Angel Fund Update 4/2009
We have been using the Angel Fund for several things: clinical research,
cost reduction (for all shunt patients), and extra support for a few shunt
patients that have special needs. Most recently, our special needs
patients included a Yorkie with a shunt that had complications (the bill
exceeded the owner's budget; supplement with the Angel Fund allowed us to
provide life saving treatment instead of Euthanasia), a shunt dog with a
stomach ulcer and pneumonia that needed extra care, and a rescued Golden
retriever with an intrahepatic shunt that needed a CT to confirm the
diagnosis.
Our current research project is on the Protein C test. The previous study
on Protein C (from Cornell) showed that Protein C activity overlaps in dogs
that have a variety of liver conditions. When only comparing shunt dogs and
dogs with MVD (microvascular dysplasia secondary to congenital portal
hypoplasia), then any dog with a value below 70% had a shunt. In our
current study, we are finding more overlap in our groups; in fact, our dogs
with other congenital defects like PDAs (heart defects) had low Protein Cs.
So, we are revisiting the accuracy of the Protein C test, which should be
very helpful to our Yorkie owners. That project is being partially funded
by the Angel Fund and is expected to be completed by the end of the summer.
We've recently published 3 other studies on CT and transplenic scintigraphy
for diagnosing shunts; these projects were also partially funded by the
Angel Fund and 2 of the projects won awards for best clinical research.
Our next project is to review the past 500 shunts and get follow-up. We
have a summer work study student (veterinary student doing a summer
research project) who will be partially funded by the Angel Fund. As with
the other projects, we will publish the results of the retrospecitve study
so that there will be more information for practitioners and owners on
outcomes of surgery.
As noted, the Angel Fund has helped to keep costs low for all animals; my
understanding is that an uncomplicated case at UTCVM costs about half as
much as what is charged in most major cities. The added benefit to us at
UT, and therefore to the owners, is the huge number of patients that we
see, and therefore the extensive experience we have in managing these
animals. We believe that improves our chances for a good outcome after
surgery. In the last 2 weeks we have had people fly (or drive) in from
Texas, Indiana, and California because they think we are the best, and
because we are affordable.
I no longer have a television show. I just finished submitting my first
surgery textbook (due out in October) and will soon begin to edit the
Textbook of Small Animal Surgery. Because of all the wonderful clinical
"case material" - especially our Yorkie patients- I've been able to publish
over 50 articles- most commonly on shunts- and have been given the honor of
this editorship because of my expertise. The research, writing, and
surgery clinics (about 22 weeks a year on surgery) have limited my ability
to do continuing education talks for the public and I no longer do online
shunt consults for private individuals, although I still answer questions
forwarded to my by officers of YAP and YTNR. Those are the main areas that
has been affected by my busy schedule.
I'm really looking forward to Dr. Center's genetic testing- I hope this
will revolutionize our breeding programs. With luck, I will be out of a job
(at least as far as Yorkie shunts are concerned), so it's a good thing I'm
diversifying my career objectives!
You're welcome to post any of this information or use it to answer
questions.
Karen Tobias DVM MS ACVS
University of Tennessee
Department of Small Animal Clinical Sciences
P.O. Box 1071
Knoxville TN 37901-1071
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