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. Stuart 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!”