Attorney Bliss Foster is a Council Member of the State Bar of Texas Animal Law section and volunteers for the Texas Humane Legislation Network.
Wellness: Healthy Living
Innovative diagnostic procedures and treatments make it one of the nation's finest
Dogs, cats, llamas, wallabies and tigers need not fret about receiving expert medical care, particularly if they live in Texas. Veterinarians at Texas A&M University’s College of Veterinary Medicine and Biomedical Sciences have treated them all, and then some.
Established in 1916, Texas’s only vet school is recognized as one of the world’s leading institutions in veterinary education, animal health care and research. People bring their pets from across the United States—and around the world—to the rolling hills of College Station to receive advanced treatment.
As an integral educational component of the college, the Veterinary Medical Teaching Hospital (VMTH) cared for 19,468 patients in fiscal year 2005. This number represents the number of animals seen and treated in the small animal hospital, large animal hospital, and zoological and wildlife medicine facility. The small animal hospital alone accounted for 12,197 of those cases; many of the patients were dogs.
Noted for its compassionate approach to veterinary medicine, VMTH employs over 200 faculty members specializing in a myriad of fields. Surgical heart treatment, nephrology research, small animal rehabilitation and the unique testing available at the gastrointestinal lab are just a few ways the vet school is helping beloved pets everywhere. The progressive health care options available at TX A&M offer hope to people who cherish their animals.
Surgical Heart Treatment
Until recently, veterinary open heart surgery for the treatment of congenital heart defects and acquired heart disease was largely unheard of, due to limited expertise and the costs associated with equipment. Fortunately, this is changing, albeit slowly.
In 2001, with the use of a heart/lung machine, the first successful open heart surgery at A&M’s vet school was performed in 92 minutes on a two-and-a-half-year-old Golden Retriever named Luke, who is feeling much better these days. Luke suffered from a congenital heart defect known as subaortic stenosis, which can lead to sudden death early in life.
According to Dr. Theresa Fossum, professor of surgery at the school’s small animal hospital and a pioneer in veterinary surgical heart treatment, the condition is a common one, although to date, only two other dogs have been treated surgically for the defect at A&M. This is primarily due to the cost, which ranges from $8,000 to $12,000, and the high mortality risk associated with operating on a diseased heart.
Because the school provides the tools required for the use of invasive surgical techniques (such as the heart/lung machine) as well as for non-invasive coil or catheter-based techniques, the treatment mode can be matched to the patient’s needs. Insertion of intravascular coils or balloons is appropriate treatment for some heart defects, and substantially decreases the expense as well as lowers the surgical risk. Intravascular coils for patent ductus arteriosus (PDA), a common congenital defect in dogs, generally run between $2,500 and $3,000, approximately the same cost as a surgical correction, which, with this particular defect, does not require use of the heart/lung machine.
Robin Presnall, executive director of Small Paws Rescue, Inc., a Bichon Frise rescue and adoption organization in Tulsa, Okla., has traveled to the vet school 28 times in the past five years. “Small Paws just finished its 31st heart repair at A&M,” she said, pointing out that many were PDAs. “On the last trip, I took four puppies. One of them died on the way there, but the other three are feeling much better since the repairs.”
In addition, Dr. Fossum and another A&M heart surgeon, Dr. David Nelson, are interested in mitral valve degeneration, an acquired, difficult-to-treat cardiac disease that eventually leads to heart failure. “Our theory is that if we went into it early and did a simple procedure using a ring around the valve, it would prevent the valve from stretching out,” she explained, adding that treatment of the disease at end-stage is a much tougher proposition, since over time, the valves become increasingly deformed and the heart muscle itself becomes impaired. Because drugs are ineffective, Dr. Fossum is currently seeking funding to support the cost of surgery, which would encourage earlier intervention and thus prevent progression of the disease.*
“Open heart surgery is in its infancy,” she said. “Because we see so much cardiovascular disease, the field needs to continue to grow. There are a great many lives that could be saved.” As with all surgeries, there are risks. “With the heart/lung machine, we’re taking all of the blood out of the body, putting it into a pump, reoxygenating and putting it back in [the body]. There is a risk for bleeding and arrhythmia,” Dr. Fossum explained. Surgical candidates are considered by veterinary referral.
Kidney disease is a common condition in dogs, and kidney-related disorders have been identified in 25 to 30 breeds. Dr. George E. Lees, professor of small animal internal medicine, has been studying hereditary nephritis (HN) in dogs (in humans, this is known as Alport Syndrome) since 1992, when he evaluated an English Cocker Spaniel with the disease. In 1993, Dr. Lees and his colleagues diagnosed another genetic form of the same disease, known as “x-linked HN.” As a consequence, in 1997, Dr. Lees began studying a group of dogs at A&M with x-linked HN; the study is known as the Canine Hereditary Nephritis Project. HN, Dr. Lees explained, is a term used “to designate a general category of inherited kidney diseases, [which] include Alport Syndrome as well as some other disorders that seem to have similar features.”
The aim of the project is to benefit both humans and canines, and the studies have been supported by a series of grants from the National Institutes of Health. “We hope to contribute to the growing understanding of why people who have Alport Syndrome develop chronic renal failure (CRF),” he explained. He added that CRF occurs when the kidneys fail to function sufficiently well to maintain overall bodily health, and the patient becomes ill with a condition known as uremia, which can cause vomiting, weakness and other symptoms.
Additionally, Dr. Lees is hopeful that he and his colleagues, Dr. Anne Bahr and Dr. Keith Murphy, professors in the College of Veterinary Medicine and Biomedical Sciences, will make strides within the international nephrology research community toward slowing or halting the advance of chronic progressive renal disease in dogs. Such an achievement could one day result in a delay of the onset of CRF or, possibly, prevent it in its entirety. Dr. Lees believes that methods can be devised to test urine and/or renal biopsy specimens for “molecular markers” that may help indicate the presence of a specific type of chronic progressive injury common in all renal diseases that lead to CRF.
“The techniques that we have truly ‘mastered’ so far are more along the lines of advancing the diagnosis of the disease than its treatment,” he said. “Being able to do this is essential if we are to study treatment of the disease at all.”
Small Animal Rehabilitation Program
The Small Animal Rehabilitation Program was established at A&M three years ago, and has seen a steady rise in interest by those who want to do everything possible in assisting their pets to heal more quickly and regain strength following surgery or injury. “Our goal is to get the animal back to its pre-injury status as quickly and safely as possible, with an emphasis on patient comfort and good quality of life,” said Dr. Sharon Kerwin, the school’s associate professor of small animal surgery.
The program is similar to physical therapy for humans. Services offered include therapeutic exercises, individualized home exercise programs, neuromuscular stimulation, therapeutic ultrasound, aquatic treadmill and thermal agents. Among the common conditions that benefit from these services are osteoarthritis/degenerative joint disease, hip dysplasia, elbow dysplasia and neurological conditions. Patients also include animals recovering from orthopedic surgery and sports-related injuries.
Not surprisingly, animal rehabilitation has gained popularity among pet guardians who have themselves benefited from participation in physical therapy programs. As a result, animal rehabilitation clinics are popping up across the United States.
When choosing a clinic for a pet, said Dr. Kerwin, it is crucial that owners inquire about the credentials of the person performing the rehabilitation, even if that person is a “human” physical therapist. “Dog and cat anatomy and diseases are very different from humans,” she explained. Animal rehab technicians should have participated in an animal rehabilitation training program and have solid experience with a range of modalities, such as ultrasound and electrical stimulation.
The Gastrointestinal Lab provides specialized testing services, which allows veterinarians to submit samples that help them diagnose and treat GI diseases in dogs, cats and, in some cases, other species. The testing frequently benefits pets suffering from diarrhea, vomiting, weight loss, poor body condition and appetite problems. It is the only GI lab of its type in the world, and the tests that are performed here are considered the international gold standard by the veterinary profession.
“What makes us different from a service lab is our research. We have the largest research group in veterinary gastroenterology in the world. There are 10 vets in our lab conducting research on diagnostic tests, drugs—virtually everything,” said Dr. Jörg Steiner, associate professor of small animal internal medicine and director of the GI Lab.
Dr. Steiner pointed out that GI disease is one of the most common problems in pets. As a result, the GI Lab receives approximately 900 samples per week, including serum, fecal, urine and breath, from veterinarians in the United States, Germany, Switzerland and Great Britain.
The lab offers exocrine pancreatic function testing to diagnose exocrine pancreatic insufficiency (EPI) and pancreatitis. Animals with EPI cannot digest their food because the pancreas does not function properly; the disease is treated with pancreatic enzymes. Pancreatitis is an often deadly disease, especially in pets who remain undiagnosed.
A test for protein-losing enteropathy is also utilized to detect loss of protein in the GI tract. The disease is common in many breeds, especially the Yorkshire Terrier, Soft-coated Wheaten Terrier and Norwegian Lundehund.
Another frequently requested test determines serum cobalamin deficiency, also known as vitamin B-12 deficiency. The disease is common and, Dr. Steiner explained, easily treated. “It is very important to have this test if a dog or cat suffers from chronic diarrhea,” he noted.
Lab testing is also available for bacterial overgrowth, hepatic function, systemic inflammation, and GI permeability and mucosal function. Samples must be sent to the lab by a licensed veterinarian—Texas licensure law prevents the GI Lab veterinarians from speaking directly with individuals unless their pets are patients at the small animal hospital.
Using the school’s one-of-a-kind diagnostic procedures and cutting-edge treatment methods, veterinarians at the Texas A&M University College of Medicine and Biomedical Sciences give pet owners everywhere one of the greatest gifts of all—healthier and happier friends.
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