Angel Fund Update 4/2009

We have been using the Angel Fund for several things: clinical research, cost reduction (for all shunt patients), and extra support for a few shunt patients that have special needs. Most recently, our special needs patients included a Yorkie with a shunt that had complications (the bill exceeded the owner's budget; supplement with the Angel Fund allowed us to provide life saving treatment instead of Euthanasia), a shunt dog with a stomach ulcer and pneumonia that needed extra care, and a rescued Golden retriever with an intrahepatic shunt that needed a CT to confirm the diagnosis.

Our current research project is on the Protein C test. The previous study on Protein C (from Cornell) showed that Protein C activity overlaps in dogs that have a variety of liver conditions. When only comparing shunt dogs and dogs with MVD (microvascular dysplasia secondary to congenital portal hypoplasia), then any dog with a value below 70% had a shunt. In our current study, we are finding more overlap in our groups; in fact, our dogs with other congenital defects like PDAs (heart defects) had low Protein Cs. So, we are revisiting the accuracy of the Protein C test, which should be very helpful to our Yorkie owners. That project is being partially funded by the Angel Fund and is expected to be completed by the end of the summer.

We've recently published 3 other studies on CT and transplenic scintigraphy for diagnosing shunts; these projects were also partially funded by the Angel Fund and 2 of the projects won awards for best clinical research. Our next project is to review the past 500 shunts and get follow-up. We have a summer work study student (veterinary student doing a summer research project) who will be partially funded by the Angel Fund. As with the other projects, we will publish the results of the retrospecitve study so that there will be more information for practitioners and owners on outcomes of surgery.

As noted, the Angel Fund has helped to keep costs low for all animals; my understanding is that an uncomplicated case at UTCVM costs about half as much as what is charged in most major cities. The added benefit to us at UT, and therefore to the owners, is the huge number of patients that we see, and therefore the extensive experience we have in managing these animals. We believe that improves our chances for a good outcome after surgery. In the last 2 weeks we have had people fly (or drive) in from Texas, Indiana, and California because they think we are the best, and because we are affordable.

I no longer have a television show. I just finished submitting my first surgery textbook (due out in October) and will soon begin to edit the Textbook of Small Animal Surgery. Because of all the wonderful clinical "case material" - especially our Yorkie patients- I've been able to publish over 50 articles- most commonly on shunts- and have been given the honor of this editorship because of my expertise. The research, writing, and surgery clinics (about 22 weeks a year on surgery) have limited my ability to do continuing education talks for the public and I no longer do online shunt consults for private individuals, although I still answer questions forwarded to my by officers of YAP and YTNR. Those are the main areas that has been affected by my busy schedule.

I'm really looking forward to Dr. Center's genetic testing- I hope this will revolutionize our breeding programs. With luck, I will be out of a job (at least as far as Yorkie shunts are concerned), so it's a good thing I'm diversifying my career objectives!

You're welcome to post any of this information or use it to answer questions.

Karen Tobias DVM MS ACVS
University of Tennessee
Department of Small Animal Clinical Sciences
P.O. Box 1071
Knoxville TN 37901-1071

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