January 2006

Animal Attraction: Women in Contemporary Veterinary Medicine

Investigating Interactions in Polymer Blends

Giving Voice to the "Silenced"

Exploring Biological Questions Through Organic Synthesis

Broadening Perspectives on Chemistry Research

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Bryn Mawr College
A newsletter on research, teaching, management, policy making and leadership in Science and Technology

Animal Attraction: Women in Contemporary Veterinary Medicine
By Dorothy Wright

Recently a young adult female with signs of lethargy and appetite loss was brought by her family to a University of Pennsylvania hospital in Philadelphia, where she was seen by a team of specialists. Results of a complete blood count, blood chemistry profile, urinalysis, and chest and abdominal radiographs were normal. Nevertheless, the internist ordered an abdominal ultrasound examination, which indicated an abnormality of one of the blood vessels to the liver. A specialized blood test showed an elevated level of serum bile acids, providing additional evidence of a liver abnormality.

The radiologist recommended an abdominal CT scan to provide a clearer image of the liver, including the abnormal blood vessel. Results of the CT scan allowed the radiologist and internist to diagnose a condition called portosystemic shunt, an abnormality that allows blood to bypass the liver and recirculate through the body without having been detoxified. Medication and a special diet would help, but the internist recommended surgery to partially close the shunt and redirect blood-flow into the liver. The family chose surgery, and the patient is now on the road to recovery.

Today, it is not unusual for patients with health insurance and access to modern health-care facilities to be treated by a team of medical specialists using advanced diagnostic and surgical procedures to restore the patient's health and quality of life. In this case, the patient was a three-year-old female spayed Shih Tzu named Honey, whose family paid thousands of dollars for her care at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. And that's becoming increasingly common, as well.

Specialized Care

Meryl P. Littman
Meryl P. Littman '72

"More and more people consider their animals to be members of their family," observes Meryl P. Littman '72, Honey's internist and an associate professor of medicine at the University of Pennsylvania School of Veterinary Medicine. "Many of them are looking for the same level of specialized medical care for their animals as for themselves or any other family member."

Indeed, last year the American College of Veterinary Internal Medicine (ACVIM) reported that 73 percent of veterinarians in the United States and Canada said their clients sought more referrals to veterinary specialists than they had just five years earlier and veterinarians are meeting the demand. During the same time period, membership in ACVIM surged 45 percent to 1,537 diplomates, who are board-certified in one or more of five specialties: small-animal internal medicine, large-animal internal medicine, cardiology, neurology and oncology. In addition to internal medicine, there are more than two dozen board-certified veterinary specialties, including anesthesiology, clinical pathology, dermatology, nutrition, ophthalmology, radiology and surgery.

"I don't think it is just consumer demand that is driving specialization in the veterinary profession," Littman says. "There is just too much knowledge required to treat 'all creatures great and small.'" In fact, the James Herriott-style practitioner who treats all patients, from horses to hamsters, is the rare exception in the United States, where only 8 percent or so of the members of the American Veterinary Medical Association (AVMA) have a "mixed" animal practice today.

Littman says, "The real pioneers of veterinary specialization were from Penn in the 1960s. Young clinicians would do a fellowship working with human doctors at Penn's School of Medicine and bring their knowledge back to the vet school."

For example, in 1969, Penn's vet school established the first veterinary section of medical genetics. In fact, the vet school was established in 1884 on the recommendation of Penn's School of Medicine, and it is the only veterinary school to be developed in association with a medical school. Today the  Ryan Veterinary Hospital at Penn, the busiest veterinary teaching hospital in the country, sees more than 28,000 small-animal patient visits a year. The Widener Hospital at New Bolton Center, Penn's large-animal clinic, sees more than 6,000 patients, and the Field Service sees more than 19,000. Penn also has one of the largest equine surgical facilities in the world.

Advanced Technologies

Cynthia R. Ward
Cynthia R. Ward '82

Veterinarians are using many of the same advanced medical technologies as their counterparts in human medicine. "We can take advantage of the advances that have been made in human medicine, in many cases because the technology was actually perfected in small research animals," says Cynthia R. Ward '82, an associate professor of medicine at the University of Georgia College of Veterinary Medicine. "Cardiologists place pacemakers in animals and do balloon dilations to stretch constricted vasculature. Surgeons are doing a lot now with laparoscopy techniques and thorascopy techniques, which allow them to insert small cameras into tiny incisions in either the chest or the abdomen, either for diagnosis or microsurgery. We are also using a lot of other noninvasive diagnostic techniques, such as endoscopy."

One of the challenges, of course, is the small size of many animal patients. "Fortunately, a lot of these techniques are used in neonatal and pediatric medicine, so very often we are using instruments developed for infants and children," Ward says. "Our biggest challenges involve getting blood samples from tiny two- or three-pound animals. The first challenge is getting access to a vein, and the second is getting an adequate volume of blood to run certain tests. It's like working with a premature baby."

Ward recalls a small, female, mixed-breed dog that was urinating frequently and passing blood in her urine and was diagnosed using cystoscopy. "We inserted a cystoscope through her urethra into her bladder, identifying a bladder tumor and obtaining a tissue sample for biopsy. Ten years ago, she would have required abdominal surgery to obtain a tissue sample."

Veterinary Specialists

Raquel M. Walton
Raquel M. Walton '87

Enter the veterinary clinical pathologist. "We look not only at the disease processes that cause changes in fluids or cells, but also the artifacts associated with certain changes, and that requires advanced technology and instrumentation," explains Raquel M. Walton '87, a postdoctoral fellow and former clinical pathologist and lecturer at Penn. "For example, the laser technology that is integral to flow cytometry enables us to analyze cancer cells in a fluid or organ to identify the type of cancer.

"The development of ultrasound imaging has also impacted advanced animal cytology," Walton continues. "Radiologists can perform ultrasound on large organs to identify masses, aspirate them, and supply veterinarians with cells for diagnosis. As a result, we have a real-time image of a mass and an immediate cell sample, which is put on a slide, air-dried and analyzed. We can have a diagnosis within perhaps 30 minutes."

In fact, veterinary radiology is almost as advanced as it is for humans, although not nearly as widely available, says radiologist Lisa Ziemer '94, an associate of PetRad, LLC in Ambler, Pa. "We can do just about anything in animals that can be done in humans, including radiographs, CT scans, MRI, ultrasound and nuclear medicine."

Lisa Ziemer  
Lisa Ziemer '94

For example, today radiologists use a variety of modalities to "stage" cancer patients. "Usually the standard staging work-up for pets with cancer would be chest radiographs and abdominal ultrasound to look for tumor spread," Ziemer explains. "We also use CT scans of the chest to look for the extent of tumors, particularly in the thorax. And we are researching the use of positron emission tomography, a nuclear medicine technique that is the cutting edge in cancer imaging in humans, to look for evidence of metastases in animals."

Diagnostic radiology is often essential to a diagnosis of more "routine" veterinary conditions. Ziemer recalls a male French poodle who had had chronic nasal discharge. "Nobody could get to the bottom of it," she says. "They tried antibiotics and steroids. They tried flushing his nose. They took a biopsy. Finally, his vet ordered a CT scan. The dog had a small rock lodged way up in his nose! The rock was removed and the dog has been fine ever since."

Ziemer says that's what she loves about radiology: "Every case is a mystery that you are setting up to solve, and often, diagnostic imaging is at the heart of the clue."

Nutritional Treatment

Andrea J. Fascetti
Andrea J. Fascetti '87

Just as in human medicine, there is more emphasis today on preventive medicine, including proper nutrition. Take the case of Pepper, a 10-year-old miniature schnauzer with a history of pancreatitis and elevated serum triglycerides. "Several years ago, Pepper's veterinarian prescribed a veterinary therapeutic diet that was fat-restricted to reduce his triglyceride concentrations and to help control his bouts of pancreatitis," recalls Andrea J. Fascetti '87, an associate professor of nutrition at the University of California, Davis, Veterinary Medical Teaching Hospital. "Pepper did well on this diet his triglyceride concentrations returned to the normal range and he did not have any clinical signs of pancreatitis for several years." 

Recently, however, Pepper was diagnosed with renal disease. "Unfortunately there are no diets on the market that simultaneously treat all three conditions pancreatitis, hypertriglyceridemia and renal disease," Fascetti explains. Pepper's veterinarian, realizing that what Pepper needed was a home-prepared diet that could address all of those conditions, contacted the Nutrition Service at UC Davis. The Nutrition Service provides consultation and support for patients at the teaching hospital, as well as veterinarians all over the country, and even a few overseas. The service formulates about 350 home-prepared diets every year.

Fascetti created a diet to address all of Pepper's medical conditions, using ingredients that Pepper liked and the owner could prepare at home. "Pepper is eating his diet and doing well," she reports.

Complementary Medicine

Rosemary D. Ganser
Rosemary D. Ganser '85

Given people's increasing interest in complementary or alternative medicine for themselves, it is not surprising that in recent years many owners have begun seeking it out for their animals. Rosemary D. Ganser '85, an integrative veterinarian in Danbury, Conn., began practicing complementary veterinary medicine in 1996 after witnessing the successful use of acupuncture on a horse in an otherwise conventional large-animal practice.

"At one time I thought it was complete quackery," she says. "We were treating a horse with an intestinal impaction, which can be fatal. We had treated her medically with fluids, trying to rehydrate her and stimulate her intestinal motility to try to get the obstruction to pass. That wasn't working. We took her to surgery and removed the impaction. She impacted again and was medically re-treated without success. The owner finally said, 'I've run out of money to treat this; you have to put her down.' Out of desperation, we called in a veterinary acupuncturist. The treatment worked: it broke the impaction. The horse recovered without a recurrence. That was an 'Aha!' moment for me."

So Ganser pursued training and certification in veterinary acupuncture and chiropractic. Today her equine practice focuses on maximizing her patients' well-being and athletic performance. "People are keeping horses longer," she explains. "It is not uncommon to find horses in their mid-20s getting ridden regularly, and just a couple of decades ago, that was unheard of. Many people are looking for preventive sports medicine for their horses. They want to maximize the horse's athletic potential and make sure the horse is pain-free."

Unlike a conventional practice, where Ganser might see a horse only when there is an acute medical need, she sees a lot of horses on a monthly basis. "It is interesting to follow these horses' athletic development," she says. "I can tell where they are in their training by their muscular development, and I can tell what problems they may run into at certain stages in their career as they learn to use different parts of their bodies and develop new athletic skills."

As they live longer, animals are also developing more chronic diseases. "I think that is where complementary medicine can really shine," Ganser says. "You wouldn't use it for a broken leg, serious bacterial pneumonia, or an acute stomach problem in a horse, but if the horse has chronic lameness, for example, that's where you would start to use it along with conventional Western medical therapy."

Although veterinarians have been using acupuncture since the mid-1970s and chiropractic since the late 1980s, Ganser says, there has been little controlled research on these therapies. "We need research to provide evidence to back up their efficacy and gain acceptance."

Animal-Specific Research Focus

For those veterinarians who do research, it is challenging to secure financial support for projects that focus on animal health for its own sake. Virtually all of the large, multi-year public research grants fund animal research as a model for human health, so animal health researchers rely on smaller grants from private sources, according to Littman.

A major concern for dog owners is Lyme disease. "They accept a diagnosis that their dog has Lyme disease," Littman says. "However, recent research at Penn and Cornell suggests that there are a lot of animals that will be seropositive on the blood test and few that will ever get sick. Antibiotic treatment for most Lyme seropositive asymptomatic dogs may be unnecessary. Labrador and golden retrievers are especially at risk for a serious immune-mediated kidney ailment associated with Lyme seropositivity. It is theoretically possible that they may be sensitized or get sick from Lyme vaccine antigens, so we recommend good tick control rather than vaccination to prevent Lyme disease."

For many cat owners, a major problem is hyperthyroidism. "It's a huge problem in cats as they get older," Ward explains. "One of the interesting things about the disease is that it has really emerged only over the last 15 years. Epidemiologic studies suggest that there might be a food or environmental cause. My lab is looking at environmental pollutants that are known to disrupt the human endocrine system to see whether they activate cat thyroid cells in culture. The other interesting avenue to this research is the fact that these animals are 'sentinels.' They live with us, drink the same water, and play outside as we do. If we can identify the cause of this disease in cats, it may benefit human medicine, as well."

Gender Shift

Another hallmark of contemporary veterinary medicine is the preponderance of women students in vet school 77 percent of the students in the classes of 2005-08 are women, according to the American Association of Veterinary Medical Colleges (AAVMC). As one might imagine, it wasn't always so. AAVMC's earliest survey in 1968-69 found that women comprised just 8 percent of the student body at member colleges. Women remained in the minority until 1986-87, when they achieved parity at 53 percent of the vet-school student body. Since then, the percentage of women has steadily increased. However, ethnic and racial minorities are underrepresented at vet colleges, making up just 8 percent of the classes of 2005-08. Membership in the AVMA was still running about 57 percent male to 43 percent female as of December 2004.

Why the male-to-female shift? There is no research, but also no shortage of plausible hypotheses. "People talk about it a lot," Ziemer says. "I think there are multiple factors. Unfortunately, veterinarian's starting salaries aren't anywhere near those of medical doctors. It may be a generalization, but I think a lot of men probably still feel they need to make a ton of money."

If, as a result, fewer men are applying to vet school, more opportunities may be opening up for qualified women. "I think the reason women are entering veterinary medicine is because they can," Ward maintains. "Thirty years ago, it was really hard for women to get into veterinary school, and now it's not."

Perhaps the shift from male to female parallels the shift in focus in veterinary medicine. "In the past, the focus of veterinary medicine was on food animals, and there was a bias that large-animal medicine required a big strong guy," Ganser observes. "Also, more and more veterinary practices are offering part-time employment and flexible hours, which are helpful for women raising a family."

"At the same time, one of the challenges for women in science in general and in veterinary science in particular is the academic field," Fascetti adds. "We are always trying to encourage more women to go into academia, but it is challenging to go through the tenure process, particularly if you want to raise a family."

In this context, it is worth noting that AAVMC counts only four women deans at the 32 vet colleges in the United States and Canada, including Joan Hendricks, a Penn V.M.D. who became Penn's dean in January 2006.

Ward believes the increasing number of women is having a positive impact on the profession, including the trend toward more-flexible work schedules, especially in private practice. "I think women make better doctors anyway!" Ward laughs, acknowledging her bias. "We tend to listen more and empathize more, and that's what people need. When our clients bring their animals in, they need to talk."


About Our Sources

Andrea J. Fascetti '87 is an associate professor of nutrition at the University of California, Davis, Veterinary Medical Teaching Hospital. Fascetti established the Nutrition Service at UC Davis and serves as nutrition service chief. A diplomate of the American College of Veterinary Internal Medicine (ACVIM) and the American College of Veterinary Nutrition, Fascetti has served for a number of years on the ACVN executive board, currently as secretary-treasurer. Her research includes trace-mineral requirements for the gestational period in cats and taurine requirements in dogs. Fascetti earned her V.M.D. from the University of Pennsylvania School of Veterinary Medicine, Philadelphia, and her Ph.D. from UC Davis.

Rosemary D. Ganser '85 practices equine integrative medicine in Danbury, Conn. From 1991 to 1998, Ganser worked in conventional small- and large-animal practices. She worked in a holistic veterinary practice from 1998 to 2004, with special interest in equine lameness, and started her own practice in December 2004. Ganser received her certification in veterinary acupuncture from the International Veterinary Acupuncture Society and her certification in veterinary chiropractic from the American Veterinary Chiropractic Association. She earned her V.M.D. from Penn.

Meryl Podolsky Littman '72 is an associate professor of medicine at the University of Pennsylvania School of Veterinary Medicine. She joined the faculty in 1979 after several years in private practice and completion of her internal medicine residency. She has served as chief of the section of medicine and head of the internship program. A diplomate of the ACVIM, Littman is chair of the ACVIM Lyme Consensus Statement Committee, which is developing guidelines for Lyme disease diagnosis and vaccine use. Littman earned her V.M.D. from Penn.

Raquel M. Walton '87 is a research associate and a former clinical pathologist and lecturer at Penn. A diplomate of the American College of Veterinary Pathology, she is also a member of the American Society of Gene Therapy, American Society for Veterinary Clinical Pathology and American Veterinary Medical Association. Walton's research focuses on neural gene therapy for Sly disease, a lysosomal-storage condition. Walton earned her V.M.D. from Penn and her Ph.D. from Colorado State University, Fort Collins.

Cynthia R. Ward '82 is an associate professor of medicine at the University of Georgia College of Veterinary Medicine, Athens. She is formerly an assistant professor of medicine at Penn, where she was honored with the Norden Teaching Award and Alumni Distinguished Teaching Award. A diplomate of the ACVIM, she is also a member of the American Association of Feline Practitioners, the American Association of Cell Biology and the American Veterinary Medical Association. Her research includes the role of environmental pollutants on the development of feline hyperthyroidism. Ward earned her V.M.D. and Ph.D. from Penn.

Lisa S. Ziemer '94 is an associate of PetRad, LLC in Ambler, Pa., and a radiological consultant for the Center for Animal Referral and Emergency Services, Langhorne, Pa. A diplomate of the American College of Veterinary Radiology, Ziemer was a senior research associate at Penn, where she focused on molecular and optical imaging of cancer, and investigating new ways to diagnose and characterize tumors in humans and animals. She also served as a lecturer and clinical radiologist. Ziemer earned her V.M.D. from Penn.


Dorothy Wright contributes news and feature articles on science, technology, engineering and general-interest topics to a variety of publications, including Civil Engineering and Engineering News Record .

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