Metzger, one of 13 Republicans who filed for the job, defended her conservative leanings Wednesday, arguing that anyone who questions her standing doesn't know her.
"I am conservative," Metzger said in a prepared statement. "I am fiscally, socially and politically conservative. Everything about my life, my faith, my family and my work shows that."
Still, an email that Cook sent encouraging fellow Democrats to pull Republican ballots next week to vote for Metzger prompted criticisms from local GOP leaders. In the email, the Cape Girardeau resident says that Metzger has been her friend and neighbor since 1994. Cook, who served as Missouri secretary of state from 1994 to 2001, cites portions of Metzger's resume, including her master's in social work and her job as director of case management and social services at SoutheastHEALTH. Cook encourages Democrats in the email to take a Republican ballot to support Metzger.
Missouri holds open primaries, meaning every eligible registered voter may select the party ballot of their choice. But primary voters may only pick one party's ballot.
Evan Trump, chairman of the Cape Girardeau County Republican Party, also points out that Metzger contributed to Cook's 2004 lieutenant governor campaign. A review of Cook's financial contributions that year revealed that Metzger did donate $150 to Cook, who lost the election to Republican Peter Kinder by less than 1 percent.
"That just raised a red flag for me and many members of the Republican Party," Trump said. "She's not been politically active before and it's raised some questions about if she's really a Republican. If Barack Obama or Jay Nixon lived next door to me, that doesn't mean I'd give them money, let alone vote for them."
Metzger countered that Cook is a "terrific person and a good friend." She acknowledged that she supported Cook more than 10 years ago because she believed Cook had the best qualifications.
"I think she supports me in this election for those same reasons," Metzger said.
Metzger said she was not aware that Cook had sent an email out asking for others to support her. But Metzger said she's glad she did.
The job calls for being the legal guardian of the county's roughly 150 individuals who have been deemed unfit by a judge to care for themselves.
"It's too important to let politics or personality to get in the way of this decision," Cook said.
But the connection between Cook and Metzger is unsettling, said Holly Lintner, the executive director of the National Federation of Pachyderm Clubs.
"She's given donations to a Democrat and been endorsed by a Democrat," Lintner said. "I understand that people want to capitalize on this county's Republican successes, but we need to make sure that our value system and our party is being represented by someone who respects those values."