Oath
The
TEACH • HEAL • DISCOVER
FALL/WINTER 2017
Making an Impact page 2
A New Approach to Treating Colic page 3
Incredible Journeys page 11
For the Love of Horses page 14
Radiating Hope Helping Pets Fight Cancer page 5
FROM THE DEAN
Strength in Diversity Having a new class start their DVM program each August is always exciting and gives everyone a lift as the semester begins. The Class of 2021 is certainly no exception. They have already demonstrated their character and they are nothing if not enthusiastic. They seem to approve of our house system. They certainly approve of the house shirts and, according to our canteen staff, they can eat! Sales shot up in the newly renovated dining hall, which is often full over the noon hour. The new class is also from a broad range of backgrounds. Out of the class of 100, we recruited 39 graduates from the Department of Animal Sciences at NC State’s College of Agriculture and Life Sciences. We have two students with doctorates, six with a military background (including a 21-year veteran of the Marines), teachers, nurses, beekeepers and a winemaker. In addition to the 80 in-state students, we have students from 16 other states and one from Puerto Rico. The Class of 2021 brings another kind of diversity, as they make a huge contribution to the number of under-represented minorities in our student population. Veterinarians need to be everywhere and to work with everyone... To continue reading, visit: cvm.ncsu.edu/fromthedean
D. Paul Lunn Dean, College of Veterinary Medicine NC State University
1
THINK & DO
Extraordinary Leadership Harrison Dudley, clinical assistant professor of ruminant health management, was named the 2017 Young Veterinarian of the Year by the North Carolina Veterinary Medical Association. A 2012 CVM graduate, Dudley returned to the college to teach in 2014. Duncan Lascelles, professor of small animal surgery and pain management, was the recipient of the 2017 American Veterinary Medical Association/Winn Feline Foundation Research Award. The annual award recognizes outstanding contributions to the advancement of feline health and welfare through research. Lascelles is an international leader in pain research and chronic pain management. “Dr. Lascelles is a gifted and dedicated veterinary surgeon, mentor and leader, said Tom Meyer, AVMA president. “His research has been instrumental in advancing the entirety of feline health care in veterinary medicine.”
Top-bottom: Harrison Dudley, Duncan
Lascelles, Thierry Olivry. John Barnes, poultry health management professor, has been inducted into the American Association of Avian Pathologists hall of honor. Barnes has been an influential teacher and researcher at the CVM since arriving in 1982 to help establish the school’s poultry medicine program. “To be appreciated and asked to join the icons of the poultry industry who are in the AAAP hall of honor was humbling, but at the same time a great honor,” he said. Bruce Hammerberg, immunology professor, and Thierry Olivry, immunodermatology professor, were among the NC State researchers awarded a grant from the Chancellor’s Innovation Fund. The grant, designed to help support university projects addressing global challenges that have promising commercial potential, will allow the pair’s project, an innovative therapy for dogs suffering from chronic allergies, to enter a clinical trial. The project launched with a CIF grant in 2013.
IN THE SPOTLIGHT
Making an Impact Emily Martin is talking about white blood cells and in this moment it’s the most exciting thing you’ve ever heard.
Ranch Scholarship from the American Association of Equine Practitioners.
She lights up when describing how they move and the intricate pathways through which they interact with each other, how they defend the body against bacteria but can also cause a slew of inflammatory diseases.
The award, given to just four veterinary students across the country this year, recognizes those with great promise as leaders in the future of performance horse medicine.
“It’s such an intricate design,” she explains. “These cells are their own entities. They’re like little people in your body doing battle for you.” Martin soon shifts to describing their effect on cells that line the gut of horses and exploring therapeutic options to target inflammation in horses.
“My hope is that I will make an impact on performance horses from all disciplines, as well as the future students of equine sports medicine, by blending clinical medicine, research and training,” Martin told the AAEP in the scholarship announcement.
“My hope is that I will make an impact on performance horses from all disciplines, as well as the future of equine sports medicine, by blending clinical medicine, research and training.” ~ Emily Martin
“So I’m really, really interested in the immune system. It’s fascinating,” she says definitively. It’s that curious spirit that has guided Martin through the rigorous dual DVM/Ph.D. program at the CVM that demanded an unbreakable work ethic and Martin’s flexibility to shift between lecture halls, sterile labs and dusty barns. And it’s that devotion to veterinary medicine that has just earned Martin, of the Class of 2018, a $75,000 Coyote Rock
Her graduation comes at a particularly exciting time for the CVM’s equine service. A proposed $37.9 million expansion and renovation of equine health services is part of NC State’s Think and Do the Extraordinary fundraising campaign.
The expansion includes elements particularly exciting to Martin: a new sports medicine facility, a revamped orthopedics service, upgraded intensive care facilities and cutting-edge imaging services. “The equine program is just a great environment, and it’s a great place to be mentored,” said Martin, who earned her Ph.D. in 2016. “You get help to achieve any goal you want to achieve.” ~ Jordan Bartel/NC State Veterinary Medicine
2
GROUNDBREAKING RESEARCH
A New Approach to Treating Colic They’re called “mini guts,” and they are a leap forward in the study and prevention of devastating intestinal diseases in horses.
Researchers at the NC State College of Veterinary Medicine have successfully isolated and recreated the innermost layer of a horse’s intestine using stem cells. All the intricate nooks and crannies of intestinal cells can be seen in the 3-D structures, a true out-of-the-body representation of what’s going on deep inside the intestine of an animal.
It is the most complex, complete 3-D replication of equine intestinal cells created to date. The work will allow equine researchers to better understand the precise mechanisms behind tissue damage and also find the most effective ways to treat gastrointestinal diseases such as colic, the leading cause of death for horses between the ages of 1 and 20. The mini guts, or enteroids, could also one day lead to effective therapies for the estimated 60-70 million Americans a year who suffer from a range of intestinal disorders — all by mastering the regenerative capabilities of intestinal stem cells. The first author of the study, published by the Equine Veterinary Journal, is Amy Stieler Stewart, a current Ph.D candidate in the lab of Liara Gonzalez, CVM assistant professor of gastroenterology and equine surgery. Gonzalez is the corresponding author on the study, with research specialist John Freund as co-author. “This opens up so many opportunities with regard to potential treatment options,” said Gonzalez. “We’re now only limited by our imagination. 3
During her Ph.D. studies at the CVM, Gonzalez was the first to develop a large animal porcine model for the study of intestinal stem cells for translational gastroenterological research. The new equine intestinal study uses similar techniques Gonzalez developed a few years earlier when working with pig stem cells.
Tissue layers, called crypts, rich in intestinal stem cells, were isolated and successfully nurtured in a dish. That resulted in complex budding structures of detectable stem cells and all of the cell types that exist in the innermost layer of a horse’s intestinal tissue, or epithelium. Another breakthrough from the research: The team was able to freeze the crypts, store them for multiple days and then thaw out still-viable stem cells. Potentially, that can lead to a bank of intestinal stem cells, a reserve of treatment solutions targeting specific injuries. “If we are able to come up with a new therapy or a new treatment, we would just have to go to the freezer,” said Gonzalez. The work is just beginning. The freezer-storage element of the research will be the subject of the team’s newest study. Next is exploring clinical applications. The crypts can be used to test epithelial resistance to different types of injuries, providing an up-close view of how cells talk to each other, change and move.
IN THE FIELD OF EQUINE HEALTH, THE CVM IS DEDICATED TO USING STEM CELL RESEARCH AS A DIRECT PATH TOWARD IMPROVING HUMAN HEALTH.
“This is big picture. This is new. We’re introducing a new approach to treating colic that hasn’t been used before.” Using mini guts, researchers may find a drug that stimulates the epithelium, making it regenerate faster and more effectively, said Gonzalez. Through funding from Kemin, an animal and human nutritional health ingredient company, the team will study the impact of hypoxic injury, or loss of oxygen, on the intestinal stem cells. Gonzalez’s original research with pig intestinal stem cells was funded by the National Institutes of Health. Though intestinal stem cell research is relatively new compared to orthopedic-related mesenchymal stem cell work, NC State is at the forefront of the field. Though veterinarians have improved surgical interventions, there have not been any new, major breakthroughs in treating colic for years, said Gonzalez. “We have the potential to make a broader impact on the veterinary community and to really help more horses and more clients,” she said. “Helping an individual client and horse is very fulfilling to me. But if I can have a broader impact. That’s what really inspires me and keeps me up thinking at night.” ~ Jordan Bartel/NC State Veterinary Medicine
4
EXTRAORDINARY CARE
Radiating Hope Petco Foundation Grant Advances Battle Against Companion Animal Cancer Dexter
Just like their human friends, pets develop cancer. Often, the cost of extensive treatments necessary to combat cancer is prohibitive for pet owners, resulting in shortened lives and lost bonds. It also means losing clinical experiences beneficial to veterinary medicine through learning more about the most effective treatments for different cases. 5
The Petco Foundation defrays the cost of treating rare cancers in animals and helps medical professionals research innovative and effective therapies for conditions that are not often seen or treated. The grant is paying dividends for pets, owners and clinicians. Here are three of their stories.
Dexter Sean New is a busy young man with a job that keeps him hopping, a fiance named Hira and a lively adopted Jack
happened to come across a pet adoption event. There were two dogs in crates, one large dog and one small dog. As I approached them, I saw the small Jack Russell terrier with a Post-it note on it reading, ‘Dexter 1 yr old.’ I never thought about a Jack Russell, but what I knew about them was that they were small dogs with big dog personalities. I took him for a short walk, loved him and adopted him that day.” The three became fast friends. In time, however, Dexter began having nosebleeds and developed swelling behind his right eye. A CT scan revealed a tumor and a biopsy determined that it was cancerous. The case was referred to the NC State Veterinary Hospital for treatment. Mike Nolan, assistant professor of radiation oncology and biology at the NC State College of Veterinary Medicine, and head of the radiation oncology service at the hospital, found that Dexter had an advanced stage nasal tumor. With stereotactic radiation therapy, Dexter’s life expectancy could be improved and his quality of life maintained. Without it, the outlook was grim.
ONE IN FOUR DOGS AND ONE IN FIVE CATS WILL DEVELOP CANCER IN THEIR LIFETIME. NEARLY 50 PERCENT OF DOGS AND CATS OVER THE AGE OF 10 WILL DEVELOP SOME TYPE OF CANCER.
Russell terrier named Dexter who graces the cover of this issue. As New tells it, when he and Hira talked about getting a dog, they had different ideas about what they wanted, so they ended up compromising. But New held out for one thing. As a big fan of the television show “Dexter,” that was the name he wanted.
Such treatment can be a burden on the budget of a young family. With assistance from the Petco foundation grant, Dexter has access to advanced treatment at NC State and he and his new family will have more time to enjoy one another.
Bernice
Bernice is a 12-year-old domestic shorthair cat who, along with her owners Alissa Hendershot and Justin Carrasco, hails from Durham by way of Kalamazoo, Mich. Bernice was adopted at the age of 4 and, with her affectionate way and love of attention, took to her new family and even strangers right away. But Bernice was on her way to becoming something of a medical puzzle. During a routine visit to her local vet last July, a blood test revealed that Bernice had slightly elevated globulin levels. Nothing too alarming, but abnormal. A follow-up test was scheduled for three months later.
What happened next seemed almost predestined.
Bernice’s globulin level remained elevated and she experienced persistent weight loss. With the likely possibility of a more serious condition, she was referred to the internal medicine service at the NC State Veterinary Hospital in April.
“It was about a week before Christmas,” he recalls, “and I
A series of diagnostic tests were performed to determine 6
if Bernice may have an infectious disease. Samples of cells from her liver and spleen were drawn, but results were not definitive. But the tests did reveal what oncology resident Rhiannon Doka termed as rare atypical round cells. In this scenario, the most common cancers causing elevated globulins are lymphoma or plasma cell tumors. Both are cancers of lymphocytes, a type of white blood cell. In lymphoma, the cancerous cell is a less mature lymphocyte then plasma cell tumors.
“Once results confirmed myeloma, we knew there would be challenges in deciding on her best treatment plan since we don’t know a lot about this disease in cats. We’ve tailored a chemotherapy protocol for her that is working well.” ~ Joanne Intile, clinical assistant professor of medical oncology Differentiating between the two diseases requires advanced diagnostic tests beyond those routinely available at primary veterinary offices. As a result, Bernice was referred to the hospital’s oncology service. Further tests determined that her results were most consistent with plasma cell neoplasia. Bernice began chemotherapy sessions with Doka. Bernice’s condition is quite rare in cats. Hendershot and Carrasco were told that the NC State medical team encounters it three or four times a year. Fortunately, given the rarity of Bernice’s diagnosis, it was a perfect fit for a Petco Foundation grant. So far, Bernice is responding very well to treatment. Her symptoms have subsided and she is in remission. Prospects are good for a better and 7
Bernice
longer life. “We’re happy to have as much time as we can get with Bernice,” Carrasco says, “and we are extremely grateful that this program exists.”
Lucky What do you name a dog who survives more close calls and narrow escapes than a superhero? Lucky is an 8-year-old golden retriever belonging to Carl Jewett of Nashville, N.C. And his close shaves date back to puppyhood, when he was in the Ashe County dog pound. (Even superheroes get captured sometimes!) Just one day before he was due to be put down, he was adopted by Jewett. Lucky, indeed! Life in Lucky’s world was good until last December, when he developed lameness in his right hind leg. By early January, he had a noticeable mass over his knee. Initial examinations by private veterinarians indicated a possible osteosarcoma, or
“Because of the rarity of Lucky’s diagnosis, our ability to learn from his care and treatment is invaluable. We’re able to show students his X-rays and teach them about primary bone lymphoma, a disease process they may never have heard about.” ~ Joanne Intile bone cancer. In February, Lucky was evaluated for amputation, frequently a part of osteosarcoma treatment. That’s when another stroke of luck came into play. Amputation turned out not to be necessary. Lucky was referred to the NC State College of Veterinary Medicine for enrollment in a clinical trial involving chemotherapy drugs. Once he was at NC State, the first step, a routine one, was taking a tissue sample by aspirating the bone mass on Lucky’s knee and performing a diagnostic evaluation on the cells. The result was anything but routine. Lucky did not have an osteosarcoma, so the clinical trial no longer made sense. Lucky actually had an extremely rare large-cell lymphoma of the bone, osseous lymphoma. The case was referred to NC State’s medical oncology service, where medical oncology resident Carly Stevens and clinical assistant professor of medical oncology Joanne Intile took responsibility for Lucky’s care. “Lymphoma primarily affecting bone is an uncommon diagnosis in dogs and only 12 cases have been described
Lucky
in the literature to the best of my knowledge,” Stevens says. “Of these cases, only four may be classified as primary lymphoma of bone. Of the patients with only bone involvement, just one dog had lymphoma limited
to a single bone.” Not only was Lucky’s form of cancer rare, but the fact that it had not spread beyond its original site was extremely fortunate. But the good news didn’t end there. Because of his rare condition, Lucky qualified to have his care subsidized through the grant from the Petco Foundation. When Lucky’s response to treatment was evaluated at the end of June, the news was all positive. The exam findings and tests were consistent with complete remission, Stevens says. “I’m grateful to get to follow Lucky’s case and see him doing so well. He’s also a real ham, so continued visits here are a real bonus for the whole service. Lucky always makes the day better,” she says. ~ Steve Volstad/NC State Veterinary Medicine 8
Welcome Class of 2021 The 100 members the Class of 2021 bring an array of backgrounds and interests to the CVM. But the tie that binds them is an unwavering devotion and passion for animal health. They are future orthopedic surgeons and anatomy teachers, cancer researchers and equine specialists. Thanks to them, the future of veterinary medicine is even brighter.
6 students have a military background
9
1 student has experience as a winemaker
39 students majored in animal science 3 students are NC State Goodnight Scholars
11 students have earned additional degrees: 9 have a master’s and 2 have a Ph.D.
10
EXTRAORDINARY EXPERIENCE
Cowabunga’s Incredible Journeys Harrison Dudley knew he wanted to practice large animal medicine, but he also knew he lacked something very important: hands-on experience.
11
So during his first year at the NC State College of Veterinary Medicine, Dudley used his winter break to take part in the Bovine Educational Symposium, a weeklong immersive experience designed to expose veterinary students to different types of cattle production farms and approaches to animal care. He’s now CVM’s clinical assistant professor of ruminant health management.
“I remember what we talked about because of the technique. It’s a different type of learning. It’s observational learning. It’s inreal-time learning.” ~ Kate Bailey, 2009 CVM graduate and clinical assistant professor of anesthesiology a disease that they just learned about,” said Derek Foster, CVM assistant professor of ruminant health and production, who co-authored the study.
The Bovine Educational Symposium, more popularly — and affectionately — known as Cowabunga, would shape much of Dudley’s educational experience at the CVM and influence his teaching style.
The study, published by the Journal of Veterinary Medical Education, was completed through pre- and post-trip surveys of more than 100 CVM students who attended the Bovine Educational Symposium over three years, as well as an alumni group discussion.
“My first trip was an eye-opening experience,” said Dudley. “What I didn’t realize at the time was how much those experiences would stick with me … and how they would shape my decisions on case management, ethical standards and even applied techniques.”
Through the decades, students have crisscrossed the United States, from the feedlots of the Great Plains to the organic dairies of the Northeast. Students have toured Amish and Mennonite farms, grazing pastures of the South and drylot dairies of the Southwest.
A new study evaluating Cowabunga’s effectiveness as a teaching tool shows an impact lasting beyond graduation, from learning the nitty-gritty daily life of the cattle industry to finetuning effective client communication.
Kate Bailey, a 2009 CVM graduate and now a clinical assistant professor of anesthesiology at the college, went on a Cowabunga trip as a student, visiting farms in Florida. She had never seen a dairy farm.
Study participants said they have a more complete understanding of bovine production systems and they would be able to apply knowledge gained about biosecurity and herd health to real-world situations.
“That was more than 10 years ago and I still remember the farms,” said Bailey. “I remember what we talked about because of the technique. It’s a different type of learning. It’s observational learning. It’s in-real-time learning.”
“Some of the concepts that students have learned in class can become much more real when they see a farm struggling with
~ Jordan Bartel/NC State Veterinary Medicine
12
EXTRAORDINARY OPPORTUNITY
Expanding Focus on Equine Health
There are plans for a major expansion of equine health services at the NC State College of Veterinary Medicine and Veterinary Hospital. Taking full advantage of the progress of veterinary medicine today, however, requires increasing the size and scope of the current equine hospital. The proposed expansion and renovation of equine health services – part of the university’s broader Think and Do the Extraordinary fundraising campaign to raise $1.6 billion in private support by the end of 2021 – calls for a $37.9 million investment while setting a new standard for equine and farm animal health. The timing coincides with growing incidences of sports-related equine injuries in recent years, as more people become interested in sport horses. This program will treat performancerelated diseases in Olympic, dressage and pleasure-riding horses, as well as endow professorships, fund equipment purchases, facilities and renovations of others. “This is a big project, but we can do it and we must. The impact on our equine and our farm animal programs will be tremendous,” said D. Paul Lunn, dean of the College of Veterinary Medicine. “This will give us an entirely new equine hospital and a new farm animal hospital that will be the match of any facilities anywhere. It will be a welcoming place to bring your horse, and it will give our clinicians, staff and students the space they need to be the best.” The overall expansion plan calls for a phased approach, to 13
continue providing services while the renovations and new construction takes place. The four phases envisioned are: •
Renovation and/or construction of the new sports medicine facilities, an arena, lobby and administrative offices, orthopedics and ophthalmology services, and a ruminant health and field services addition.
•
Construction of new animal holding stalls, nuclear medicine and other imaging services.
•
Renovation and upgrade of equine intensive care and soft tissue treatment facilities.
•
Renovation of emergency treatment and surgical care facilities, along with additional office and administrative spaces, and additional equine holding stalls.
NC State’s aggressive plans aim high and represent a major commitment to state-of-the-art veterinary medical services and facilities for the equine community in the 21st century. For more about the NC State College of Veterinary Medicine’s equine program, visit cvm.ncsu.edu/efavc.
SUPPORTING CARE
For the Love of Horses Life with horses inevitably means occasional medical concerns, just as it is with humans and other animals. As a proud NC State alumnus with full awareness of the worldclass reputation of the College of Veterinary Medicine, Bill Thompson looked to the CVM when his horses needed expert care.
It all started with a horse named Cactus Wimpy for Bill Thompson Jr. of Willow Spring, N. C. Cactus Wimpy was Bill’s horse growing up in the farming community of Aurora, N.C., just off the Pamlico River in Beaufort County. Hours of boyhood fun in the saddle matured into a collection of warm memories and a love of horses that developed and grew as the boy became a man. That young man followed his father, William B. “Billy” Thompson Sr., a 1949 graduate, to the College of Engineering at NC State University, where he graduated in 1978 with a degree in chemical engineering before earning an MBA from the University of Virginia. A successful career followed, and Bill’s love of horses carried into his adult life in a number of ways, including the breeding of thoroughbred racehorses, as well as keeping a stable on his farm in rural Wake County. The horses are like part of his family, he says. “We’ve seen Dr. [Rich] Redding a number of times for the removal of bone chips,” he says, “and we’ve had colic cases treated there several times — all successfully.” As a way to show his gratitude and to support the work of the College — and as a way to pay tribute to the horses that have meant so much to the Thompsons — Bill has made a number of donations to the Gallop of Honor program. A gift to the Gallop of Honor means a commemorative horseshoe mounted on a personalized plaque will be displayed on the Gallop of Honor wall in the CVM’s Large Animal Hospital or the Equine Health Center at Southern Pines.
As an outgrowth of his relationship with the CVM, four years ago, Bill joined the board of directors of the North Carolina Veterinary Medical Foundation. Established in 1978 to attract funding for the College’s teaching, learning, research and extension in the field of veterinary medicine, the Foundation operates exclusively for educational and scientific purposes. Bill says that serving on the board “has given me much more insight into the College’s operations and its initiatives for the future.” The Thompson Family is a dedicated part of Wolfpack Nation, so in addition to the Gallop of Honor they have generously supported the College of Engineering and, in 2015, both Bill Thompson and his father Billy, and their wives, Brigid and Jackie, endowed scholarships for students at the College of Veterinary Medicine. The first two were awarded during the 2016-17 academic year to students Jennifer Patterson and Jennifer Stiles. Support from people like the Thompsons is critically important as NC State pursues its ambitious $1.6 billion Think and Do the Extraordinary fundraising campaign — a goal that includes plans to dramatically upgrade and expand equine care facilities at the CVM. ~Steve Volstad/NC State Veterinary Medicine
14
NC State Veterinary Medicine NC Veterinary Medical Foundation 1060 William Moore Drive • Raleigh, NC 27607 Give Now: Use the giving envelope enclosed, (checks payable to “NCVMF”), or give online at cvm.ncsu.edu/giving. Contact Us: Giving Office: 919-513-6660 cvmfoundations@ncsu.edu The Oath is published by the NC State Veterinary Medicine Communications and Marketing office. Contact us at CVMCommunications@ncsu.edu
Think and Do CVM DENTISTS HELPED FIX AN INJURED TURTLE WITH ELASTIC AND BUTTONS THAT ARE USED IN HUMAN DENTISTRY, A SOLUTION LIKELY NOT USED BEFORE. THE TURTLE IS RECOVERING ON CAMPUS BEFORE BEING RELEASED INTO THE WILD.