MAGAZINE OF THE CUMMINGS SCHOOL OF VE T ERINARY MED I CINE SUMMER 2013 VOL. 14 NO. 2

VETERINARY MEDICINE

DOGGONE DNA Inherited health problems in pets case solved

Upsy-daisy

The 4-month-old miniature donkey named Daisy seemed a bit slug- gish last fall. Her owners attributed it to the recent cold snap. A couple of days later, though, the foal was unable to stand. Their local veterinarian, Stefani Gagliardi, of the Chatham Small Animal and Equine Medical Center in New York, made a house call to stabilize Daisy “and didn’t like what she saw,” says the donkey’s owner, Tom Crowell. She urged the Crowells to take Daisy to Tufts’ Hospital for Large Animals, two hours away. “We loaded her into the back of our SUV and headed out I-90,” says Crowell. As Daisy grew weaker and more lethargic, Cummings School veterinarians moved quickly to determine what was wrong. Blood work showed the donkey’s liver was failing, and her iron-starved blood cells struggled to carry enough oxygen through her body. An ultrasound showed a large amount of fluid around her lungs. “It was surprising, because she wasn’t experiencing breathing difficulties,” says Daniela Bedenice, a large animal veterinarian. “We removed just under one and a half liters [of fluid], a lot for a little girl like her.” Tufts veterinarians anticipated that an analysis of the fluid would reveal infection, heart failure or even cancer. “Neither heart disease nor cancer was a good prognosis,” says Crowell. “I hated the idea of breaking the news to our 11-year-old daughter.” The news didn’t turn out to be so grim. Tests identi- fied the culprit as granulocytic anaplasmosis, a bacte- rial disease transmitted by a tick bite. The bacterium infects wild and domesticated mammals, including horses, alpacas and dogs, as well as humans. Daisy’s case “was unlike known reports in other species,” says Bedenice, noting that horses with anaplasmosis typically develop a fever and swelling in their legs. The donkey spent 10 days at Tufts, receiving intrave- nous antibiotics while recuperating next to her mother, Marshmallow, who had made the trip in case her foal needed a blood transfusion. Daisy went home with a supply of oral antibiotics and iron supplements. Crowell says the donkey was none the worse for her ordeal: “She had a spring in her step and was back to her bouncy self.” —genevieve rajewski

PHOTO: BRAD DECECCO contents SUMMER 2013 VOLUME 14 NO. 2 features 6 The Biggest Losers The nation’s obesity epidemic has hit our pets. Deborah Linder, V09, helps portly pooches and fat cats slim down— not for six-pack abs, but for a longer and healthier life. By Genevieve Rajewski

COVER STORY 10 Doggone DNA All dogs and cats carry genetic risks for health problems. Veterinarians are studying this defective DNA to treat and prevent disease in animals and humans. By Genevieve Rajewski

16 Running with Thoroughbreds As a 25-year citizen of Belmont Park’s “vet village,” Russell Cohen, V87, still relishes his life in the fast lane alongside illustrious trainers and racehorses. By Kim Thurler 16

20 Itching to Know Our pets are susceptible to hundreds of skin problems. Veterinary dermatologists share their advice for dealing departments with all things lumpy, bumpy, red and splotchy. 2 FROM THE DEAN By Genevieve Rajewski 4 UPFRONT 24 Creature Comforts P EOP LE, PL A CES & AN I M A LS 28 RESEARCH After completing a Ph.D. in child development at Tufts, THE PATH TO DISCOVERY Megan Kiely Mueller joins the Cummings School to explore the under-studied science of how animals and people help 30 ON CAMPUS each other. By Linda Hall CUMMI N G S SCHOOL NEW S 33 ADVANCEMENT G I V I N G . GROW TH. GRAT I TUD E. 36 ASK THE VET THE AN ATOMY O F A SNEEZ E

Cover illustration by Aaron Meshon 30 Back cover photographs by Steffan Hacker from the dean

VETERINARY MEDICINE

Valued Profession VOL. 14, NO. 2 SUMMER 2013

commencement marks the end of our annual academic Executive Editor cycle and offers an opportunity to reflect on the achievements of Deborah T. Kochevar, Dean Cummings School of Veterinary Medicine our graduates and their prospects for productive, satisfying careers. This year was no different, except that the Class of 2013 emerged into Editor Genevieve Rajewski the working world at a time of turmoil in the veterinary profession. Such issues as student debt, employment and veterinary school Editorial Director Karen Bailey accreditation have become regular editorial topics in online veteri- nary forums and print media. The exchange of ideas is healthy, and Design Director it is our obligation to provide an accurate context for these discus- Margot Grisar sions. The Association of American Veterinary Medical Colleges Design (AAVMC) and the American Veterinary Medical Association (AVMA) have redoubled their 2COMMUNIQUÉ efforts to provide data that inform our national discussions of veterinary medicine. I will Contributing Writers finish my term as AAVMC president in July and am encouraging our profession to take an Linda Hall, Laura Ferguson, Lindsey Konkel, Heather Stephenson, Mark Sullivan, Kim evidence-based, positive view of opportunities and challenges. Thurler A recent review of past veterinary workforce studies published in the Journal of the Staff Photographers American Veterinary Medical Association earlier this year (Dicks, 242:8, 1051) set the stage Alonso Nichols for the 2013 U.S. Veterinary Workforce Study: Modeling Capacity Utilization released by the Kelvin Ma AVMA in April. This study found relative balance in the public health, food safety, research Contributing Editor and regulatory affairs sectors but an excess capacity in some areas in small animal prac- Bob Sprague

tice. In a recently completed AAVMC assessment of employment data for 2011 and 2012 Editorial Advisors graduates, more than 97 percent reported being employed in veterinary medicine at least Ana Alvarado, Senior Director, six months after graduation. Both studies suggest that better, more complete employment Veterinary Development and Alumni Relations data are needed and that we must be proactive in making information available to students Lorraine Daignault, Marketing Director

at every stage of their preparation for a veterinary career. Joe McManus, Executive Associate Dean It is worth remembering that veterinarians, like those in other professions, experience cycles of lean and plenty. While the prolonged recession continues to be a serious challenge, Rushmie Nofsinger, Associate Director, Public Relations it is short-sighted to discount a profession that provides life-long career satisfaction for most. And as I noted recently in an open letter to AAVMC colleagues, “Despite our challenges, Virginia Rentko, Medical Director, Foster Hospital for Small Animals we should remember those who possess veterinary medical degrees are uniquely equipped and Hospital for Large Animals to tackle some of society’s most pressing problems. There is growing recognition that the Tufts Veterinary Medicine is funded in part by academic rigor and comparative nature of a D.V.M. degree spanning multiple species brings the Edward Hyde Cox Fund for Publications. value and application across a broad spectrum of technical, scientific and medical careers, It is distributed to alumni, friends, veterinary including homeland security, public [global] health, disease detection and prevention, students, veterinarians and key university personnel. research and protecting the safety of our nation’s food supply.” All of higher education must face the challenges of student debt and workforce balance. We welcome your letters, story ideas and suggestions. It is our responsibility to manage them. At the same time, we should recognize that we Send correspondence to: are a nation that loves and values animals and the relationships we share with them. The Genevieve Rajewski, Editor best and brightest students, like the Class of 2013, are to be congratulated for choosing a Tufts Office of Publications 80 George Street valuable, caring profession that supports the health and well-being of animals and people. Medford, MA 02155 or email: [email protected] Sincerely, The Cummings School’s website is vet.tufts.edu The telephone number is 508.839.5302. Follow us on Facebook and Twitter. dr. deborah turner kochevar, d.v.m., ph.d. © 2013 TRUSTEES OF TUFTS UNIVERSITY dean and henry and lois foster professor

Tufts Prints Green Printed on 25% post-consumer waste 2 tufts veterinary medicine summer 2013 recycled paper. Please recycle. upfrontPEOPLE, PLACES & ANIMALS

Caryn Goulet, the human resources manager at Cummings Properties, snuggles with Smokey.

Work Perk

Massachusetts firm subsidizes specialized care for employees’ pets by Heather Stephenson

ine-year-old smokey usually runs and plays ball even A commercial real estate firm based in more than the puppy that shares his house. Last autumn, Woburn, Mass., Cummings Properties though, the 85-pound shepherd mix started limping. started offering the benefit in November to “We brought him to our local vet, and Smokey tested posi- full-time employees with at least one year Ntive for Lyme disease,” says his owner, Caryn Goulet. After two rounds of anti- of service. More than 335 people who work biotics, the Lyme disease was gone, but the dog still wouldn’t put weight on his at Cummings Properties and its affiliates, right rear leg. the New Horizons retirement communi- The most likely culprit seemed to be a torn ligament, which would require ties in Woburn and Marlborough, Mass., surgery. Goulet asked her vet to refer her to the Foster Hospital for Small Animals are eligible for the benefit, says Goulet, at Tufts, about 45 miles from her home in Wilmington, Mass., so she could take the firm’s human resources manager. The advantage of a new employee benefit from her company. Her employer, Cummings reimbursement covers specialized treat- Properties, paid 25 percent of the bill. ment, not routine veterinary care, and

PHOTO: ALONSO NICHOLS summer 2013 tufts veterinary medicine 3 upfront

there is no cap on how much the company veterinary school over 15 years. Smokey had a torn ligament, but Tufts veteri- will pay in specialized-care subsidies. The inspiration for the benefit came narians also discovered he had two tumors, “Without this benefit, I never would from an employee who knew about Bill on his spleen and on an anal gland. have thought to bring Smokey to Tufts,” Cummings’ support of Tufts. “One of the students first noticed it, says Goulet. “I don’t know anyone else who “It’s strictly a question of doing the and drew it to the attention of the doctor,” has a benefit like this.” right thing,” Cummings says. “Household Goulet says. Surgeons at the Foster Hospital removed the tumors; one was malignant, and the cancer is likely to recur. “On the positive side,” she says, “they found it when “When a pet needs expert specialized it was small—it was marble-sized—and it services, we are delighted to assist our hadn’t metastasized.” For now, Goulet and her family have colleagues in obtaining those …” decided to let Smokey recover from his can- —Bill Cummings, A58 cer surgery and then assess whether to have the ligament repaired. Their local veterinar- ian, Christine Pelletier, V01, who practices Company founder William S. pets are very dear to people. When a pet at VCA Wakefield Animal Hospital, has Cummings, A58, is a major supporter of needs expert specialized services, we are been in regular contact with her colleagues Tufts’ veterinary school as well as a trustee delighted to be able to assist our colleagues at Tufts about Smokey’s follow-up care. emeritus of the university. In 2005, the in obtaining those at the Cummings School Just two weeks after the surgery in school was renamed the Cummings School by providing some financial relief.” February, Smokey seemed to be on the of Veterinary Medicine after Cummings For Goulet, Smokey’s health issues cre- mend, Goulet reported. “He’s on all fours. Foundation, for which Bill Cummings ated unexpected challenges and expenses, so When warmer weather comes, we’ll see serves as president, committed to invest- she was even more appreciative of the special- how active he is. We hope he’ll be running ing $50 million in New England’s only ized-care benefit. An X-ray did confirm that and jumping and his normal self.”

Cat Nappers

Cats seem to be able to sleep anytime and anywhere. But contrary to a popular notion, they’re not feline Rip Van Winkles. “Cats don’t oversleep,” says Nicholas Dodman, director of the Animal Behavior Clinic at the Cummings School of Veterinary Medicine. “In fact, they don’t sleep much more than dogs, but might sleep as much as a baby or young child. It is important to recognize that there is a difference between catnapping and being asleep.” When cats nap, their bodies and minds are operating in essentially a standby mode, says Dodman. During a nap, a cat is similar to an idling car engine, which can be put into “drive” at a moment’s notice—especially if a cat senses prey nearby. That said, adequate sleep is important to a cat’s health, longevity and mood, and changes in sleep patterns may signal illness. Cats with hyperthyroidism or hypertension, for example, may sleep less and be more active than usual. In both cases, cats may vocalize at night, loud enough to wake their owners. Cats infected with feline immunodeficiency virus (FIV) often sleep less, much as people with HIV do. Sudden bouts of prolonged sleep are more indicative of poor health and can indicate such conditions as kidney disease, diabetes and heart disease. If you notice your cat is sleeping more or less than usual, talk to your veterinarian to make sure any potential health issue is addressed early.

ADAPTED WITH PERMISSION FROM CATNIP: THE NEWSLETTER FOR CARING CAT OWNERS, PUBLISHED BY THE CUMMINGS SCHOOL OF VETERINARY MEDICINE. FOR SUBSCRIPTION INFORMATION, GO TO TUFTSCATNIP.COM OR CALL 1.800.829.0926.

4 tufts veterinary medicine summer 2013 ILLUSTRATION: WARD SCHUMAKER Backyard Hunters

A recent report says our feline friends are killing wildlife at an alarming rate, but the issue is much more complex by Genevieve Rajewski

cientists from the smith- cats scavenge sheep carcasses by the side in-doors or safely confined on a leash sonian Conservation Biology of the road. So when you are looking at or in a fenced backyard. All cats should Institute and the U.S. Fish what a cat has eaten, you don’t know wear identification on a collar. They Sand Wildlife Service recently how it got into the cat’s mouth in the also should get spayed or neutered and released a report in the journal Nature first place, or what was going on with be vaccinated, which keeps them from Communications that sought to esti- that particular animal at the time the cat contributing to the population of out- mate the number of wildlife killed by found and ate it. Cats are specialists in door cats and decreases their risk of cats in the United States. The main- catching rodents, but they are very flex- catching a disease if they do get outside. stream media seized on the study, ible in terms of what else they’ll eat. And SLATER: Most animal-welfare and which used older, small studies to some data suggest that cats only catch rescue organizations try to get peo- conclude that cats are killing billions birds that aren’t healthy to begin with. ple to keep their cats indoors—the of birds and mammals each year. EMILY MCCOBB: Another issue with American Bird Conservancy and the Within days, the story generated sig- the study is that you can trace the Humane Society of the United States nificant outcry from cat lovers and research back through several pub- had widely publicized programs with others who questioned the accuracy of lications, only to discover it’s based that goal—but I’m not aware that any the research. on one guy’s experiences with his cat in of these educational efforts has been Two experts from the Center for his backyard or that a widely cited study evaluated to determine how well they Animals and Public Policy at the on predation is based on just three pet worked. That would be a great thing Cummings School—Emily McCobb, cats. Using those papers as a basis to to do, because if we knew there were V00, M.S.02, the center’s assistant extrapolate data for a state or country— successful ways to get people to change director, and ASPCA senior director or even incorporating them into a series their behaviors about their own pets, of veterinary epidemiology Margaret of extrapolations—is problematic. we could concentrate on those. Slater, who teaches a class on free- In a recent predation study involving roaming cats—told Tufts Veterinary Are cats the invasive species suggested 55 cats, researchers at the University of Medicine that the issue is way more in this report? Georgia attached video cameras to the complex than stalk, kill and devour. MCCOBB: It is true that cats are excellent cats’ collars. Some of the cats in the predators and that they were brought study hunted (24 of the Tufts Veterinary Medicine: How to this continent by human settlers. 55), although relatively accurate are these new prey estimates? But how much effect cats have on wild- few actually caught any- MARGARET SLATER: There is no way to life really depends on the ecosystem thing—only 16 cats did. know the truth about cats’ effect on where the cats are living. In Worcester, What was really eye- wildlife. There’s just not enough data Mass., where the Cummings School opening is all the risky things available. The study in question is a works with the Spay Worcester pro- cats are doing. They encoun- meta-analysis of existing published gram to manage feral cat colonies, ter dogs, get into fights research. While I haven’t recently I don’t think they are having much w it h ot her cats, reviewed each paper individually, I am effect. Cats in urban environments are dart across busy familiar with them. They use a num- living off garbage as well as rodents roads, drink and eat ber of methodologies to determine that we consider to be pests. But there stuff of unknown origin and the quantity and type of cats’ prey— are other regions, such as protected teeter along rooftops. This might including owners counting the number shoreline, that are not appropriate loca- be more compelling to people of dead animals their cats bring home tions for free-roaming cats, whether in terms of understanding why and scat and stomach-content analy- they are feral cats or pet cats that own- it’s imperative to keep their cats ses—and each has its limitations. ers allow outdoors. indoors. Everybody thinks, ‘My cat For example, it’s pretty common in doesn’t go anywhere.’ But these vid- Australia to find sheep in cats’ stomach What can cat owners do to protect their eos show that’s not true. Ordinary contents. It’s not because herds of cats pets and wildlife? house cats get into an amazing are pulling down sheep, but because MCCOBB: A pet cat should be kept amount of mischief.

summer 2013 tufts veterinary medicine 5 The nation’s obesity epidemic has hit our pets. Deborah Linder, diet doctor to portly pooches and fat cats, helps them shed those unhealthy pounds

BY GENEVIEVE RAJEWSKI PHOTOGRAPHY BY ALONSO NICHOLS

THE BIGGEST L

6 tufts veterinary medicine summer 2013 Bella now weighs 17 pounds, down from 23.2 pounds, below, and is working toward a goal weight of 16 pounds.

ST LOSERS ll the signs were there. Instead of a trim waist and Adefined hips, Bella’s body plumped out in all the wrong places. With her big brown eyes and winning personality, though, her fam- ily found it easy to overlook the fact that the 4-year-old dachshund was losing the battle of the bulge. The portly pooch is hardly alone. She’s one of 80 million dogs and cats in the United States that are overweight or obese, according to the Association for Pet Obesity Prevention. “We never really thought about her weight,” says Bella’s owner, Pamela Borek. “It’s like when you see the same person every day. They just look normal to you.” Like the overweight guy who gets serious about weight loss only after suffer- ing a heart attack, it took a medical emer- Amy DiRocco, of Quincy, Mass., was referred to Tufts’ obesity clinic after seeking help with her gency for Bella’s family to realize a change 7-year-old cat Tinkles’ litter-box issues. Deborah Linder, V09, who heads the clinic, says the was needed. When the dog started having case was challenging because Tinkles lives with another cat and requires a low-calorie diet that also supports intestinal health. Linder says DiRocco has done a stellar job—herding cats into trouble breathing, she was rushed from their separate rooms at mealtime to maintain Tinkles’ diet regime. “Tinkles is doing fantastic,” she home in Pawtucket, R.I., to the emergency says. Now 13.1 pounds, down from 14.6 pounds, inset, Tinkles is closing in on her goal weight room at Tufts’ Foster Hospital for Small of 12 pounds. “I’m always saying to her, ‘You’re so skinny!’ ” says DiRocco. Animals. “It was an hour-and-a-half drive with her in distress,” says Borek. “It was so awful to see her suffering.” and the health consequences for their pet.” will equal less time with your pet.” Bella was diagnosed with intervertebral The Association for Pet Obesity Fat dogs and cats don’t develop coronary disc disease, a degenerative condition that Prevention calls this phenomenon the “fat artery disease—common with human obe- can lead to partial or complete paralysis. pet gap.” Its latest study found that 45 per- sity—but being overweight leads to other To prevent permanent nerve damage, Bella cent of dog and cat owners thought their serious health issues. Chunky pets are at risk underwent emergency surgery at Tufts. pets were of normal body weight, even for diabetes, orthopedic problems, respira- Dropping a few pounds was the dachs- though the animals were actually over- tory issues, high blood pressure and many hund’s best shot at a good recovery, and the weight or obese. The association reports types of cancer. weight loss might also prevent a flare-up of that 52.5 percent of dogs and 58.3 percent of Shedding those extra pounds isn’t easy, her disc disease. “We didn’t want her to have cats are classified as overweight or obese by says Linder, whose faculty appointment at surgery again,” says Borek. “And if it was a their veterinarians—a disturbing trend that Tufts is funded by a grant from Royal Canin matter of her losing six or seven pounds, we amounts to fat pets being the new normal. USA. Part of the problem stems from foods decided we’d do it.” Unlike us, pets don’t make impulse buys marketed as “diet,” “low calorie” or “lite.” of candy in the grocery checkout aisle or eat Linder conducted a study in 2010 of all FAT GAP to make themselves feel better. But they do the cat and dog foods that are touted to help Bella’s journey to doggie svelte began at the pack on the pounds for the same reasons we pets lose weight. “They were all over the Tufts Obesity Clinic for Animals, one of the do: They eat more calories than they need board in terms of calorie content,” she says. first in the country for overweight pets. Her (often in the form of treats) and don’t get “An average canine weight-loss dry diet ran story is a typical one. “I don’t think owners enough exercise. anywhere from 217 to 440 calories per cup.” have figured out that they need us yet,” says “There is definitely the sentiment among In addition, the feeding directions on Deborah Linder, V09, the board-certified vet- pet owners that food is love,” says Linder. foods that promote weight loss can be very erinary nutritionist who heads the clinic. Pet “But when it comes down to it, we’ve got confusing. “The directions are based on the owners “usually book an appointment after overwhelming evidence to show that over- pet’s weight—not its goal weight, but its cur- they’ve been told that their pet is overweight weight pets live shorter lives. Excessive treats rent weight,” says Linder. “So if you’re feeding

8 tufts veterinary medicine summer 2013 your pet according to those directions, you your schedule. But sometimes I fix that, and owner could get the dog to take it was to could feed it up to twice the energy require- the pet’s weight comes off.” hide it in a stick of butter. ments for their obese weight. Your pet is actu- Generally, Linder recommends a pet lose To manage weight loss in a multipet ally going to gain weight on that diet.” 1 to 2 percent of its body weight per week. house, Linder might ask owners to feed the Much like human dieters who neglect If the weight loss exceeds that, she says, the healthy-weight cat in a box with an opening to count the calories in their beverages, pet animal is at risk of losing more muscle than that the rotund cat can’t squeeze through. If owners often don’t recognize animal treats fat, developing such behavioral problems as the bigger cat manages to bust into the box, as calorie bombs. “Almost every dog owner begging and regaining the lost weight. In she’ll recommend a high-tech covered bowl gives a rawhide or chew for dental health,” cats especially, extreme weight loss can lead that only reveals food when the microchip says Linder. “And everything adds up. A 5- to fatty liver disease, which can be fatal. on the healthy-weight pet’s collar gets close by 2-inch strip of rawhide is approximately You might expect a fat cat to show gusto enough to tell it, “Open Sesame.” 100 calories. If you have a very small dog, for chowing down just about everything, In homes where Fido may be indulging that could amount to a third of their rec- but often the opposite is true. Many cats are in a daylong smorgasbord because family ommended calories per day. I won’t even go partial to the feel of a particular texture in members don’t know who’s already fed him into some of the bones—those can have up their mouth, says Linder, who will prescribe or how much, Linder creates a fail-proof to 1,000-plus calories.” a diet using food in that particular shape system for portion control. “After the initial The people who live with a pet often (be it little stars or triangles) instead of the consult, I provide a list of the pet’s favorite unknowingly contribute to their animals’ ubiquitous round kibble. treats and their calorie content. Each eve- tubbiness. “I see many multiowner house- Other pets may need a new method of ning, someone in the family measures out holds—a husband and wife, an extended taking their medications. Linder recalls one the pet’s allotted amount of food, selects family member and three teenagers—so case in which she and the other veterinar- treats that add up to the pet’s daily treat cal- nobody knows who’s feeding what to the ian couldn’t figure out why a dog wasn’t los- orie allowance and places everything into a dog or how often,” says Linder. “There’s ing weight. They eventually videotaped the ‘food allowance box’ for the next day. Once another family with an elderly member who portly pup at home and discovered that the the box is empty, the pet is out of calories,” has dementia. She can’t remember if she’s dog was on a daily medication they didn’t says Linder. actually fed the cat or not.” know about—and that the only way the A similar strategy is working for Bella, Other pets in the house can thwart the dachshund. weight loss as well, for example, when one “I have three kids, and everybody feeds cat is a grazer and the corpulent cat, acting TELL-TALE FLAB Bella,” says Borek. “She still gets treats, but like a feline vacuum, swoops in the minute those are limited to no more than 10 a day its housemate abandons the food bowl. Is your pet overweight? It’s pretty now.” And for the dachshund with the dis- simple to find out. cerning palate, Linder found two foods that ONE SIZE DOESN’T FIT ALL Borek serves in rotation. Although she confesses that she doesn’t fol- “Because dogs and cats have different Five months after her disc surgery, Bella low the work of any popular human weight- shapes, sizes and types of coats,” you is well on her way to a full recovery and a loss gurus, Linder shares many of their finer can’t judge if an animal is fit or fat just by trimmed-down figure. She has lost more qualities. She forgoes Richard Simmons’ looking at it, says Deborah Linder, V09, than 6 pounds—27 percent of her starting trademark spandex and sequins, but man- head of the pet obesity clinic at Tufts. weight. (Think about a 200-pound person ages his trick of helping the overweight get “You have to actually feel your pet.” slimming down to 146 pounds.) lean without resorting to being mean. And “Bella is now a speed demon in the exam like the trainers on the NBC reality show Here’s how: room,” says Linder, who credits the family’s The Biggest Loser, Linder acts as both a coach  Feel your pet’s ribcage. determination for the daschund’s weight- and cheerleader—finding ways to solve their  Now hold out your open hand, palm loss success. unique barriers to weight loss, setting small down, and feel the back of your hand “Once they knew Bella’s health was at goals and then generously heaping on the over your knuckles. That’s how the risk due to her excess weight, they com- praise at each successful weigh-in. ribs of a healthy-weight pet should pletely changed their routine and haven’t “I like to have lengthy discussions in feel. looked back since,” says Linder. “There person and see as many family members  If your pet’s ribs feel as soft as the are so many diseases where it’s frustrating, as possible coming to the appointments,” palm of your hand, your pet is too because all veterinarians can do is help the says Linder. “A lot of times, a successful plump. animal live a little bit longer or improve its weight-loss plan depends on us just working  If your pet’s ribs feel like your knuck- symptoms. We do the best we can, but we out the logistics of multiple pets and kids. les when your hand is closed in a fist, can’t always cure their problems. But with Normally, you don’t think about your vet- it’s too thin. obesity we can. Obesity is not just prevent- erinarian being the person who organizes able—it’s a totally curable disease.” tvm

summer 2013 tufts veterinary medicine 9 10 tufts veterinary medicine summer 2013 Doggone DNA d he herite alth In p ts roblems in pe

he bbc television documen- result of inbreeding. Not so, says Bell, tary Pedigree Dogs Exposed who notes that experiments with labora- caused an international uproar tory animals show that repeated matings in 2008, with footage of a between full siblings over generations will Cavalier King Charles spaniel with a skull cause many family lines to die out because Ttoo small for its brain and basset hounds of infertility and genetic defects—and oth- described as “deformed congenital dwarfs.” ers to thrive. The results depend entirely on In 2011, under the headline “Can the bulldog whether a particular family line propagates be saved?,” an article in the New York Times or loses disease-causing genes in successive Magazine detailed serious health problems in generations. that breed, including the untimely demise of What does produce inherited disease in two University of Georgia bulldog mascots. our pets is the unchecked propagation of With that kind of media exposure, is it defective genes. any wonder that purebred pets have become Most breeders do the right thing as synonymous with poor health? best they can, says Leslie Lyons, a profes- But that’s an unfair rap, says Jerold sor of genetics at the UC Davis School of Bell, a geneticist at the Cummings School Veterinary Medicine. From chatty Siamese of Veterinary Medicine and coauthor of to sunny golden retrievers, she says breeders the Veterinary Medical Guide to Dog and create “beautiful animals with wonderful Cat Breeds (Teton NewMedia, 2012). Any personalities and traits,” including ones that dog or cat can have diseases and disorders are quite useful, such as bomb-sniffing dogs. linked to genetics, says Bell, “but what is “But everybody—whether you’re a dog, lacking in the popular press about pure- cat or human being—carries different bred dogs and pedigreed cats is that there genetic mutations,” she says. are choices about how you acquire them For example, the Afrikaner population and that health-conscious breeding can in South Africa has an unusually high inci- insure a healthier future.” dence of Huntington’s disease, the inherited BY GENEVIEVE RAJEWSKI Because all individuals in a dog or cat neurodegenerative disorder, because most ILLUSTRATIONS BY breed are related to each other, you might are descendents of a small group of Dutch AARON MESHON assume that any health problems are the settlers, one of whom carried that gene.

summer 2013 tufts veterinary medicine 11 In livestock, genetic health is considered School who conducts research at the Broad There was pushback from some vital to quality control, notes Bell. “It’s only in Institute of MIT and Harvard, where scien- Dalmatian breeders about allowing dog and cat breeding that we have had a long tists are studying the DNA of purebred dogs these dogs to be registered as purebred history of pairing mates without any regard to gain insight into how cancers, diabetes, Dalmatians, but now their descendants are to their genetic health.” As a result, he says, cardiovascular problems and other diseases considered legitimate members of the breed. “we see diseases in cats and dogs that should develop. “To use a very crude analogy, each Another example of the unintended con- have been prevented over and over again.” breed is like a population expanded from a sequences of selective breeding is the Shar- Inherited health problems don’t hound few families of humans,” she says. Pei, says Tufts veterinary dermatologist only purebred animals. Thirteen of the most The higher incidence of certain disor- Lluis Ferrer. The ancient Chinese breed hov- common hereditary disorders in dogs— ders in these “families” can be traced to an ered near extinction after the Communist including degenerative hip disease, an eye condition that causes blindness, some can- cers and slipping kneecaps—occur with equal frequency in mixed-breed and pure- “Frankly, if we said today that every animal bred animals, according to research done at that is a carrier or has a genetic disorder UC Davis and just published in the Journal of the American Veterinary Medical Association. can’t be bred, we might as well just go ahead It’s not unusual to see inherited diseases and say goodbye to domestic animals.” in mixed-breed animals—be it a randomly —Jerold Bell bred mongrel or a designer breed such as a Labradoodle (Labrador retriever crossed with a poodle)—because they are “ances- increase in the genes responsible for those Revolution, when keeping pets was con- trally down line from where those original health problems. Most often this is a result sidered a bourgeois luxury. (Pets in China mutations occurred,” Bell says. “Frankly, if of what is known in the dog-show world as were taxed heavily at first, and later exter- we said today that every animal that is a car- the “popular sire syndrome.” When a male minated.) In the early 1970s, a Chinese busi- rier or has a genetic disorder can’t be bred, dog wins championships, he often becomes nessman pleaded with American dog fanci- we might as well just go ahead and say good- a trendy stud that’s bred widely. The effect ers to import the few remaining Shar-Pei bye to domestic animals.” is twofold, says Bell. “His genes—includ- to save the breed. Today American Kennel ing any unhealthy mutations—are quickly Club statistics list the Shar-Pei as the 52nd ORIGINS OF CANINE DISEASE multiplied and represented much more most popular breed in the United States, First domesticated more than 15,000 years prominently than those of other males in the with most of these dogs descended from the ago, the dog, more than any other animal, population. The breed also loses the diversity handful of Shar-Pei that arrived from China has been defined by artificial selection, of those genes carried by the now-sidelined 40 years ago. However, because of select- says Lyons, who will speak at the Tufts quality males.” ing for fashionable heavier wrinkles from Canine and Feline Breeding and Genetics Genes responsible for health issues may within this small group of founders, the Conference September 27–29 in Boston. be located near other genes that are being western Shar-Pei carry a genetic mutation Humans tamed wolves and then almost selected for, says Bell. For example, the genes that both creates the skin folds and predis- immediately began selecting from within that produce Dalmatians’ spots were located poses some dogs to periodic fever syndrome, this small group of founders for ones that near an abnormal gene that made some dogs which can lead to kidney or liver failure. were good for protection or hunting. “We unable to metabolize uric acid, leading to Genes that predispose certain breeds to then further refined hunting dogs to be bladder stones. Over time, the Dalmatian disease also can increase in a population masters at specific types of hunting,” Lyons completely lost the normal version of the when breeders select for certain physical says, such as breeding to produce experts at gene responsible for uric acid metabolism, so traits. Breeding for extremely short, baby- pursuing quarry into holes. in the 1970s, at the request of the Dalmatian like faces in bulldogs, pugs, Boston terriers Distinct dog types appeared 3,000 to Club of America, the American Kennel Club and Pekinese can result in brachycephalic 4,000 years ago. Modern breeds, however, sanctioned a mating between a Dalmatian complex, in which narrowed airways cause trace their roots to much smaller groups and a pointer to reintroduce the normal gene breathing problems, overheating and even of individual animals chosen over the last to the breed. The spots of collapse. couple of centuries, when it became popular the first generations were “Most of the extreme physical traits we to raise dogs with specific physical attributes poor, but now, after more see are not called for in the breed standard,” for showing. than 10 generations of mating which is each registry’s official guidelines “It took only a handful of dogs to estab- their offspring with Dalmatians, for what a dog or cat in the breed must look lish each breed,” says Noriko Tonomura, a the breed has perfect spots and or move like, says Bell. The research assistant professor at the Cummings can once again metabolize uric acid. problem instead lies with

12 tufts veterinary medicine summer 2013 Animal DNA Offers Insights into Human Health

Learning about how genes malfunction in cats and dogs not only Human Genetics, Pablo Moya, a researcher at the National Institute improves their health; it also advances human medicine. of Mental Health, reported on two segments of the human gene Cats, dogs and humans share pretty much the same genes, says linked to OCD, one predisposing individuals to a more severe form of Leslie Lyons, a professor of genetics at UC Davis School of Veterinary OCD and the other linking OCD to Tourette disorder. An imaging study Medicine. “Each time we figure out how those genes work in a par- by former Cummings School behavior resident Niwako Ogata, pub- ticular organism, the more we understand about how they work in a lished this year in the journal Progress in Neuro-Psychopharmacology human,” she says. & Biological Psychiatry, found that Dobermans exhibiting compulsive Yet it’s much more difficult to discover the genetic cause of dis- behavior had structural abnormalities in the brain similar to those ease in humans than in a purebred dog. People have mated relatively seen in humans with OCD. freely over thousands of years, so our DNA tends to come in many Dodman and research partners Edward Ginns at the University varieties. In looking for genetic mutations that differentiate a woman of Massachusetts Medical School, Elaine Ostrander of the National with skin cancer from a woman without it, for example, research- Institutes of Health and Matt Huentleman at T-Gen are hot on the ers need to examine as many as a million genetic markers for clues trail of another defective gene, found in English bull terriers, that may about that kind of malignancy, says Noriko Tonomura, a research cause a canine version of autism spectrum disorder. assistant professor at the Cummings School. “Some bull terriers chase their tails repetitively,” Dodman says. Within a line of purebred dogs, however, “large chunks of DNA “But they also can have other odd behaviors, including sometimes got passed from one generation to another without interruption,” explosive aggression. They also do this thing called trancing, where Tonomura says, essentially mowing the haystack of one million genet- they freeze and just stare—and then snap out of it. It’s like an ab- ic markers in humans down to about 170,000 in one canine breed. sence seizure. To conduct a genetic study of most canine diseases, researchers “The primary behavioral expression of autism in humans is that need two pools of 200 to 300 dogs, one group with the disease and a child is slow to develop speech and other social behaviors,” says one without. Dodman. “But if you weren’t able to factor speech into the equa- “In humans, you’d need 100 times more participants,” says tion—say, for example, an English speaker observing an autistic Tonomura. “If we find the gene culprit in a dog, it can guide us to child from China—you would still observe repetitive behaviors like where to start looking to find its equivalent in human patients.” rocking or flapping hands, outbursts and sometimes seizures. At Tufts, the veterinary behaviorist Nicholas Dodman led a team Affected bull terriers show many of these behaviors.” that helped pinpoint the only mutation of a behavior gene identified If the researchers’ hypothesis proves true, Dodman says bull to date: a canine version of the gene for obsessive-compulsive dis- terriers will expand our understanding of autism biology and enable order in humans. Found in Doberman pinschers, the defective gene the development of human genetic tests for autism, which affects predisposes affected dogs to obsessively suck or lick their flanks. 1 in 50 schoolchildren, according to the Centers for Disease Control In a study published earlier this year in the European Journal of and Prevention. the “more-is-better” philosophy of some the Canine Health Information Center, start in the genetic mutation arena, as has breeders, show judges and the public. could encourage breeders of dogs at risk for the fact that cat owners generally spend Bell says it’s important for veterinar- brachycephalic complex to have the nasal less on their animals. “About 90 percent ians and breeders to work together to avoid openings of all prospective canine parents of U.S. cats are randomly bred, with just a such extremes. Brachycephalic complex, measured and tracheas X-rayed to promote very small percentage of fancy-breed cats,” for example, is caused by such physiologi- the mating of dogs with healthy anatomies. says Lyons. “For dogs, the converse is true. cal factors as the length of the dog’s muz- True to their reputation for indepen- Complete mongrel dogs are actually very zle, the width of its nasal openings and dence, cats have resisted genetic meddling, hard to find in the U.S. at this point.” the diameter of its windpipe. “Researchers until recently. But give pedigreed cats just a little more have determined that the width of the nasal “They essentially self-domesticated,” time, and they’ll quickly catch up in the openings should be one-third the width of says Lyons, of UC Davis. “Cats began hang- genetic-problems department, predicts the entire nose in order to allow the pas- ing around humans about 5,000 years ago, Lyons. “We’re getting there with Persians,” sage of air,” says Bell. “We also know what a drawn by the easy access to rodents, which she says, noting that indiscriminate selec- normal diameter of the trachea should be in hung around our grain stores. And up until tion for a short face has produced many proportion to a dog’s third rib.” This means the 1800s, cats did what they are good at, and animals with watery eyes prone to bacterial that breed clubs, which promote their man- nobody really messed with them.” infection as well as misaligned bites and dif- dated premating genetic screening through This has given dogs a considerable head ficulty breathing.

summer 2013 tufts veterinary medicine 13 Inherited Health Problems in Common Breeds

MOST POPULAR DOG BREEDS MOST POPULAR CAT BREEDS

LABRADOR RETRIEVER PERSIAN  Degenerative joint diseases  Polycystic kidney disease, which leads  Eye problems that cause blindness to kidney failure  Extreme muscle weakness after intense  Eye problems exercise or excitement  Brachycephalic syndrome, which causes breathing problems and inflammation of GERMAN SHEPHERD the facial skin folds  Degenerative joint diseases  Primary seborrhea, a skin condition  Temperament issues  Retained testicles  Eye problems  Heart conditions EXOTIC  A thyroid condition that can cause skin  Polycystic kidney disease, which leads and behavioral changes to kidney failure  Degenerative myelopathy, an autoim-  Eye problems mune disease of the nervous system  Brachycephalic syndrome, which causes breathing problems and inflammation of GOLDEN RETRIEVER the facial skin folds  Degenerative joint diseases  Primary seborrhea, a skin condition  Eye problems, including one causing  Retained testicles blindness  Cardiac conditions MAINE COON  A thyroid condition that can cause skin  Thickening of the heart muscle, and behavioral changes which leads to heart failure  Allergies  Hip dysplasia  Spinal muscular atrophy, a neurodegen- BEAGLE erative disorder  Hip dysplasia  Eye problems RAGDOLL  Heart and lung problems  Thickening of the heart muscle, which  A thyroid condition that can cause skin leads to heart failure and behavioral changes  Musladin-Lueke Syndrome, a ABYSSINIAN connective-tissue disease  An eye condition that causes blindness  Kidney failure BULLDOG  Dislocating knee caps  Degenerative joint diseases  An enzyme deficiency that leads  Dislocating knee caps to intermittent or even life-threatening  Heart and lung problems anemia  Brachycephalic complex, in which narrowed airways cause breathing problems and even collapse  Eye problems  A thyroid condition that can cause skin and behavioral changes SOURCES: AMERICAN KENNEL CLUB, CAT FANCIERS’ ASSOCIATION AND JEROLD BELL, CLINICAL ASSOCIATE PROFESSOR OF GENETICS AT THE CUMMINGS SCHOOL AND COAUTHOR OF THE VETERINARY MEDICAL GUIDE TO DOG AND CAT BREEDS

14 tufts veterinary medicine summer 2013 One upside to inherited health problems all veterinarians can do for those that do is to who ignore recommended genetic tests and is that “the hallmark of genetic disease is pre- try and slow the progression of the disease. screenings. dictability,” says Bell. “If you can diagnose a “If a breeder who skips genetic screening genetic disease even before its onset, we can AN OUNCE OF PREVENTION can put an ad on the Internet and people will often intervene and either prevent or slow The most effective medicine for treating still send them thousands of dollars to buy a that progression.” If a young dog has a severe genetic disease is to stop dogs and cats from puppy or kitten, what’s the impetus for them case of hip dysplasia, it can be prevented if a being born with those diseases in the first to be health conscious and do the right thing?” puppy is diagnosed early enough. “Surgery place. says Bell. “And, sadly, people will spend much has to be done before any bony changes “If you’re trying to produce healthy ani- more time researching what computer to buy occur,” he says. mals, you need to breed healthy parents,” than finding a healthily bred pet.” Thanks to the sequencing of the canine says Bell, who raises Gordon setters. “And By asking for test results from a purebred genome, or hereditary map, in 2005 and if we work to improve how pets are bred animal’s parents, owners not only end up the feline genome in 2012, researchers have each year, we can very quickly and signifi- with healthier pets; they also create a higher begun to identify the mutations responsible cantly diminish the number of animals with demand for responsibly bred dogs and cats. for many inherited diseases. genetic illness.” If official test results are not available, it’s For boxers, which can develop an abnor- There is good news to report. Bell says that time to find a different breeder, advises Bell. mal heart rhythm that leads to cardiac fail- over the past decade, canine registry-required Finding a healthy puppy or kitten from ure, “we now have a genetic test that will genetic testing has resulted in significant a responsible breeder may take up to six tell us which dogs are prone to developing reductions in progressive retinal atrophy, an months. This means you may not get the that arrhythmia,” says Bell. “I test all boxers eye condition leading to irreversible blindness breed you want “off the shelf” as soon as when they’re young to determine if they have in many dog breeds, including Portuguese you’d like. But given that a pet may be part that gene. If they do, we monitor their heart water dogs, English cocker spaniels and Nova of your family for 15 years or more, it’s worth rate and rhythm, especially between 4 and Scotia Duck Tolling retrievers. The most recent the wait, Bell says. 8 years of age, when the arrhythmia usually statistics from the Orthopedic Foundation for Although “a lot of irresponsible breeders begins to develop. As soon as we see it start- Animals show a 25 percent reduction in hip have a health guarantee,” Bell says, “what ing, we can put the dogs on a drug that pre- dysplasia over the past five years versus his- that guarantee states is that they will replace vents the abnormal heartbeat, which means torical averages across all breeds. the animal with one of equal quality if any they’ll never go into heart failure.” Breeders of Burmese cats have used a genetic defects occur. But pets aren’t toast- Other breeds—including collies, new genetic test to nearly eradicate a type ers. Once an owner purchases an animal, Shetland sheepdogs, Old English sheepdogs of hypokalemia (abnormally low potassium that emotional bond develops within the and Australian shepherds—have a mutation levels associated with severe skeletal muscle first five minutes. If something goes wrong, in the gene called MDR1, which helps the weakness) in just one year, Lyons says. most owners are not going to say, ‘OK, I’ll animals metabolize drugs. If dogs with two Unfortunately, an impulsive pet-buying give it back, and I’ll get another one.’ A pet is copies of that mutation receive drugs com- public often enables irresponsible breeders part of the family at that point.” tvm monly used to prevent heartworm or treat diarrhea, they can experience seizures or die. “Veterinarians can and should test all breeds Do Your Research that may carry that mutation before using any of the potentially toxic drugs,” says Bell. Before you fall for that purebred puppy or kitten, make sure you’re starting off on the Some Doberman pinschers, Shetland healthiest paw possible. A few suggestions: sheepdogs, poodles and members of several other canine breeds carry defective genes  The Canine Health Information Center (caninehealthinfo.org) lists genetic and other linked to von Willebrand disease, a bleeding tests that should be conducted for each dog breed. disorder similar to inherited hemophilia in  At the Orthopedic Foundation for Animals (offa.org), you can enter a canine parent’s humans. Bell notes that these breeds should name or registration number from such registries as the American Kennel Club or be tested for the mutation before surgery to United Kennel Club and find genetic test information if it exists. The site includes test avoid excessive blood loss. results for other branches of the parents’ family tree, including offspring and half-sib- Of course, not all genetic testing can stave lings, which is helpful in assessing familial health around inherited disorders involving off inherited disease. Researchers have dis- more than one gene. covered genetic mutations in Maine coon and  Fab Cats (fabcats.org/breeders/inherited_disorders) provides details on hereditary ragdoll cats associated with cardiomyopathy, feline diseases, highlighting those for which genetic tests are available. a thickening of the heart muscle that leads to  Pup Quest (pupquest.org) lists attributes of a reputable dog breeder— heart failure. But not all cats with the genetic and red flags for irresponsible ones—almost all of which also apply to cat breeders. defect develop heart disease, says Lyons. And

summer 2013 tufts veterinary medicine 15 A spring race at Aqueduct, where Russell Cohen also sees clients. Along the backstretch of Belmont Park, Russell Cohen, V87, is having the time of his life

BY KIM THURLER PHOTOGR APHY BY Running with ALONSO NICHOLS Thoroughbreds

it’s 5:15 on a dark, chilly late-march morning, but track. With his handlebar moustache and nonstop jests, Belmont Park is wide awake. At the track where Man o’ Cohen stands out, even in the Runyonesque world of War and Secretariat set records, horses are already lined Thoroughbred horse racing. up for their morning workouts. Exercise riders, grooms “This is more fun than you could ever imagine. It’s and trainers talk easily in Spanish and English. Roosters a circus,” he says, driving past the security booth on his crow faintly. way to the barns. “This has never been work for me a Behind the wheel of his muddy Land Rover, Russell day in my life.” Cohen, V87, is ready to roll. He is one of a half-dozen Belmont’s backstretch is home to 61 barns with 2,200 private veterinarians based in Belmont’s “vet village” stalls. Like a circus, it’s a tight-knit community, with a hos- who care for the horses stabled at the Long Island, N.Y., pital, kitchen and housing for workers as well as animals. Cohen gives yield signs and curbs mini- electrolytes lost during her morning work. an internship at the Bronx Zoo, where he mal deference as he drives from barn to Keeping these equine athletes healthy hoped to work after graduation, but there barn, his cell phone ringing constantly. A involves their mental as well as physical were no openings. Eager to return to New woman named Tammy, an owner, trainer, needs. Outside each stall hangs a bundle York City and to practice with large animals, breeder and exercise rider, totes a big stock of hay, which satisfies the horse’s need to Cohen began cold-calling every equine pot. Each morning she cooks up a batch of munch, and a big “Jolly” ball that func- veterinary practice near the Big Apple. He oats, apples and carrots for her charges— tions as an equine punching bag. Goats are struck gold when he landed a job at Belmont chicken soup for the racehorse’s soul. favored to calm nervous horses, and one with the renowned Thoroughbred breeder A glossy chestnut pokes its head out of its (reputed to be faster than some horses in and veterinarian William O. Reed. Eighteen stall. Cohen, a stand-up comic who appears the barn) butts heads with its equine com- months later, Cohen started his own race- monthly at the Gotham Comedy Club in panion; another ambles over to Cohen for track practice. Manhattan as well as at charity benefits, a scratch. A coach of championship seventh- and can’t resist throwing out the classic horsey eighth-grade recreational baseball, football joke: “Hey, why the long face?” COLD CALLS, THEN GOLD and basketball in Oakland, N.J., near his March is Belmont’s quiet season. Racing Cohen landed at the track almost home in Pompton Lakes, Cohen says that at the track, which is home to the last jewel accidentally. working with equine and human athletes is of the Triple Crown, the Belmont Stakes, Born in the Bronx, the son of a produce “absolutely similar.” doesn’t start until April 26. Its most talented wholesaler, he grew up in New Jersey in a “Horses have all the same traits as young residents winter in Florida at Gulfstream family surrounded by pets. He studied biol- athletes,” he says. “Every year the 2-year- Park. Less-competitive horses remain in ogy at Michigan State (Magic Johnson was olds come into the barn, and everyone gets New York and are vanned to race at nearby a student there at the time) and Hofstra excited. They could have the next Derby Aqueduct, where Cohen also has clients. University before heading to Texas to pur- horse, just like every year there’s a draft, All horses have distinct personalities, sue a master’s degree in population genet- with new kids coming in. You don’t know if notes Cohen. “Some are a little smarter than ics. “I was a Jewish boy from the Bronx at you have the next [Kareem] Abdul-Jabbar or others. Some are easygoing. Some are tough. Texas A&M, a Baptist school,” he notes. “It Magic Johnson. It’s a ball of fun.” It was hard for me to understand when I first was very entertaining.” Cohen had been Over the past 25 years, he has worked started. But I certainly understand it now. accepted to Tufts’ veterinary school and with such horses as Kentucky Derby and The good ones know they’re good. They was planning to defer his enrollment, when Preakness winner Alysheba and Breeders’ have an aura around them.” his father made him an offer he couldn’t Cup Classic victor Proud Truth, as well as Cohen is calm and efficient in dealing refuse: “Go to vet school now, and I’ll pay. some of the best trainers in the business. with his 1,000-pound patients. Beautiful Wait, and you pay.” So Cohen headed to “Come on, I’ll introduce you to a very Risk, a 5-year-old bay wearing a plaid blan- Massachusetts and finished his master’s famous guy,” he says, pulling up to another ket and maroon leg wraps, stands quietly as during his first year of vet school. client barn. “This is Billy Turner. He trained he slides an intravenous drip into her neck. He relished his clinical rotations in a cheap horse name named Seattle Slew.” Two liters of Ringer’s solution will replenish Tufts’ Hospital for Large Animals and A tall man with bright blue eyes and

18 tufts veterinary medicine summer 2013 From far left: Cohen going nose to nose with Distant Sky, a 7-year-old Chestnut gelding; sharing a joke with an exercise rider and conducting a pre-workout exam during his morning rounds of the barns. Cohen says all horses, like people, have different personalities. trademark newsboy cap, Turner condi- believes that uniform national medication Although survival rates vary depending on tioned 1977 Triple Crown winner Seattle policies, modeled on New York’s stringent the injury—and treatment can be costly— Slew. He is one of a select group of trainers standards, will soon replace existing patch- a broken leg, for example, no longer means whom Cohen holds in high esteem for his work state regulations. automatic euthanasia. And injured horses horsemanship and integrity. Some people will always try to get an can learn new vocations. Cohen’s patients The most recent Triple Crown winner, edge at the expense of the horse, Cohen include former racers retrained as therapy Affirmed, completed the Derby-Preakness- says. “But some of us do our best to protect horses for children and adults with physical Belmont hat trick in 1978. Why no winners in these critters, and I’m one of them. It’s cost and mental challenges. 35 years? Cohen points to bad breeding and me lots of business. As far as I’m concerned, One retiree, Oh How We Danced, overmedication: “The horses can’t take it.” the horse is number one, and I’d rather lose occupies a special place in Cohen’s heart. The overuse of drugs has resulted in business than put them in harm’s way.” He bought her following a career-ending generations of what Cohen calls “fraudu- Overmedication notwithstanding, ankle fracture, and she became a successful broodmare, foaling Double Dees, the 1996 New York champion 3-year-old filly. Now “The good ones know they’re good. age 29—that’s about 90 in human years— Oh How We Danced, the only horse Cohen They have an aura around them.” owns, lives on a farm in New York. “She’s my responsibility, and I take care of her,” he says. —Russell Cohen, V87 Cohen sometimes consults with equine experts at the Cummings School on his dif- lent” horses. While legal, medications such advances in equine veterinary medicine ficult cases and talks with Tufts students as Lasix, a diuretic prescribed for respira- have produced huge benefits for these about the 24/7 job from which he’s never tory bleeding that many believe enhances animal athletes and the industry. New, taken a day’s vacation. performance, mask problems that show up more sophisticated imaging technology It’s not a life for every veterinarian. in the next generation. Breeding marginal helps trainers identify problems before Asked about alternative paths, Cohen stock in an attempt to make a quick profit they become serious. “They can stop pauses, seemingly perplexed. “I don’t know. has further contributed to the deterioration training before a terrible injury occurs,” I couldn’t even answer that question,” he of Thoroughbred horses, he says. Cohen says. says. “I can’t believe I’m having this much Fortunately, things are heading in the Modern techniques also mean that “there fun. This is a circus. This is the coolest thing right direction, according to Cohen. A are few severe orthopedic injuries that can’t in the world.” tvm tougher economy has helped decrease be fixed,” he says, pointing to more refined the annual U.S. foal crop from 40,000 to arthroscopic procedures; internal and exter- Kim Thurler, the director of public relations 22,000. In the wake of pressure from the nal fixation techniques involving screws, at Tufts University and a follower of public, Congress, state regulators and horse- pins and plates; lightweight casts; newer Thoroughbred racing, can be reached at men and horsewomen themselves, Cohen anesthetics and better recovery facilities. [email protected].

summer 2013 tufts veterinary medicine 19 20 tufts veterinary medicine summer 2013 to Know BY GENEVIEVE RAJEWSKI ILLUSTRATION BY KATHERINE STREETER

Advice for dealing with all things lumpy, bumpy, red and splotchy on your pet’s skin

mutts turn mangy. kittens’ chins break “The skin is an organ we can see,” says out in pimples. Dogs pepper the rug with Lluis Ferrer, who oversees the veterinary dandruff. Cats scratch themselves at a fever- dermatology service at Tufts. So although ish pitch. you can’t tell whether your dog has a head- Our pets are susceptible to hundreds of ache or tightness in the chest, an itch that bacterial and fungal infections, parasites won’t quit is easy to spot. “If your cat has a and autoimmune disorders of the skin— growth on her face, you are going to notice ranging from the merely annoying to the that immediately, versus a growth on her downright deadly. So it’s no wonder that pancreas, which you won’t be aware of until dermatological issues are the number one after it starts causing some serious prob- reason that dogs and cats end up at the vet. lems,” says Ferrer.

summer 2013 tufts veterinary medicine 21 Owners often worry that a pet’s skin con- infections in otherwise-healthy animals is the “hygiene hypothesis,” which suggests dition might be contagious—and rightly so, is allergies, which can morph that body- that Western society’s obsession with dis- in some cases. You can get ringworm, an protecting envelope into a sieve. infecting every surface in sight has made itchy fungal infection, from your cat. “If you think about your skin, its struc- animals’ immune systems hypersensitive to The bottom line is that healthy skin ture is like a brick wall—nothing penetrates foods and other allergens. Other suspects is important to your pet’s well-being. it,” says Lam. “But an allergic dog has skin include environmental and chemical pollu- Essentially an envelope for the body, the that’s more like a crumbly stone wall. There tion, which may harm the immune system, skin keeps good things in (water and elec- trolytes) and bad things out (toxins, germs and UV rays from the sun). It also helps “ Just like some people are your pet maintain a healthy body tempera- ture by regulating blood supply and sweat allergic to dogs and cats, gland function. When it comes to all things lumpy, —Andrea Lam bumpy, red and spotty, pet owners often they can be allergic to us, too.” assume a veterinarian will be able to diag- nose a skin disease just by looking at it. Not are all these tiny gaps where environmental and genetic changes that have occurred over so, says Ferrer, who goes beyond skin deep allergens like dust or mold can seep through generations. to try to identify the molecular causes of and cause an inflammatory reaction.” The Dogs with allergies can suffer from many dermatological conditions—from warmth of inflamed skin creates the perfect chronic ear infections, chew their paws or why Shar-Peis’ skin is wrinkled and prone breeding environment for the normal sup- scratch themselves frequently. In addition to to chronic infections to why certain dogs die ply of yeast and bacteria living on the skin these symptoms, a cat with allergies might from infestations of the typically harmless to multiply, she says. groom itself obsessively—sometimes to the parasitic mites known as Demodex, which point of total hair loss—or have raw, scaly live in the hair follicles of most mammals, PET PEEVES patches in one area of the body. “Sometimes including humans. Although there is little research data on pet cats with allergies only develop lesions at Despite the mind-boggling number and allergies for comparison, it appears that the base of their tongues,” says Lam, “so you diversity of dermatological problems in atopic dermatitis—a.k.a. eczema, the itchy, might not notice the lesions if they don’t animals, the skin has a limited repertoire scaly skin caused by allergies—is far more interfere with the cat eating.” of signals—itching, hair loss, bumps and prevalent in dogs and cats than it was a few Because dogs and cats can be allergic to scales—to give owners and veterinarians decades ago, according to Ferrer. many things, identifying the culprit requires clues into what’s going on. Getting to the “The situation is similar to that in chil- time and a bit of trial and error. Until an right diagnosis is important. dren,” says Ferrer, who notes that as many allergen is confirmed, your veterinarian “First, we want to make sure it’s not some- as 10 percent of all dogs and between 10 and may recommend antihistamines, such topi- thing that can be easily treated,” says Andrea 15 percent of children suffer from atopic cal treatments as shampoos and sprays and Lam, a board-certified veterinary dermatol- dermatitis. even steroids to keep your pet comfortable. ogist who works with Ferrer at Tufts’ Foster It is not known why more pets (and kids) To discover what’s causing an allergic Hospital for Small Animals and at the Tufts have allergies. One explanation, Ferrer says, reaction, veterinarians generally start by put- VETS clinic in Walpole, Mass. ting the pet on a strict diet for two months. Fleas and other contagious parasites— “If your immune system has never encoun- such as sarcoptic mange mites, which a Skin Deep tered something, it can’t have an allergic reac- dog can pick up if coyotes and foxes live tion to it,” says Lam. “So our goal is to take nearby—are common and easily treatable If your dog or cat has any of the away all the most common food allergens— causes of extreme itchiness and hair loss. following symptoms, it may signal a protein sources like beef, chicken and soy— A bacterial or yeast infection can be cured skin problem. Be sure to tell your and replace these with special foods made with antibiotics or antifungal drugs. primary care veterinarian. with protein sources your pet has likely never To diagnose an infection, a veterinarian eaten, such as venison, rabbit or kangaroo.” presses a glass slide directly onto a lesion or  Itchiness If a pet’s symptoms diminish, the owner sticks a piece of tape to the affected area.  Hair loss is instructed to give the pet its old food once “Then we can look at it under a microscope  Smelly ears more to see whether symptoms get worse. in the exam room and show the owner the  Head shaking “Animals with food allergies will have a yeast or bacteria right there on the spot,”  Foot licking reaction within days, sometimes within says Lam.  Skin lumps hours,” Lam says. By far, the most common cause of skin If the dietary regimen doesn’t work, the

22 tufts veterinary medicine summer 2013 next target is environmental allergies. Tufts veterinary dermatologists perform a blood test in combination with a skin allergy test, which is similar to the prick test for people suspected of having allergies. Managing an environmental allergy in pets is usually not possible with lifestyle changes alone, says Lam. “Tree, weed and grass pollen can blow in from far away. It doesn’t matter what’s in your yard, or if you keep your dog inside. Every time you open a window or the door, those pollens will get in your house,” she says. “Some pets are aller- gic to house dust or house dust mites. You can vacuum a lot, but it won’t be enough to fix the problem.” “And if you are a really unlucky dog, you might be allergic to people,” notes Lam. “Just like some people are allergic to dogs and cats, they can be allergic to us, too.” Lam says that roughly 25 percent of her patients with environmental allergies test positive for an allergy to human dander. Unlike people with pet allergies, dog and A Horse with Hay Fever? It Happens cats typically do not experience respiratory problems as a result of human dander, but Allergies are not as common in horses as they are in small animals, but diagnosing and they can become extremely itchy and develop treating them is tricky. secondary infections just by being around us. “Probably the most common skin-complaint call we get is an owner saying, ‘My horse Fortunately, your veterinarian will never was fine last night, and this morning has so many hives its skin looks like corn on the tell your dog or cat to find you a new home. cob,’ ” says Alfredo Sanchez Londoño, an equine veterinarian with Tufts’ Ambulatory Instead, a vet can develop an immuno- Service in Woodstock, Conn. “A case like that is kind of a nightmare, because there are therapy regimen for your pet’s most serious so many factors to try to control.” allergens. Administered as a series of injec- Dogs and cat owners can try a variety of foods to eliminate potential allergens, tions over many months, these allergy shots whether it’s wet food or kibble made from venison, rabbit or duck. With horses, “you can contain minute diluted amounts of sub- try a different source of hay or grain,” says Londoño, “but the ingredients are all pretty stances to which your pet is allergic. much the same.” “Each pet has a totally customized plan,” Environmental allergies in horses are quite common, caused by dust, pollen and says Lam, noting that immunotherapy molds, which thrive in the fields and stables where they spend most of their time. improves symptoms in about 70 percent of To diagnose this kind of allergy, horses have to undergo both blood and skin-prick cases. “If a client is very lucky, the pet will tests, as is the case with dogs and cats. Londoño recommends the testing be done in a improve in the first three months, but results hospital environment. “It’s hard to do this testing outside in a field,” he says. “If you in- can take a full year,” she says. However, most ject a horse with an allergen, and a severe reaction occurs three hours after you’re gone, owners say their pets’ comfort outweighs the that can be a disaster. The horse needs to be monitored continuously.” lengthy treatment. In addition, “a lot of horses are extremely sensitive to insect bites,” says Londoño. “I have a cat that’s allergic to chicken and There are a number of steps owners can take to lessen animals’ exposure to bugs, a few other foods,” Lam says. “If she eats says Linda Frank, V85, a veterinary dermatologist at the University of Tennessee’s something she’s not supposed to, within Veterinary Teaching Hospital. hours, she’ll turn bright red and start lick- The most common cause of insect allergy in horses is Culicoides biting midges, which ing herself obsessively,” she says. “So I really feed at night, Frank says. She recommends that owners keep their horses inside from feel for clients with itchy pets.” tvm an hour before dusk to hour after dawn and spray them nightly with insect repellant. Installing a fan in the barn is also helpful, because these insects are less likely to hang Genevieve Rajewski, the editor of this maga- around if there’s a breeze. And be sure to eliminate pools of standing water, where the zine, can be reached at genevieve.rajewski@ bugs breed. —g.r. tufts.edu.

summer 2013 tufts veterinary medicine 23 BY LINDA HALL PHOTOGRAPHS BY ALONSO NICHOLS Creature

Our special relationships with the animals in our lives sustain, soothe and heal us Comforts

guests at megan kiely mueller’s wedding “I think this is an under-studied but had no doubt about the importance of ani- highly significant area of human devel- mals in the bride’s life. Wearing a collar opment,” says Richard M. Lerner, the of roses, Jett, her adopted black Labrador Bergstrom Chair in Applied Developmental retriever mix, led Mueller down the aisle. Science in Tufts’ Eliot-Pearson Department “As a part of our family,” Mueller says, of Child Development, who was Mueller’s “it was only right that he was part of our Ph.D. advisor. wedding.” “We don’t have a rich developmental Close relationships with animals have been data set to understand the role of animals a constant in her life, and now Mueller, A08, in promoting positive development or as a G10, G13, who recently completed her Ph.D. therapeutic tool, and not enough evidence in child development at Tufts, is focused on from such research to build good programs the science that underpins how animals and in health promotion or disease prevention” people help each other. Her doctoral disserta- or to shape policies to enhance animal wel- tion examines the ways in which human-ani- fare, he says. Gmal interactions mold healthy development “What we need is longitudinal research, in childhood and adolescence—from build- following kids repeatedly through the ing character to community involvement to years, to understand the role of animals success in the classroom. in their lives,” Lerner says. In this evolv- “People in general, and youth in par- ing field of social science, “I think Megan ticular, feel an incredibly strong, emotional is going to be one of the foundational connection to animals,” she says, “and people.” understanding the nature of these relation- “What’s so fun and exciting about this ships is critically important” for designing field,” Mueller says, “is that no matter who programs and policies that support positive you talk to, they understand the power of benefits for people and animals. animals in their lives.”

24 tufts veterinary medicine summer 2013 Megan Kiely Mueller and Jett, a member of her wedding party

summer 2013 tufts veterinary medicine 25 Whether animals are pets, assist in therapy, compete and entertain, or are raised as food, “these relationships also raise interesting moral issues [about] the different functions that animals [should or should not] serve for humans.” —Megan Kiely Mueller

Mueller felt that power early on. She familiar images—an elderly woman cud- had a menagerie of pets growing up—cats, dling with her cat, a service dog helping his birds, fish—and she began riding horses at blind owner navigate city streets, a show age 5. She competed on the Tufts Equestrian horse in competition, animals on a working Team as an undergraduate and was named farm. The rewards of those relationships are Intercollegiate Horse Show Association commonly recognized, albeit mostly with captain of the year. Her teammate, Stuart anecdotal evidence. Mueller, E05, E11, not only shared her affec- What is lacking, Mueller says, is the tion for horses, he fell in love with her. They science—long-term and large-scale studies married in August 2010 in Goddard Chapel to produce the kind of evidence needed to on Tufts’ Medford/Somerville campus. guide human-animal interactions in ways At one time, Mueller considered becom- that will benefit both sides. ing a veterinarian and tested the waters in Since last summer Mueller has been high school by participating in Adventures in part of an interdisciplinary team at Tufts, Veterinary Medicine, the Cummings School’s working on the project known as Integrated summer career exploration program. Health: Pets and People, which is staking In the end, though, she decided she out a research direction in human-animal wanted to know more about the workings interaction and perhaps even a new minor of the human mind; she earned a bachelor’s for Tufts undergraduates. The team includes cotaught a new course in Tufts’ School of degree in child development and psychol- faculty from the Cummings School, School Arts and Sciences called Human-Animal ogy at Tufts, followed by a master’s. Then, of Medicine, the Eliot-Pearson Department Interaction in Childhood and Adolescence. while attending a child development confer- of Child Development, and the Friedman The course, Lerner says, generated “amaz- ence during her Ph.D. studies, she discov- School of Nutrition Science and Policy. They ing” student interest. Typically, a new course ered a field that melded her devotion with have expertise in human nutrition and obe- attracts five students; this one pulled in 20. a profession. sity, overweight pets and animal nutrition, “I’ve taught a lot of new courses in the past clinical psychology and animal behavior. 14 years, and I’ve never had a response like BRAND-NEW SCIENCE “This type of research really lends itself to this,” he says. Mueller was energized: Could she focus her interdisciplinary collaboration in a mean- The course explored how human-animal research, even her career, on human-animal ingful and logical way,” Mueller says. bonds can lead to positive development in relationships? She approached Lerner: “She For example, she is working with faculty children, families and communities as well said, ‘What I’d really like to do is to fol- at the Tufts Obesity Clinic for Animals at the as produce benefits in therapeutic settings. low my passion and build a career doing Cummings School and the Center for Youth (Animals, especially dogs, often are used in research on human-animal interaction Wellness at Tufts Medical Center to develop therapy to reduce stress, heighten positive in terms of child and adolescent develop- a program that would use animals to help feelings and encourage communication and ment,’ ” he recalls. “And then she added: ‘Is adolescents manage their own weight issues. socialization.) The course also examined that too crazy?’ ” Participants would learn about healthy how an animal’s interactions with people Mueller’s proposal “was definitely a lifestyles for pets and interact with therapy affect its well-being. brand-new idea in my department,” says animals—“using the engaging nature of ani- “For animals that are participating in Lerner. He thought it had merit: “These days mals,” says Mueller. “Tufts is uniquely posi- animal-assisted therapy, we need to ask: Is in the U.S., a child is more likely to have a tioned to do this kind of research because of this a stressful experience for them, or not?” pet in their home than to have two parents.” the strengths we have across all the schools.” Mueller says. “How can we better measure Human-animal relationships conjure up This semester Mueller and Lerner that” and use those findings to create the

26 tufts veterinary medicine summer 2013 Megan Kiely Mueller cotaught a child development class on human-animal interaction this spring. In the background, Perkins School for the Blind trainer Jennie Feinstein demonstrates one of the commands that her dog Norm has learned to assist his human companion. Above: A blindfolded Emily Zhang, A16, gets to know Norm.

asked about the most important and mean- ingful activities in which they invest their time. Many of their responses focused on their interactions with animals. “That finding shows how salient” those relationships are, Lerner says. “So then the question is, What are these kids like and how are they different best experiences for the person receiving leadership roles, participating in commu- from other kids?” therapy and the animal that is assisting? nity service and helping others. Youth who Whether animals are pets, assist in ther- were involved with animals also scored apy, compete and entertain, or are raised as STABLE BONDS higher on measures of positive character food, “these relationships also raise interest- Now a research assistant professor at the attributes and lower on measures of symp- ing moral issues [about] the different func- Cummings School, Mueller is leading a toms of depression. She also found that tions that animals [should or should not] study about how animals affect youth in adolescents living in urban areas were half serve for humans, and how we feel and think military families who often have to cope as likely to own a pet or engage in an activ- about those relationships,” Mueller says. with multiple moves and school changes. ity that involved animals than those in more “How do the different purposes of animals The study, funded by Pfizer, is examining rural areas. change our emotions and cognitions? How such issues as the role of pets in promot- Mueller’s assessments were based on do we balance human well-being and animal ing coping skills, creating a source of social data from the 4-H Study of Positive Youth well-being?” interaction and reducing stress. Development, research sponsored by the As Mueller continues to study these issues, Her doctoral dissertation, which evalu- National 4-H Council in which Tufts has she remains sure of one thing: the impor- ated how human-animal interaction pro- participated for more than a decade and with tance of animals in her own life. She and her motes healthy development in young people which Mueller worked as a doctoral research husband still ride, occasionally compete and ages 18 to 26, has already identified some assistant at the Tufts Institute for Applied help out at Tufts Equestrian Team events. benefits of such relationships. Research in Youth Development. The study And, of course, Jett remains an important “I found that emotional attachment to has surveyed more than 7,000 adolescents member of their family. “He’s great,” she says, animals was associated with higher levels of in 42 states to determine the impact of 4-H although after being invited to their wedding caring behavior toward others and connec- programs on future success, from healthier “he did sleep through the whole thing!” tvm tion to family, school and peers,” she says, lifestyle choices to academic achievement to in addition to higher engagement in con- civic engagement. Linda Hall is a freelance writer in Hopkinton, tributing to their communities by taking As part of the survey, adolescents were Mass.

summer 2013 tufts veterinary medicine 27 researchTHE PATH TO DISCOVERY

That patient was the elderly woman, Tufts scientists reported the first who lived on a farm in New Jersey. Over U.S. case of human B. miyamotoi four months, she had experienced progres- infection earlier this year. sive mental decline, becoming increasingly confused. Her gait grew wobbly, and she didn’t have much of an appetite. Her immune system was compromised from a previous bout with cancer, so her doctors drew spinal fluid in the hopes of finding out what was going on. When technicians at a commercial diag- nostic laboratory saw the mysterious spiral bacteria, they sent the sample to Telford, whose laboratory serves as a reference cen- ter for unusual zoonotic infections, that is, those that pass between animals and humans. Telford and Heidi Goethert, J93, a microbiologist at the Cummings School, sequenced the spirochete DNA, and identi- fied it as Borrelia miyamotoi, which was first found in ticks in Japan in 1995 and is closely related to the bug that causes Lyme disease. Previous cases of B. miyamotoi infections in people had been identified in Russia in 2011. The Tufts scientists reported in the New England Journal of Medicine in January the first U.S. case of human B. miyamotoi infec- tion. (The infected woman was treated with antibiotics and has since recovered.) A New Tick Disease The B. miyamotoi bacteria may be an under-recognized source of human disease, especially in such regions as the northeast- What looks like Lyme could be a completely different illness ern United States, where Lyme disease is transmitted by the same bug by Lindsey Konkel prevalent, say Telford and his coauthors. There’s been lingering disagreement in the scientific and medical communities about whether a person can test negative nder the microscope, sam telford surveyed the tiny, spiral for Lyme and still have Lyme, says Telford. bacteria floating in spinal fluid taken from an 80-year-old woman. This latest research raises the question of They looked very similar to the spirochete bacteria that can cause whether patients with atypical Lyme dis- Lyme disease. But in fact, he had discovered yet another public ease—those who have symptoms but whose Uhealth threat—a new disease that people can get from the same ticks that trans- blood doesn’t test positive for Lyme—may mit the Lyme bacteria. actually be infected with B. miyamotoi, he “We’ve known that this bacteria existed in the Northeast in deer ticks, but says. Both are treated with the same course there was little data linking it to human disease” until now, says Telford, an of antibiotics. expert on tick-borne illness and a professor in the Department of Infectious While an estimated 12 to 18 percent of Diseases and Global Health at the Cummings School of Veterinary Medicine. coastal New Englanders have been infected “We just needed the right patient to confirm the presence of the disease.” with the Lyme bacteria, called Borrelia

28 tufts veterinary medicine summer 2013 PHOTO: KELVIN MA burgdorferi, only between 1 and 3 percent of people have likely been infected with ‘Spotlight’ Drug Detects its lesser-known cousin, B. miyamotoi, researchers at Yale reported in commen- Lingering Cancer Cells tary that accompanied the Tufts study in NEJM. (The Yale team is led by Peter When a tumor is surgically removed, there’s always a chance the can- J. Krause, M71, and includes Timothy J. cer will return. Even the tiniest bit of malignancy left behind creates a Lepore, M70.) pathway for the disease to recur—often within a couple of months. Not all deer ticks carry B. miyamo- “The problem in both human and veterinary medicine is that we toi, just as they don’t all carry the Lyme- can’t tell if we’ve gotten microscopic bits of tumor out, because we causing bacteria. Previous assessments of can’t see them,” says John Berg, a veterinary surgeon at Tufts. tick populations suggest the new bacte- Berg’s clinical research could one day lessen the odds that a rium appears to be much less common— cancer will come back—in both animals and humans. He’s testing a roughly 10 percent as prevalent—than new surgical tool developed by researchers at MIT that will let doc- the one that causes Lyme, according to tors know whether even a single malignant cell remains—while the Telford. While to date there has been just patient is still in the operating room. one confirmed case of human B. miyamo- Dogs undergoing surgery for soft-tissue sarcoma and a com- toi infection in the United States, research- mon skin cancer known as a mast cell tumor—both of which recur ers have known for some time that the at high rates if not completely removed—are injected with a drug ticks carry these bacteria. Telford suspects containing a fluorescent dye that acts like a cancer-illuminating that people were being infected, but there spotlight during the operation. wasn’t proof until the New Jersey woman Administered 24 hours before surgery, the drug is made of a was diagnosed. protein bound to two fluorescent molecules. Cancer cells have This latest tick-carried disease, which an inordinately large number of enzymes, which act as biological has yet to be named, is the fifth known switches when they come into contact with the drug, causing the human infection to come from deer ticks malignant cells to light up. “The fluorescent dye remains in cancer in the Northeast, after Lyme, babesiosis, cells for about 48 hours or so,” says Berg, “so we can distinguish ehrlichiosis and deer tick virus. cancer cells from normal cells when we do sur- Ticks are notorious transmitters of gery the next day.” infectious disease around the globe. Their Once the tumor is removed, the surgeon indiscriminate dining habits (they don’t aims a specially designed camera at the surgi- seem to care what animals they feed on) and cal site where the cancer once thrived. The the relatively large amount of blood they camera emits a beam of fluorescent light: “If consume (200 times their own body weight) we see fluorescence, we’ve left tumor [cells] make them particularly adept at picking up behind,” says Berg. The glowing areas “pinpoint pathogens and then spreading them. where we need to remove any residual cancer.” “Lyme disease alone is enough of an Preliminary results on 20 dogs are promising, argument to take action to reduce risks, let Exposed to the Berg says. “What we’ve learned is that the technology is very good alone four other [tick-caused] infections,” fluorescent drug, the at distinguishing cancer from normal tissue. It does that with a high says Telford. “In some New England com- cancerous cells in degree of accuracy,” he notes. “What we haven’t yet proven is if it will this tumor “light up” munities, as many as a third of residents allow us to see microscopic quantities of tumor. That’s because with white or light gray, have been exposed to at least one tick-borne while the normal most of the dogs we’ve treated, we’ve been able to make a very wide infection,” says Telford, who suggests that tissue remains black. incision around the cancer, allowing us to remove the entire tumor.” public education about tick-borne diseases To assess whether the surgical cancer detector lives up to its and reducing deer herds, while controver- claim of being able to sniff out as little as one lingering cancerous sial, may be a good places to start. cell, Berg plans to conduct a larger study. “We’re probably five to 10 years from this technology being a reality in regular practice,” Lindsey Konkel is a freelance writer in he says, “but I think it has tremendous promise for both animals Worcester, Mass. and humans.” —genevieve rajewski

IMAGE: COURTESY OF LUMICELL DIAGNOSTICS summer 2013 tufts veterinary medicine 29 on campus CUMMINGS SCHOOL NEWS

From a world health perspective, the Hellen Amuguni is leading the challenge is daunting. Africa is a hot spot fight against pandemics in Africa. for zoonotic illnesses—those diseases that animals transmit to humans and vice versa. An astounding 70 percent of the diseases that have infected people over the past half-century have been zoonotic in nature, according to the U.N. Food and Agriculture Organization. Scientists believe the HIV/AIDS epi- demic got a foothold in Africa from people eating infected monkey meat. Also prob- lematic in the region is tuberculosis, which can be transmitted by elephants or con- tracted by drinking raw milk. Yet another zoonotic threat is Ebola, which is often fatal and has no known cure, and is transmitted by eating monkey, buffalo and other kinds of bushmeat infected with the virus. Many Africans live in close proximity to both domestic and wild animals and often compete with them for water and other scarce resources, so conditions for the transmission of disease—through infected food and shared drinking and bathing Women of Change water—are rife, says Amuguni. The U.S. Agency for International Development (USAID) and global health Disease prevention on the African continent begins at the village organizations have taken a number of steps drinking well by Mark Sullivan to control disease outbreaks in Africa as well as in other parts of the world where the risk is high: in Southeast Asia, where the serious pneumonia SARS and avian ellen amuguni laughs easily, but is dead serious about the flu thrive; along the Amazon River and work in Africa that has defined her career: halting the spread of across a swath of Central and South Asia infectious disease, helping communities thrive—and empower- that includes Pakistan, Bangladesh, Nepal ing women. and India. HOver lunch recently in the Agnes Varis Campus Center at Tufts, Amuguni, Through the multimillion-dollar global V11, a research assistant professor in the Cummings School’s new Department effort known as RESPOND, the USAID of Infectious Disease and Global Health, talked about how she began her career and its partners are developing training focusing on women’s roles in the nomadic livestock-keeping communities of programs for veterinarians, physicians and her native Kenya. public health officials in regions where new Newly graduated from the veterinary school at the University of Nairobi, diseases are likely to emerge. she says she would get a call from a farmer about a sick cow. “I would go [to the Amuguni is the Tufts University liai- home], and ask, ‘When did the cow fall sick?’ son for RESPOND in an African region “He’d turn and ask his wife. The wife would tell him, and then he’d tell me. encompassing six countries—Kenya, I’d say, ‘Why don’t I just talk to her, and she’ll give me the information?’ ” Uganda, Tanzania, Rwanda, Ethiopia and She laughs and rolls her eyes in the telling. The exchange among the farmer, the Democratic Republic of Congo—that his wife and the veterinarian sounds a bit like domestic comedy, but women’s are home to more than 280 million people status in some cultures has serious implications for human and animal health. and 400 species of mammals. She helps Amuguni uses the story to illustrate a larger point: Engaging women and bring- health professionals there respond to infec- ing them more to the forefront in African communities are essential for man- tious disease outbreaks employing what is aging disease outbreaks at the village level in order to avoid pandemics with known as “one health”—a collaboration global consequences. among multiple disciplines, including

30 tufts veterinary medicine summer 2013 PHOTO: KELVIN MA medicine, veterinary medicine and public used to find it funny that I only had two than 1,600 miles from east to west, roughly health—to protect people, animals and the kids: ‘How can you have two kids only? You the distance between Boston and Denver. environment. should be having 20 children!’ ” And also: She consults with faculty members at 14 In some African communities, a sim- ‘Where’s your husband? Why would your African universities on training programs ple family meal of infected bushmeat and husband let you come all this way on your in one health. “The mandate we have is unboiled milk can be life-threatening. own? He should divorce you!’ to build the capacity of governments, insti- Something as simple as straining drinking “I really built a relationship with the tutions and civil societies in the countries water through a cloth can stop the spread men first,” she says. “I’d get them to give me we work in to respond to any emerging of such parasites as bilharzia, which attacks a calendar of who does what in the house- pandemic disease,” Amuguni says. The the liver, lungs and eyes in humans. “If hold. They’d realize women did so much. work involves training scientists and oth- you educate women, you definitely kill” Who wakes up in the morning, brings the ers at the universities as well as building the potential for disease transmission, says water, feeds the animals, milks the animals, emergency response teams of veterinar- Amuguni. “Women will go to the well and treats the animals when they’re sick?” ians, physicians, anthropologists and agri- pass on that information to every other The men would respond: “That’s the cultural experts. woman in the village.” women’s job.” Amuguni pushed ahead: “I love talking,” says Amuguni, who did “OK, do you think we should give these her doctoral work in infectious disease. HOMEGROWN HEALTH AGENTS women a little more training so they’d And I like working with people a lot more Amuguni’s idea of empowering women as know how to identify these diseases?” The than just doing bench science.” agents in combating health threats was put men relented. Tzipori’s department develops pro- to the test a decade ago when she worked “Working in Africa, and also having grams to support RESPOND, including for Veterinarians without Borders among grown up there, one of the things I’ve real- courses in emerging zoonotic diseases, Kenya’s Turkana people. The Turkana are ized is that sometimes it doesn’t matter how risk assessment, environmental health and nomads whose livelihood depends on live- educated people are,” she says. “Social and grant writing. stock, and she hoped to train the women, cultural issues and the way they do things It’s been a good partnership. who tend the cattle and prepare the food, to are still really, really important, and I have “Hellen Amuguni knows her Africa serve as community-based animal health- to respect that.” through personal experience,” says Tzipori, care agents. Amuguni is not one to give up eas- who also holds the Agnes Varis Chair in Her biggest challenge, however, was just ily. “She’s a no-nonsense person,” says her Science and Society at Tufts. “She has man- getting to talk to the women. Ph.D. advisor at the Cummings School, aged to command a great deal of respect Sometimes it took two or three months Saul Tzipori, chair of the Department of from her African colleagues and part- simply to gain permission from the male Infectious Disease and Global Health. ners, some of whom were her teachers. She leaders. “I spent months just talking to He hired his former Ph.D. student to knows her stuff.” men,” recalls Amuguni. “We’d spend a lot lead Tufts’ participation in the RESPOND The daughter of a physician, Amuguni, of time talking about my children. They project in Africa, in a region spanning more 47, once considered a career in social sci- ences. Her current work enables her to help both humans and animals. She describes speaking to farmers about the importance of testing for tuberculosis and brucellosis before selling milk at the marketplace. “Even more important is ensuring that health workers and the gov- ernments know how to contain disease,” she says. Last year, for example, there was an outbreak of Ebola hemorrhagic fever in Uganda and the Democratic Republic of Congo. “We have been working with their governments to train and develop an emer- gency response team in preparation for such outbreaks,” she says. “We can see it beginning to work.” In many African communities, women are the sole caretakers of the livestock that feed their families. Mark Sullivan is a freelance writer in Ashland, Mass.

PHOTO: COURTESY OF HELLEN AMUGUNI summer 2013 tufts veterinary medicine 31 on campus

Juggling Act

Keiko Petrosky, mother of three, researcher and now veterinarian, recasts her career to encompass human and animal medicine by Lindsey Konkel

s the sun rises through the found herself drawn to the work of the projects and family,” says Barbara Davis, trees, Keiko Petrosky walks Novartis veterinarians. “Any time a medi- a former pathologist at Tufts who was her briskly toward Tufts’ Foster cine or drug is approved for humans or advisor on a research project on dog tumors, AHospital for Small Animals. animals, it must first go through a veteri- for which Petrosky received a Morris Animal A 34-year-old mother (her third child, a nary pathology review. Veterinarians play Foundation Veterinary Student Scholarship. daughter, was born in April), Petrosky, an incredibly important role,” she says. Early on at the Cummings School, V13, prepares to check in on her cancer Petrosky, the scientist, understood the Petrosky found a small group of career- patients. Her alertness belies the hour. It’s effects of a drug on a given protein or tis- changers and students with young chil- 7 a.m., but she’s been up since 5. “I don’t sue. Still, she felt something was missing. dren who leaned on each other for support need an alarm clock,” she jokes. “If my cat The Novartis veterinarians understood and shared creative studying strategies. doesn’t wake me up, my kids do.” how a medication affects the entire body. “I learned to make up bedtime stories for Going to veterinary school and rais- “I wanted that,” she says. “I had the sci- my son about how the kidneys or heart ing a young family are each full-time jobs, ence, but I needed the medicine.” worked,” she says. but she’s taken on both, as she carves out a After two years overseas, Petrosky and She also benefited from an extremely professional life at the nexus of veterinary her husband moved back to the States, supportive family. “My husband has been medicine and human medical research. their infant son and adopted shelter cat incredibly hands-on. My in-laws would take Becoming a vet is a second career for in tow. “At that point it was either look for the kids overnight, and my mom lived with Petrosky, who first trained and worked as another lab job or start vet school,” says us two to three months out of the year.” a scientist. After obtaining a Ph.D. in bio- Petrosky. She took the plunge. Between her first and second years, physics from the University of California, Being back in a classroom was a bit of a Petrosky took a year off for the birth of San Francisco, in 2006, Petrosky and her shock, she admits. Sometimes she would set her second child. When she resumed husband, a fellow graduate student at UCSF, her alarm for 3 a.m. to study while the rest classes, she got a boost from the American moved to Basel, Switzerland, home of the of the family slept. Yet she quickly learned Association of University Women, which drug maker Novartis. There she helped to how to juggle schoolwork and family and awarded her a $12,000 career-development perfect a laboratory technique for testing put her laboratory experience to good use. grant to help pay for child care. the effects of a new osteoporosis drug on “Keiko has such enormous energy During clinical rotations in her final living tissue samples. and organization. I was in awe of how she year of veterinary school, achieving a bal- The job was exciting, but Petrosky managed veterinary school with research ance between her studies and family life was especially difficult. With 12-hour shifts required for some specialty rotations, “I didn’t see my kids for days,” she says. While there have been plenty of sac- rifices, Petrosky says it’s paying off. In September, she’ll start a residency in vet- erinary pathology at the New England Primate Research Center at Harvard Medical School, where she will work on methods for treating diseases that occur in animals and humans. One of her favorite parts of clinical rotations was watching her kids’ faces light Keiko Petrosky with her husband, up when she would show them cell phone Baruch Harris, and their children pictures of a turtle, cow or dog she had Shizuko Petrosky-Harris, 3, and Itzhak helped heal. Petrosky-Harris, 5. The couple’s third child was born this spring. “At the end of the day, those little things helped get me through,” she says.

32 tufts veterinary medicine summer 2013 PHOTO: ALONSO NICHOLS advancement GIVING. GROWTH. GRATITUDE.

An artist’s rendering of the new entrance to the Foster Hospital. Opposite: A roomier patient reception area.

Time to Grow

We’re expanding our hospitals to better serve you and your pets By Heather Stephenson

hen the henry and lois foster hospital for small “This project is necessary so that we can Animals opened in 1985, veterinarians anticipated pro- continue to provide the high level of service viding care to 12,000 cats, dogs and other companion that our clients have come to expect—the animals a year. Now, more than 26,000 pets come to the kind of care that inspires families to bring Whospital annually, representing one of the highest patient caseloads of any their pets to us and veterinarians to make veterinary academic teaching hospital in the country. While the care is excep- referrals here,” says Cummings School tional and Cummings School students receive a top-flight clinical education Dean Deborah Kochevar. “Improving the in a busy veterinary teaching hospital, the 30-year-old building is at capacity. quality and size of our hospital complex To better provide 21st-century care for animals and enhance services for is also essential to attracting the best stu- their owners, the Cummings School has launched an initiative to renovate dents and faculty to our school.” and expand its teaching hospitals, collectively known as the Tufts Veterinary The expansion will create a welcoming, Hospitals. The first phase of the project, which will cost $8 million, will focus well-designed veterinary medical center on the Foster Hospital. The school’s ambitious master plan further details a that will make it more hospitable for clients comprehensive $60 million project that will entail more extensive renovations to get the care their animals need and more and expansion of the small animal hospital as well as work on the Hospital amenable for clinicians and students to do for Large Animals. their work. The first phase of the project

summer 2013 tufts veterinary medicine 33 advancement

To see a video and learn more about the hospital renovation, Animals Count visit vet.tufts.edu/renovation. The Foster Hospital project at a glance 26,000 Pets that the Henry and Lois Foster Hospital for Small Animals cares for each year 12,000 Companion animals that the Foster Hospital was designed to will renovate sections of the Foster Hospital care for when it opened in 1985 and a small portion of the Large Animal Hospital. New elements will include: I Larger, more welcoming reception areas 100 with separate spaces for different species Veterinarians who to help reduce the stress on patients work in the hospital and their families waiting to see their caregivers; 2,300 Students, interns and residents I Additional state-of-the-art exam rooms who have trained in the hospital to accommodate the growing number of over the past 30 years clients who rely on Tufts veterinarians for sophisticated specialty care for their animals; I New, larger treatment rooms for spe- cialty services in ophthalmology, cardi- ology, neurology and dermatology that 16 will reduce client and patient wait times Existing patient exam rooms for such specialized care; and I A reflection room offering hospital 20 clients a quiet, comforting space to Number of exam rooms after 86 the renovation is done carefully consider important decisions Fourth-year veterinary students who do regarding their beloved animals’ care. clinical rotations in the hospital each year

This first phase of the expansion project, 100 in the context of a larger master plan for Students who will rotate through the hospital the university’s Grafton campus, will posi- once renovations are completed tion the Tufts Veterinary Hospitals as the most advanced treatment and education center in the Northeast.

YOUR PARTNERSHIP IS VITAL. IF YOU WOULD LIKE TO SUPPORT THE TUFTS VETERINARY HOSPITALS PROJECT, 0 OR IF YOU ARE INTERESTED IN MAKING A NAMING GIFT Days the hospital will close AS PART OF THE INITIATIVE, PLEASE CONTACT ANA during the renovation ALVARADO, SENIOR DIRECTOR OF DEVELOPMENT AND $8 million ALUMNI RELATIONS AT THE CUMMINGS SCHOOL, AT Cost of renovating and expanding 508.839.7905 OR [email protected]. YOU the Foster Hospital MAY ALSO MAKE A DONATION BY VISITING THE SECURE I $500,000: To name a new feline reception area ONLINE GIVING SITE AT VET.TUFTS.EDU/GIVENOW AND I $50,000: To underwrite a new ophthalmology suite SELECTING THE HENRY AND LOIS FOSTER HOSPITAL I $150,000: To build a new cardiology suite FOR SMALL ANIMALS.

34 tufts veterinary medicine summer 2013 ILLUSTRATION: JON CANNELL Food as Medicine

Veterinary resident studies role of diet in chronic kidney disease by Laura Ferguson

essie markovich often takes to provide the highest quality of life for as change, but if it works, then I have done care of animals in desperate straits. long as we can. Every study is about break- what I could to improve the quality of life Sometimes the diagnosis and ing the problem apart and trying to find for that cat. That’s why I’m here.” Jtreatment are quick: dialysis for what small difference one small change The planned expansion and renovation the dog that ate a box of raisins, or surgery can make. of the Henry and Lois Foster Hospital for for the cat with a kidney stone. “You might try to find foods that are Small Animals will strengthen the capa- But Markovich, a resident in clinical more appealing to a cat and that help slow bilities for Markovich and other Tufts vet- nutrition at the Cummings School, also the progression of kidney disease at the erinarians to develop new treatments to sees pets whose underlying problems are same time. That may not sound like a big improve animal health and well-being. more inscrutable, especially cats, which are masters at hiding illness. Cats, for instance, “usually have three clinical signs that some- “Every study is about breaking the problem thing is wrong: They vomit, stop eating and apart and trying to find what small lose weight,” she says. “They want you to have to work to figure it out.” difference one small change can make.” Already board-certified in internal medicine (she completed her residency in that specialty at Tufts), she is develop- ing treatments for cats and dogs with such illnesses as chronic kidney disease, focus- ing on the relationship between nutrition and health. With faculty who are experts in clinical nutrition and nephrology, the Cummings School, Markovich says, is a perfect fit for her. “I feel spoiled to be here,” she says. “The collaboration is fantastic, and I have access to a wealth of knowledge and experience. I get to learn all the time—from my col- leagues and the students.” To complement her clinical work in the hospital, Markovich also conducts research. She recently completed an online survey of more than 1,000 owners of cats with chronic kidney disease in 48 states and 10 countries. She’ll examine such variables as nutrition and medication to determine if they affect the progression of the disease. The American Association of Feline Practitioners (AAFP) says the number of cats diagnosed with chronic renal disease increased nine-fold between 1980 and 2000. More than 2 million cats in the U.S. have the condition, including 49 percent of Jessie Markovich, a resident in cats over age 15, according to the AAFP. clinical nutrition, is working to ensure a good life for cats with “We don’t know all of the causes of these chronic kidney disease. diseases,” Markovich says, “but our goal is

PHOTO: KELVIN MA summer 2013 tufts veterinary medicine 35 ask the vet ADVICE FOR OUR READERS

Achoo! The Anatomy of a Sneeze

Andrea Lam, a board-certified veterinary dermatologist and assistant clinical professor at the Cummings School, responds to a reader’s question about her sneezing dog.

If my dog sneezes, does it mean she Q: has allergies?

That certainly might be the case. Veterinarians are starting to recognize that A: both sneezing and asthma in dogs can be caused by allergic reactions to pollen, weeds, dust, mold and cigarette smoke. Often, we can successfully treat these dogs with allergy injections. (For more about how veterinarians diagnose, treat and manage allergies, see “Itching to Know,” page 20.) However, sneezing in dogs has many different causes. A fungus, virus or bacterial infection, such as a sinus infection, can be at the root of sneezing. A foreign object as small as a blade of grass stuck in a puppy’s nose can cause it to sneeze. In older dogs, nasal dis- charge or a bloody nose, in addition to sneezing, may be a sign of a nasal tumor. So when your dog is sneezing, it’s best not to as- sume it’s simply seasonal allergies. Always start with PLEASE EMAIL YOUR QUESTIONS FOR “ASK THE a visit to your family vet for a thorough exam to rule out VET” TO GENEVIEVE RAJEWSKI, EDITOR, TUFTS VETERINARY other things first. MEDICINE, AT [email protected].

HOW TO REACH US

Main hospital switchboard and after-hours emergencies 508.839.5395 Website: vet.tufts.edu Henry and Lois Foster Hospital for Small Animals, appointment desk 508.839.5395 Hospital for Large Animals, appointment desk 508.887.4840 If you are interested in learning Tufts Ambulatory Service, Woodstock, Conn. 860.974.2780 more about how you can support the Tufts Veterinary Emergency and Treatment Specialties, Walpole, Mass. 508.668.5454 Cummings School of Veterinary Wildlife Clinic 508.839.7918 Medicine, contact Ana Alvarado, senior Directions to Tufts (ext. 84650) 508.839.5395 director of veterinary development and Cummings School of Veterinary Medicine Administration 508.839.5302 alumni relations, at 508.839.7905, or Veterinary Student Admissions Office 508.839.7920 [email protected]. Veterinary Alumni Relations 508.839.7909 Cummings Veterinary Fund 508.839.7905 Tufts Pet Loss Support Hotline 508.839.7966 Continuing Education 508.887.4723 Public Relations 508.839.7910

36 tufts veterinary medicine summer 2013 ILLUSTRATION: WARD SCHUMAKER “Cummings found a place in our hearts, and in our estate planning.”

Three years ago, Jody Cuzzone and Denise LaPre took Chopper, their miniature dachshund-Yorkie, to their veterinarian after discovering lumps in his neck. He was diagnosed with T-cell lymphoma and his life expectancy was estimated to be four to six weeks. Determined to do whatever they could to help Chopper, they brought him to the Henry and Lois Foster Hospital for Small Animals.

During his 15 months of treatment, the Tufts team became their family. The doctors fondly referred to Chopper as the “King of the Corridor” because he accompanied them on their rounds, cheering up the other patients. When he passed away, their support network at the Foster Hospital—including the receptionist, technicians, and doctors— consoled them with hugs, cards, and letters.

In Chopper’s memory, Jody and Denise support oncology research and clinical studies at For more information Cummings. Jody named the Cummings School the beneficiary of her 401(k) retirement please contact Tufts’ Gift Planning Office: plan, which allows her to make a lasting difference in canine cancer treatment and

888.748.8387 provides tax benefits as well. “Cummings is a wonderful place, where wonderful people giftplanning@ tufts.edu are doing wonderful things for animals,” she says. “We wanted to help; not just one www.tufts.edu/giftplanning time, but through a legacy.” (Above: Jody, left, and Denise, right, live in Springfield with their dog, Forrest.)

www.facebook.com/CharlesTuftsSociety ILLUSTRATION: WARD SCHUMAKER Cummings School of NONPROFIT ORG. Veterinary Medicine U.S. POSTAGE 200 Westboro Road PAID BOSTON, MA North Grafton, ma  PERMIT NO. 1161 vet.tufts.edu

SPIKY, SLIMY AND SMOOTH

Dogs and cats may be America’s most popular pets, but nearly 11 percent of us share our lives with ferrets, parrots, rabbits, turtles and other creatures that require an entirely different kind of veterinary care. Read more and watch a video about how the Cummings School’s zoological companion animal medicine service cares for unusual pets—ranging from a 4-foot python to a palm-size hedgehog—at go.tufts.edu/exotics. T UFTS UNI V E RS I TY O FF I C E OF P UBL I C A T I O N S 8449 06/13