Y2S2 Week 7: Medical Oncology, Evening of Gratitude, and Pimobendan!
This week started off with a holiday, so Morgan and I went for a nice sunrise hike near Lake Berryessa! It was awesome to climb some hills and enjoy the beautiful view of the lake. We had never been hiking in that area, and it was only a short 35-minute drive from Davis! Of course, Churro joined in for the fun and even got to go for a little splash in the flowing stream. After the hike I was able to get in some quality studying. That afternoon I went to campus and prepped some things for the vendor fair that was happening the following day and then ended the day with a hot yoga session!
Tuesday started off with a quick whirl around the park with Churro before taking the fourth exam of the block. After the exam we jumped into a lecture on microbiota and how it relates to our immune system followed by a lecture on canine distemper /morbilliviruses. During lunch, I promoted Standard Process at the vendor fair, and the booth was a hit! Students loved the free samples and many of them who had never heard about Standard Process walked away with some new knowledge about an awesome company!
That afternoon, we discussed advancing inclusion in veterinary medicine. The rest of the afternoon included some quality time with Churro followed by a quick visit with Madeline. That evening, I had the opportunity to join SVVMA for a CE event centered around cardiology and treating mitral valve disease. Cardiology is super interesting, and I also enjoy pharmacology, so this talk was right up my alley! We had Jackie Thomas, a veterinarian and Boehringer Ingelheim representative explain how to stage heart disease and the impact of their drug Vetmedin (Pimobendan).
Since I enjoy cardiology and pharmacology, you all get to learn a little about Pimobendan. Pimobendan is a pretty cool drug that can significantly improve the quality and length of a patient's life who has heart failure. I had previously learned about this drug from one of my amazing mentors, Dr. Sprayberry, during my time at Cal Poly so it was fun to review the concept and tie it together with new knowledge. Pimobendan is an inodilator which means that it makes the heart beat stronger and also dilates the blood vessels. Stronger contractions and less resistance reduce the overall workload on the heart and improve blood flow throughout the body. When this drug is given during the early stages of myxomatous mitral valve disease it has been seen to extend the lifespan and overall quality of the dog’s life! During the talk, Jackie also spoke about compounding drugs and how this process may not be as great as many think.
Compounded products tend to have a high degree of variation between pharmacies and even significant variation within the same pharmacy between batches! It is also possible to request a drug to be put into a form that is not absorbed at all by the patient. For example, most of these pharmacies can create a drug in almost any form (liquid, capsule, tablet, transdermal etc.) but how the drug is administered dictates how much of it is absorbed and gets to the targeted area. If the practitioner, who is ordering the drug, is unaware of how this drug is absorbed, they may be ordering something that is completely useless and a waste of the client’s money. Overall, this talk was a great cardiology refresher and a reminder of the limitations that can arise from compounding drugs.
Wednesday morning started off with a quick run with Churro followed by a mini-rotation day on the medical oncology service. We started the day with an informational lecture on lymphoma and then dove into some treatment options. We have only had a few weeks of oncology in our curriculum thus far, so it was interesting to dive into a cancer that impacts tons of animals. After our group discussion, I teamed up with my fourth-year student and we got to see an adorable kitty who had been previously diagnosed with an aplastic sarcoma on her front left limb. The owner had elected to have the limb amputated and wanted to learn about the next possible steps, which could potentially include chemotherapy. It was interesting to listen to the resident explain the different treatment options and how they may impact the lifespan and quality of life for that patient. The rotation ended with an group discussion consisting of a review of all cases on that service for the day.
Wednesday evening, I had the opportunity to attend the UC Davis Evening of Gratitude event. This event is a way to thank all of the generous donors who have contributed to student scholarships and educational opportunities. At the end of last year, I had the privilege of being awarded a scholarship from the Class of 1963 and during this event I had the opportunity to have dinner with Dr. Joseph Spinelli, the amazing Class of 1963 representative. It was so much fun getting to know Joe and hearing about his adventures in vet school and his career as a veterinarian. He was an equine vet and then made a pivot to lab animal medicine! I also got to learn about his parrot and cute pup, Sophie! This event was an absolute blast, and I am so appreciative of all the support that these amazing donors provide. Veterinary school is not cheap and would not be possible without the generosity of people like Joe and his classmates!
Thursday morning started off with a quick run with Churro followed by a hot yoga session. We then had two lectures on canine and feline respiratory diseases followed by a lecture on the respiratory immune response. The afternoon consisted of a lecture on coronaviruses and how they can impact different species.
The rest of the evening included a nice walk with Churro followed by a meeting with Standard Process to discuss the upcoming SAVMA Symposium. We also had another committee meeting with all the SAVMA Symposium committee chairs. It was great to touch base with everyone and watch the event come together. We are officially 24 days (about 3 and a half weeks) out and we could not be more excited to see this project come to life!
Friday morning began with an 8-mile sunrise run with Churro followed by a lecture on the neonatal immune response. We then had a lecture on tick-borne diseases and bacterial mechanisms of extracellular bacterial infections. These lectures built off previous knowledge and it was interesting to learn about these conditions in more detail.
Friday also happened to be the Admitted Student Day, which is when all the newly admitted students visit UC Davis and decide if they want to accept their admissions offers. It was awesome seeing some of the students that I had the privilege of mentoring during the application process. I am so proud of them and the hard work that it took for them to get here!
Friday afternoon included an interesting discussion on fleas and heartworm disease. It was nice to dive deeper into these conditions and learn about the role of Wolbachia in the pathology of heartworm disease. Wolbachia is a bacterial endosymbiont that is present in all life stages of Dirofilaria immitis (heartworm). It is essential for normal worm growth and reproduction, which means it plays a key role in enhancing the pathology of a heartworm infection. Anti-Wolbachia therapy includes doxycycline/minocycline which kills/impairs developing larvae and reduces the ability of adult heartworms to reproduce. It is also a potential adulticidal therapy that enhances the slow-kill of these worms and reduces the microfilaria burden.
Additionally, it was interesting to learn that all FDA-approved heartworm preventative drugs are safe to use in MDR1 mutants (homozygous or heterozygous) when used at normal doses. It is known that macrocyclic lactones cause toxicity in dogs with an MDR1 gene (P-glycoprotein) mutation because these dogs have an altered ability to limit drug absorption and distribution along with a delayed excretion of the compound, but as mentioned above, these dogs can still use heartworm preventatives. Any dog can have an MDR1 mutation but is more commonly seen in herding breeds “white feet don’t treat” such as Border Collies, Australian Shepherds, Collies etc. There is an easy genetic test that can be done to see if your dog is positive for this mutation (I have also tested my Aussie, Churro). This will allow you to know if they are going to be more sensitive to these drugs along with other drugs such as ketoconazole, Spinosad, butorphanol, Comfortis, Trifexis etc. but regardless of the results, it was interesting to learn that they can still safely take heartworm preventatives.
The rest of Friday included a nice walk with Churro followed by some acupuncture studying!
Saturday started off with a quick run with Churro. I then had the opportunity to work at the Chi University booth at the UC Davis Winter CE conference. During the conference, I saw some familiar faces including the wonderful Dr. Heather Harris who teaches at Cal Poly! I also got to meet Dr. Jane Sykes who has done an incredible amount of work in the field of small animal infectious disease. Since we are in the infectious disease block, we have been using a lot of her material, and it was great to talk to her in person! I also had the ability to virtually tutor an awesome Cal Poly undergraduate in anatomy. After the exhibit hall closed, I spent the rest of the day with Churro and studied some acupuncture.
Sunday started off with a 7-mile run with Churro followed by another session at the exhibit hall. The exhibit hall ended around 2:00 so I had the rest of the afternoon to meal prep and take Churro on a walk. The rest of the evening consisted of some studying. It's also important to note that today is Morgan's 24th birthday!! Morgan and I have known each other since move-in day at Cal Poly (since we were roommates our first year of undergrad) and it's been a blast to be on this wild ride together!
Quote of the week: "Corona hits the tips; parvo hits the crypts” – Dr. Brian Murphy
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