Pets Reap Benefits of Human Medical Progress : Veterinarians Use Latest in Scientific Technology

Dr. John Madigan’s neonatal care team was busy with an emergency on this rainy February evening.

The medical workers stood in a stall at the University of California, Davis’ veterinary horse barn with Madigan, an equine specialist, evaluating and administering to a sick premature foal that had just been brought in.

There were tests run and fed into a computer for analysis, and antibiotics and a blood transfusion. Madigan decided the foal did not need to be in the special intensive care unit, but ordered round-the-clock monitoring of it and its mother, which also needed medical attention.

By the next morning, the foal was up on its feet and nursing.

This is animal medicine of the ‘80s, and neonatal care for horses is not the only thing new that’s going on.

Today’s veterinarians are taking human medical treatments, most of which were developed through research on animals, and adapting them for use in animal health care.

For horses and other large animals, and for those 51 million dogs and 56 million cats that live in American homes, there is much specialty care being offered.

New Medical Techniques

Diagnostic ultrasound, a painless procedure used to locate heart and other organ and soft tissue problems, is one of the newer medical techniques being used in pet medicine, both at universities and in private practice.

Implanting pacemakers is becoming a routine procedure for dogs with heart disease, according to veterinary cardiologists and surgeons.

Chemotherapy, radiotherapy and cryosurgery (freezing) have found their way into health care for animals, as have cataract removal and eye surgery, dentistry--complete with crowns, root canals and periodontal treatment--acupuncture and holistic medical care.

“It started with animals, research for the good of people, and now it returns for the good of animals,” said Dr. Richard Fink, a Whittier veterinarian who is president-elect of the American Veterinary Medical Assn., the Illinois-based governing group for 43,678 veterinarians in the U.S., Canada and U.S. territories. There are 4,500 veterinarians in California.

“I started my practice in 1952,” he said, noting that he has operated a veterinary hospital for cats, dogs and birds in Whittier since then. “And the difference between animal care then and in 1987 is like night and day. Sick animals we put to sleep years ago aren’t being euthanized today because of our diagnostic capabilities, the way we can handle diseases and the surgical techniques. It is an extreme joy going to work these days.”

A Growing Field

Fink and other veterinarians say that specialized veterinary medicine is a growing field.

American animal owners spent $4 billion in veterinary care in 1985. But how many people can afford a $500 pacemaker for their dog or chemotherapy for their cat that might run as high as $2,500?

“Most of the time, the technology is ahead of what the public can afford,” Fink said. “But people are demanding advanced treatment for their animals more and more. They didn’t recognize it was available until recently.”

For three years, Dr. John Madigan of UC Davis’ School of Veterinary Medicine periodically followed pediatric physicians around the university’s medical center in Sacramento, going on rounds with them, checking out their procedures with premature infants, attending their seminars on neonatal care for babies.

The result was Madigan’s neonatal unit for horses, with a “foal team” made up of volunteer veterinary residents and students who provide 24-hour care for premature or sick foals, and also operate a separate specially-designed intensive care unit for more critically-ill equine babies.

“I learned from human pediatricians--I had a lot of help from Dr. Boyd Goetzman who was chief of neonatal at Sac (Sacramento) Med Center then--how they care for premature babies and infants and translated it here,” said Madigan. “Now we have a course in neonatal foals, premature or high risk, full-term foals.”

And in April, Madigan will publish a first-of-its kind manual of pediatric technology for foals, Equine Neonatal Medicine.

“I would say physicians and veterinarians are trying to work together hand in hand,” said Dr. Stephen Ettinger of the California Animal Hospital in West Los Angeles. “Our primary goal is to help people, but the ultimate result is that we’ve turned this around and are helping animals.”

Ettinger and 13 other veterinarians operate a sizable animal clinic on Sepulveda Boulevard that is referred to by many Southern California vets as “Davis South,” because their extensive medical work with small animals includes cardiology, many kinds of surgery and cancer treatment in addition to general practice procedures.

Nickname for UC Davis

Ettinger’s animal hospital colleagues, on the other hand, like to refer to UC Davis veterinary medical school near Sacramento, California’s only veterinary school, as “Ettinger North.”

Joking aside, Ettinger is well-known by Davis faculty and students and other veterinarians across the country for his work in animal internal medicine and cardiology.

A 1964 graduate of Cornell University, New York State College of Veterinary Medicine and a former professor at UC Davis, Ettinger wrote the definitive book on canine cardiology and has a third edition coming out next year of his veterinary textbook on internal medicine diseases of dogs and cats.

“The most exciting thing diagnostically right now is our use of ultrasound,” Ettinger said. “We use the ultrasound on three to five patients a day. The whole point of it is that it’s non-invasive and it’s also safe and painless. A totally benign procedure. It is extremely useful for showing the soft tissue, heart, lungs, abdomen and what’s going on in there.”

If a pacemaker operation is indicated, it usually costs about $500.

Standing in an examining room at UC Davis veterinary hospital, Dr. Bill Thomas, chief of veterinary cardiology service there, watched as two urologists performed a diagnostic ultrasound on a dog with prostate disease.

“Ultrasound has, more than any other technology, changed the way humans and vets evaluate the heart,” Thomas said. “And the urologists use it to diagnose many of the problems they see.”

An enlarged prostate in a dog can be reduced by castration; a castrated dog is unlikely to develop cancer of the prostate. Neutered animals, in fact, live longer and healthier lives, and have less risk of developing cancer.

“The equine vets are using ultrasound a lot with obstetrics, to see the condition of the foal or if the mare is pregnant with twins,” Thomas continued. “That’s a very big problem in equine reproduction.”

Across the hall from Thomas, Dr. Mark Kittleson, a veterinary cardiologist, was testing a dog on a treadmill for “cardiovascular fitness and measuring the amount of oxygen in the blood.”

Kittleson also uses drug therapy for some canine patients with heart problems and places pacemakers in dogs. “Usually the pacemakers are for older dogs, and they usually last longer than the dogs,” he said.

“Dogs get coronary artery disease,” said Kittleson, a University of Minnesota graduate who came to Davis two years ago. “Cats, cardiomyopathy--that’s where the heart muscle just poops out. The bigger dogs get that, too; the little ones leaky heart valves. But I’ve never seen a cat with a heart attack.”

On another floor of the university’s hospital for small animals, Dr. Cleta Sue Bailey, a veterinary surgeon, and Dr. Janine Kasper, a second-year resident in neurology, were conducting a study to try to reduce Wobblers syndrome in large breed dogs, primarily Dobermans.

It is a disease that affects the interverterbral disc in the necks of the dogs, and the two veterinarians are trying enzyme injections to correct the animals’ cervical problems, a technique that has been used in humans with lower back problems.

“By the time the dogs are referred here to us, the symptoms are fairly significant,” Bailey said. “They have a lack of coordination in the hind quarters and pelvic limbs, an abnormal gait, swaying or wobbling. They may have neck pain or keep their head low, signs that could be caused by other problems of the spinal cord or tumors. For diagnosing, we use standard radiographic procedure used in humans and in veterinary medicine or myelograms, injecting a dye around the spinal cord.”

Like human surgery for disc or spinal cord disorders, surgery for Wobblers syndrome, said Bailey, is sometimes effective, sometimes not.

“Fifty percent do well with surgery, 50% do not. It’s a two to four hour operation for about $1,000 and they’re in the hospital two weeks. And in fact some animals are worse than they were before. That’s why we’re hoping to be successful with the enzyme procedure. There’s not as much risk, it takes about an hour and we’re hoping for better results.”

In his lab at the end of the hallway, Dr. Terrell Holliday was testing the hearing of some Dalmatians, because that breed of dog often has neurological problems resulting in deafness in one or both ears.

“It’s a genetic problem with Dalmatians and many other breeds, those that are predominantly white or all white,” said Holliday, who graduated from Davis and has been on the faculty there since 1965. Holliday suffered traumatic nerve damage in the service and wears hearing aids in both of his ears.

To check a dog’s hearing, Holliday uses a machine called an “evoked potential stimulating recording system” that tests each ear separately with different types of stimulation and records the signals on a computer.

Testing one of the tranquilized puppies, Holliday said: “My grandson had one of these tests 30 minutes after he was born because they were afraid of brain damage. But he was fine.”

Dalmatian breeders are supportive of Holliday’s work, he said, “because the breeders can then select breeding stock by knowing which dogs are affected. Then they hope eventually to reduce the deafness or eliminate it from the breed.”

One of the upcoming fields in pet medicine is oncology, the treatment of tumors. It is not one of the AVMA’s 14 board-certified specialties, but veterinarians expect it to be sanctioned in about two years.

To qualify for a recognized specialty status, veterinarians must complete two to three additional years of study and examinations in that specialty, over and above their four years of undergraduate work and four years of veterinary school.

Dr. Cheryl Stephens, an Iowa State University veterinary school graduate, works at UC Davis with animal patients that have various kinds of cancerous tumors. As with cancer in humans, veterinarians use chemotherapy--including new drugs like Interleukin 2 and Interferon--and radiation, often in addition to surgery, on their canine and feline patients.

“We’re in a pretty new field with this,” said Stephens, who expects to finish her oncological residency in June. “And it’s very exciting. Pet owners are more aware of what we’re doing in oncology and they are not only requesting it, they’re demanding it. Pets are healthier and they are living longer, but they are subject to the same things we are. We had one man who flew his dog here from Japan, but we were unable to help it. The cancer was too advanced. . . .

“They can do reconstructive surgery for animals who have had tumors, a dog with a facial tumor could have his face reconstructed,” Stephens said. “A lot of this kind of work is just starting. They’re using lasers on brain tumors, hormonal therapy that is used in human breast cancer patients.”

Stephens said that veterinarians at Davis are working with medical doctors to start a comparative oncology center there for both humans and animals. “We have some MDs interested and we want to bring human and veterinary medicine together to study cancer,” she explained.

Dr. Alice Villalobos and her staff currently see 2,000 animal cancer patients a year at the Animal Cancer Center in Hermosa Beach, the largest veterinary oncology practice in the United States that is privately owned. The patients--60% dogs, 40% cats--are referred by general practice veterinarians. Villalobos also offers personal counseling for owners who have lost their pets.

“I’ve become an experienced pet-loss counselor to grieving owners,” she said. “The most important thing is that they should not be ashamed to feel terrible because they have lost their pet. People are bonded to their pets, and it’s a heartbreak to lose them.”

According to Villalobos, the most common cause of death in canines and felines is major organ failure (heart, kidney and liver). The second most common cause of death in pets over 10 is cancer.

“We don’t have a lot of data on cancer in dogs and cats, so we use human data,” said Villalobos, who graduated from UC Davis 15 years ago and began a private general practice before becoming an oncology specialist. “I say, ‘Well, if it works for humans, maybe it will work here. Humans can serve in research for dogs and cats.’ ”

Villalobos and six other veterinarians also operate a 24-hour general practice hospital for small animals and birds as well as their cancer clinic.

On Wednesdays, Villalobos sees animal cancer patients at the Animal Emergency Care Center in Woodland Hills; on Thursdays, at the Animal Cancer Clinic in Garden Grove.

Cost of cancer treatment at Villalobos’ center varies, depending on the size of the animal and the type of disease. Ten to 12 radiation treatments for a tumor over a period of three to five weeks costs about $750. An extensive chemotherapy program, including blood tests and other lab work, can run $2,500. “We had one client whose dog had leukemia, and she spent about $3,800 here in four months.”

Specialization in veterinary medicine, Villalobos said, is changing rapidly. “Before, all the specialists were going to universities to teach, now they’re coming out (to the private sector). You still can’t make it alone in practice as a specialist without doing general practice, too. But there are a lot more independent contractors (veterinarians who lease space from general practicioners and do only specialty care).”

Dr. Kathleen Boldy is an independent contractor in her specialty, veterinary ophthalmology. A 1980 graduate of the University of Pennsylvania veterinary school, she treats eye diseases of small animals at the Animal Hospital West in West Los Angeles. She also provides on-site treatment for horses and zoo animals.

“We mostly see dogs here, 80%,” Boldy said recently following a cataract operation she had just performed. “There are certain breeds that have a high instance of eye disease, others have hereditary eye problems.” (A routine canine cataract surgery for one eye costs about $700 to $800.)

“There is a whole world of eye problems in animals,” Boldy said. “What we need to do is make the public aware so we can examine the animal and catch the disease early. What we need is preventive care.”

Another fledgling field of pet medicine is animal dentistry, according to Dr. Michael Floyd of Albany, near Berkeley. Floyd, who graduated from UC Davis 25 years ago, began doing dental work at his veterinary clinic two years ago and is continuing his education.

“Human dentists are more than happy to help us,” Floyd said. “I’ve had help from several here in the area. One is going to bring his cat over here, so we can put a crown on a broken tooth. It’s not a cosmetic thing, but functional so the animal can eat properly.

“Dental disease is the single most common health problem in pets,” said Floyd, showing a visitor how he removes plaque from a dog’s teeth with an ultrasonic scaler. He has bought about $15,000 worth of human dental equipment, including a high-speed drill, and adapted it for his canine and feline patients.

To have their teeth worked on, both dogs and cats must be anesthetized. Dogs have 42 teeth; cats, 30. Floyd charges $60 for a cleaning and polishing; a root canal is about $200, a tooth restoration using bonding composite, $150. The regular cleaning takes about 20 minutes, according to Floyd; other procedures one to two hours.

“We’re not into cosmetics here,” Floyd said. “I think that’s stupid. What we want to do is raise people’s consciousness about dentistry for their pets. They can do their own preventive dentistry by brushing their pets teeth and taking them to the vet once a year for cleaning and polishing.”

Floyd is treasurer of the California Veterinary Dental Assn., and is a member of the American Veterinary Dental Society.

“There are probably 20 people in the (California) association and maybe seven full-time dentists in the whole state,” Floyd said. “This is a very young field, but eventually you will see it a board-recognized specialty.”

Although the use of acupuncture to alleviate chronic pain in animals is not widely accepted by veterinarians, there are about seven vets in the Los Angeles area who use it in their practices.

Dr. Sheldon Altman has been performing acupuncture on small animals since 1975, after he participated in an acupuncture research program for people and animals at the pain control unit of UCLA Medical Center.

“I was one of the evaluators in the program,” Altman said. “We sent animals there that we couldn’t do anything with for their pain and treated them. It worked 50% to 70% of the time. Cases of hip dysplasia, disc diseases in the back, degenerative diseases, chronic arthritis, paralysis because of neurological damage or being hit by cars.

“After a year they weren’t treating the animals at UCLA anymore, so there was no place to send them,” Altman added. “So we got the UCLA people to teach us human and animal acupuncture. Here in the United States, acupuncture started on people and then went to the animals. But 4,000 or 5,000 years ago in China it was used on animals.”

At his clinic in Burbank, where he also has a general practice with two other veterinarians, Altman performs 200 acupuncture treatments a month.

In recent years, acupuncture also has been used on large animals, mostly horses and cows.

Altman, a 1961 graduate of Colorado State University’s veterinary school, lectures in the U.S. and abroad on animal acupuncture and use in animal medicine.

Pet medicine, as in people medicine, also is trying the holistic approach, using acupuncture, herbs, nutrition and homeopathy for animals.

At his Holistic Animal Clinic in North Hollywood, Dr. John Limehouse, a 1966 veterinary graduate of Ohio State University, still uses regular veterinary procedures but he also is trying holistic practice.

“I’ve been doing the holistic approach, too, for about eight years,” Limehouse said. “The AVMA is just begining to recognize us. Most vets are using acupuncture strictly to relieve pain, but we’re working with animals with stomach, liver and kidney diseases, leukemia, urinary cystitis. We can clear up 20% of the illness coming in the door just by clearing up the (pet’s) diet. We prescribe homemade diets, Chinese herbs, Western herbs.

“There might be a deficiency in the animal’s diet or nutritional problems. There are too many chemicals in these pet-store foods.”

Limehouse’s partner, Dr. John Ottaviono, has been practicing holistic medicine for 17 years. He has a degree in Oriental medicine, not veterinary medicine.

“This is relatively new as far as animals go,” Limehouse said. He said they are the only holistic animal practice in Southern Calfifornia.

Limehouse has recently purchased a new diagnostic machine with a computer that reads electrical impulses through acupuncture points.

“We’ve only had this machine three months, but they’ve been doing this in humans for quite a few years,” Limehouse said. “We’re really excited about what we can do with it. What’s exciting about animals is when a treatment works, it’s not a placebo effect. You know because you can see it has helped the animal.”