Monthly Archives: September 2013

Canine Cancer Study Will Improve Treatment For Sick Children

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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!”

Knee Fix Gives Beloved Alpaca Legs To Stand On

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Kanip in her short summer coat and shaved legs from recent knee surgery, is not, perhaps, looking her best but is feeling much, much better.
Kanip, in her short summer coat and shaved legs from recent knee surgery, is not, perhaps, looking her best, but is feeling much, much better.

Kanip is a three-foot tall, fluffy alpaca with big brown eyes. Physically, she doesn’t stand out from the crowd of 26 alpacas and 6 llamas that live on Mary Warbin’s farm in LaCenter, Washington, but Kanip is not an average alpaca.

For one thing, she is unusually vocal; she grumbles, clucks, and screeches.  And when she is anxious or unhappy, she really let’s it rip. She may be curly and cute, but her screams are ear-splitting. “We got her from a farm in Ohio and they had named her Conniption Fit,” says Warbin. “I thought, ‘Who in the world would name an alpaca Conniption Fit?’ Well, it describes her perfectly.”

After the birth of her first baby, Kanip was a reluctant mom. She refused to nurse, so Warbin had to bottle-feed the newborn. “Every time I touched the baby, Kanip would scream at me.” One morning, after many nights sleeping in the barn, feeding the baby, Warbin woke up to find Kanip snuggled at her feet. Then the new mom got up and started nursing her baby. “Since then I am her best friend,” says Warbin. “We are now very close.”

Last year, Warbin went out to the pasture and was surprised when Kanip didn’t come to greet her. She soon realized that something was very wrong. “She could not get up,” says Warbin. “I called the vet but by the time he arrived, she was up and walking normally.”

Then, last month, it happened again. “She was on the ground screaming,” says Warbin. This time she could not get up so Warbin and her husband carried her into the trailer and drove her to the OSU Veterinary Teaching Hospital (VTH). X-rays revealed that both her rear knee caps had dislocated and shifted off to one side.

A knee cap that shifts out of position is known as a luxated patella. The condition is fairly common in dogs, but is rare in alpacas. In most cases, a luxated patella is caused by a congenital deformity in the groove where the patella sits; the groove is not deep enough to hold the knee cap in place.

Dr. Michael Huber, a veterinary surgeon with 33 years of experience, is an expert at handling difficult cases like Kanip’s. “It was challenging because both limbs were involved – she did not have a good leg to stand on,” says Huber. “The knee caps were loose and moving both medially and laterally [to the inside and outside]. Since it is usually just to the outside, this indicates severe instability.”

He explained to Warbin that Kanip’s kneecaps could be fixed with a surgical technique called trochlear recession and soft tissue imbrication. The surgery would deepen the groove in the leg bone where the knee cap sits and tighten the bands of tissue that hold it in in place.

Fourth-year student, Christina Crawford, was assigned to large animal hospital rounds when Kanip first arrived. She provided much of the basic care the alpaca received before and after her surgery. “Kanip was quite shy when she first arrived,” says Crawford. “We moved slowly and talked quietly around her. We discovered that she really enjoyed being petted right behind her ears, and that seemed to calm her.”

The OSU Veterinary Teaching Hospital has the largest group of board certified veterinary specialists in Oregon, so complicated surgeries are often a team effort. For Kanip’s surgery, Huber consulted with small animal surgeon Dr. Wendy Baltzer, who had performed this procedure on dogs. Huber also had the benefit of onsite anesthesiology specialists. “They provided controlled, prolonged anesthesia and monitoring,” he says.

Kanip had some complications, including a shift of one patella due to a post-surgery fracture of the stabilizing bone. Once Huber fixed that issue, Kanip was able to take advantage of the hospital’s extensive rehabilitation unit, primarily used for dogs and cats. “Kanip was the first large animal to have planned physical therapy at the VTH,” says Huber. “Treatment included cold laser therapy, limb manipulation, and electrical muscle stimulation. It had a major role in her recovery.”

As a student, Crawford valued the learning experience of working alongside Dr. Huber’s team and caring for Kanip. “I learned that a case can take unexpected turns, and that you should not give up because they can have excellent results.”

“The students were very important in her recovery,” says Warbin. “They provided the pampering and babying she needs because she is so emotional. Without them, she would not have recovered so quickly.”

Six weeks after her surgery, Kanip is nearly back to normal. “She has been a wonder. She has picked up her pace and is even walking up inclines,” says Warbin. “ One day her baby was startled and landed on Kanip’s back leg. I freaked out but everything held and she was okay.”

Dr. Huber is also pleased with the results. “Kanip was a special patient; very vocal with some ‘human’ responses and emotions. I understand Mary’s connection to her.”

In fact, that connection is now so strong, Warbin has built a new home for Kanip and her baby between the house and the alpaca pens where the rest of the herd lives. “She is part of our family so we built her stall right next to our deck so she can be near us.”