When you're sick as a dog...

Israel's only veterinary teaching hospital treats many of the same diseases as hospitals for humans do.

By
May 27, 2007 01:03
When you're sick as a dog...

dog 88. (photo credit: )

 
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When Dr. Gillian Denk called the organizers of a meeting of oncologists for an invitation, she was asked who she was. When she identified herself as a specialist in animal cancer - one of only two in Israel - the organizers laughed and said she wasn't qualified to attend. Only after explaining that she treats the same types of cancer as they do in humans and uses the same treatments of surgery, chemotherapy and radiation was she invited. Human and animal medicine are not very different, even though most patients at The Hebrew University Veterinary Teaching Hospital at Beit Dagan, where Denk works, have four legs. Medical expertise is often derived from work on animals, while veterinarians also learn a great deal from clinical experience in humans. It is also quite common for dogs and cats to get lung cancer as a result of passive smoking. Overexposure to the sun, especially in dogs with little fur, presents a risk of skin cancer, and obese dogs can develop the same chronic diseases - such as heart problems and diabetes - as humans. One in four dogs and half of all those over age 10 will get some kind of cancer, according to Denk. She is often asked why she doesn't just put such dogs down. But the aim of treating cancer in pets is different than in humans, Denk explains. It is not for extending life at all costs. "If the animal is given a good quality of life, is happy, able to eat and drink, eliminate and play, why not treat them, even if we can't cure them? One young man who owns a big black eight-year-old dog named Belle noticed she had swollen glands and took her to Denk. The beloved pet was diagnosed with lymphoma and given expensive chemotherapy - at the owner's expense - for nine months. Now in remission, Belle functions well and lives at home. Another of Denk's patients is a seven-year-old Labrador who could hardly eat due to an esophageal tumor caused by a worm. Ever since his successful surgery, he goes to the veterinary oncologist for a checkup every three months and is fine. TODAY, veterinary medicine is "no longer Dr. Doolittle. It is a scientific profession," says Prof. Hylton Bark, the South African-born director of the hospital, which has functioned on a large campus at the edge of Rishon Lezion since it was founded in 1989. Bark inevitably gets a lot of teasing about his last name, and is asked whether he became a vet because of it or doggedly changed it when he earned his diploma. He says it was changed by an immigration official when his family arrived in South Africa. The institution is the only round-the-clock veterinary hospital in Israel, and among the best in the world, with staff coming from the nearby Koret School of Veterinary Medicine of The Hebrew University, which is headed by Prof. Gadi Glaser, a physician and former dean of the HU medical faculty in Jerusalem. The veterinary hospital functions as a non-profit organization that receives NIS 5 million in support annually from HU, and money for development from generous donors, mostly from abroad. It caters to thousands of animals - the vast majority of them pets - 365 days a year. Fully 55 percent of the patients are dogs, 26% cats, 11% horses and 7% "exotic animals" ranging from iguanas, snakes and rabbits to wild birds, monkeys and turtles. During a recent press tour of the hospital, Dr. Adi Gantz - a veterinarian responsible for the treatment of exotic animals who always wears shirts printed with a variety of creatures - had to postpone his lecture to rush to the emergency room and "treat a sick chinchilla." Gantz reported later that a bird of prey whose species is in danger of extinction had two chicks on the Golan Heights. Observed by webcam, the bird suddenly began behaving very strangely, and one of the chicks died. The mother was brought in, leaving the father to feed the remaining chick. Gantz performed blood tests and bacterial cultures, put an endoscope down her throat and found a large mass inside. Apparently, he explained, she had eaten a bone that scratched the inside of her esophagus and caused a granuloma that had to be removed in surgery. Before too long, she was well enough to be returned to the nest. ALTHOUGH THERE are a handful of private veterinary hospitals, they do not have emergency rooms, intensive care or receive patients round the clock. They also don't have the experts in cardiology, oncology, ophthalmology, internal medicine and other specialities like the Beit Dagan institution. Dr. Danny Ohad, a specialist in cardiology, performs Echo Doppler scans, catheterization, valve surgery and angioplasty on dogs, and the hospital has even done four canine heart transplants. After treatment, some dogs are put through rehabilitation - including runs on treadmills - by Dr. Lisi Sharon. There is even a "behavioral unit" that treats dogs that constantly bark, bite or refuse to be housebroken; while there is no "dog psychiatrist" who lays pets down on a couch to discuss their puppyhoods, training can improve behavior. There's a dog blood bank, but it still lacks a radiology institute (a donor for such a facility is being sought.) Sometimes animals are brought to (human) hospitals late at night for treatment. Glaser noted that teaching veterinary students costs twice as much as training physicians, but Koret enrollees pay the same as other students. As a result, the Council for Higher Education's powerful planning and budgeting committee allows Koret to produce only 40 graduates a year, even though the program could add about 20 more without expanding facilities. "If we were allowed to accept 60 students a year, it would help us financially, but we have not been allowed to do so," he added. This is unfortunate, as each year some 80 Israelis who go abroad (mostly to Eastern Europe) to study veterinary sciences and then come back home to work. Today, there are 1,200 working vets in Israel - most of them graduates from foreign schools. VETERINARY STUDENTS study for seven years, three in a variety of life sciences and another four in theoretical and practical studies in veterinary science. Unlike physicians, they are qualified upon graduation to set up their own practices or work elsewhere as vets, without serving as "residents." But if they want to go into a specialty, they must study for at least another four years. The Koret School was aimed at training a new generation of veterinarians for agriculture, meat and poultry slaughterhouse supervision, research, public health services and, of course, for treating pets. Eighty percent of the veterinary students are women. The school also offers continuing education for working Israeli and new immigrant vets. After a year of functioning, the veterinary hospital became a non-profit organization generously subsidized by HU, without which it couldn't function. It's required to have a balanced budget (now NIS 17 million a year), so it can't give free treatment. If you bring a wounded wild animal - even a baby bird that fell from a tree - to the emergency room, you will be asked to pay NIS 100 towards expenses. Glaser noted that with the expected launch of horseracing in the Jezreel Valley next year, the number of horses in the country has grown to the current 25,000 head, and the hospital will supply veterinary services to these very expensive animals. It has already opened a center for horse fertility. Dr. Amir Steinman, who treats large animals, including horses, said Israel's rising standard of living is responsible for the growth in the number of horses being purchased for recreation. Local ones can be had for $1,500, but rare Arabian-Egyptian thoroughbreds can cost millions. His unit obtains frozen horse semen from abroad, at some $7,000 a dose, for impregnating local horses. "We also implant embryos in surrogate mothers, as some mares can get pregnant but can't carry the pregnancies to term. We treat horses with uterine problems, and keep some males solely for breeding. One of the stables is the home of Mukhtar, a thoroughbred who was injured and now has changed his 'profession' to a provider of high-quality semen. Tonga, one of the country's best racehorses, gave birth and suffered damage to her genitals three years ago; she underwent surgery and got pregnant after insemination a month ago. Veterinarians in the unit perform rectal ultrasound scans - inserting their arms encased in long cellophane gloves - to determine whether mares are ready to be impregnated. "In the future," predicted Steinman, "there will be hormone treatments and in-vitro fertilization of horses, as well." HEIDI ROTHBERG, daughter of noted HU benefactor Sam Rothberg, donated money for an intensive care unit for horses. If foals are born with sepsis and don't nurse, they lack antibodies, as these come only from mother's milk. "We treat them here," said Steinman. A few weeks ago, a horse only a few hours old was brought in with paralysis in one leg. He couldn't stand and nurse. Thanks to physiotherapy and other treatment, pressure on a nerve and inflammation were relieved, and he recovered rapidly. "In the Wild West, it was said that you have to shoot a horse with a bad leg. Today, it isn't true; in most cases, we can cure them. We do orthopedic surgery with screws, as with humans," Steinman said. Although the Arab world puts a premium on horses, most Arab countries don't have veterinary facilities like those in Israel, so they still sometimes send horses here for treatment. "There is some cooperation with Palestinians in east Jerusalem, and we have an Arab veterinarian here part time. But unfortunately, since the intifada there hasn't been much business with Arab countries," he continued. "We may be able to do it in a neutral country like Cyprus or Turkey." Dr. Eran Lavi of the Koret School presented his research on slow-release drugs developed with animals that eventually will be used to relieve human suffering. "Conventional drugs," he said, "have ups and downs. Sometimes they can reach toxic levels. But slow release makes the concentrations in the body more stable. We need to keep the drug in the stomach as long as possible to be most effective, as many drugs are not absorbed by the intestines." Lavi's team developed a delivery system made of a hollow polymer in folded form, with a drug reservoir that swells and unfolds to release the drug steadily over a long period in the stomach. One potential commercial use is for levadopa, the drug used to treat Parkinson's disease, and which is best kept in the stomach for six hours. Thus, for those who regard animal hospitals as a waste of money when many people don't receive adequate care, the HU Veterinary Teaching Hospital and the Koret School of Veterinary Medicine are good for everyone, whether they walk on four legs or two.

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