High-tech tools add hope, but also costs

Los Angeles Times - - THE PETS ISSUE - BY LILY DAY­TON

If your golden re­triever was di­ag­nosed with can­cer 10 years ago, you were likely given two op­tions: chemo­ther­apy or com­pas­sion­ate eu­thana­sia. To­day, you may have ac­cess to a va­ri­ety of ad­vanced treat­ments, such as stents that de­liver high doses of chemo­ther­apy straight to the can­cer­ous growth, the in­jec­tion of tiny beads that block the tu­mor’s blood sup­ply or pre­cise ra­di­a­tion guided by high­def­i­ni­tion im­agery. You may even be able to take ad­van­tage of what many vet­eri­nary on­col­o­gists con­sider the holy grail: new im­munother­a­pies that har­ness your pet’s im­mune sys­tem to launch an at­tack on can­cer­ous cells. ¶ “That’s what is so cool about this,” says Dr. John Chretin, head of on­col­ogy at VCA West Los An­ge­les An­i­mal Hos­pi­tal. Not only are there more treat­ment op­tions avail­able, but “nowa­days, we’re get­ting bet­ter at pre­dict­ing which can­cers will do bet­ter with min­i­mal ther­apy or if we need to break out the big guns.” ¶ Can­cer treat­ment is one area that has seen a huge trans­for­ma­tion — in part be­cause of new imag­ing tech­niques that al­low vet­eri­nar­i­ans to know ex­actly what they’re deal­ing with. But high-def­i­ni­tion imag­ing has also al­lowed for the de­vel­op­ment of min­i­mally in­va­sive pro­ce­dures used to treat such con­di­tions as kid­ney stones, col­lapsed air­ways, blood clots and bro­ken bones. ¶ High-tech tools that are stan­dard equip­ment in hu­man medicine, such as MRI ma­chines, CT scan­ners and spe­cial­ized scopes, have only re­cently be­come more widely used in vet­eri­nary medicine. ¶ “We have the same tech­nol­ogy avail­able as hu­man medicine; the only lim­it­ing fac­tor is the cost,” says Dr. David Proulx, head of ra­di­a­tion on­col­ogy at Cal­i­for­nia Vet­eri­nary Spe­cial­ists in Carlsbad. Med­i­cal equip­ment costs the same whether you use it on a per­son or a poo­dle. How­ever, as hu­man fa­cil­i­ties up­grade to newer, bet­ter ma­chines, vet­eri­nary hos­pi­tals can buy sec­ond­hand equip­ment. ¶ There are far fewer re­search stud­ies in vet­eri­nary medicine than there are in hu­man medicine, Proulx says. Be­cause drug com­pa­nies don’t make high prof­its from in­vest­ing in vet­eri­nary treat­ments and gov­ern­ment agen­cies are fo­cused on hu­man medicine, very lit­tle fund­ing goes to­ward vet­eri­nary re­search. The ex­cep­tion is when an­i­mal model stud­ies can be ap­plied to hu­man medicine. ¶ And when new treat­ments are avail­able, they of­ten come at a high cost — rais­ing dif­fi­cult ques­tions for pet own­ers. Few have pet in­sur­ance, and those who do have poli­cies may find that they have high de­ductibles or are re­im­bursed for only a small per­cent­age of ex­pen­sive pro­ce­dures. In the face of life­sav­ing treat­ments that may cost up­ward of $10,000, even those who can af­ford to foot the bill may strug­gle with the ques­tion of how much their ca­nine com­pan­ion’s life is worth. ¶ The pro­lif­er­a­tion of op­tions is what is so ex­cit­ing, Chretin says. “Now we can say, ‘Your dog has lym­phoma.’ We can give stan­dard treat­ment with medicine. Or we can do an­ti­body ther­apy in ad­di­tion to chemo­ther­apy. Or we can go crazy with a [bone mar­row] trans­plant.” ¶ Start­ing at left, here is a glimpse into some of treat­ments that might add years to pets’ lives.

Pho­tog raphs by Christina House For The Times

DR. NI­COLE BUOTE per­forms la­paro­scopic surgery on Coach, a year-old Ber­nese moun­tain dog, at VCA West Los An­ge­les An­i­mal Hos­pi­tal. Stem cells were also har­vested dur­ing the pro­ce­dure.

CAR­ING PAUSE by chief of surgery Ni­cole Buote helps to com­fort a ca­nine pa­tient at VCA West.

FAT from a dog will be used to harvest stem cells that can be used in var­i­ous treat­ments.

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