SUGGESTED MEDICAL INNOVATIONS IN DIAGNOSTICS, TREATMENT AND SURGICAL APPLICATIONS IN VETERINARY PRACTICE

 

Dr. K.SARAVANAN, B.V.Sc & AH

Registered Veterinary Practitioner

Regn No. TNSVC 6717

 

Email : saravana13089@gmail.com,

Mobile  :  9043538613

 

 

The greatness of a nation can be judged by the way its animals are treated.
                                                                                                           –  MAHATMA GANDHI

ABSTRACT

Human medical advances have always laid the groundwork for eventual application to animal health efforts. By Various aspects, the recent advancements in human medicine can be adopted to animals. It includes diagnostics, treatment protocols, surgical equipments, orthopedics, etc.

Biomarkers in veterinary cancer screening.  MRI is most useful for the identification of tumours and tumour margins within soft tissue before surgery or radiation therapy. Capsule endoscopy can enable the non-invasive detection of gastric and small intestinal mucosal lesions in dogs presenting for evaluation of gastrointestinal bleeding. Laparoscopic procedures are less invasive than most surgical options and produce a clear image. The drug Verdinexor, a new therapeutic option for canine lymphoma from human medicine. Stem cells can be used in clinical veterinary medicine in therapeutic applications for the treatment of musculoskeletal injuries in horses and dogs.

Laser surgery for animals.  Like humans, animals deserve to be rightly treated. Budding veterinarians should make efforts to ensure the availability of recent advancements of human medicine in veterinary practice at affordable cost for the clients.

 

INTRODUCTION

Over the course of generations, medical technology has developed to a great extent. Now-a-days,   hi-tech systems in the medical field have been created for the most effective tools for a high-level of patient care. All humans have an equal basic moral status. Likewise, animals also possess the same fundamental rights, whatever possibilities, as a veterinarian, we should ensure an utmost care and treatment to our companions of all times. Modern veterinary science often “borrows” technological advances from human medicine and applies them, albeit in a slightly different way, to animal medicine. This is good. Human medical advances have always laid the groundwork for eventual application to animal health efforts.

By various aspects, the recent advancements in human medicine can be adopted to animals. It includes diagnostics, treatment protocols, surgical equipments, orthopedics, etc.

1. DIAGNOSTICS

 

1. Biomarkers in veterinary cancer screening

Biomarker can be defined as a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. The potential applications of biomarker identification in veterinary cancer patients include diagnosis, staging, determining prognosis, and in monitoring the response to therapy. If we define a screening test as a method of facilitating disease detection in a sub-clinically affected patient, then the veterinary community has a poor track record in appropriately applying such tests in practice. Hence, use of biomarkers for disease screening should be promoted. This will facilitate early diagnosis and treatment.

Beyond screening: other applications for biomarkers

Beyond the value of biomarkers for early cancer detection, there exists the potential to use tumour-specific biomarkers for patient monitoring and to inform case management decisions. Tests such as the V-BTA, TK and Pet-Screen lymphoma assays could potentially be used to monitor remission status and to determine if and when re-initiation of therapy is warranted.

Protein biomarkers for early detection of diseases

The detection of health problems at an early-stage when therapies could be more effective depends on the capabilities of the proteomics investigations. Use of such diagnostics reduces the cost of treatment.

ii).   Potential  role of MRI  which makes to adapt in animal practice

Over the last decade, magnetic resonance imaging (MRI) has become established as a useful referral diagnostic method in veterinary medicine that is widely used in small animal brain and spinal diseases, aural, nasal and orbital disorders, planning soft tissue surgery, oncology and small animal and equine orthopedics. MRI is non-invasive, has high spatial resolution and few safety drawbacks.

Because of the accurate details, MRI is most useful for the identification of tumours and tumour margins within soft tissue before surgery or radiation therapy. MRI is also a very sensitive monitoring tool following therapy that carries some risk of identifying other abnormalities with unknown relationship to the primary disease process. Compared to other imaging modalities, lesions identified on MRI appear to be more extensive .This may reflect true disease extent or may over estimate lesion size. This method, which is frequently used on humans for diagnosis of disease conditions and injuries that exists within various parts of the soft tissue, is apparently becoming more accessible for use on animals. Further, non-invasive nature of MRI is highly safety for use on animal tissues.

iii). Capsule endoscopy

Capsule endoscopy is a single-use pill containing a tiny camera that takes pictures as it moves its way through the patient’s digestive system. The camera transmits data wirelessly to a monitor worn by the patient, allowing clinicians to more clearly view the entire gastrointestinal tract and to pick up any lesions in real time, either from the patient’s monitor or from the clinic computer screen.

Capsule endoscopy can enable the non-invasive detection of gastric and small intestinal mucosal lesions in dogs presenting for evaluation of gastrointestinal bleeding. Capsule endoscopy is a great option for the pets that cannot be anesthesized /sedated safely, or in cases when there is a need to examine the entire gut.

iv). Nuclear medicine – Single photon emission computed tomography (SPECT)

SPECT uses collimated scintillation crystals moving around the patient to generate a three-dimensional (3D) rendering of the structure of interest. The principal advantage of SPECT is a more accurate image of the distribution of the agent within the field. Identifying the target of interest within a tumour or organ could select candidates for targeted treatment and guide therapy decisions in the future. SPECT imaging can be used to evaluate tumour metabolism in dogs affected with   prolonged cancer. This targeted treatment reduces irrational use of anti-cancerous drugs on animals.

v). Laparoscopy for animals

Laparoscopic procedures use a small camera and light source that can be inserted into the abdominal cavity or thoracic cavity to examine inside the body. This is yet another example of a human medicine technology being adapted to the animal species. These procedures are less invasive than most surgical operations and produce a clear image. The first widely reported laparoscopic procedure in animals was reported in 2011, when the Royal Zoological Society of Scotland used it to remove diseased gall bladders from moon bears. The early diagnostic protocols and targeted treatment in humans could be easily adapted in animals for efficient and effective disease diagnosis and its treatment.

2. TREATMENT

 

1. Nanomedicine and veterinary science

Nanotechnology is revolutionizing human medicine, particularly in the fields of imaging and drug delivery. The use and efficacy of many currently available pharmacological agents are limited by low bioavailability and unwanted side effects. Nanoparticle drug delivery systems can be engineered to overcome these issues and thus improve the therapeutic index and safety profile of the substances they carry.

Nanoparticles improve the therapeutic index of the pharmaceutical agents they carry through four key mechanisms. Firstly, they enable the use of drugs that would otherwise be insoluble or unstable. Secondly, they increase the concentration of pharmaceutical at its intended site of action, resulting in increased efficacy. Thirdly, because of preferential accumulation at target sites, they lower systemic toxicity and drug concentration in healthy tissues. Fourthly, nanoparticles have reduced clearance compared to the parent drug and thus provide a method of sustained controlled release over a period of days or even weeks. Considering the high therapeutic index and safety profile of nanomedicine, the same could be used in animals for prolonged treatment in chronic diseases.

ii). Nanomedicine for  Vaccine delivery  in Animals

Vaccines, designed to stimulate a long lasting and protective antibody response to a pathogen, are comprised primarily of antigen and adjuvant.   Conventional adjuvants are not tuneable, but with the advent of nanotechnology, a plethora of novel antigen carrying strategies are now available. These novel nanoparticle-based adjuvants are highly tuneable and can be engineered for reduced dosage frequency via a convenient administration route in order to provoke a specific immune response, e.g. the intranasal route to better target mucosal. This makes them highly amenable to engineering for veterinary species where large numbers of animals may need to be treated at once in a commercial unit, or when vaccination by conventional means is inconvenient due to extensive management systems or poor accessibility (e.g. wildlife).

Although challenges remain in nanomedicine application, particularly relating to toxicity, nanocarrier residues and production costs, collaboration between various disciplines including human and veterinary medicine, engineering and materials science will expand existing knowledge to resolve these issues, increasing their applicability for veterinary use. Although not yet a dramatic revolution, nanoparticles are edging their way into the veterinary field and are likely to continue to do so into the future. The drug engineering concept with reduced dosage will be cost effective and that could be adapted in veterinary practice.

iii). A new cancer drug for dogs from a human medicine

The drug, Verdinexor, works by preventing powerful tumour suppressing proteins from leaving the nucleus of cells, an exodus which allows cancer to grow unchecked. It’s a new therapeutic option for canine lymphoma, potentially offering vets, an another alternative for treating the disease, which is the most commonly occurring canine cancer. Oral verdinexor drug can be given at the dose rate of 1.75 mg/kg body weight twice a week. Previously, the drug recommended for using as an antiviral agent in humans.

In human medicine, advances in the diagnosis and treatment of cancer have led to living with cancer rather than dying from it. This paradigm shift has led to greater focus on quality of life and convenience. The similarities in the ways of human and canine cancer drugs researches are not coincidental. Many types of human and canine cancers are identical at both the cellular and molecular levels, making companion animal studies an ideal place to test drive experimental compounds that appear to have anti-cancer characteristics.

iv). Stem Cell therapy in animals

Stem cells have tremendous promise to help us understand and treat a range of diseases, injuries and other health-related conditions.  Ongoing researches in stem cell therapy for animals would help in curing some of the diseases such as chronic ulcer and spinal cord injury.  It would expand the scope for regenerating tissues damaged during accident or due to metabolic disorders.

Madras Veterinary College, Chennai, one of the constituent of Tamil Nadu Veterinary and Animal Sciences University becomes frontier in whole nation by establishing stem cell research unit for animals.  The stem cell field in veterinary medicine continues to evolve rapidly both experimentally and clinically.

 

Stem cells can be used in clinical veterinary medicine in therapeutic applications for the treatment of musculoskeletal injuries in horses and dogs.  New technologies of assisted reproduction are being developed to apply the properties of spermatogonial stem cells to preserve endangered animal species. The same methods can be used to generate transgenic animals for production of pharmaceuticals or for use as biomedical models. Small and large animal species serves as valuable models for preclinical evaluation of stem cell applications in human beings and in veterinary patients in areas such as spinal cord injury and myocardial infarction.  However, these applications have not been implemented in the clinical treatment of veterinary patients. Reviews on the use of animal models for stem cell research have been published recently.

 

v). Cancer Vaccine

 

      In this aspect, veterinary medicine seems leap ahead of human. This vaccine is intended for preventing melanomas, a type of skin cancer in dogs. Since dogs spend most of their time exposed to direct sunlight without any kind of sunscreen, they are highly prone to melanomas.

    

    This therapy uses an orthologous DNA (different species) vaccine against tyrosinase, a melanosomal glycoprotein needed for melanin synthesis, to induce an antityrosinase immune response. The biggest advantage of this therapy is its ability to systemically treat malignant melanoma with minimal to no adverse effects. Chemotherapy, another systemic option, can have significant toxicity in canine patients.

 

3. ORTHOPEDICS AND SURGICAL APPLICATIONS

 

i). Microfracture detection in equine practice

          

One of the greatest threats to the health of thoroughbred racehorses is bone failure. During exercises, horses will often develop microscopic bone fissures that can quickly turn into fatal

full-fledged fractures. In order to prevent this from occurrence, a method of detecting the sonic waves produced by micro-fissures can be used, which is commonly followed in human practice. Early detection is the key for successful prevention of bony issues in horses with appropriate management and surgical procedures.

 

 ii). 3-D Printing with the use of CT Scans

The ability to print three-dimensional objects is one of the most often-discussed topics in technology today. This rapid-prototyping process should be applied to veterinary practice to create animal bone models from the information gathered from computed tomography scans.  Doing so enables vets and surgeons to have a solid grasp of a patient’s internal bone or muscle structure before going in to operate. In addition, the models help educate pet owners about the anatomy and physiology of their pets. This enables precision in handling of soft tissues and bones for quick healing.

iii). Laser surgery for animals

Laser surgery not only can be used as a corrective eye surgery in humans. Concentrated light sources can be use in spays and neuters, dewclaws, ear surgery and many more applications in small animal practice. There are three major advantages of laser surgery when compared to traditional stainless steel surgical scalpels, which are decreased pain, reduced bleeding and blood loss and also reduced risk of infection. No post operative pain is accomplished. Because, the laser seals the nerve endings as it cuts. This reduces pain impulses from the surgical site in the immediate post-operative period. Also, the decreased pain involved with laser surgery may allow the surgeon to remove small sized skin tumours using local anesthetics rather than having the pet to undergo general anesthesia.  Bleeding can be arrested through cauterization of blood vessels as the laser beam vaporizes the animal tissues. There will be no risk of surgical infection occurs due to the superheating of the tissues in the incision site, destroying any bacteria which are present at the time of surgery.

Almost all soft-tissue surgeries may be performed with the CO₂ Laser. Common procedures such as Ovariohysterectomy (spaying) or castration (neutering) can be easily done with laser. The CO₂ laser can also be used for removal of skin tumours, ophthalmic surgeries such as correction of entropion or ectropion and some of the mouth and throat procedures. Animal welfare issues viz. decreased pain, reduced blood loss and less risk of infection in laser therapy might attract both veterinarians and animal lovers.

 

iv). Rehabilitation for animals affected by orthopedic injuries

Human beings receiving a prosthetic limb undergo professional rehabilitation. This level of care is important to animals with prosthetic limbs as well. Like human Physiotherapists, animal rehabilitators should be created and well trained to meet the orthopedical related treatment for animals. Bionic limbs for amputated animals due to catastrophic injuries should be designed for better rehabilitation.

Conclusions

 To protect the well-being of animals, it is very essential to take care of them with latest diagnostics and therapeutic procedures. Like humans, animals deserve to be equally treated with recent advancements in medical field as applicable. Although, there are some philosophical and scientific debates whether animals are consciously aware of feeling decent or indecent welfare, it is our duty and responsibility to give them proper care. Considering the life of animals, it is a basic moral value that we treat every living creatures with courtesy, compassion and kindness. Whatever may be the advancements in human medicine, it should be adapted to treat animals, our true companions, to make the disease diagnosis earlier and also to relieve them from their untold sufferings faster, as animals can’t utter pain. Further, the medical innovations with non-invasive nature in diagnosis and treatment, reducing irrational use of drugs, high therapeutic index, safety standard of drugs and cost effectiveness may be aptly adapted in veterinary practice with proper care and monitoring. Budding veterinarians should make efforts firstly to aware about the recent advancements in veterinary practice and later make it available at affordable price.

“I am in favour of animal rights as well as human rights. That is the way of a whole human being.”  ― Abraham Lincoln