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and, at Penn Veterinary Medicine

Note: These stories are abbreviated versions of articles from Penn Vet Extra. View the full stories.   —Eds.

Comprehensive Cancer Care at Ryan Hospital

Dingus is undergoing Comprehensive Cancer Care, a cross-disciplinary approach to the diagnosis and treatment of cancer in pets

Dingus, a 17-year-old cat, was already being treated at Ryan Hospital for small cell gastrointestinal (GI) lymphoma. Diagnosed in November 2016, he had responded well to medication, but through the following summer he was slowly losing weight. He came back to Ryan for an examination where an abdominal ultrasound showed his intestinal tract was normal, but revealed something else. He had a mass in one of his lung lobes.

Dingus is a remarkable cat with an extensive medical history and two very loving owners, Christopher Lengner and Heather Steinman. Not only is Dr. Lengner Dingus’ owner, he is an associate professor of biomedical sciences at Penn Vet, and a cancer researcher. “On one hand,” said Dr. Lengner, “I’m the owner of a cat with cancer; on the other, I’m a cancer researcher.”

Dingus’ other owner, Dr. Steinman, is a former cancer researcher, and is now a vice president at the Wistar Institute where she continues to focus on bringing new cancer therapies, including tumor vaccines and immunotherapies, to patients.

In 2011, Ryan clinicians removed Dingus’ left eye due to uveitus and glaucoma caused by an infection. Then in 2014, he developed a benign tumor in his right ear, which necessitated the removal of the ear canal. In addition to lymphoma, he also has heart disease and chronic lower airway disease.

Dingus’s owners discussed surgery for Dingus and agreed to proceed, as his quality of life was still very good.

Beth Callan, professor of internal medicine and Dingus’ primary vet, spoke with James Perry, assistant professor of surgical oncology, the newest member of the Comprehensive Cancer Care team, and he agreed to take Dingus’ case. Comprehensive Cancer Care is a cross-disciplinary approach to the diagnosis and treatment of cancer in pets. Ryan clinicians provide a comprehensive assessment of each patient’s cancer care needs within one appointment. They work with clients through the diagnosis and subsequent treatment plan for their pets, be it chemotherapy, surgery, radiation therapy, or supportive care.

There is the notion that cancer can be treated by differentiating the cells and not killing them. If the cancer is a stem cell that divides uncontrollably and the cell can be driven to differentiate, it will exit the cell cycle and stop dividing, alleviating the disease.

“In normal tissue, stem cells are resistant to injury and repopulate the tissue in the face of injury, which is a good thing,” said Dr. Lengner. “When you irradiate a colorectal tumor, by all measures it’s gone, but five or ten years later it comes back, and it comes back in the exact same place. Those cells need to be identified, purified, and studied, so that’s really what we’re interested in.”

Dr. Perry led the surgery, assisted by Dr. Ludwig and Intern Julie Pfeifer. Instead of cutting through the sternum, Perry was able to remove the affected lung lobe through the muscle between Dingus’ ribs. This approach reduced his pain, healing time, and hospital stay.

The Penn Vet Cancer Center is a new initiative that will bring together basic cancer research, clinical trials, and patient care into one centralized location at Ryan Hospital. In this state-of-the-art facility, scientists and clinicians will be able to bring research breakthroughs directly to patients. Dr. Lengner hopes there will be a push to bring molecular diagnostics into a clinical setting with the intent of identifying genetic mutations within companion animals, particularly as it relates to cancer.

“If we knew the genetic basis of a lot of these cancers that occur in companion animals, we could easily start testing these next generation drugs under development for human cancer, including many coming out of Penn Medicine’s Abramson Cancer Center,” he said. “Hopefully Penn Vet’s new Cancer Center will embrace all the knowledge from the human side and try to translate it into companion animals. This is a personal thing for me.”

 

Prosthetic for Pete the Parrot

Benjamin Spalding was working late when he heard the screams.

He ran outside to investigate and saw that a fox had startled Pete, his 34-year-old Mealy Amazon parrot. As Pete climbed up the side of the backyard aviary, the fox grabbed his foot and tore it off.

Mr. Spalding and his wife, Stacey Gehringer, immediately put Pete into his carry cage, got in the car, and headed to an emergency veterinary clinic nearby. Ms. Gehringer called the clinic to let them know they were on the way, but the clinic said they couldn’t take Pete as a patient. There are few veterinary hospitals close to the Lehigh Valley with experienced Exotics vets on staff. Fortunately, Penn Vet’s Ryan Hospital is one of them. When Ms. Gehringer called Ryan’s Emergency Service, she was told to bring Pete in.

La’Toya Latney, service head and attending clinician of the Exotic Companion Animal Medicine service, was on call when she received the 2 a.m. phone call. When she arrived at the hospital, Pete seemed alert, despite having lost a lot of blood. Dr. Latney’s primary goal was to stop the bleeding and provide fluid therapy.

Despite the blood loss, Pete’s odds of survival were promising, as birds have a unique ability to reproduce red blood cells much faster than humans. It’s been shown that birds can lose 30% of their total blood volume without showing signs of shock. Birds would have to sustain about a 60% loss of blood before there would be a notable change in blood pressure or signs of decompensation.

“Dr. Latney’s demeanor with her patients is amazing,” said Mr. Spalding. “I’ve been to several different vets and they all treated Pete with fear. He’s never seen anything short of a kiss at Ryan Exotics!”

Having addressed the relatively short-term goal of closing the wound on Pete’s stump, there were some long-term complications to take into consideration.

“Given that Pete is a larger-bodied bird, he could experience long-term pain if we don’t provide some type of comparative support,” said Dr. Latney.

Never one to back away from a challenge, Dr. Latney reached out to Jonathan Wood, staff veterinarian in neurology and neurosurgery, with the task of designing a prosthetic leg for Pete.

Dr. Wood met with Stephen Smeltzer, digital fabrication manager at PennDesign’s Fabrication Lab, to examine the CT scan and formulate a plan. Mr. Smeltzer asked questions about birds and bird bones, the weight and stiffness of the prosthetic, and how they might attach it. He then drew sketches.

“One of the things we love about working with Penn Vet is seeing our technology have an immediate impact in the world,” said Mr. Smeltzer.

The team tried two different prototypes for Pete, but neither were secure enough to support his weight. A third design is currently being printed at the Fabrication Lab and should be ready for Pete to try out soon. 

La'Toya Latney is working with Pete to find the perfect prosthetic leg.

La'Toya Latney is working with Pete to find the perfect prosthetic leg.

Drs. Wood and Latney are currently working on an attachment system that is safe and comfortable for Pete. They estimate two to three months before the final fitted model is ready.

“In the meantime, we’ve encouraged Pete’s owners to do physical therapy on the remaining limb,” said Dr. Latney.

Even one-legged, Pete is enjoying a full range of activity at home, including climbing. Everyone involved is eager to finalize the prosthetic attachment system to give Pete an even better quality of life at home.

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