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Small Animal Internal Medicine
NEWS - August 2011

The MSU-CVM Small Animal Internal Medicine clinical service continues to grow and evolve.  With the recent addition of Dr. John Thomason (Virginia-Maryland, Class of 2006) to our faculty following the completion of his Medicine residency here, our service now has five faculty members providing specialist-level clinical service to the local veterinary community.  In addition to Dr. Thomason, Drs. Andrew Mackin, Kari Lunsford, Patty Lathan and Todd Archer are regularly scheduled on clinical duty to meet local referral needs.  Over the past year, the Medicine service has invested heavily in a number of new flexible endoscopes of varying diameters that have significantly increased the range of scoping procedures that can be performed in dogs and cats of all sizes, as well as a new image capture system that allows us to rapidly and conveniently store images from our procedures.  Dr. Archer also recently received additional training, provided by Infiniti Medical, in interventional radiology procedures.  The expanded range of procedures that are now routinely offered to veterinarians by the Medicine service include tracheal stenting, urethral stenting, and ureteral stenting.

The growth in faculty numbers within our service has not only served to broaden the range of clinical expertise offered by MSU, it has also provided the critical mass needed to develop a sustained research focus.  The Medicine group has in the past two years has taken on shared responsibility for four PhD students, all of whom are associated with the CVM’s innovative DVM/PhD program, where typically incoming students spend two years working on their PhD course work and research before entering the DVM professional program.  Over the course of their DVM program, DVM/PhD students continue working on their research, and usually complete their PhD within a year of graduating as veterinarians.  The DVM/PhD program is particularly suited to the type of clinically-related research projects developed by the Medicine group.  The research impetus provided by our expanding PhD program builds on the work associated with the Masters programs undertaken by our Medicine residents.

American College of Veterinary Internal Medicine:

Congratulations to Drs. Thomason and Archer, current Medicine faculty members, and to Dr. Kirstin Johnson, MSU-CVM Small Animal Medicine Resident 2006-2009 (currently in specialty practice at BrightHeart Veterinary Referral Center in New York), who all recently attained Diplomate status with the American College of Veterinary Internal Medicine (Small Animal Internal Medicine subspecialty). The MSU-CVM Small Animal Internal Medicine group was particularly well-represented at the ACVIM Forum in Denver, Colorado this year: Drs. Lathan, Lunsford and Mackin were all invited speakers on the main program, Dr. Archer was invited to present an update on his ACVIM Foundation-funded cyclosporine research, and Drs. Christine Bryan (senior Medicine resident), Claire Fellman (current small animal intern) and Ali Dudley (small animal intern 2010-2011) presented research abstracts.  Both Drs. Mackin and Lathan are currently serving the ACVIM as members of the specialty’s new examination rating committees.

Faculty Updates:

Dr. Patty Lathan, Assistant Professor, has been invited to speak in Florida, Colorado, South Carolina, and Virginia this year. She has also become an active member of the Veterinary Information Network by presenting two different online courses to veterinarians from around the world, along with Drs. Archer and Bryan.  Dr. Lathan was recently elected to serve as secretary/treasurer of the Society of Comparative Endocrinology, the only world-wide organization of veterinary endocrinologists.  Dr. Lathan’s area of active research is the quest for a longer-acting insulin for use in diabetic cats. The incidence of diabetes is increasing in cats just as it is in people, and these cats typically require insulin injections twice daily. Cats and their caretakers would, of course, prefer that these injections were less frequent. Drs. Lathan and Bryan are currently collaborating with researchers at the University of Tennessee College of Pharmacy to develop an insulin gel that can be given to cats once a week. As part of this project, they have validated an insulin assay that will selectively measure insulin given to a cat without interference from the cat’s own insulin. This research was presented at the 2011 ACVIM Forum.

Dr. Kari Lunsford, Assistant Professor and Program Coordinator for the newly formed Translational Biomedical Research center, is working with researchers in all three CVM departments, other MSU Colleges and academic institutions and industry both nationally and internationally to develop a core program of comparative and translational medicine that benefits both human and animal health. Current projects include collaborations with Drs. Archer, Mackin and Fellman exploring new drugs that may be valuable for the treatment of immune diseases and transplant medicine in both animals and people, and working with Drs. Lathan and Bryan exploring new ways of drug delivery that may make the treatment of diabetes easier in both dogs and cats. Dr. Lunsford is developing relationships with industry and pharmacologists at the University of Tennessee School of Health Sciences to explore other improvements in the way we provide medications for small animal patients. In addition, Dr. Lunsford is working with Dr. Thomason and Dr. Camilo Bulla on several collaborative efforts exploring the role of the platelet in health and disease, and has established within the past year the Comparative Platelet Research Laboratory, which is one of the only laboratories in the world able to provide a comprehensive evaluation of platelet function in both animals and people. Two PhD students working in this laboratory, Sandra Curotto and Shauna Trichler, have commenced projects evaluating novel approaches to understanding the role of the platelet in angiogenesis, an important step in the development of tumors. We are using what we are learning about angiogenesis and how cancer behaves in our canine patients and in studies on both dog and human platelets to help us understand how the same cancers behave in people. These collaborations have resulted in several publications and presentations at national meetings in the past two years. Through her work with Drs. Bulla and Thomason and with the Platelet Laboratory this past year, Dr. Lunsford has spoken at national meetings, and is an invited author and expert reviewer for both national and international publications and granting agencies.

Dr. Todd Archer, Assistant Professor, recently presented a range of clinical and research topics at the 2011 Summer Mississippi Veterinary Medical Association meeting.  Dr. Archer was also this year elected to the Executive Board of the MVMA.  Dr. Archer, in collaboration with Dr. Mackin, has focused his research on T-cell function and T-cell responses to immunosuppressive agents.  Dr. Claire Fellman, currently an intern at MSU-CVM, has for the past few years been undertaking a PhD working with Dr. Archer in this area or research.  Dr. Fellman will be commencing a Small Animal Internal Medicine Residency here in July 2012, and during her residency will continue her PhD by expanding on her current work with T-cell function.  Drs. Archer and Fellman have developed two methods for measuring T-cell function: flow cytometry and real-time PCR.  These methods have been explored in several in-vitro and in-vivo studies using normal dogs to assess T-cells responses to cyclosporine, a potent immunosuppressive agent which targets the T-cell.  Drs. Archer and Fellman have shown suppression of T-cell function in dogs exposed to differing dosages of cyclosporine, with some dogs showing suppression even at the low drug doses used to treat atopy.  They are expanding their research to evaluate the effects of other immunosuppressive agents on T-cells, and to study the feasibility of using their tests to assess the degree of immunosuppression in the canine patient receiving immunosuppressive therapy.  Caitlin Riggs, a DVM/PhD student who commenced her program in July 2011, is currently working on further refining the tests of T-cell function developed by Drs. Archer and Fellman. They hope to determine the most effective objective measure of adequate dosing in patients that require immunosuppressive therapy. 

Dr. John Thomason, Assistant Research Professor, in collaboration with Drs. Lunsford and Mackin, has a research interest in trying to better understand canine platelet function, not only in patients predisposed to developing blood clots, but also in patients receiving anti-platelet drugs such as aspirin in order to prevent the formation of blood clots. This research group has recently discovered the presence of the COX-2 enzyme within the dog platelet.  This enzyme was not originally believed to be located in canine platelets, and the presence of this enzyme could explain why some, but not all, of our patients respond effectively to aspirin therapy.  This group’s research has recently expanded into evaluating the effects of a number of different anti-inflammatory and immunosuppressive drugs on platelet function, in order to better understand the interaction between these medications and blood coagulation.  They are striving to determine the safest and most effective treatments for patients that require anti-inflammatory, immunosuppressive, and anti-platelet therapy.  

Dr. Andrew Mackin, Professor and Dr. Hugh G. Ward Chair of Small Animal Medicine, recently visited Australia to present as key note speaker at the Australian College of Veterinary Scientists Science Week in Surfers Paradise, Queensland, and also to serve as a Small Animal Medicine specialty examiner for the ACVSc Fellowship examination.  He also visited Osaka, Fukuoka and Tokyo to present three 2-3 day sessions on topics in small animal internal medicine and hematology to Japanese veterinarians.  Over the past 12 months, Dr. Mackin has also spoken at veterinary conferences in Alabama, Missouri, New Jersey, North Carolina, and Virginia.

Recent Publications (Past Two Years):

Journal Articles:

• Ballweber, L.G., Panuska, C., Huston, C.L., Vasilopulos, R., Pharr, G.T., and Mackin, A. (2009).  Prevalence Of and Risk Factors Associated With Shedding of Cryptosporidium felis in Domestic Cats of Mississippi and Alabama.  Veterinary Parasitology.  160: 306.
• Lunsford, K., Mackin, A., Langston, C., and Brooks, M. (2009).  Pharmacokinetics of Subcutaneous Low Molecular Weight Heparin (Enoxaparin) in Dogs.  J Am Anim Hosp Assoc.  45: 261-267.
• Fellman, C.L., Stokes, J.V., Archer, T.M., Pinchuk, L.M., Lunsford, K.V., and Mackin, A.J. (2011).  Cyclosporine A Affects the In Vitro Expression of T Cell Activation-Related Molecules and Cytokines in Dogs.  Veterinary Immunology and Immunopathology. 140: 175–180.
• Lathan, P. (2011).  Azotemia in a hyperthyroid cat. Clinician’s Brief, May 2011 On-Line Issue (http://www.cliniciansbrief.com/column/what039s-take-home/when-t4-values-are-normal?ipQwYrPoV4).
• Wallace, M., Lathan, P., and Brinkman, E. What’s Your Diagnosis: B-Cell Lymphoma. Accepted for publication in JAVMA, May 2010.
• Lam, N., Berent, A., Weisse, C., Bryan, C., Mackin, A., and Bagley, D.  Endoscopic Ureteral Stent Placement for Congenital Bilateral Ureteral Stenosis in a Dog.  Accepted for publication in JAVMA, December 2010.
• Lux, C., Archer, T., and Lunsford, K. Gastroesophageal Reflux as a Causative Factor of Laryngeal Dysfunction in a Dog.  Accepted for publication in JAVMA, January 2011.
• Eddey, P.D., Thomas, M.W., Mackin, A., Baravik-Munsell, E.D., Brinkman-Ferguson, E.L., Manion, J.S., and Archer, T.M.  Persistent Left Supracardinal in a Dog.Accepted for publication in J Am Anim Hosp Assoc, April 2011.
• Mullins, K.B., Thomason, J.M., Lunsford, K.V., Pinchuk, L.M., Langston, V.C., Wills, R.W., McLaughlin, R.M., and Mackin, A.J.  Effects of Carprofen, Meloxicam and Deracoxib on Platelet Function in Dog.Accepted for publication in Veterinary Anesthesia and Analgesia, July 2011.
• Thomason, J., Lunsford, K.,Mullins, K., Stokes, J., Pinchuk, L., Wills, R., McLaughlin, R., Langston, C., Pruett, S., and Mackin, A.  Platelet Cyclooxygenase Expression in Normal Dogs. Accepted for publication in JVIM, July 2011.
• Johnson, K., and Mackin, A.  Canine Immune-Mediated Polyarthritis Part I: Pathophysiology.  Accepted for publication in J Am Anim Hosp Assoc, August 2011.
• Johnson, K., and Mackin, A.  Canine Immune-Mediated Polyarthritis Part II: Diagnosis and Treatment.  Accepted for publication in J Am Anim Hosp Assoc, August 2011.
• Archer, T.M., Fellman, C.L., Stokes, J.V., Pinchuk, L.M., Lunsford, K.V., Pruett, S.B., Langston, V.C., and Mackin A.J.  Pharmacodynamic Monitoring of Canine T-Cell Cytokine Responses to Oral Cyclosporine.  Accepted for publication in JVIM, August 2011.

Book Chapters:

• Lathan, P. Hypoadrenocorticism in Dogs. In Rand, J. (ed). Clinical Endocrinology of Companion Animals.  In Press.

Scientific Abstracts:

• Thomason, J., Lunsford, K., Mackin, A., Pinchuk, L., Pruett, S., and Langston, C. (2009).  Effects of Cyclosporine on Canine Platelet Procoagulant Activity.  27th Annual Forum of the American College of Veterinary Internal Medicine, Montreal, Canada.  Abstract published in JVIM.
• Archer, T., Lunsford, K., Mackin, A., Fellman, C., Stokes, J., Pinchuk, L., Pruett, S., and Langston, C. (2009).  Development of a Flow Cytometric Panel of T-Lymphocyte Biomarkers to Evaluate the Immunosuppressive Effects of Cyclosporine In Dogs.  27th Annual Forum of the American College of Veterinary Internal Medicine, Montreal, Canada.  Abstract published in JVIM.
• Berent, A., Weisse, C., Zaid, M., Lam, N., Mackin, A., Bryan, C., and Bagley, D. (2010). Endoscopic Fixation of Ureteral Strictures in Dogs and Cats. Veterinary Endoscopy Society Meeting, Breckenridge, Colorado.
• Archer, T., Fellman, C., Stokes, J., Lunsford, K., Pinchuk, L., Pruett, S., Langston, C., and Mackin, A. (2010).Effects of Different Oral Doses of Cyclosporine On T-Lymphocyte Biomarkers of Immunosuppression in Normal Dogs.  28th Annual Forum of the American College of Veterinary Internal Medicine, Anaheim, California.  Abstract published in JVIM.
• Thomason, J., Mackin, A., Stokes, J., Wallace, M., Pinchuk, L., Pruett, S., Langston, C., and Lunsford, K.(2010).Effects of Cyclosporine on Platelet Activity in Normal Dogs.28th Annual Forum of the American College of Veterinary Internal Medicine, Anaheim, California.  Abstract published in JVIM.
• Thomason, J., Lunsford, K.,Mackin, A., Pinchuk, L., Pruett, S., and Langston, C. (2010).Effects of Aspirin on Canine Platelet Cyclooxygenase Expression.  28th Annual Forum of the American College of Veterinary Internal Medicine, Anaheim, California.  Abstract published in JVIM.
• Fellman, C., Flores, R., Archer, T., Stokes, J., Pinchuk, L., Lunsford, K., and Mackin, A. (2011). Effects of Cyclosporine and Dexamethasone on Canine T-Cell Expression of IL-2 And IFN-γ as Measured by Flow Cytometry and Quantitative RT-PCR.  29th Annual Forum of the American College of Veterinary Internal Medicine. Abstract published in JVIM.
• Dudley, A., Thomason, J., Grady, J., Pinchuk, L., Mackin, A., and Lunsford, K. (2011). Effects of Low Dose Aspirin on Canine Platelet Function.  29th Annual Forum of the American College of Veterinary Internal Medicine. Abstract published in JVIM.
• Bryan, C., Lathan, P., Curotto, S., Bulla, C., Lunsford, K., and Pruett, S. (2011).  Lack of Cross Reactivity of Feline Insulin with a Commercial Human Insulin Assay. 29th Annual Forum of the American College of Veterinary Internal Medicine. Abstract published in JVIM.
• Beall, M.J., Breitschwerdt, E. B., Cohn, L.A., Couto, C.G., Dryden, M.W., Eddlestone, S., Guptill, L., Hoffmann, W.E., Kennedy, M.A., Lathan,  P., Little, S.E., Roy, A., Sayler, K.A., Sinsabaugh, J., Snowden, K., Stillman, B.A., Welles, E.G., Yabsley, M.J. (2011).  Seroprevalence Of Three Ehrlichia Species In Dogs: A Multi-Institutional Study.  29th Annual Forum of the American College of Veterinary Internal Medicine. Abstract published in JVIM.
• Archer, T. (2011).  ACVIM Foundation Research Report:  Development of Assays for the Pharmacodynamic Monitoring of Cyclosporine in the Dog.  29th Annual Forum of the American College of Veterinary Internal Medicine. Abstract published in JVIM.