For pets, Ko puts heart into neurosurgery

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Rainier Ko’s parents gave him three career choices: a doctor, a doctor or a doctor.

Somehow, he forged a path in the medical field that’s almost completely his own. He’s one of only seven veterinary neurosurgeons in the world.

It’s been a long road — 15 years of post-high-school education in two countries — but Ko says the goal was never to be a veterinary neurosurgeon.

“That was the product,” he explains. “It was the endpoint to my academic curiosity and having the ability and the freedom to pursue it. … It wasn’t one of those dreams that I had like many others do: ‘At 6 years of age I wanted to be a veterinarian.’ That wasn’t how it played out for me.”

Ko was born in Montreal, Quebec, one of three sons of South Korean parents, and spent his childhood in an English-speaking pocket of French Canada.

Like most first-generation kids, he said, he had a “relatively spartan” upbringing.

“The expectations were — at least for any young Korean boy — to be fluent in at least two languages, be classically trained in at least two instruments, as well as a high expectation for academic success… ,” Ko said. “As I started to grow into my own, I started to ask myself: What inspires me? What do I want to do? I certainly was very passionate about medicine … but I had an innate love for animals, domestic and companion. I decided perhaps I’d fuse the two passions together, and the logical outcome was to be a veterinarian.”

Ko earned his undergraduate degree in biology from McGill University before tackling his doctorate of veterinary medicine at the University of Montreal — where he had to complete his studies in French.

In 2000, Ko moved to the United States to do his internship at the world’s largest animal hospital, Angell Memorial Animal Hospital (now Angell Animal Medical Center) in Boston, Mass. He returned to the University of Montreal, and worked as a veterinary anatomy instructor for a year to bolster his training, then moved to Indiana to complete both his master’s in science and his small animal surgery residency at Purdue University.

In 2005 he started as a veterinary specialist at Alameda East Veterinary Hospital in Denver, where his desire to become a veterinary neurosurgeon crystallized.

Ko talked with the Business Journal about his path to Colorado Springs, his drive to give the best care to pets and “pet parents” — and his stint on TV.

What led you to neurosurgery?

As a surgeon, at times there were dogs and cats that would completely confuse me in the way they walked and moved and what they showed. I began to realize the commonality with these so-called odd cases was many of them had neurologic diseases that I couldn’t quite understand. … And it almost seemed — for example, dogs that had brain tumors — that could be considered an immediate death sentence at the time that I was a young training veterinarian. And I thought to myself that on the human side, there are always options that are offered, especially if this is your child, a family member, a friend — and that euthanasia isn’t an option in that field. …

Several factors coalesced at the same time that then influenced me. One was an intrigue for these odd neurologic cases that I could not understand. The second was the desire to drive a field — one where the philosophy wouldn’t be immediate euthanasia for neurologic cases that are deemed to have such a negative prognosis. The third factor that allowed me to pursue this dream … was the fact that I was still single, I had a cat, my parents were doing well healthwise and were traveling the world. So I decided I would embark on a very daunting second residency.

I started my second residency training program [in 2009 at Purdue] in Indiana. Unfortunately 2009 was the same year my mother was diagnosed with gastric adenocarcinoma … . I ended up putting my second residency program on hold, I returned to Canada, I spent time with her helping her through her care and her chemotherapy until she passed. That was in 2010. … I actually lost my residency training program because I was out of it for long enough that in order to fill the needs of the hospital Purdue had to, understandably, hire someone else on.

I asked myself at that point, ‘What do you want to do in life?’ It was a reality check for me. I realized, the best place in the world has always been Colorado, and I want to continue my training program. … [With] Paul Cuddon, who is one of the godfathers of neurology and a friend of mine … we managed to figure out a very novel form of residency training program where I’d spend part of my time as a surgeon at Wheat Ridge Animal Hospital in western Denver, Wheat Ridge paid for my salary and for me to go up to Fort Collins every two weeks, and Colorado State University had [me as] a [veterinary] neurology resident. … I graduated in 2014.

What brought you to Colorado Springs?

I was seeing a lot of neurologic cases referred up I-25 into Denver; neurologic conditions that needed specialty-level care and diagnostics. … When Forbes in 2012 ranked Colorado Springs as the No. 1 pet-friendly city in the U.S., I thought that was quite a paradox. How could we be ranked No. 1 if we could not offer the entire panoply of veterinary specialties in southern Colorado? At the same time, a friend offered me the opportunity to move down to Colorado Springs and to work with Powers Pet Emergency and Specialty — that’s the name of the current hospital that I’m employed at. I thought that would be a fantastic idea. I’ve never been afraid of new endeavors; I’ve never been afraid of moving to a different country, let alone a different city. I had already developed the neurology service at Wheat Ridge Animal Hospital, so I knew what it took to build it. That’s what brought me to Colorado Springs.

You’re double board certified in your field — one of seven worldwide?

Correct. As of right now I believe there’s only seven people that have had the audacity and the insanity to go through two residency training programs. … Legally there isn’t a requirement for me to have this level of training. I feel that my training allows me to perform at a higher level — but to the general public, their understanding of a subspecialist is somewhat irrelevant. Essentially I function as a full-time neurologist, and that extra training that I have benefits the patient.

You had pets growing up?

My dad was a young, poor farmer in Korea — yet throughout my entire childhood he plain-faced lied to me that he was allergic to animals, and I only found that out decades later. I can’t believe I had the wool pulled over my eyes — until he came over to Indiana, hung out with me, and my cat Nikita was rubbing up on him every single day and it finally dawned on me: ‘He hasn’t sneezed once!’

So as a kid, your love of animals was from a distance?

Absolutely. It’s not like you have to grow up racing Ferraris to love them.

How do people afford treatment — is it through pet insurance?

Pet insurance currently is not as pervasive as you’d love for it to be — it’s the minority that are covered by pet insurance. As such, it’s not every person that can afford advanced diagnostics such as magnetic resonance imaging or advanced procedures such as decompressive spinal procedures or fusions or things like that. There are ways, financially, to help a client get through that, whether it be secondary parties that get involved such as CareCredit [veterinary financing] or figuring out payment plans.

The reality is … I personally would be far more successful, financially speaking, if I went to Aspen or certain areas of California … so what would allow one to be successful in Colorado Springs as a specialist, period? I think this is where the central theme of relationships [is important]. All of my appointments are over an hour long — it’s not a 5-minute, quick drive-by, typical human consult. There’s a very in-depth history-taking — that is paramount because animals can’t talk to us, much akin to newborns in pediatrics where it’s the parent that has to translate what they see in terms of symptomology. So there’s that uniqueness when one is spending a lot of time listening to clients, and performing a very in-depth neurologic examination which is almost like an 84-point car inspection on a cat or a dog … and afterwards devising a diagnostic or treatment plan. …

A lot of [clients] are taken aback by what they learn, the explanations and being a part of the process. I never whisk a dog or a cat back behind closed doors and say what I think; it’s always done right there in front of them. That breeds trust, breeds loyalty. And to me, there are … very few situations where I feel like surgery is the only option. …You could coerce people to getting a second mortgage on their home in order to pay for their pet’s needs. That’s not how I work. I do understand that specialty-level care may be unattainable financially … so I can always come up with a secondary plan — and that’s important. I think the word gets out when there’s this ‘Canasian’ Dr. Ko here in Colorado Springs who’s willing to help your pet, no matter what your financial portfolio is. Because most people can afford the consult fee.

You were part of a television show — tell us about that.

Alameda East Veterinary Hospital was the featured medical institution on a show called E-Vets, short for emergency vets. It was the most successful and watched televised program on Animal Planet during that time. A spinoff occurred from it called E-Vet Interns, focusing on the lives and trials and tribulations of the young doctors that interned through that hospital … during the time that I was hired on as a surgeon at Alameda East. It was a wonderful experience — it was reality TV, nothing was scripted — and I think that’s what made it incredibly appealing and dramatic and realistic. …

The reason why I believe Dr. Bob Taylor, who was the former CEO of Alameda East Veterinary Hospital, was so open to such an idea in the first place is because he always believed in transparency — a huge principle when it comes to a business. … He never wanted anything to be behind closed doors, and he wanted the world to see, truthfully, what happens in a veterinary hospital, even one as large and specialized as Alameda East. That captured the audience. We’re talking about 11 million viewers worldwide. …

More than a couple of times you’d say, ‘Gosh, I really hope this surgery turns out!’ I mean, they had the boom overhead, they had you miked, you’re going in on an advanced cardiac procedure knowing full well if things didn’t go well blood could’ve gone shooting up hitting the ceiling and watching a cat die from a patent ductus arteriosus ligation repair failed attempt. It was a lot of pressure. But it’s what made the show unique.

Across your career, is there a case that you keep going back to in your mind?

I know of one amazing case — is it the one I learned the most from? I don’t know. I don’t think it is, but it’s very intriguing. It was a surgery I performed up Colorado State University during my second residency, the one in neurology. Both Dr. Cuddon … and I were charged with the task of treating this older mixed-breed dog that had a cervical vertebral sarcoma, which is a very malignant destructive tumor of bone. It was involving C2 and C3, the second and the third cervical vertebrae.

Interestingly, I’d never been asked before to take the next step — surgical resection or debulking of the majority of the tumor, followed by radiation therapy and chemotherapy — because ultimately it’s a very daunting task to do a partial vertebrectomy, which is partial removal of vertebra or spine, necessitating stabilization and fusion of the neck without damaging the spinal cord and inducing permanent paralysis, followed by a full course radiation therapy and chemotherapy. When you look at the statistics involved with that, the prognosis is pretty abysmal. But I had a very committed family and they wanted what was best. Financially they had the means to move forward with it, and after a long discussion with them, they decided to move forward with all of these procedures.

It was an eight-hour surgery where Paul and I divided and conquered — he did the debulking of the tumor, and with my expertise in orthopedics and implants … it was teamwork and the amalgamation of these special skills that allowed us to perform one of the most incredible surgeries that has ever been performed in Colorado State University. So we did partial vertebrectomy, fused the entire cervical spine — and even the radiation oncologist up at CSU worked with a human radiation physicist down in Denver to figure out how best to dose the follow-up radiation post-surgery. Essentially what I had to do to remove the tumor was build a fortress around it to keep the neck from falling apart, with steel pins, polymethyl methacrylate (otherwise known as bone cement) so it was an incredibly collaborative project. Then of course the veterinary oncologist also followed up with chemotherapy because it was a metastatic form of cancer.

The most amazing part was realizing that Dusty did incredibly well for six months before the pet was humanely euthanized. I went over to the family’s home and did it in the comfort of their own home, with their toddler putting his hand on Dusty during his last breaths. It was absolutely amazing. Are cancers necessarily the death sentence and you can’t do anything about it? What would we have done in a person? Those are literally the words the family told me: “Yes, we’re committed, Dusty is a member of our family, we’re going to do for him what we would do for our family member.” With that was the opportunity to use every bit of knowledge and understanding and training in my skill set to help him. Isn’t that great? I think that’s why it’s somewhat of a pivotal case.

Tell us about your pets.

I have three dogs currently. From youngest to oldest we have 1½-year-old Cricket, who is a Pomeranian poodle mix and a national mill dog rescue. We adopted him at a very young age — he was going to be euthanized by the unscrupulous breeder out in Missouri, [along with] his sister. They both were born with a heart condition that would’ve led to a very early death. They underwent thoracic surgery to have that repaired. His sister was also adopted at the same time, and she unfortunately also had a liver condition and she passed from that. Cricket is faring very well, and is so named because he loves people and will repetitively bound three feet off the ground.

Rowdy, who’s our five-year-old, he’s probably an American bulldog mix. He’s very active, [and] prognathic which means he has this huge underbite, which makes him look akin to a caveman. He’s what I call my crag dog — it’s a term that climbers use when they take their dogs out to the crag or the climbing area.

Finally there’s Hope. She’s 10 years old and she’s a boxer pitbull mix, and she’s the princess of them all. I love her. She actually was adopted by my wife Jenna, and Hope is Jenna’s soul dog. Everyone has a soul pet.

This is an extended version of the profile that appeared in the June 8 print edition of the Business Journal.

Dr. Ko and Rachel Newcomb, a certified veterinary technician, work with patient Gracie at Powers Pet Emergency and Specialty. Photo: Karalyn Robertson

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