Cannabis research for veterinary patients advances, cautiously
Dr. Stephanie McGrath with Atticus, a 3-year-old Saint Bernard enrolled In a clinical trial of cannabidiol for the treatment of epilepsy, and Breonna Thomas, clinical trials coordinator at Colorado State University's Veterinary Teaching Hospital (Photo by John Eisele/Colorado State University Photography)
Citation: American Journal of Veterinary Research 79, 9; 10.2460/ajvr.79.9.908
More than half the country has legalized marijuana use in one form or another.
Despite the dramatic shift in public opinion and state policies over the past two decades, little conclusive evidence exists concerning the short- and long-term health effects of a drug that, according to one nationwide survey, was used by 22.2 million Americans during a 30-day period in 2014.
One explanation for the lack of cannabis research is the federal classification of cannabis as a schedule I controlled substance. The most restrictive of the Controlled Substances Act categories, schedule I applies to drugs with no known medical benefits and a high potential for abuse, such as heroin and LSD.
The farm bill passed by Congress in 2014 included a provision that legalized the growing and cultivating of industrial hemp for research purposes under certain conditions. The law defined industrial hemp as all parts of the marijuana plant (Cannabis sativa L.) containing less than 0.3 percent tetrahydrocannabinol. THC is one of 104 cannabinoids identified in the marijuana plant and the substance responsible for the psychotropic experience in human users.
Laws regulating the approval process for prospective pharmaceutical products and the criteria to conduct research on such products were not amended, however. Neither did any change occur in the Controlled Substances Act itself, which governs the manufacture, distribution, and dispensing of controlled drug products.
Those wishing to study the effects of cannabis or cannabinoids must navigate a challenging process that may involve the National Institute on Drug Abuse, Food and Drug Administration, Drug Enforcement Administration, offices or departments in their state's government, state boards, their home institution, and potential funders.
Some researchers have viewed the process as sufficiently onerous that it dissuades them from proceeding, while others have negotiated it successfully. In June, the FDA approved Epidiolex, the nation's first drug derived from marijuana, for the treatment of seizures associated with two rare and severe forms of epilepsy in humans.
Still other researchers are studying cannabis in animal patients without explicit FDA and DEA approval, but in a manner they contend complies with federal and state law.
Dr. Stephanie McGrath, a neurologist and assistant professor at Colorado State University's College of Veterinary Medicine & Biomedical Sciences, has completed two clinical studies since 2016 on the effects of cannabidiol in dogs with osteoarthritis or epilepsy. Cannabidiol is a nonpsychotropic cannabinoid that is thought to have positive effects in alleviating chronic pain and aiding in the treatment of autoimmune diseases.
Applied Basic Science Corp. provided Dr. McGrath with the CBD as well as funding for the canine osteoarthritis and epilepsy studies. The company manufactures and sells a hemp-hybrid plant oil extract for relief of signs of various medical conditions in pet animals.
An initial investigation involving 30 healthy research animals found that CBD was tolerated and resulted in measurable blood concentrations. Dr. McGrath expects results of that study will be published this year. Data from the other studies are being analyzed, but preliminary results of the epilepsy investigation were promising enough that, in January, Dr. McGrath began a three-year crossover study of CBD for epilepsy in dogs with a $350,000 grant from the American Kennel Club.
Dr. Dawn Boothe, director of clinical pharmacology at Auburn University College of Veterinary Medicine, is studying cannabidiol as a treatment for epilepsy in dogs and is also developing an assay to measure cannabinoid toxicity and efficacy.
Condensed from Aug. 1, 2018, JAVMA News
The dangers of improper drug disposal
Hundreds of human-made chemicals flow into U.S. streams and waterways.
Dana W. Kolpin, a research hydrologist for the U.S. Geologic Survey, said wildlife interacts with those products in unpredictable ways. Marine life is hit with a complex soup of contaminants, all maybe at low levels that could have additive effects.
The pharmaceuticals in that mix—and products of their deterioration—arrive in water discharged from wastewater treatment plants, passed through tile drains from manure-fertilized fields, washed off livestock farms, or leached from landfills and septic systems. One of the concerns is unused drugs that are flushed down the drain.
How much comes from proper use, versus improper disposal, is hard to quantify, Kolpin said. Throwing unused medicine into a toilet was a more common practice 20 years ago, he said, but it remains part of today's pollution problem. It also is the easiest source of contamination to reduce.
A U.S. Geologic Survey scientist collects water samples from a stream near swine farms in Iowa. The samples were tested for livestock-related contaminants, such as drugs, hormones, nutrients, and pathogens (Photo by Dana W. Kolpin/USGS)
Citation: American Journal of Veterinary Research 79, 9; 10.2460/ajvr.79.9.908
From 2012–14, USGS and Environmental Protection Agency scientists collected water samples from 38 streams across the country and tested for about 720 human-source contaminants. They found more than 400, including about 230 active drugs and poisons (Environ Sci Technol 2017;51:4792–4802).
The number of contaminants ranged from four in a creek near a small Arkansas town to 161 in the Chicago Sanitary and Ship Canal, with a median of 70.
The contaminants are dangerous to fish, insects, and other life, which can be more sensitive to contamination in low concentrations during development and growth.
Condensed from Aug. 15, 2018, JAVMA News
Unusual pet diets may be linked to heart disease
Some specialty diets may be causing heart disease in dogs, and researchers are trying to identify the connection.
Dr. Lisa M. Freeman, a nutritionist and professor at the Cummings School of Veterinary Medicine at Tufts University, wrote June 4 on the university's Petfoodology blog about a 4-year-old Beagle-Labrador mixed-breed dog saved from life-threatening dilated cardiomyopathy with treatment and a change of diet. Before treatment, the dog had been eating grain-free pet food containing kangaroo meat and chickpeas.
Food and Drug Administration officials since have announced that the agency is studying a possible connection. Dr. Freeman noted that cardiologists also are investigating.
A dog or cat with dilated cardiomyopathy has an enlarged, weak heart, which can cause abnormal rhythms, congestive heart failure, and death.
Cats and at least some dogs can develop dilated cardiomyopathy if their diets contain too little taurine, an amino acid found in meat and milk. It is a neurotransmitter and cell membrane stabilizer, among other functions, according to the National Institutes of Health.
Despite the known link between dilated cardiomyopathy and taurine deficiency, most dogs that develop the disease have taurine concentrations within reference limits. The cause of cardiomyopathy in those dogs is typically unknown, but Dr. Freeman wrote that she has seen a consistent connection with boutique diets.
Dr. Freeman recommends that owners submit reports to the FDA when their dogs are determined to have dilated cardiomyopathy. The Department of Health and Human Services accepts reports to the FDA at www.safetyreporting.hhs.gov.
Condensed from Aug. 1, 2018, JAVMA News
Comments sought on proposed specialty in equine diagnostic imaging
The AVMA American Board of Veterinary Specialties has received a petition for recognition of equine diagnostic imaging as a new specialty within the American College of Veterinary Radiology. In compliance with ABVS procedures, the board is seeking comment from the public and the profession regarding the proposed specialty.
The organizing committee of the proposed specialty submitted a letter of intent to the ABVS in 2015 and a formal petition for recognition of the specialty to the ABVS Committee on the Development of New Specialties in November 2017.
According to a one-page description from the organizing committee, “The current ACVR format is heavily weighted towards small animal imaging.” The description continues: “The goal of this proposal is to provide a specialty within ACVR with dedicated training for the equine radiologist to increase their service to equine general practitioners and specialists; to further raise the standard of care of equine imaging; and promote research, teaching and academic development in equine imaging, as well as clinical service.”
All AVMA-recognized specialty organizations and specialties comply with recognition guidelines outlined in the ABVS Policies and Procedures manual, which is available online at https://jav.ma/ABVSpolicies. Refer to those guidelines when developing comments regarding the proposed specialty of equine diagnostic imaging.
A link to the petition in PDF format as submitted to the ABVS can be found on the ACVR website at http://jav.ma/equineimaging. Comments must be signed and received no later than Sept. 17.
Send comments regarding consideration of recognition of equine diagnostic imaging as a veterinary specialty to ABVS@avma.org.
Condensed from Aug. 15, 2018, JAVMA News
New aim of debt program is helping veterinarians thrive
The Veterinary Debt initiative, formerly the Fix the Debt initiative, has shifted direction after its creation two years ago, with a new framework and goals.
The co-leading organizations—the AVMA and Association of American Veterinary Medical Colleges plus the Veterinary Medical Association Executives as of July 2017—say it is necessary to provide a new framework that will facilitate better organization and coordination of efforts. At a meeting this past April, organization leaders agreed to have more regular communication.
They also created a new framework for coordinating initiative objectives in which there will be three areas of focus: the individual, the veterinary profession, and society. Specific objectives can be categorized under each of the three spheres of influence. For example, collaborating with allied health professions would fall under society, while developing a pathway for personal financial success would fall under the individual.
Finally, the co-leading organizations revised the goal of the initiative, which is now to help veterinarians thrive in financially sustainable and rewarding careers.
For the remainder of 2018, the organizations will work on, among other things, developing a timeline of key financial decision-making events from preveterinary studies to retirement, transitioning volunteers with working groups to new opportunities, and identifying a set of indicators to define and track progress on educational debt.
Next year, the goals of the initiative are to identify and develop tools and resources for individual veterinarians, define and prioritize research topics, develop scholarship metrics, explore potential new programs, and continue to support the federal advocacy agenda via the AVMA Congressional Advocacy Network and AVMA Government Relations Division.
Condensed from Aug. 15, 2018, JAVMA News
AVMA website devoted to early-career veterinarians
My Veterinary Life is a dedicated website with information and resources on personal well-being, financial literacy, and career success. The site, located at https://myvetlife.avma.org, launched just before AVMA Convention 2018.
A new resource available only on the site is a series of seven short videos featuring Paul Garrard, founder and president of PGPresents, who is an expert on the management of educational debt. In the videos, he gives advice on how to take the guesswork out of repayment strategies, explains how the Public Service Loan Forgiveness Program works, and goes over the differences among repayment plans.
Those still in veterinary college can explore international exchange opportunities compiled by Student AVMA officers and volunteers. Or they can check out the recently updated Student Externship Locator that lets users search by field of interest and state or school.
Recent graduates and rising professionals will find self-assessment tools to help them navigate their best career path or measure their professional quality of life. There are also a number of on-demand webinars on client communication, practice ownership, and other topics.
In addition, My Veterinary Life links to the newly developed Veterinary Salary Estimator. Through the use of historical data trends, this tool provides approximate salary ranges for various careers—from industry to academia to private practice—that can be used as a guide for pay negotiations as well as budgeting and financial planning.
The site links to the AVMA's Personal Financial Planning Tool, too. This member-only tool can help users build a profile of their finances so they can evaluate potential salaries, expenses, loans, and savings strategies through customized scenarios.
Condensed from Aug. 15, 2018, JAVMA News
Behavior specialty marks 25th year
When the AVMA granted specialty status to the American College of Veterinary Behaviorists 25 years ago, it was a signal to the profession and public that behavioral pathologies among animals are within the scope of veterinary medicine.
Since 1993, the number of ACVB diplomates has grown from eight charter members to 79 active diplomates. There are residencies in seven universities and nearly 30 individual mentoring programs.
Board-certified veterinary behaviorists work with animal owners, shelters, rescue organizations, zoos, and other groups to remedy individual and population-level behavioral issues, from aggression and excessive vocalization to obsessive compulsive disorder and offspring rejection. Behaviorists also address any underlying medical conditions that are either causing or contributing to a problem.
For ACVB President Valarie Tynes, the number of diplomates, residencies, and mentorships are encouraging given the specialty's rather humble start with just eight members. She is especially proud of the book the ACVB published for pet owners in 2014 titled “Decoding Your Dog: The Ultimate Experts Explain Common Dog Behaviors and Reveal How to Prevent or Change Unwanted Ones.”
Yet Dr. Tynes laments the underutilization of veterinary behaviorists, whose interventions, she says, can literally save lives.
“We've come a long way in 25 years, but you look at the fact that, for more than two decades, behavioral issues are the No. 1 reason why animals are relinquished to shelters, and you realize how badly our message needs to get out there,” observed Dr. Tynes, a veterinary service specialist with Ceva Animal Health.
Condensed from Aug. 15, 2018, JAVMA News
AVMA addresses pet obesity, opioid abuse
The AVMA Board of Directors met June 19–20 at Association headquarters to consider an agenda that included pet obesity, the opioid abuse epidemic, and a pilot program designed to promote mutual understanding between U.S. and foreign veterinary clinics.
During the meeting, chaired by Dr. Michael Whitehair, the Board approved, among other things, a proposal from the AVMA Future Leaders class of 2017–18 for the AVMA to endorse the Global Pet Obesity Initiative position statement.
The statement, unveiled at AVMA Convention 2018 in Denver, calls for a uniform definition of pet obesity and a universal body condition scoring system and calls for defining pet obesity as a disease.
The Board adopted a new AVMA policy, “The Veterinary Profession's Role in Addressing the Opioid Epidemic.” In 2017, the Board formed a working group to consider the veterinary profession's responsibilities and appropriate responses to legislative activities seeking to include veterinarians in state prescription drug monitoring programs.
The AVMA Board also approved a plan under which the AVMA would help manage a pilot program to launch a clinic-to-clinic twinning project between select companion animal veterinary clinics in three countries that are members of the African Small Companion Animal Network and select companion animal veterinary clinics led by AVMA-member veterinarians in the United States.
The AFSCAN is a global initiative of the World Small Animal Veterinary Association Foundation.
Condensed from Aug. 15, 2018, JAVMA News
Puschner assumes Michigan State
Dr. Birgit Puschner will serve as the new dean of Michigan State University College of Veterinary Medicine. She fills the position left vacant by Dr. John Baker, who is stepping down after working to reduce educational debt.
Dr. Puschner begins at MSU on Oct. 1, having received approval by the MSU Board of Trustees on June 22. She currently is chair of the Department of Molecular Biosciences at the University of California-Davis School of Veterinary Medicine. After completing her residency in veterinary toxicology in 1999, Dr. Puschner joined the UC-Davis veterinary faculty.
She credits her upbringing in rural Bavaria, Germany, for providing a love of and connection to agriculture and animal health, according to a June 21 university press release. Dr. Puschner received her veterinary and doctoral degrees from the Faculty of Veterinary Science at Ludwig Maximilian University of Munich, Germany. She did postgraduate training at the Animal Medical Center in New York and went on to complete a postdoctoral fellowship with the University of Michigan School of Medicine. She is a diplomate of the American Board of Veterinary Toxicology. Her research concentrates on diagnostic veterinary toxicology and the development of criteria for interpretation of analytical data.
Dr. Birgit Puschner (Courtesy of MSU CVM)
Citation: American Journal of Veterinary Research 79, 9; 10.2460/ajvr.79.9.908
Dr. Puschner will succeed Dr. Baker, who has served as dean since 2014 and is stepping down on June 30 to pursue other work within the veterinary college as he transitions to retirement. An administrator is filling the dean position from July 1 to Oct. 1.
Condensed from Aug. 15, 2018, JAVMA News
Tufts promotes Kochevar
Dr. Deborah T. Kochevar has left her position as dean at the Cummings School of Veterinary Medicine at Tufts University after 12 years. She has taken over as Tufts's interim provost and senior vice president as of April 16.
Dr. Joyce Knoll, associate professor and chair of the Department of Biomedical Sciences at the veterinary school, agreed to serve as interim dean starting May 21. Dr. Kochevar has said she will not return to lead the veterinary school; a search for its next permanent dean is now underway.
Dr. Kochevar (Texas A&M ‘81) earned a doctoral degree in cellular and molecular biology from the University of Texas Southwestern Medical Center in 1987. She was a National Institutes of Health National Research Service Award fellow from 1984–86.
Afterward, she joined the faculty at Texas A&M University, where she remained until 2006, when she became dean at Tufts.
Dr. Deborah T. Kochevar
Citation: American Journal of Veterinary Research 79, 9; 10.2460/ajvr.79.9.908
Dr. Kochevar is a former Congressional Science Fellow to the Senate Labor and Human Resources Committee, is a diplomate and past president of the American College of Veterinary Clinical Pharmacology, and is active in the AVMA, having chaired its Council on Education and the Educational Commission for Foreign Veterinary Graduates. She completed service as president and chair of the board of directors of the Association of American Veterinary Medical Colleges in 2013. She has developed special interests in international aspects of health education, including the importance of the interprofessional one-health concept in curriculum design. Her efforts in support of diversity and inclusion have been recognized at the school, university, and national levels.
Condensed from Aug. 15, 2018, JAVMA News
