Blog – Medical Advances

By November 25, 2016Blog, Newsletter

I graduated from veterinary school in 1982 . . . I know that was a long time ago; my staff members constantly point out that most of them weren’t even born then! Like many others in my circle of friends who are veterinarians of “advancing years”, I occasionally reminisce about the “good ol’ days”. However, medically speaking . . . boy, are we better off now! I’ll give you a few examples that spring quickly to mind–

 

Feline Leukemia

At my first post-veterinary school job—Brookline Animal Hospital, in Boston—we diagnosed cats and kittens with Feline Leukemia (FeLV) disease almost daily. This was a terribly disheartening diagnosis; at the time, no available vaccine for prevention, and a terrible prognosis for the affected feline. The cold hard fact was (and is) that cats persistently infected with the FeLV virus had close to a 90% fatality rate within 2 years from the time of diagnosis—and various treatment regimens did little to affect that long term prognosis. One of the side effects from this virus is a serious impairment of immune system function; so, cats became ill and often died from infections and cancers that would have been overcome with normal immune response. It was awful.

Thankfully, by the end of my second year in practice (or, beginning of the third), the first effective feline leukemia vaccine became available in the veterinary market. Like most vaccines, it was not 100% effective, but darn close. This vaccine has dramatically changed the incidence of feline leukemia in the cat population at large . . . we might see one “positive” lab result/month in our practice today.

Canine Parvovirus

Similar to FeLV in cats, this was a disease in need of a vaccine in the late 1970s. Canine parvovirus appeared as a “new” disease in California, then spread relatively quickly eastward across the continent.

My first veterinary “externship” was at a practice in town (Columbia, Missouri); working with the veterinarians who had employed me prior to my admittance to veterinary school at the University of Missouri. In the early fall of 1980, parvovirus “hit” us on its way east—close to the same day I began my externship. Since it was in fact, “new” to dogs; there was no prepared immune response to the disease—puppies and young dogs affected with the virus had a severe hemorrhagic diarrhea and often succumbed within hours to days.

Parvovirus was a known entity in many other species—for example, feline “distemper” is a parvovirus; in fact the canine disease likely originated from a modified live feline vaccine given to a dog. As canine parvovirus worked its way across the U.S., vaccine companies got quickly to work; within 6 months, there was an effective vaccine on the market. Prior to that date, I recall the veterinarians I was working for administering the available pig parvovirus vaccine to dogs—we had lines of clients with their dogs at the front door as vaccine shipments arrived. Once again; the canine vaccine essentially cured the disease—when we diagnose parvovirus today, it is almost always in unvaccinated or improperly vaccinated puppies and young dogs.

Feline Urologic Obstruction–”Blocked Cats”

This syndrome is still a relatively common cause of illness in cats; typically seen in young adult male cats. For a variety of somewhat complicated physiologic reasons; cats tend to form crystals in their urine. In male cats, these crystals combine with mucus produced in the long, narrow, urethra (tube from the bladder to the tip of the penis) to form a “grit” which effectively obstructs the opening to the outside. Affected cats are brought to us because they are painful, straining to urinate (but unable to), and have a large, firm bladder.

These cats are miserable, and need to have the obstruction relieved right away; if untreated, they rapidly become sicker because persistent obstruction leads to acute kidney failure. Typical, immediate treatment involves, anesthesia, IV catheter and fluid therapy, passing a urinary catheter into the bladder to relieve the obstruction, flushing the crystals out of the bladder, hospitalization, pain and other medications, dietary change, etc. . . . a big deal!

This treatment regime is similar, in many respects, to those we employed during my first 1-2 years in practice—we had no prescription diets available to prevent the recurrence of these bladder issues in male cats. Consequently, we would treat these cats, send them home with no treatment other than a few guesses at dietary modification, sometime urinary acidifiers were prescribed, fingers were “crossed”. Often (usually?) these cats came back to us within 2-4 months, presented with the same symptoms, received the same treatment . . . very frustrating for all; unhealthy and painful for the poor cat, expensive for the owner. Many times, the “curative” step was a relatively major surgery (perineal urethrostomy, or “PU”) which effectively increased the size of the “opening” for urination—so the small crystals and mucus plugs did not obstruct urine outflow. It was not unusual for us to perform this surgery 1-2 times per week in the Boston practice.

Thanks to prescription diets (Hill’s C/D initially; first available in early 1984 (?); now, we have multiple brands at our disposal) which typically include long-acting urinary acidifiers, and a lower content of the minerals which are involved in the crystal formation, this recurrence rate has drastically decreased. In our practice today—and, we see a significant number of “blocked” cats throughout the year, due to the large group of emergency patients who visit WVH—the necessity for performing the “PU” surgery has dropped to 1-3 cats/year . . . much to the relief of veterinarians, staff, cats, and their dedicated owners!

 

Anyway, that’s my “plug” for advancements in the “art” of veterinary medicine . . . in many respects, the “good ol’ days” have improved with help from the tincture of time and medical knowledge.  

medical adv. 

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