A four-year-old lab, Otter, gets an MRI at Johns Hopkins to find out what is wrong with his back. In the past few months, Johns Hopkins has begun offering high-tech equipment for use on pets. (Kim Hairston/Baltimore Sun video)
Unconscious and with furry yellow paws in the air, Otter was guided into the MRI machine.
The 4-year-old Lab had been having increasingly severe episodes of back pain over months and a neurosurgeon wanted to confirm his suspicions about the cause.
"You can see he has a huge protrusion," said Dr. Larry Gainsburg, pointing to computer images of a herniated disk taken on equipment in a basement at the Johns Hopkins University medical campus. "He'll need surgery."
For the past few months, veterinarians from outside practices have been able to get advanced diagnostic scans and therapies for their animal patients — mainly dogs and cats, but also birds and other more exotic creatures — at the renowned medical school for humans.
With the Center for Image-Guided Animal Therapy, Hopkins joins the ranks of veterinary schools, specialty veterinary clinics and even stand-alone imaging facilities that offer such high-tech services to pets.
It's an unusual arrangement, given that Hopkins is not affiliated with a vet school. But it melds with the institution's research mission, officials said.
In re-purposing technology normally used for animal studies, the center's doctors can help pets immediately, and both animals and people eventually, as they see more naturally occurring disease and trauma.
"Our primary goal is to get pets the advantages of our high-tech equipment," said Dr. Dara Kraitchman, a veterinarian and biomedical engineer who was a Hopkins radiological science professor for years before spearheading the center.
"We also want to take pets that have diseases that we don't have good therapies for in veterinary medicine, but there are things in the pipeline we want to develop," she said.
The MRI, CT and PET scans are pricey, costing $2,000 and up, money that is used to offset the cost of research, equipment and staff. And while not considered a big moneymaker for the university, the services could draw some business away from the region's specialty veterinary clinics, even if Hopkins doesn't ramp up significantly from the 10 or so pets seen each week.
Like many specialty centers, Hopkins sees referrals only. And the university center is not open to the public; veterinarians bring in the pets.
The costs may put the imaging out of reach for some pet owners, the center's leaders acknowledge, though the amount people are willing to spend on their animals continues to grow. The American Pet Products Association estimates that pet owners will spend more than $60 billion in 2015, including almost $16 billion on vet care.
It was demand from the public and advances in animal medicine that resulted in a proliferation of specialty veterinary care centers outside of academic institutions in the last decade or two, according to Dr. Bess Pierce, an associate professor at Virginia-Maryland College of Veterinary Medicine in Blacksburg, Va.
There are now 22 specialties recognized by the American Veterinary Medical Association, with focuses on internal medicine, surgery, dentistry, ophthalmology, dermatology, anesthesiology and radiology, among others, which require advanced training.
Specialties have been around for years, but now an MRI machine, for example, is available in most cities in the country, Pierce said.
"Specialty medicine is growing very rapidly in veterinary medicine," Pierce said. "We very much parallel human medicine. Research is definitely a driver, and another driver is pets are very important in our lives and we want the best care for them."
Hopkins officials have begun collaborating with human researchers and specialists in developing diagnostics and treatments that could benefit both pets and humans. One study involves a new pain medication.
Such partnering is not uncommon, said Dr. Lorin Warnick, director of Cornell University's Hospital for Animals. It goes on in some way at every veterinary school in the country, he said.
It's a concept called "one health," or a recognition that human health is connected to animal health and the environment. The U.S. Centers for Disease Control and Prevention employs that approach to monitor public health threats.
Warnick said it's been getting more attention in recent years, perhaps because of infectious disease outbreaks in the news, including bird and swine flu, Ebola, and his area of research, salmonella, which are passed or shared in some way by the species.
He said the bulk of animal-human research is done in academic settings such as Cornell, where, for example, a new treatment for knee injuries in animals and humans was recently developed. The school also has hired a human oncologist to conduct studies potentially benefiting both species.
"There is a very long tradition of veterinarians and human doctors working hand and hand," Warnick said. "We don't draw such a strict dividing line between humans and animals."
Back at Hopkins, specialists were working together to diagnose Otter. A radiologist read Otter's scans, though it was already clear to Gainsburg, a Catonsville veterinary neurologist, that disk material had moved and was pressing on nerves around the end of the dog's spine. It would have to be removed.
The images were taken over an hour as an anesthetized Otter lay on his back, covered in warm blankets. He was given ear plugs, as the machine clicked loudly. Dr. Rebecca Krimins, a veterinary anesthesiologist, monitored his vital signs on special equipment.
The MRI, or magnetic resonance imaging, machine uses radio waves within a large round magnetic tube to capture details not seen on an X-ray.
Krimins said the machinery is set up so animals could be moved easily on tables between scanners, the first to find disease and the next to aid in biopsies or therapies. The scanners are constantly updated with the latest technology for research, though Hopkins has for years also scanned zoo and aquarium animals.
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Otter lives on a farm in Butler in northern Baltimore County, with Sherry Fenwick and her family. Fenwick said Otter recently recovered from surgery for a torn knee ligament and began having back trouble immediately. She thinks both injuries may be related to an encounter with a squirrel.
She said his episodes began sporadically, so veterinarians weren't able to see his symptoms. He would run and play and then have trouble getting up in the morning, only to recover. But recently, he began having trouble getting up altogether.
The normally engaging and energetic dog — a "ferocious swimmer" and constant tail-wagger — was clearly miserable, Fenwick said.
With a definitive diagnosis from the MRI, he had surgery a week ago, shortly after his scans.
"He went through X-rays and exams and everyone wanted to put off an MRI because it's such an expense," said Fenwick, an animal lover and advocate. "But as an owner of an animal with seriously painful symptoms, I would have had it months ago. I'm so glad to have the surgery now."