Stem cells in theory and practice
Many veterinarians in private practice have been using adult stem cells from fat, bone marrow, and other tissues as a promising treatment for orthopedic conditions and other health issues in horses, dogs, and the occasional cat.
These stem cells can differentiate into many types of cells, including bone and cartilage cells. Probably the most common approach to the treatment is to collect fat or bone marrow from an animal, send the tissue sample to a laboratory for processing, and then inject the stem cells into the animal. The cost to clients is in the $2,000 to $3,000 range.
Anecdotal evidence for stem cells as a therapy is compelling, but research is under way to establish the efficacy of the treatment—and the mechanisms of action. The effect of stem cells on cellular signaling could be as important as their potential to rebuild tissue.
Some researchers hesitate even to refer to these cells as stem cells because no one has proved that the cells have the ability inside of animals, rather than in the laboratory, to differentiate into other cell types.
Dr. Douglas J. Herthel, founder of Alamo Pintado Equine Medical Center in Los Olivos, Calif., was one of the first practitioners to use stem cells. In 1995, he started using stem cells from bone marrow to treat ligament and tendon injuries in horses. The stem cells seemed to promote healing, so he began to use them for other conditions.
Some private practitioners process stem cells in-house, including Dr. Herthel. Many practitioners send tissue samples to Vet-Stem Inc., university laboratories, or other laboratories for processing.
Dr. Robert J. Harman, Vet-Stem's chief executive officer, said his company compiles case studies and has sponsored some clinical trials to compile data about the efficacy of stem cells from fat for treating various conditions. One trial was a blinded study that found improvements in clinical signs of arthritis in dogs that received an injection of stem cells, compared with dogs that received a placebo.
Some veterinarians see a need for more caution in the use of stem cells.
Among them is Dr. Brennen A. McKenzie of Adobe Animal Hospital in Los Altos, Calif., president-elect of the Evidence-Based Veterinary Medicine Association. The EBVMA has no position on stem cells, but Dr. McKenzie personally believes that the evidence of efficacy and safety is inadequate to justify the expensive treatment in most cases.
Dr. McKenzie thinks the use of stem cells is a promising avenue for therapy, but he would prefer for clinics to offer stem cells as a truly experimental treatment in formal clinical trials.
Researchers at veterinary colleges continue to study stem cells, trying to tease out whether they work as a treatment for various conditions in animals—and how.
One of the few researchers studying stem cells in cats is Dr. Jessica M. Quimby, a fellow at the Colorado State University College of Veterinary Medicine & Biomedical Sciences. Her group is studying the anti-inflammatory aspects of stem cells in the treatment of chronic kidney disease in cats.
One of the many researchers studying stem cells in horses is Dr. Thomas G. Koch, an adjunct professor at the University of Guelph Ontario Veterinary College. Dr. Koch is studying the use of stem cells from umbilical cord blood as a treatment to improve cartilage repair in horses.
The new North American Veterinary Regenerative Medicine Association seeks to act as a clearinghouse of information on stem cells in veterinary medicine. The first official meeting of NAVRMA will be in June, and the plan is to create committees to address subjects such as clinical trials and regulatory affairs.
To date, no federal agency has approved or blocked the use of stem cells as a treatment for any condition in animals. The Food and Drug Administration has promulgated regulations on stem cells in human medicine, but neither the FDA nor the Department of Agriculture has promulgated regulations specific to stem cells in veterinary medicine.
6 factors in declining veterinary visits
Some pet owners think that routine checkups are unnecessary for dogs and cats. The cost of veterinary care can be much higher than many pet owners expect. Plus, cats are plain difficult to take to the clinic.
These are the three primary client-related factors associated with a recent decline in the frequency of veterinary visits for dogs and cats, according to the new Bayer Veterinary Care Usage Study.
The study also identified three primary environmental factors associated with the decline—the recession, fragmentation of veterinary services, and use of the Internet as a source of information about animal health.
Bayer Animal Health, Brakke Consulting Inc., and the National Commission on Veterinary Economic Issues released the study results Jan. 17 during the North American Veterinary Conference. The study included a survey of pet owners and interviews with veterinarians and pet owners.
Even before the recent recession, AVMA data indicated a decline in veterinary visits for dogs and cats. Dogs averaged 1.5 visits in 2006, down from 1.9 visits in 2001, according to the AVMA's 2007 U.S. Pet Ownership and Demographics Sourcebook. Cats averaged 0.7 visits in 2006, down from an average of one visit in 2001.
The Bayer study found that 24 percent of pet owners agreed with the statement that routine checkups are unnecessary. Thirty-three percent of dog owners and 41 percent of cat owners agreed that if their pet did not need to be vaccinated annually, they would not take it to the veterinarian as often.
Twenty-four percent of dog owners and 39 percent of cat owners would visit the veterinarian only if their pet were sick.
Regarding the price of veterinary care, 53 percent of pet owners said costs are usually much higher than they expected. Thirty percent would try another clinic that had a coupon or special, 26 percent would switch veterinarians if they found one who was less expensive, and 26 percent are always looking for less expensive options for veterinary services and products.
The study found that 64 percent of cats visited the veterinarian within the past year, in comparison with 86 percent of dogs. Cat owners were more likely than dog owners to say their pet hates going to the veterinarian and just thinking about a veterinary visit is stressful.
The study found that environmental factors also might be contributing to the decline in veterinary visits.
The impact of the recession is on the top of veterinarians' minds, according to the study. The study found that unemployed pet owners and pet owners with lower incomes were less likely to have taken their pet to a veterinary clinic in the past year.
Fragmentation of veterinary services is high on veterinarians' minds, according to the study. Pet owners can visit store clinics, specialty practices, mobile clinics, and animal shelters as well as traditional clinics. Veterinarians in focus groups expressed concerns about full-service clinics losing starter services that establish a relationship with clients.
Fifteen percent of pet owners in the survey said that with the Internet, they don't rely on the veterinarian as much. Thirty-nine percent look online first if a pet is sick or injured.
Research reduces guesswork of ape transfusions
As a newly minted zoo clinician in the early 1990s, Dr. Kathryn Gamble twice faced the possibility of transfusing gorillas.
Fortunately, the procedure wasn't necessary in either instance, but Dr. Gamble was surprised by how lean the scientific literature on great ape hematology was. Then, in 2005, while Dr. Gamble was director of Veterinary Services at Lincoln Park Zoo in Chicago, her patient Mumbali, a young, severely anemic female gorilla, was facing both a blood transfusion and dialysis.
Dr. Gamble soon learned that the hematology literature had not advanced at all in a decade.
While veterinary medicine knows much about the blood types of domestic dogs, cats, horses, and even llamas and ferrets, until recently, the same couldn't be said for the great apes: gorillas, orangutans, common chimpanzees, and bonobos. Dr. Gamble was taken aback by this revelation, especially in the case of chimpanzees, which have been used for decades as models in human health studies.
“I had had enough,” she recalled.
With little time to waste, Dr. Gamble anesthetized Kwan, an unrelated male silverback also in the LPZ collection. She performed a major-minor cross match—a standard procedure with animal species for which little blood type data exist—in which red blood cells and plasma are screened to determine whether a potential donor and recipient are a match.
Jill Moyse, assistant lead keeper, trains Kwan, a male silverback gorilla, to insert his arm into a sleeve so that, eventually, blood can be drawn without sedation. (Courtesy of Lincoln Park Zoo)
Citation: American Journal of Veterinary Research 72, 3; 10.2460/ajvr.72.3.290
Although the test showed Kwan to be a suitable donor, and the transfusion did take place, Mumbali died as a result of her illness.
“There was a lot of grieving. This was a young animal in the prime of her life,” Dr. Gamble said, and staff struggled to find meaning in the ape's death, especially Mumbali's trainer, Jill Moyse. “My answer to Jill was, ‘Help me do what needs to be done.’”
That conversation started Dr. Gamble and Moyse down the road to identifying and cataloging the blood group phenotypes for great apes housed in North American and European zoos as well as some in situ ape populations managed in Africa and Asia.
Using human monoclonal antibody technology and in collaboration with the University of Chicago Department of Human Genetics, they assigned human ABO blood groups to whole blood samples from nearly 700 great apes, creating a “virtual blood registry” maintained by Dr. Gamble and her staff.
Hundreds of small, chemically coated cards donated by a Danish company were sent to participating institutions. Drops of blood revealed the donor's group, and the card was either sent or e-mailed to Chicago as a digital image. It took four years to gather the samples because they were collected during regularly scheduled procedures, which can be more than two years apart, Dr. Gamble explained, adding that it took Lincoln Park Zoo nearly two-and-a-half years to get through its 27 apes.
This registry is intended to facilitate quality transfusion medicine by taking the guesswork out of locating suitable blood donors. “Blood loss is a major concern. You may not need blood during a procedure, but you're more confident if it's available,” Dr. Gamble said. “Now if someone is faced with (doing) a blood transfusion, and there is no good match on-site, they can contact Lincoln Park Zoo to learn which institutions a short distance away have appropriate potential donors.”
Dr. Thomas Meehan, head of the veterinary advisory group to the Gorilla Species Survival Plan for the Association of Zoos and Aquariums, said the registry gives veterinarians the assurance to perform advanced surgeries on apes in which blood loss could be a problem. “Such procedures are relatively rare for great ape species,” Dr. Meehan explained, “but it's nice to know extra blood's available, should it be needed.”
Dr. Gamble and the research team found orangutans in the Bornean genus have all four human blood group phenotypes—A, B, AB, and O—which has not been previously documented. They also learned common chimpanzees and bonobos are predominantly group A, but chimpanzees with wild origins are more likely to be group O.
Ironically, the blood group of the gorilla—the very species that inspired the project—is still indeterminate. “Gorillas appear to be O, but our collaborators at University of Chicago say it's not all the same O, and it's not responding in a way consistent with O in humans,” Dr. Gamble said. “We don't know right now how we're going to be able to determine them except through major-minor cross match.”
Dr. Gamble has already been contacted for donor information since the results of the project were published in the November/December 2010 issue of the journal Zoo Biology.
Jill Moyse, the gorilla trainer, is currently working with Kwan so that blood can be drawn from him without sedation.
“We feel like we can now do better transfusion medicine,” Dr. Gamble said. “Is it ideal? No, but we're so much in a better position than we were.”
AVMF makes disaster preparedness possible
The American Veterinary Medical Foundation has awarded $85,000 in 2011 to five state or regional disaster organizations looking to enhance their disaster preparedness and response efforts. These matching grants are offered every year by the AVMF through its Animal Disaster Relief and Response Fund. The money can be used for expenses related to state training and training-related activities, medical supplies, and disaster response-related equipment. All five organizations have previously benefited from AVMF disaster grants. Here is an update on their activities:
The Kansas State Animal Response Team is in the process of acquiring sheltering equipment to use as a deployable resource in the event of an animal-related incident as well as transport equipment that would be housed in a central location. KSART would be responsible for training these team leaders. This year's $20,000 matching grant will help it procure several large tents with walls and flooring to house animals, climate-control systems for use in the tents, and generators, lighting, fencing, and caging systems.
The Louisiana State University Foundation requested funding from the AVMF for disaster response training for graduate veterinarians, veterinary students, animal control officers, first responders, emergency managers, and other animal care personnel.
Much of the AVMF $20,000 grant will go toward speakers and trainers, educational material, and training equipment and supplies in addition to funding a part-time technical-administrative assistant for the response team and training courses for a year.
The Texas Veterinary Medical Foundation's Texas State Animal Resource Team, with $20,000 in funding from the AVMF and other partners, “will recruit, train, and position for deployment two animal emergency re-entry teams along the Texas Gulf Coast and we will upgrade and deploy a state-of-the-art mobile disaster response unit (truck and self-contained trailer) for actual response situation,” according to TVMF's grant application.
The Oklahoma Veterinary Medical Foundation was awarded a $5,000 matching grant this year. The OVMF will put on disaster-related training in conjunction with the Oklahoma VMA annual convention, and support an Oklahoma task force's search dogs. The OVMF provides for the dogs' medical care as well as purchases needed logistic items for training and deployments.
The Colorado Veterinary Medical Foundation received $20,000 in matching funds from the AVMF. The recent funding request will support recruitment and training of veterinary professionals in disaster preparedness on the Western Slope of the state with the Colorado Veterinary Medical Reserve Corps. The CVMF also is looking to educate Colorado's Medical Reserve Corps units and Community Emergency Response Teams about including veterinary professionals in their units and to build Community Animal Response Teams throughout the state.
AVMA invites nominations for trial leadership program
The AVMA is seeking to identify emerging leaders in veterinary medicine for a pilot leadership development program.
Up to 10 participants will be selected for mentorship in a yearlong AVMA Future Leaders Program. This pilot program is designed to bolster leadership and problem-solving skills related to organized veterinary medicine.
Veterinarians are invited to apply if they have graduated within the past 15 years and are interested in developing their leadership skills so they can take an active role in the AVMA and other veterinary organizations. Preference will be given to those with leadership experience and those nominated by a principal or constituent allied organization in the AVMA House of Delegates.
Participants will take part in leadership and project management training exercises, working with a professional facilitator. They will also work together on a focused project impacting organized veterinary medicine.
If the AVMA implements the Future Leaders Program as an ongoing program, it envisions the 2011-2012 participants serving in mentorship roles for the 2012-2013 group.
Nominations are due by March 21. To apply, to nominate a colleague with leadership potential, or to learn more program details, go to www.avma.org, click on the blue “Services” bar, and scroll down to “Leadership development.” E-mail questions to FutureLeaders@avma.org or call (800) 248-2862, Ext. 6636.
Pfizer Animal Health is providing support for this program, which originated with the AVMA staff working group on leadership strategy. The Executive Board approved it with the concurrence of the Task Force on AVMA Programs for Students and Recent Graduates.
AVMA fellows take posts on Capitol Hill
The two 2010-2011 AVMA Congressional Science Fellows—Drs. Kathryn A. Simmons and Terry Ryan Kane—have taken posts on Capitol Hill.
In December, the AVMA announced Dr. Ryan Kane is working in the office of Sen. Kirsten Gillibrand of New York and Dr. Simmons had taken a position in the office of Sen. Olympia Snowe of Maine.
Sen. Gillibrand is a member of the Senate Agriculture Committee. Sen. Snowe is the ranking Republican member of the Senate Small Business and Entrepreneurship Committee.
For more information about the AVMA Congressional Science Fellowship program, visit www.avma.org and click on the Advocacy section.
Racetrack surfaces just one factor in horse racing fatalities
More information has been released on North American racetrack fatalities, with a specific focus on the effect racetrack surface has on fatality rates.
The study “Comparison of racing fatality rates on dirt, synthetic, and turf at four California racetracks” showed that racing fatalities declined 37 percent after dirt track racing surfaces were converted to synthetic racing surfaces over a six-year period.
The study, which lasted Jan. 1, 2004, through Dec. 31, 2009, collected data from the Del Mar, Golden Gate Fields, Hollywood Park, and Santa Anita racetracks.
The racing fatality rate was 3.09 fatalities per 1,000 starts on dirt before conversion to synthetic surfaces and 1.95 fatalities per 1,000 starts after conversion to synthetic racing surfaces, according to the study. The racing fatality rate on turf was 2.44 per 1,000 starts over the same six-year period. There was no significant difference between the 2004-2006 turf fatality rate (2.37 fatalities per 1,000 starts), when the main tracks were dirt, and the 2007-2009 turf fatality rate (2.50 fatalities per 1,000 starts), when the main tracks were synthetic.
In another look at horse racing fatalities in North America, the Jockey Club released updated statistics from its Equine Injury Database, the North American database for racing injuries, in a Dec. 15, 2010, press release.
Results of an analysis of 754,932 starts at more than 70 participating racetracks collected from Nov. 1, 2008, through Oct. 31, 2010, showed the prevalence of fatal injuries declined to 2.00 per 1,000 starts, compared with 2.04 reported in March 2010 for a one-year period starting Nov. 1, 2008.
The analysis was performed by Dr. Tim Parkin, a veterinarian and epidemiologist from the University of Glasgow, who serves as a consultant on the Equine Injury Database.
Among other trends gleaned from Dr. Parkin's analysis of the cumulative two-year data were these:
• The prevalence of fatal injuries continued to be unaffected by distance, weight carried, and movement of races off the turf.
• Fillies and mares competing in races that were open to horses of both sexes were not at increased risk of fatality compared with those competing in races restricted to fillies and mares.
• The prevalence of fatality in 2-year-olds racing on dirt surfaces continued to be significantly lower than the prevalence in older horses. However, on synthetic or turf surfaces, there was no significant difference in the prevalence of fatality between 2-year-olds and older horses.
Food safety problem-solving method to be explored with grant
A multi-institutional project is under way to teach a new framework for problem solving to veterinary students involved with food safety and food animal medicine.
The Department of Agriculture recently awarded a $308,667 Higher Education Challenge Grant to Dr. H. Scott Hurd, an associate professor in the Department of Veterinary Diagnostic and Production Animal Medicine at Iowa State University College of Veterinary Medicine.
His project, “Food Systems Veterinary Medicine for the 21 st Century,” will be a collaboration among the Iowa State veterinary college, Kansas State University College of Veterinary Medicine, and the University of Arkansas Dale Bumpers College of Agricultural, Food & Life Sciences. Faculty from these institutions will incorporate a new framework—systems thinking—into some of the existing topics they're already teaching.
Systems thinking is an approach to problem solving that views problems as parts of an overall system. It is based on the belief that the components of a system can be understood best in the context of relationships with each other and with other systems, and how things influence one another within a whole.
With this grant, faculty at the three schools will develop case studies that will convey systems thinking and the basics of diseases. The institutions were chosen for their expertise in poultry (Arkansas), beef cattle (K-State), and swine (Iowa State) medicine. These three schools form the Food Safety Consortium, which has been successfully researching food safety topics for more than 20 years.
The World Health Organization and Food and Agriculture Organization will be working on the three-year project as well.
It will start this spring with faculty conducting baseline evaluations of the students to ascertain their existing knowledge. Classes will begin in the fall and will expand as warranted.
Partnership forged between ISU, specialty practice
Iowa State University College of Veterinary Medicine will purchase a 24-hour Des Moines veterinary hospital this year. According to the veterinary college, the resulting partnership will enhance the clinical and educational experiences for its students and residents.
The Iowa Board of Regents on Jan. 13 unanimously approved the $4.6 million purchase of Iowa Veterinary Specialties, which will be handled through a nonprofit business entity, ISU Veterinary Services Corporation. The resulting affiliation between IVS and the ISU veterinary college's Lloyd Veterinary Medical Center in Ames, about 35 miles north of Des Moines, “will bring together unique strengths and resources to provide enhanced veterinary care in central Iowa,” according to an ISU press release.
Iowa Veterinary Specialties is a modern, 7,200-square-foot private veterinary hospital that includes a 24-hour small animal emergency facility and surgical and internal medicine specialty practices. The acquisition of IVS includes the real estate, equipment, and active veterinary practice. Approximately $1.6 million of the purchase price will be financed through a Wells Fargo master lease; the remaining $3 million will be financed through an ISU trust, according to the regent's meeting agenda.
ISU-VSC is to be organized for charitable, scientific, and educational purposes and will provide “students and residents with opportunities for learning, faculty and staff of the ISU College of Veterinary Medicine with opportunities to assist in the provision of quality veterinary health care in the greater Des Moines area, researchers at the ISU College of Veterinary Medicine with opportunities to advance the practice of veterinary medicine, … and a physical location to conduct continuing education programs for veterinarians and their staff in the greater Des Moines area,” according to the university's request to the board of regents.
Iowa Veterinary Specialties and the Lloyd Veterinary Medical Center will continue to focus on emergency and specialty care and will operate independently in their current locations.
IVS was founded in 1980 as an “after hours” emergency hospital by 18 Des Moines veterinarians. IVS staff includes six full-time emergency doctors, two surgeons, one internist, a dermatologist, 30 veterinary technicians, and six receptionists. The hospital serves more than 7,500 patients annually.
The Lloyd Veterinary Medical Center provides veterinary emergency and specialty care as a referral hospital for large and small animals throughout Iowa and the region. The LVMC serves more than 11,000 small animal patients annually.
Vet, human medicine start regenerative medicine venture
The Virginia-Maryland Regional College of Veterinary Medicine announced Jan. 20 the formation of the Center for Veterinary Regenerative Medicine.
The center is the product of a research agreement that Virginia-Maryland made with Wake Forest University's Institute for Regenerative Medicine in Winston-Salem, N.C., according to a Virginia-Maryland press release.
The veterinary college and the institute will work together with ongoing collaborations in translational research in regenerative medicine through the new center. The agreement facilitates the application of cutting-edge regenerative treatments to both human and animal patients, the release stated.
There is no dedicated building; it is a virtual center. Some of the research will take place in the translational medicine facility the veterinary college is planning to build as well as in existing facilities.
As part of the collaboration, clients at Virginia-Maryland's veterinary teaching hospital, located on the Virginia Tech campus in Blacksburg, may have the option to enter their pets into clinical trials, giving them access to cutting-edge technology.
The center has been up-and-running in the sense that research has been ongoing for more than a year. Current research at Virginia-Maryland focuses on chronic kidney disease in cats, which are being treated in an effort to induce kidney regeneration and restore renal function.
Willard H. Eyestone, PhD, research assistant professor of reproductive biology and biotechnology at Virginia-Maryland, will act as lead faculty member at the veterinary college and the liaison to Wake Forest in the collaboration, according to the release. Dr. J. Koudy Williams, professor of pathology and surgical sciences at Wake Forest, will serve as the lead faculty member from the institute.
Award nods sought for influential veterinarians
Nominations for the 2011 Penn Vet World Leadership in Animal Health Award are due March 18.
The Penn Vet World Leadership in Animal Health Award Committee is accepting nominations for the prestigious honor, which the University of Pennsylvania School of Veterinary Medicine gives to veterinarians who have positively influenced the practice and image of veterinary medicine and influenced others' lives and careers. It carries a $100,000 monetary award.
The selection committee is chaired by Dr. Alan M. Kelly, dean emeritus of the School of Veterinary Medicine, and includes representatives from U.S., European, and South American veterinary schools.
“All nominees will be reviewed based on their vision, lifetime achievements, and future potential,” university information states.
More information is available at www.vet.upenn.edu/worldawards.
