adjustments, which can be challenging for some patients,” says Loeber. “The 3D C-arm’s accuracy and real-time imaging is hugely beneficial to making efficient and effective surgical adjustments while in the OR, reducing burdens for both our patients and our clinicians.”
Today, Timmy is doing great and is expected to live life just like any other dog born with a fully formed spine. He’s visited UWVC for physical therapy and two follow-up appointments, and has returned to being the playful, two-year-old pup he was before the accident.