Dr. Milan Milovancev, soft-tissue veterinary surgeon at the OSU Veterinary Teaching Hospital, uses cutting-edge technology to remove the lobe of a dog's lung.
Dr. Milan Milovancev, soft-tissue veterinary surgeon at the OSU Veterinary Teaching Hospital, uses cutting-edge technology to remove the cancerous lobe of a dog’s lung.

The well-thumbed magazines and stacks of newspapers in the sunny lobby of the Small Animal Hospital at OSU represent many hours of patient waiting for the thousands of pet owners who visit the Lois Bates Acheson Veterinary Teaching Hospital each year.

Referred by their family veterinarian, most of the hospital’s clients bring pets with complex health issues like cancer, compound fractures, heart conditions, or rare diseases. With the largest group of board-certified veterinary specialists in Oregon, and state-of-the-art facilities, OSU can bring together diverse resources and a team effort to heal these challenging conditions.

A recent example of complex teamwork kicked into gear in January when a twelve-year-old Weimaraner visited the hospital with a swollen toe.

Alijah was an outwardly healthy, active dog but his family veterinarian was concerned about a small growth on the second toe of his right foot. She referred his owners to OSU for further evaluation.

Dr. Stewart Helfand is a veterinary oncologist with thirty years of experience in cancer care for companion animals. When the x-rays he ordered for Alijah revealed a suspicious area in his lung, Dr. Helfand was able to consult with Dr. Sarah Nemanic, a veterinary radiologist at OSU. They advised Alijah’s owners  that a Computed Tomography (CT) scan would help determine the nature of this suspicious mass.

The OSU Veterinary Teaching Hospital (VTH) has a 64-slice CT scanner that is currently the fastest, and only one of its kind, used in veterinary medicine in the United States. This high-speed and precise machine is capable of capturing detailed, 3-dimensional images of the entire body of small animals, providing diagnostic information that cannot be obtained using other imaging techniques.

Alijah’s CT scan revealed a two-centimeter, irregular lesion on his left lung. Based on the shape of the lesion, Drs. Helfand and Nemanic decided it was likely to be a lung tumor. The CT also revealed a ten-centimeter mass in the dog’s spleen. Dr. Nemanic then did an ultrasound-guided biopsy of the lung lesion which was tested in the OSU Veterinary Diagnostic Laboratory and found to be cancerous.

As with many cases at the VTH, doctors offered Alijah’s owners several options for treatment, from continued monitoring to surgery. His owners elected to have Alijah’s spleen, second toe, and right lung surgically removed. This option was possible because a dog doesn’t need his spleen, the second toe is not a major weight- bearing toe, and the loss of one lobe of the lung does not create a major impairment.

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Cytology team at the Veterinary Diagnostic Laboratory: Dr. Sue Tornquist, Dr. Austin Viall, and Dr. Elena Gorman.
Cytology team at the Veterinary Diagnostic Laboratory:
Dr. Sue Tornquist, Dr. Austin Viall, and Dr. Elena Gorman.

While clients of the small animal hospital are waiting to get a diagnosis on a pet who may or may not have cancer, a crack team of cytopathologists are working behind the scenes at the OSU Veterinary Diagnostic Laboratory (VDL) to provide answers as quickly as possible.

That team of experts includes Dr. Elena Gorman, Assistant Professor of Clinical Pathology, Dr. Sue Tornquist, Interim Dean and Clinical Pathologist, and Dr. Austin Viall, Clinical Pathology Resident. Their work involves the examination under a microscope of preparations made from body fluids or solid tissue that is sent to them by doctors at the OSU Veterinary Teaching Hospital.

“In the course of a day, we take multiple ultrasound-guided, fine needle aspirates and within a few hours, or less if needed, we can get an answer if the patient has potential cancer or not,” says Dr. Susanne Stieger-Vanegas, Assistant Professor of veterinary diagnostic imaging. “Without their tremendous expertise and knowledge, we would not get a quick answer on what we are dealing with,” says Stieger-Vanegas.

Fine needle aspiration is a rapid method for determining if a solid lump of tissue is benign or malignant. By using a syringe to extract cells from a suspicous growth, then examining them under a microscope, an experienced cytopathologist can look for the presence of cell abnormalities and make a diagnosis. It is faster and less invasive than a biopsy.

In addition to the rewards of helping to treat and save pets, there are other aspects of cytopathology that make this team passionate about their work. “Cells are really very beautiful,’ says Dr. Tornquist. “I’m a big mystery fan. Looking for patterns in the cell types, and other things we see in a cytology sample, is like trying to put together all the clues in a mystery and solving it. And at the end of this process, you can have an impact on the lives of animals and their people.”

One advantage of being a VDL pathologist, as opposed to working at a laboratory that services hundreds of veterinary hospitals, is that the patients and doctors are located right down the hall. “I love that I have a plethora of specialists who I can turn to for information and education,” says Gorman. “Being associated with a teaching hospital makes our diagnostic capabilities so much stronger. It’s invaluable to be able to discuss the clinical aspects of a case and even go look at the patient if I so choose,” she says. “I can’t imagine working anywhere else.”

In addition to diagnosing disease, the pathologists also participate in numerous research projects and teach students. “I love teaching and working with students, house officers and clinicians,” says Gorman. “It’s so much more fun to share the experience because, well, cells are cool!”

Dr. Jennifer Warnock, an orthopedic surgeon at the Lois Bates Acheson Veterinary Teaching Hospital, releases at Merlin falcon after repairing its fractured wing.
Dr. Jennifer Warnock, an orthopedic surgeon at the Lois Bates Acheson Veterinary Teaching Hospital, releases at Merlin falcon after repairing its fractured wing.

At the Rogers Wayside Park near Silverton, Oregon, Dr. Jennifer Warnock and OSU veterinary student Kyra Knutson placed a pet carrier in the middle of a grassy field. It was a quiet spot surrounded by trees and, more importantly, it was on the north-south bird migration path of the Pacific Flyway. Warnock donned a pair of heavy, foot-long, leather gloves, opened the carrier door, and gently removed a brown bird the size of a cockatoo. The bird was covered with a lightweight blanket to keep it warm and calm. As Knutson removed the blanket, Warnock lifted her arms and let go. The bird was so fast, it took off in a blur and landed in the nearest tree before they could even watch it fly. After a few minutes, the bird flew across the field to a taller tree. “She’s cutting just the way she is supposed to; that’s a good sign,” said Warnock.

The bird was a Merlin, a type of small migratory falcon, also known as a Pigeon Hawk.  Six months earlier, a good Samaritan had stopped and rescued the bird from the middle of a road north of Rogers Wayside and took it to the Turtle Ridge Wildlife Center near Salem. The Merlin had a fractured wing so they called the OSU Veterinary Teaching Hospital to ask if a surgeon was available to repair it.

Unfortunately, the answer to that question is often, ‘No’. The small animal hospital at OSU is generally limited to the treatment of cats and dogs, but Warnock is an orthopedic surgeon with a personal interest in raptor rehabilitation, and squeezes enough money out of her teaching fund to help about one bird a year. She uses that opportunity to give students with an interest in avian medicine an chance to observe the surgery. “It’s a great learning experience for them,” she says.

One of the missions of the OSU Veterinary Teaching Hospital is to use minimally invasive surgery whenever possible. Dr. Warnock repaired the Merlin’s fractured radius and ulna using fluoroscopy, a technique that uses images obtained during surgery via x-ray. Those images appear on a monitor that the surgeon watches as she operates. “We were able to stabilize the fracture without making incisions, which not only decreases postoperative pain,” says Warnock, “but also preserves bone blood supply, thus allowing comminuted fractures to heal.”

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Dr. Wendy Baltzer helps Henry move his weak leg on the underwater treadmill while student Giovanna Coto helps him stay upright.
Dr. Wendy Baltzer helps Henry move his weak leg on the underwater treadmill while student Giovanna Coto helps him stay upright.

Andy Michaels’ goat Henry is a bit of a couch potato. Although he shares a goat house next to the Michaels’ family home with his buddy, Chris, Henry rarely joins Chris on a stroll around the yard. “He is no athlete,” says Michaels. “He never climbs up on his house and he doesn’t walk about. He is more of a cuddler.”

Michaels’ fondness for the two goats is obvious, and they are definitely pets rather than livestock, so when Michaels found Henry laying on his side, unable to rise or stand on his own, he took the goat to the local veterinary emergency room.  There Henry was diagnosed with mild anemia and intestinal parasites, neither of which explained his lameness. Henry’s x-rays were normal so the veterinarian recommended Michaels take Henry to OSU Veterinary Teaching Hospital.

When Henry arrived at OSU, large animal veterinarian Keith Poulsen ordered diagnostic tests, but it was a simple physical exam that gave him his first clue to Henry’s problem. Dr. Poulsen detected significant muscle atrophy in Henry’s legs. He suspected Henry was suffering from white muscle disease, so while he waited for the test results, he put Henry on vitamin supplements and a high protein diet.

White muscle disease is a degenerative muscle condition caused by deficiency in either selenium or Vitamin E. Selenium is a trace mineral found in soil and it plays a critical role in reproduction, thyroid hormone metabolism and muscle cell health. Most livestock producers in the Pacific Northwest know that Oregon soil contains very low amounts of selenium, so animals whose primary nutrition comes from pasture and locally grown hay or alfalfa need selenium supplements. But people who own a couple of goats or horses as pets are often not aware of the problem.

Before a pet owner considers adding selenium to an animal’s diet, they should check with their veterinarian. Most dog and cat food already contains selenium and too much selenium can be toxic.

Once Henry’s diagnosis of white muscle disease was confirmed, Dr. Poulsen ordered selenium supplements and a program of rehabilitation for nerve dysfunction and muscle weakness. This included acupuncture, range of motion exercises, physical therapy and walking on the underwater treadmill.

How hard is it to get a goat to walk on an underwater treadmill? Depends on the goat. Henry’s mellow personality made it a cake walk, so to speak. Fourth-year student Giovanna Coto was assigned to Henry’s care while he was in the hospital and quickly became attached to the affectionate, easy-going goat. “He’s a love,” she says.

Every other day, for the first week Henry was in the hospital, Coto loaded him onto to a wheeled platform for his journey through the large animal stalls, down the hallway to the treadmill. He required no straps or sedation, but quietly lay still for the entire ride. Once there, Coto sat with him, stroking his back and talking to him while he waited his turn for the rehab room.

At first, although supported by a sling, Henry had trouble moving his legs on the treadmill and required help. But within a week, he showed marked improvement in strength and coordination. By his eighth treadmill session, he was able to walk from his stall to the rehab room on his own, use the treadmill without help, and walk back to his stall.

Now home with his family, Henry is fully recovered with no residual lameness, but it might be hard to tell because he is back to his sedentary ways. The weeks on the OSU treadmill did not turn him into an exercise afficianado. “He still looks like a stuffed goat,” jokes Michaels,”but he can get around just fine.”

Watch video of Henry on the underwater treadmill.

Oregon State College of Veterinary MedicineWhat do you do when your back forty is covered in blackberries? You can spray herbicides (expensive and not environmentally friendly), you can hire a crew to chop them down (expensive and temporary), or you can get a goat.

Goats love to eat, and they really love the nasty stuff: blackberries, ivy, scotch broom. They’ll even eat poison oak.

That’s how Debbie Bales became a goat fan. “We bought a place with a pasture that was overrun with blackberries,” she says. “Someone wisely suggested we get a goat or two.”  Their first goat, Sweetie Pie, was a Boer, a breed known for their distinctive white body and red head, large size, and docile personality; perfect for a family pet that will do some yard work.

Sweetie Pie gave birth to Kahlua, and soon after, Bales bought Chewy and Bambi. They now have seven goats, half from what Bales refers to as the ‘sweetie’ line. “Sweetie, Kahlua, and her two daughters all exhibit the same affectionate, loving personality,” she says. “It is very comparable to a dog that likes to cuddle.”

Kahlua, whose nickname is Loo Loo, is especially friendly. “She is always the first to approach people and will stand with her head resting on your leg, begging for some petting.  She loves scratches on her top shoulders and she returns the favor by putting her nose in my face very gently, to let me know she likes me back.”

Kahlua’s close bond with Bales helped them both through a recent health crisis: Kahlua was diagnosed with breast cancer.

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Oregon State College of Veterinary MedicineWhen Thomas and Virginia Knott decided to get a family dog, they did their homework. First they made a list of qualities that fit their lifestyle: good with children, athletic and outdoorsy, easy to train, and a history of good health. Then they started attending dog shows and visiting breeders.

One day, they saw a breed that really impressed them: the Landseer European Continental Type. Sometimes confused with the Newfoundland Landseer, the Landseer ECT is taller, more athletic, and has shorter hair. The Knotts decided to investigate further.

They discovered that the breed is strictly controlled by the German Landseer Club, which restricts breeding to dogs who pass x-ray checks and other requirements. This has prevented Landseers from developing hip dysplasia and other joint issues associated with many large, purebred dogs.

The German Landseer Club showed the Knotts books of documentation on every dog that had been released for breeding, going all the way back to 1976. The Knotts were so impressed they bought their first Landseer, a male named Charlie.

In 2005, a job transfer took the Knott family to China, where they lived for several years. Then they settled in Seal Rock, Oregon and, at last, were able to follow their longtime dream of introducing Landseer dogs to the U.S.

In 2011, the Knotts brought a female Landseer named Ginger back from Germany, and soon Charlie was the father of eight puppies. Ginger had a difficult labor and, sadly, died during an emergency C-section. Her puppies survived and one had a black mark on her shoulder that looked like a flower. The Knotts named her Bluemchen, which means “little flower” in German.

Bluemchen grew into a confident, strong dog who loves swimming in the ocean. Soon she was ready to be a mother but the Knotts had a dilemma. There were no other Landseer males in the U.S., and taking Bluemchen all the way to Europe and back would have been an ordeal for her.

Then the Knotts heard about the artificial insemination program at the OSU Veterinary Teaching Hospital (VTH). With approval from the German Landseer Club, VTH Dr. Hernan Montilla imported frozen semen from a certified Landseer in Belgium and soon Bluemchen was pregnant – with thirteen puppies!

On average, Landseers have six puppies, so the Knotts were concerned about Bluemchen, and when she went into premature labor, they decided to take her to the VTH for observation.

By the time Bluemchen arrived at the hospital, she was running a fever and was very uncomfortable. She delivered three puppies but no more. Dr. Montilla gave her IV fluids and pain killer, but when she still had not delivered the remaining puppies by the next day, he advised the Knotts that a C-section would be necessary.

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OSu College of Veterinary MedicineCold laser therapy is a noninvasive procedure that uses light to stimulate cell regeneration and increase blood circulation. Although it has been used in humans for decades, cold laser therapy is a relatively new treatment option for dogs and cats.

A laser is a beam of light that travels at a frequency high enough to generate heat and penetrate tissue; it can be an effective alternative to surgery or medication for certain problems like arthritis. “The laser helps to encourage repair of damaged or weak tissue and reduces inflammation,” says Sarah Smith, Certified Rehabilitation Practitioner at the OSU Veterinary Teaching Hospital. “It is a good option for pets with arthritis, tendon or soft tissue injuries, or post-surgery pain and stiffness.”

At the OSU Veterinary Teaching Hospital, laser therapy is just one of the tools used in the small animal rehabilitation unit. In the treatment room are colorful balls and toys, a row of pet swim-gear, a pet-sized swimming pool and an underwater treadmill. To one side is a big, cushy mat where Smith reclines with patients receiving laser therapy.

One of her regular patients is Levi, a 12-year-old Shepard mix. When Levi was 8 years old he was diagnosed with bone cancer and his left hind leg was amputated. Although dogs adapt to three legs fairly well, Levi’s age and arthritis made walking more of a challenge for him. “He had developed a pogo-stick hop,” says Smith. That method of movement was hard on his body so Dr. Wendy Baltzer prescribed a plan of rehabilitation to modify his walk.

“He spent several months on the underwater treadmill to encourage him into a rolling walk,” says Smith. Then he began laser therapy for the arthritis in his right hip. “It helps lubricate the cartilage,” says Smith, “and encourages scar tissue which helps pad his joint.”

Levi is very relaxed as Smith applies the laser wand to his hip. He has been receiving this treatment for several years and comes about once a month.

Each laser treatment takes 10 minutes or so and has no unwanted side effects. In fact, animals seem to enjoy the therapy. Results may not be immediate, but after a few treatments, the reduction in pain and increased mobility will usually last for several weeks.

Dr. Morrie Craig has translated his research into a plan for using sheep to clean contaminated soil.
Dr. Morrie Craig has translated his research on rumen bacteria into a plan for using sheep to clean up soil.

The Iraqi invasion of Kuwait in 1991, and the ensuing Persian Gulf War, left behind half a million unexploded land mines. Today, Explosive Ordnance Disposal teams are still working to clear out those mines.

Less critical, but still a serious health concern, is the residue left from exploded ordnance. Soil across Kuwait is contaminated with TNT and other explosive compounds. If inhaled in dust, or ingested through ground water, TNT residue can cause dermatitis, kidney disease, anemia, and even cancer. Traditional soil cleaning methods like incineration are expensive and mar the environment. OSU Professor Morrie Craig has a better idea: Send out the sheep.

As a toxicologist in the College of Veterinary Medicine, Craig discovered that the multiple stomach chambers in a sheep contain bacteria that break down alkaloid toxins in plants. This makes it possible for them to eat all kinds of nasty weeds that make other animals sick.

When the U.S. military heard about his research, they suggested Craig test sheep bacteria on a synthetic alkaloid toxin: TNT. Used in the manufacture of bombs for the U.S. military since World War II, the military was looking for cost-effective ways to clean up TNT-contaminated sites in the U.S. and around the world.

In 2011, Craig and researchers from the U.S. Department of Agriculture fed sheep TNT for three weeks and found that it broke down in the sheep’s stomach so completely there was no trace of it in their feces. When coupled with Craig’s earlier research on the use of grasses to suck contaminants out of the soil, these new findings gave Craig a plan for bioremediation of explosives residue: Plant grass in contaminated areas then graze sheep on those fields.

CraigCamelAfter testing his plan on soil at a military base, Craig estimates a flock of 20 sheep can completely clear an acre of explosives residue in less than three years. Now he is working with the Kuwaiti government to help them adapt his discoveries to a plan that will work in their country. They are currently testing warm-season grasses for TNT uptake, and they are investigating the possibility of using camels as well as sheep. Funding for the projects comes from a tax on Iraqi oil as part of a United Nations settlement to compensate Kuwait for damage done by the Persian Gulf War.

In December, Dr. Craig will be the keynote speaker at an international seminar in Kuwait on The Environmental Impact of Explosive Remnants of War.

OSU’s International Veterinary Students Association made their annual trek to Nicaragua in August, creating a free clinic in the jungle for a rural community that has no veterinary care available. In just six days they treated 623 animals, providing spay and neuter surgery, dental care, disease treatment, and health education. Thirty-two veterinary students, four veterinarians, and three certified veterinary technicians volunteered their time to the mission, which relies on charitable donations for supplies and travel expenses. Read more.

 

WoodyWoody was rescued from an abusive owner when he was just a puppy. Adopted by Mari McGovern and her family, the gentle Golden Retriever was able to blossom on their ranch in the Willamette Valley, and his difficult start in life was followed by many happy years of kids, Frisbees, and exploring the forest.

Then in 2010, Woody was diagnosed with osteosarcoma, an aggressive bone cancer that is more common in dogs than people. McGovern’s vet referred her to the oncology unit at the OSU Veterinary Teaching Hospital (VTH). There, doctors told her that, in order to stop the spread of the cancer, Woody’s left rear leg would have to be amputated. They were heartbroken, and to make things worse, it was just a few days before Christmas. “They took him in on Christmas eve and performed the surgery that saved his life,” says McGovern.

When her family returned to the hospital on Christmas day to see how Woody was recovering, they were amazed when he came running out with his usual happy face!

Osteosarcoma is challenging to treat, in both humans and dogs (it tends to resist chemotherapy), so Woody’s prognosis was not great: another year at best. Fortunately, the VTH had just agreed to collaborate on a research project on osteosarcoma that offered more hope for Woody.

Developed by Drs. Charles Keller and Lara Davis at the Oregon Health & Science University, the Osteosarcoma Research Project enrolls OSU dogs for clinical trials of a new approach to treatment:  Instead of choosing chemotherapy drugs based on a best guess of what would work, doctors took a sample of Woody’s cancer cells and sent them to OHSU where a large selection of the latest cancer drugs were tested on cell cultures developed from his tissue. The drug that had the biggest impact was selected for Woody.

“We try to increase the chances of hitting the right drug at the start, rather than doing a shotgun approach, “ says VTH Dr. Shay Bracha. “Before, if you had 100 patients with osteosarcoma, they would all get the same drug because the assumption was that bone cancer all behaves the same. But we know for many years now that the cancer of each individual is very different.”

Usually the average survival time for a dog diagnosed with osteosarcoma is about a year. Woody lived for nearly three years.  When you consider that this is one-fifth of a dog’s life span, it was quite a dramatic result and very inspiring for the doctors collaborating on the project. “It was an impressive remission,” says Bracha.

In his favor, Woody’s disease was diagnosed before there were signs of cancer in his lungs. This rarely happens; by the time most dogs see a vet, x-rays show the osteosarcoma has spread to the lungs. This was the case for another patient in the osteosarcoma study: a big, furry German Shepard named Nuit.

Nuit is currently receiving the same personalized treatment that Woody had, but Nuit already showed tumors in his lungs by the time he came to the VTH. He was given a matched drug and in less than a year, two of the masses in his lungs had disappeared completely. “Usually, when you can see lung masses, the progression of the disease is very fast – three months and they are dead,” says Bracha. “He is a year out and doing fantastic.” In fact, last month his x-ray was completely clear.

Most of the dogs in the osteosarcoma project have had equally good results, but not all. “We still need to figure out many things,” says Bracha, “but when it works, it is phenomenal.

Osteosarcoma is also a devastating disease in children – in fact, although it only accounts for 2% of cancer cases, it is responsible for 10% of all pediatric cancer deaths. The information gathered in the joint OHSU/OSU osteosarcoma project will benefit human treatment also. “They are doing some of these trials in children as well, but we can learn a lot from the dogs,” says Bracha. “Statistically, there are many more dogs with this disease than children. Because the progression of the disease is very, very similar in the dog, it makes sense to study the disease in both species.” Another benefit: Dogs have shorter lifespans so the study can collect data fast.

OSU has completed the pilot phase of the study. Currently, Dr. Bracha and another OSU researcher, Dr. Milan Milovancev, are fundraising to finance the next phase. “We still have a lot of data to collect,” says Bracha. “We have to get a large number of patients from different institutions – that is always the gold standard to do a multi-institutional study with big cohorts of patients to have statistically significant findings.”

Dr. Bracha has been treating dogs with cancer for nearly ten years. “We get very, very attached to our patients. We see them on a weekly basis for months, years sometimes. They become a big part of our lives so it is devastating when we lose them, and it’s a huge celebration when they surpass the average survival rate and do better,” he says. “Then they come and they wag their tail.” Despite the emotional roller coaster, Dr. Bracha views oncology as his mission. “It’s a privilege to do something that may change the survival or prognosis for dogs and for people,” he says.

Woody died last spring. Although they miss him very much, his family will always remember the contribution he made to science. “We were so fortunate to be given the opportunity to be part of the program,” say McGovern. “The experimental drugs allowed us two-and-a-half more years with him, and for that we will be eternally grateful. We hope the information gathered from Woody’s case study will be helpful to children and teens facing this terrible disease. Woody would have wanted it that way!”