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Cornell Veterinary Medicine

`HIGH-TECH' COMES TO `VET MED' Fiberoptics to repair a racehorse's knee, a pacemaker to extend the life of the family dog, plastic surgery for cats--clearly, modern medical technology isn't just for people.

A yearling filly lies on her back on a surgical table, her front legs tied together and her body draped with blue sterile cloths. Carefully, the veterinary surgeon removes degenerating bone from the horse's left hind leg using arthroscopic surgery, a microscopic surgical procedure. Using a special fiberoptic tool that can be viewed on a television monitor, the surgeon watches the screen to guide his movements as he performs the operation. An electrocardiograph monitors the filly's heartbeat as the blue-suited surgical team pays close attention to other vital signs.

Awake and alert 45 minutes after major surgery, the filly paws the straw and prances around in her stall. Being a thoroughbred, the filly can now look forward to competing at the racetrack.

Arthroscopic surgery is most often used in sports medicine to repair the joints, tendons, and ligaments of injured human athletes. But increasingly the joints, tendons, and ligaments of equine athletes--racehorses--are also being repaired by arthroscopy, as medical procedures that were once considered fit only for humans have found a niche in animal care.

What's true of ailing horses is also becoming true for dogs, cats and other critters, too. When it comes to modern medicine nothing, it seems, is too good for the family pet. Schnauzers with abnormal heartbeats get pacemakers, cocker spaniels with cataracts get surgery and soft contact lenses during recovery, large dogs with hip deterioration get metal and plastic prostheses, and chemotherapy and plastic surgery helps animals with cancer live longer. The list goes on. CAT scans and ultrasound--the latest in diagnostic techniques; blood banks; arthroscopic, laser and open-heart surgeries; and organ transplants aid the sick pet.

Veterinarians at Ohio State University performed one of their first successful kidney transplants on a large, mixed-breed dog who suffered kidney failure after he lapped up some sweet-tasting antifreeze. After being kept alive for a time on a dialysis machine, the family pet received a donated kidney from his sister and continued to live a dog's life for the two years he survived after the surgery.

That pet owners are willing to go to such lengths should come as no surprise. "A lot of people treat pets as part of the family," says Alan Entin, a psychologist who is president-elect of the Division of Family Psychology of the American Psychological Association. Sometimes people even get along with their pets better than their spouses, he notes.

America is clearly a nation smitten with pets. "In 1987, Americans spent between $10 billion to $12 billion on pet products, grooming services, and veterinarian bills," says Marshall Meyers, general counsel to the Pet Industry Joint Advisory Council. Pet ownership has reached an all-time high: There are 49 million dogs, 58 million cats, and about 245 million other furred, feathered or scaly pets sharing our homes. No one has bothered to count the fish in our aquariums, says Meyers, but the numbers are probably high. To support this large pet population Americans spend five times as much on dog and cat food as on baby food.

The history of veterinary medicine can be traced to the ancient Egyptians, Greeks, and Romans. They left records that mention how they spayed to control the animal population. And the Roman emperor Augustus had hospitals built for sick animals. But modern veterinary medicine began in 1762 with the founding of the National Veterinary School in Lyon, France, which later became the site of much of Louis Pasteur's work searching for a cure for rabies in dogs.

In the 1940s and 1950s antibiotics made their mark in veterinary medicine. "Antibiotics had a tremendous impact on veterinary medicine, substantially reducing infectious diseases and allowing animals to live longer," says Gerald B. Guest, the veterinarian who heads FDA's Center for Veterinary Medicine.

As a result of living longer, animals succumb to many of the same geriatric diseases as the aging human population: cancer and other kinds of tumors, heart disease, and dental and eye problems. Many of the same medical procedures that save the lives of their human owners can extend the lives of pets.

"Techniques from human medicine are readily adaptable to animal medicine," says Guest. For example, Cornell University's School of Veterinary Medicine recently purchased the latest in laser technology, a carbon dioxide laser scalpel. With this scalpel, veterinarians can remove tumors that couldn't previously be excised because the procedure would cause excessive bleeding, says Alan Nixon, associate professor of veterinary medicine. Laser surgery causes less bleeding and less trauma to the body than conventional surgery.

Although Cornell is one of the first veterinary schools to purchase this tool and veterinarians have not fully explored its use, Nixon anticipates no problems in adapting it to animal surgery.

Plastic surgery, now more popular than ever among humans, has also invaded the animal world. Surgery for oral cancer, a common disorder among dogs and cats, may leave the animal unable to breathe properly, eat, or swallow because of the hole left behind after removing the tumor. Plastic surgery can repair the hole, often saving the pet's life.

"We are often able to extend the life of an animal a few years," says Michael Pavletic, a veterinary plastic surgeon with special skill in skin grafting. Pavletic rebuilds an animal's face with skin grafts from the lips, cheeks or other areas. And pets have a distinct advantage over humans: Their fur hides the scars.

Horses, because of their large size, merit their own special kind of care. At Tufts University School of Veterinary Medicine's neonatal intensive care unit, premature foals (and a growing number of premature llamas--the newest "in" pet) are infused with plasma, antibodies and glucose to ensure their survival. Heated waterbeds to prevent bedsores, a king-sized incubator, padded stalls, and oxygen equipment complete the unit. Round-the-clock nursing is provided, and, just as with human "preemies," foal "preemies" (who can weigh as much as 100 pounds) are held and cuddled by the nursing staff.

Owners bring in not only thoroughbred foals, but also preemies whose bloodlines are not so pure. "It doesn't take long for a foal to win your heart," says veterinarian Mary Paradis, director of the neonatal unit. She adds that owners say they would mortgage their home if necessary to pay for the care of a premature foal.

Paradis says they've been able to save 50 percent of the foals since the unit opened in 1984. Before, most would have died.

The 24-stall equine hospital (with an additional five intensive care stalls) at the Virginia/Maryland Regional Veterinary College's duPont Scott Equine Medical Center in Leesburg, Va., rivals any human hospital. Each of the two 12-stall wings has a nursing station and each stall is equipped for providing intravenous treatment for the recovering horse.

The center also has cardiology, radiology, surgery, autopsy, and recovery rooms, as well as its own pharmacy and blood laboratory. It is equipped and staffed to provide the latest in surgical techniques--laser and arthroscopic surgery--and in diagnostic procedures, including ultrasound and video endoscopy.

The use of the video endoscope has alerted veterinarians to a high incidence of equine ulcers. A video endoscope is a long tube with a miniaturized video camera at one end. It is passed through the horse's nose and down the throat to the stomach where it transmits pictures for viewing on a color monitor.

A recent survey conducted in Virginia, Maryland, England and Ireland by Michael Murray of the Equine Center revealed that 50 percent of the foals checked had stomach ulcers. Even higher rates were discovered in adult racehorses: 80 percent had ulcers, compared with an incidence of 35 percent in show, riding school, and pleasure horses.

"Without the endoscope we would not have been able to discover the true prevalence of equine ulcers," said Murray, who presented his findings for the first time at the Third Equine Colic Research Symposium in Atlanta last November. "We haven't yet determined the cause for this high incidence of ulcers in racehorses, but I suspect that exercise may influence the physiology of the stomach, making it more receptive to ulcers," he said.

Of course, all this high-tech care comes with a high-tech price tag. The American Veterinary Medical Association estimates that veterinary costs for household pets total $5 billion a year. Still, veterinarians charge far less than doctors who care for humans. A veterinary ophthalmologist might charge $500 to $700 to remove cataracts on a dog; for a human, the cost of surgery soars to between $1,600 and $1,900.

Nonetheless, the good old days of veterinary medicine, when the major pet medical bill consisted of paying for routine vaccines, are probably over.

For instance, the kidney transplant operation for the dog at Ohio State cost $14,000. The owner paid $2,000 while the University bore the remainder. And the expenses don't end with the surgery: There is an ongoing monthly bill of approximately $500 for the drug cyclosporine to keep the dog's body from rejecting the new organ. Another dog who received a kidney transplant survived only seven months because the owners switched to a less expensive drug, which may have contributed to the dog's eventual death from recurrent urinary infections.

"You have to be pretty wealthy to afford transplant surgery for your pet," observes Dennis Chew, the veterinarian who operated on both dogs.

A new pacemaker to regulate heartbeat costs between $5,000 and $6,000. To offset the costs of pacemakers for pets, the Pinellas Animal Foundation in Florida has established a dogs' pacemaker bank with devices donated from human heart patients who have died or had their pacemakers replaced. (The same pacemaker that fits humans also fits many animals, from cats to horses.)

High medical bills were bound to bring about one thing: pet health insurance. There has been a "dramatic increase in people applying for pet health insurance"--especially since pet bills can range from several hundred to several thousand dollars, says Christopher Cross, vice president of marketing for the Animal Health Insurance Agency in Danbury, Conn. Currently, two pet health insurance companies offer plans.

High-tech vet care may be expensive, but for the owner of Linde Star, a silver-gray schnauzer, the cost was worth it. Linde Star had a serious health problem at the age of 10. She was fainting every 15 minutes because of severely deteriorated heart muscles resulting from an irregular heartbeat. But instead of putting her to sleep, Linde Star's owner took her to the local veterinarian, who installed a pacemaker.

Today, Linde Star is back to her old tricks, which include chasing lizards in the backyard and pounding on the family piano with her front paws when she wants attention or food. As a canine celebrity, now famous for her surgery, she has appeared on the major television networks and in numerous newspaper articles, thanks to high-tech veterinary medicine.

PHOTO : A veterinary surgical team at the duPont Scott Equine Medical Center in Leesburg, Va.,

PHOTO : finishes bandaging the hind leg of an injured filly after performing arthroscopic surgery,

PHOTO : a microscopic surgical procedure often used on human athletes. The filly, a thoroughbred,

PHOTO : can now compete at the race track.

PHOTO : In photo above left, Jane Kay, a large-animal medicine technician at Tufts University

PHOTO : School of Veterinary Medicine at North Grafton, Mass., supports a thoroughbred foal on a

PHOTO : heated waterbed to keep it warm. The foal is attached to a

ventilator to help it breathe.

PHOTO : In the middle photo, Michael Pavletic, a veterinary plastic surgeon at Tufts veterinary

PHOTO : school, examines a dog's mouth for oral cancer, a common disorder among dogs and cats.

PHOTO : Removal of the tumor often leaves a hole that may interfere with the pet's ability to

PHOTO : breathe, eat or swallow. Pavletic can repair the hole with skin grafts, allowing the

PHOTO : animal to live longer.

PHOTO : In photo at right, veterinary student Liz Devitt feeds a premature llama milk at Tufts

PHOTO : veterinary neonatal intensive-care unit.

PHOTO : Michael Murray, center, a veterinarian with the duPont Scott Equine Medical Center, uses

PHOTO : a video endoscope--a long tube with a miniaturized video camera at one end--to examine a

PHOTO : yearling's stomach for stomach ulcers, a fairly common disorder in horses. The tube is

PHOTO : passed through the horse's nose, down the throat to the stomach, transmitting pictures

PHOTO : for viewing on a color monitor.

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