KANSAS STATE UNIVERSITY

Student’s HardWork SavesDraft Horse

Brown Cow hasPurple Knee

Speaker FoamSaves Dog

Afghanistanis Special

to Specialist

W

SUMMER 2008

V E T E R I N A R Y M E D I C A L T E A C H I N G H O S P I T A LLIFE

Inside

Animal

AnimaLIFE / pg. 3

Editor

Patrice Scott1700 Denison Ave.103 Trotter Hall

Manhattan, KS 66506-5601785.532.4046

pscott@vet.k-state.edu

Photography

Digital Instruction, Support andCreative Services

College of Veterinary MedicineKansas State University

Dave AdamsPatrice Scott

Personal family photos

Publisher

AnimaLIFE is published by theVeterinary Medical TeachingHospital at Kansas State

University, Manhattan, KS 66506.For advertising informationcontact Patrice Scott at

785.532.4046.

All rights reserved.

Contents of thismagazine may not be reproducedin any manner without the written

consent of the publisher.

SUMMER 2008

Contents

Pg. 5 Dr. Amy Rankin

Dr. Amy Rankindidn’t original lyenvision a career inveterinary medicine.Now she’s anophthalmologist.

About the Cover

After a lengthy stay at the KSU-VMTH, 11-year-old Dachshund, Little Pup (LP) is backhome with his owners, Bill and Dee Wills.

AnimaLIFE / pg. 2

Pg. 6 Pulling Through

A senior studentshares h is accountof a draft horsethat pul led throughdespite enormousmedical chal lenges.

Pg. 10 HowNow BrownCow?

Cow rece iveswor ld ’s f i rs tar t i f i c ia l l igament ,known as theW i ldcat PowerCord.

Pg. 12 Road to Recovery

Dog’s l i fe dependson a vacuum,speaker foam and aveter inary surgeonwho works wel lunder pressure.

Pg. 16 Kabul-ing itTogether

Afghan is tan comesa l i ve in Dr. Dav idHodgson ’s r i ve t ingaccount aboutteach ing veter inarys tudents in thewar - torn count ry.

Pg. 2 AnimaLIFE Editor’s column

Pg. 4 VMTH Director’s columnShap ing the fu ture of the hosp i ta l happens every day.

Pg. 15 Referring Vet

Honesty is thebest pol icy forDr. Rober t Johnson.

I remember a wonderful summer day when I was about 6 years old. It was late afternoonwhen my Dad parked the station wagon in front of our two-story home in Kansas City. Aswe got out, a police cruiser stopped in the street. The officer said, "Little girl, do you likepuppies? I only have one left." He lifted the tiny creature up and handed it to me. Sheimmediately snuggled her nose to my neck. I flashed my Dad a look with pleading eyesthat begged, "Can we?" Dad smiled. I darted into the house with excitement andannounced that we had a puppy. We named the seventh female of the house,Officer Squad Car Macan.

Dogs were important members of myfamily growing up. People often talkabout the animals they love, but weseldom talk about the people whotaught us to love and care for them.For me, that person was my Dad.

My amazing father passed away thiswinter. For those who wondered ifthey’d missed the fall/winter edition,you now know why one was notproduced. It touched me deeply thatmany readers cared enough aboutAnimaLIFE to contact me andinquire. If you appreciate the way the articlesare crafted in the magazine, my Dad has touched your life. I simply couldnot write them the way I do without the life foundation I was blessed with. Loved ones –animals and people – are gifts.

Thank you for indulging me in my story. As always, please contact me if you have a storyyou'd like to share. I'd love to hear from you.W

All the best,

Patrice Scott, “AnimaLIFE” editor, with Clyde.Right: Dad with my sister Rita and Officer.

The two words “an ima l ” and “ l i f e ” sha re the “L ” because—jus t l i ke ou r pe t s—they a re a seamless pa r t o f ou r l i ves .

Patrice ScottMarketing and Development OfficerVeterinary Medical Teaching Hospital1700 Denison Ave., 103 Trotter HallManhattan, KS 66506-5601Phone: 785.532.4046E-mail: pscott@vet.k-state.edu

A Father’s Gift

AnimaLIFE / pg. 5AnimaLIFE / pg. 4

Faculty Profile

G reetings from the Veterinary Medical Teaching Hospital at Kansas StateUniversity. I hope your summer was fulfilling and that you had an opportunity toenjoy family and friends. We are excited to share more wonderful stories about

our patients and clients as well as some of the hospital’s successes and challenges. Weare pleased to get AnimaLIFE back to you after a short hiatus!

The Pet Health Center renovation was completed recently. The new area betteraccommodates the heavy traffic flow in the busy local practice area of our hospital. Withnew cabinets, countertops, exam lights and LCD monitor for the microscope, the spaceis more efficient and addresses the needs of the doctors, students, technicians andpatients. It is an excellent learning environment.

Our equine clients will be happy to know that we will soon begin construction on anequine lameness center that will be located on the east side of the hospital. The equinefaculty will have a dedicated and enclosed space designed for diagnosing lameness.

We are quite hopeful that our small animal surgery suite can be renovated within threeyears. Currently we have four operating rooms and the suite has remained much thesame since the hospital was built in 1977. Tentative plans call for a total infrastructureupgrade and the addition of one operating room. The floor plan will be modified so thatcritical services are unified. For example, the anesthesia induction area and patientrecovery will be co-located near ICU to increase efficiency and optimize patient care.

We would appreciate your help in making these plans become reality. Some of our needspropel our visions; others help patients today. Recently, our linear accelerator becameinoperable. Then we learned that it was irreparable. This is an extremely important pieceof equipment in our fight to help animals with cancer. Oncologists use the linearaccelerator to deliver targeted beams of radiation to kill cancerous tumors. If you areinterested in learning more about the many ways you can help our hospital help animals,please call Patrice Scott, marketing and development officer, at 785.532.4046 or e-mailher at pscott@vet.k-state.edu.

Thank you for supporting our hospital, and thank you for caring about animals.W

Warm Regards,

Roger B. Fingland, DVM, MBA, DACVSAssociate Dean, Clinical ProgramsDirector, Veterinary Medical Teaching Hospital

Shaping the Future...TODAY D r. Amy Rankin, assistant

professor ofophthalmology, didn’t

originally envision a career inveterinary medicine let alonebecoming a veterinaryspecialist. All that changed whenshe applied to veterinary schoolher junior year in college. Beforelong, her long-range planincluded becoming anophthalmologist.

“After three years of generalpractice, I decided I was readyfor a new challenge,” Dr. Rankinsays. “I love ophthalmologybecause I get to work with everyspecies. Ophthalmologistsmanage eye problems in cats,dogs, horses and exoticanimals. For me, it’s the best ofall worlds wrapped into onespecialty,” she says. “Everyanimal has two eyes.”

Dr. Rankin finds it doublygratifying to help clients andpatients because many of themhave never heard of a veterinaryophthalmologist until they needone. “So many people don’tknow that this specialty exists,”she says. What I want our clientsto know is that we’re happy tohelp them, and we’re happy towork with their veterinarians.”

VMTH client Medina Roynon is atypical client who was unawareof the specialty until her puppy,Pebbles, needed advanced care.Pebbles’ breeder told Medina that the puppy’s left eye was scratched bya littermate. When problems persisted, she took Pebbles to aveterinarian who treated her for an eye infection. “She kept blinking andher eye seemed to irritate her,” Medina says. A friend suggested thatshe make an appointment at the teaching hospital to see anophthalmologist. Surprised by the existence of the specialty and hopeful,Medina quickly made an appointment. “I guess it was something I neverthought of because I’ve never had a dog with an eye problem.”

Pebbles, at 5 months, came to the VMTH. “Dr. Rankin thoroughlyexamined Pebbles then shared her diagnosis,” Medina says. “Pebbleswas born with a congenital eye defect – her left eye had no tear

production. I felt so relieved thatwe finally knew what was wrong.We just apply the prescribedointment to her eye daily andshe’s perfect.”

Dr. Rankin advises clients to bealert to possible signs that theirpet is experiencing eye (vision)problems. If, for example, a petis squinting, rubbing at the eyes,producing extra tearing/watering; if the eyes have acloudy or bluish cast or the whitearea turns red, it may be time tosee an ophthalmologist. If ahorse is spooked whenapproached from one side butnot the other, this may be a signof a vision problem.

The great opportunity here is thatso much can be done.Many corrective microsurgicalprocedures are available to helppatients suffering from diseasesor degeneration of the eye.Dr. Rankin tells of a VMTH patientthat was completely blind fromcataracts. “His cataract was socomplete I couldn’t see hisretina. So, if I can’t see in, hecan’t see out.” She surgicallybroke apart the cataract and wasable to restore the patient’svision to nearly normal of 20/70.

More help is on the way for smalland large animals thanks to herresearch. Dr. Rankin is currentlyassessing different models ofinflammation inside the eyes of

cats to determine which medications can be used clinically to reduceinflammation. She’s also conducting a corneal sensitivity project withalpacas.

Dr. Rankin comes to the VMTH from a busy ophthalmology practice nearMilwaukee, Wis. She earned her DVM from the University of Wisconsinand her master’s degree from Purdue University.

Dr. Rankin’s husband, Dr. David Rankin, is an anesthesiologist at theVMTH. They live in Manhattan with twin daughters, Eleanor and MaryFrances, 4. The family has three cats, Frank, Herb and Myrtle; a dog,Sugar; and two birds, Hector and Speedy.W

Eye Know-HowDr. Amy Rankin

Story by Patrice ScottPhoto by Joe Montgomery

Dr. Amy Rankin at home with husband, Dr. David Rankin, and twin daugh-ters, Mary Frances and Eleanor. The family adopted Sugar when shefailed her eye examination during the service dog certification process.

AnimaLIFE / pg. 7AnimaLIFE / pg. 6

”I met Wilma on Monday...”I met Wilma on Monday...

...The tremors intensified......The tremors intensified...Dr. Beard made Wilma her top priorityDr. Beard made Wilma her top priority

“Whatever it takes.”“Whatever it takes.” With that, we went to work.

With that, we went to work.

I had been so busy with Wilma thatI had been so busy with Wilma that

I suddenly realized my two weeks with her was up.

I suddenly realized my two weeks with her was up.

With one e-mail to my classmates,With one e-mail to my classmates,

I had secured another two weeks with Wilma

I had secured another two weeks with Wilma

I reached day 28 with WilmaI reached day 28 with Wilma

Wilma went home after 38 days in the hospital.

Wilma went home after 38 days in the hospital.

All the best, Wilma, you will not soon be forgotten,

All the best, Wilma, you will not soon be forgotten,

if ever. if ever.

Editor’s note:An

incredible group of

people were brought

together thanks to

their unwavering

commitment to

animals. The

following article was

originally written as

an essay by senior

veterinary student

Elliot Stevens about

his experience with

Wilma, an equine

patient. He wrote the

detailed piece when

he was nominated for

the Radar Mullet

Scholarship for

Clinical Excellence by

Dr. Beth Davis,

associate professor

and equine section

head.

‘I metWilmaonMonday...This is an edited account of Wilma’s 38-day hospital stay. Itis also an extraordinary firsthand look at a senior student’strue responsibilities.by Elliot Stevens, DVM—Kansas State University 2008

Wilma, left, with her best friend and

pulling partner, Betty, back at home.

Edited by Patrice Scott

through the stethoscope. Her respiratory rate had been16 breaths per minute before the penicillin; afterward itwas 80. I realized Wilma’s clinical signs were consistentwith an allergic reaction to the penicillin. Dr. Beardconfirmed the diagnosis.

Wilma’s owners, Stephanie and Keith Guthrie, have 70horses and a few cats and dogs. Stephanie is bestdefined by a line from the Emma Lazarus poem “TheNew Colossus” that describes the Statue of Liberty. Thepoem ends with the statue herself speaking: “Give meyour tired, your poor, your huddled masses yearning tobreathe free, the wretched refuse of your teeming shore.Send these, the homeless, tempts tossed, to me: I lift mylamp beside the golden door.” Stephanie would dowithout for the benefit of her animals. Her doorstep andpastures in Inman, Kan., have eased suffering andprovided happy days for many animals.

We explained to Stephanie that a medical interventionwas necessary and outlined the costs. She said,“Whatever it takes.” With that, we went to work. Wilmastarted to grind her teeth, often a sign of extreme pain.One hour after administering the penicillin, Wilma’s urineturned red in color. This was the result of an immunemediated hemolytic event, which culminated in herimmune system destroying her red blood cells. All cellsare important, but the loss of red blood cells that carryoxygen to her body amplified the critical situation. Piecesof the now-destroyed red blood cells lodged in herkidneys and caused a pigment nephropathy that can

W ilma, a 23-year-old Belgian mare, arrivedSunday, Aug. 26, 2007, at the KSU-VMTHwith several swollen areas on the left side of

her neck and with a cough, which had been treated withan antibiotic without response. Accompanying Wilma washer best friend and pulling partner, Betty. I could not haveimagined the events that would transpire during herhospital stay or the diligent efforts of a wonderful owner.

I met Wilma on Monday, the first day of my two-weekequine medicine rotation. After completing a physicalexam, I placed a catheter and drew and submitted bloodfor a complete blood count and chemistry panel. Westarted Wilma on two antibiotics, penicillin andgentamicin, that provide broad coverage against manybacteria associated with respiratory disease. Afterinfusing a very small amount of penicillin, Wilma becamerestless and began having intense muscle tremors. Iimmediately stopped infusing the penicillin and watchedher for a few seconds. The tremors intensified, andWilma began circling in her stall with a maniacal unease. Inotified the intern, Dr. Tami Karges, and she monitoredWilma as I ran to find the senior clinician, Dr. LaurieBeard. Dr. Beard made Wilma her top priority.

Wilma’s circling ceased within five minutes, and Iproceeded with a brief physical exam. Her heart rate thatmorning had been 36 beats per minute and was difficultto hear given her large size. Following the penicillinadministration, the heart rate increased to 130 beats perminute and sounded like someone knocking on a door

AnimaLIFE / pg. 9

progress to renalfailure. We weremanaging a severeallergic reaction topenicillin,monitoring thedestruction of thered blood cells,and trying toprevent kidneyfailure.

It was importantto beginaggressive fluidtherapy toprotect Wilma’s

kidneys. She weighed 1,700pounds and needed 46 liters (12 gallons) of fluids tomeet her daily requirements. However, we needed Wilmato produce more urine than normal to prevent the lodgingof the destroyed red blood cells, so we administered IVfluids at the rate of 92 liters every 24 hours, twice herdaily need.

Wilma’s hematocrit, a measurement of red blood cells,was 16 percent at 5 p.m., which meant she needed ablood transfusion. I could feel Stephanie’s unease as shewas nervous about Wilma’s condition. I reassured her wewere going to do everything we could to get Wilmathrough this event. Given that Wilma’s immune systemwas destroying her red blood cells, we closely monitoredall physical parameters that might indicate an allergicreaction to the blood being transfused.We recordedWilma’s heart rate and breathing pattern everyfive minutes for 5 ½ hours until the transfusion wascomplete. It was a late night, but when I checked Wilma’shematocrit before going home, it was 22 percent. Wewere going in the right direction!

The next morning, Wilma seemed uncomfortable, andwe were concerned that a blood clot may have lodged inthe arteries or veins that supply blood to hergastrointestinal system. If it wasn’t a clot, her reducedred blood cell numbers may not have been able toprovide oxygen to her gastrointestinal system. Theoutcome of either scenario may have resulted in thefailure of part of her gastrointestinal system. Weperformed an ultrasound of her gastrointestinal systemand found that her small intestine and stomach were fluiddistended. In the horse, a fluid distended stomach can belife threatening because horses cannot vomit. Weimmediately passed a nasogastric tube and refluxed 26liters of fluid. This was more bad news for Wilma and herowners. We called Stephanie and told her that we wereconcerned that Wilma had developed ileus, decreasedmotility of her gastrointestinal system. She told us,“Whatever it takes.” Again, we went to work.

We continued fluid administration in an attempt to preventkidney failure from the hemolytic process. We alsoneeded to account for the fluid that had refluxed from hernasogastric tube. That meant Wilma would need 118 (92+ 26) liters of fluids. Additional reflux must also bereplaced. Unfortunately, she continued to reflux: 90 litersthat day. It was virtually impossible to meet her fluiddemand, but we gave her as much as we could. Over thenext two days, Wilma refluxed 75 to 80 liters each day.The good news was that her hematocrit was stable, andshe stopped producing red urine. We were beyond theallergic response and the immune mediated red bloodcell destruction. We now focused on managing the ileus.

After being on fluids for four days, we had twomajor problems! We needed to get Wilma’sgastrointestinal system moving, and she needed propernutrition. We addressed the first situation with lidocaine.(Lidocaine is typically used to block pain for short surgicalprocedures, but it is also used as a pro-motility drug.)Wilma required 52, 100-ml bottles of lidocaineadministered intravenously each day of treatment. Thefirst day on lidocaine, Wilma’s reflux decreased to 45liters and normal GI motility sounds were auscultated.Wilma’s condition improved and lidocaine therapy wasdiscontinued after four days.

Wilma’s body was converting fat into energy because shehad not eaten solid food in four days. We talked withStephanie about placing Wilma on total parenteralnutrition (TPN) to be certain Wilma’s nutritional needswere being met. We explained the expense with the TPN,and once again, Stephanie said, “Whatever it takes.”Wilma was on TPN for three days.

On day 11, despite having been through an allergicreaction, an immune mediated hemolytic event and ileus,Wilma appeared stable so we decided to allow her to eatsmall amounts. I fed Wilma one handful of pelleted feedevery four hours and added brome hay to her ration. Iwas also able to do something I had never done before: Itook Wilma and Betty outside for a walk and grazing. Thefuture was looking bright.

I had been so busy withWilma that I suddenlyrealized my two weeks with her was up. It was hardto leave Wilma since we had been through so many latenights, early mornings and full days. I knew so muchabout her that I could never adequately tell the nextstudent what she liked and what she didn’t like. Forinstance, Wilma likes to be groomed every morningstarting at the back and working forward; she likes you toscratch her behind the jaw; and she likes you to stand inthe stall with her. There was just so much about her that Icould never transfer on a piece of paper or in a briefconversation.

Luckily, I was scheduled for a supplemental equinerotation and might be able to stay with Wilma if a studentwould switch rotations with me. With one e-mail to my

classmates, I had secured another two weeks withWilma. Deep down I hoped I would not need that muchtime before sending her home.

Monday, Sept. 15, the first day of the supplementalrotation,markedWilma’s 15th day in the hospital.She was stable in the morning but that all changed in theafternoon. She laid down in her stall and was groaning.Her heart rate and breathing increased. We gave her painmedication and monitored her closely. A rectalexamination revealed that her cecum was distended withgas. We talked with Stephanie about surgery. Our planwas to monitor Wilma closely and be prepared to takeher to surgery if necessary.

Wilma was treated with fluids and pain medication andreceived vigilant monitoring. Over the next 24 hours, shedid not lay down, but her condition did not improve. Wedecided very early Monday morning to start Wilma on thedrug, yohimbine, a pro-motility drug. It required all theyohimbine in the hospital to give her just one dose.Following administration of yohimbine, her gastrointestinalmotility improved, and she appeared to be much lesspainful. Thankfully, surgery would not be necessary. Weoffered her small amounts of food and water, which sheaccepted without hesitation. Over the next few days, wechallenged Wilma’s digestive system by increasing herfluid and food intake until she was no longer refluxing. Itwas her 22nd day in the hospital and she appearedto be doing very well.

Over the next few days, we increased outside time froma half-hour to an hour, three times a day. She loved beingoutside, and it was great to see her so happy after allshe had been through. Since she was doing well, weturned our attention to Wilma’s problem at presentation;the swellings on the side of her neck. We evaluated theswellings with an ultrasound and aspirated them using a3-inch spinal needle. The cytology was consistent with aseroma. There was a small amount of drainage seepingfrom one of the swellings, so we talked with Stephanieabout opening it to allow it to drain properly. Weexplained this would extend Wilma’s hospital stay, andStephanie told us she would have it no other way: Shewanted Wilma to have the best care. Again, “Whatever ittakes,” was the answer.

I reached day 28 withWilma, and it was time for meto move on to surgery so I transferred Wilma to anotherstudent who is a good friend. I continued to visit Wilmafor our daily conversations, to groom her (even thoughshe didn’t need it), and to take her outside whenever Iwas free.Wilma went home after 38 days in thehospital. I was not able to be there when she left, butmaybe it was better that way.

As I conclude this writing, I am looking out the windowthinking about Wilma and Betty standing side by side on apasture under the vast, open, starry Kansas night sky. Allthe best, Wilma, you will not soon be forgotten, if ever.W

Radar was a straywho adopted his

“mama,” LavonneMullet, when he wasbetween the ages of 6and 8. Their six yearstogether were markedwith constantcompanionship andhappy times. Lavonneand Radar werereferred to the

teaching hospital when Radar wasdiagnosed with kidney disease. In a letterposted on the hospital’s Web site, Lavonnewrites: “Thanks to your incredible staff, wewere able to manage his kidney disease,and I had another wonderful year with myprecious little dog.” (To read Radar’s story,go to www.vet.ksu.edu, click on TeachingHospital, then ‘Why We Do What We Do.’)

Lavonne was so impressed with their experience she decided to honor Radar’s veterinary students by establishing ascholarship that memorialized Radar and recognized veterinary students with exceptional communication skills andacademic achievement. Thus was born the Radar Mullet Scholarship for Clinical Excellence.W

From left to right: Keith and Stephanie Guthrie, Wilma’s owners;Lavonne Mullet, VMTH grateful client and philanthropist; seniorstudent Elliot Stevens and wife Sheila; and Dr. Beth Davis whonominated Elliot for the scholarship. The group gathered at theannual senior honors banquet where Elliot was announced thewinner of the Radar Mullet Scholarship for Clinical Excellence.

This “stray” was the beginning of a friendshipand scholarship

Lavonne Mullet andRadar

‘I metWilma

onMonday...

Wilma and Betty with owner Keith Guthrie.

Photo by Dave Adams

AnimaLIFE / pg. 8

AnimaLIFE / pg. 11AnimaLIFE / pg. 10

F ortunately, Wilhelmina’s owner recognized the value of savingher. Mike Frey is the son of Dr. Russ Frey, a legend at theCollege of Veterinary Medicine. “She’s owned by the son of an

important faculty member in our college’s history,” Dr. Anderson says.“It’s wonderful that there is aconnection to Dr. Frey with thiscase and that Mike understands theteaching value.”

Mike says he was happy to be partof an effort that could help animals,producers and students. “I wasalways under the assumption thatan animal with this problem wasgoing to be heading down theroad,” he says. “If they couldperfect this so that a cow could bekept in production, that would beworth quite a bit.”

Dr. Anderson explains that thecruciate ligament is a dense tissuethat connects the bones in the kneejoint. Injuring it can be career-ending and often life-ending – untilnow. The three published surgicaltechniques for anterior cruciaterupture in large animals have afailure rate of approximately 50percent, Dr. Anderson says. Thisfact caused him and surgerycolleagues Drs. Guy St-Jean andAndre Desrochers to investigate alternatives in the 1990s. The teamdesigned a cruciate ligament using braided polyester; however, thematerial was not strong enough for heavy cattle. Dr. Anderson

continued to experiment with a variety of materials until he discoveredan unusual form of nylon monofilament, a solid material about thediameter of a coffee straw. But the question remained: Could this man-made material replace the natural ligament of a 1,500 pound animal?

On Jan. 17, Dr. Anderson replacedWilhelmina’s torn ligament with theartificial one, dubbed the “WildcatPower Cord.” Dr. Anderson’ssurgery team included surgeryresidents Drs. Kara Schulz andJose Bras, intern Dr. ManuelChamorro, along withanesthesiologists, veterinarystudents and technicians.

The next day, the Jersey cow wasled across the hospital’s videosynchronization pressure mat todetermine her level of lameness.“Her stride length had increased 30percent, and she bore 25 percentmore weight on her operated leg,”Dr. Anderson says. “To have thatmuch improvement is spectacular.”(His long-term goal was to developa replacement ligament strongenough for bulls. Lab tests revealedthat the Wildcat Power Cord couldwithstand up to 12,000 newtons ofpressure – roughly 50 percentmore than an adult bull requires.)

Wilhelmina retuned home and was kept in a box stall for a week or so,Mike says. After that, she had the run of the free stall. “We had a toughwinter with all of the snow and ice,” he says. “I didn’t think she’d getaround as well as she did.”

Nichole DeBellis and Shelby Reinstein were the senior veterinarystudents who named Wilhelmina. They appreciated the vast learningopportunities this case presented, especially those relative to anatomyof the stifle and monitoring Wilhelmina for specific conditions dairy cowsare at risk for developing. These include inflammation of the udder(mastitis) or of the uterus (metritis), a metabolic imbalance (ketosis),ulcers and displacement of the abomasum, the fourth compartment ofa ruminant’s stomach.

“We worked really hard for her and spent long hours at the hospital, butit was definitely worth it after seeing how well she did post-op,” Shelbysays. “I love being part of the discovery aspect of veterinary medicine,and it is always really rewarding to try something you’re not sure aboutand have it work. And, my parents were quite impressed that I couldmilk a cow!”

Wilhelmina continues to do well today thanks to the efforts of thehospital’s faculty, staff and students. So the next time you hear thephrase “how now brown cow,” you’ll know she’s fantastic.W

n 8-year-old Jersey dairy cow is back at her

Manhattan, Kan., farm thanks to a decade of

research and an experimental surgery performed

at the Veterinary Medical Teaching Hospital.

The cow, namedWilhelmina Jolene by the

veterinary students assigned to her case,

sustained a breeding injury in December 2007

when the cruciate ligament in her right knee

ruptured. Dr. David Anderson, professor and head

of agricultural practices, replaced the ligament

using synthetic material called monofilament

nylon. The procedure’s success will have

enormous implications for breeding quality cows

and bulls with the same injury.

Dr. Anderson replaced Wilhelmina’storn ligament with the artificial one, dubbed the

‘Wildcat Power Cord.’

Shelby Reinstein and Nichole DeBellis were the senior veterinarystudents who named Wilhelmina.

Story by Patrice ScottPhotos by Dave Adams

Since operating on Wilhelmina (above), Dr. Anderson has successfullyimplanted the Wildcat Power Cord in two adult bulls. The surgery isnow offered routinely at the Veterinary Medical Teaching Hospital.

AnimaLIFE / pg. 13AnimaLIFE / pg. 12

Achance encounter on Aug. 17, 2007,with a large breed dog in their ruralneighborhood led Bill and Dee Willsand their 11-year-old Dachshund,Little Pup (nicknamed LP), on anunimaginable odyssey. Bill, an

independent truck driver, could never have guessed thattheir medical journey would last months and that successwould depend on a veterinary specialist and speakerfoam.

Bill describes the day LP was bitten. “He was sitting onthe couch in the living room when he went flying off thecouch and out his dog door into the front yard,” he says.“LP ran outside to protect his property, and the other dogbit him and shook him.” LP never cried or yelped, butwhen Bill got to him the damage was obvious. “He wascut wide open,” Bill says. “He was ripped from the middleof his back to his groin. He looked at me with his eyesand said, ‘Fix me.’ ”

Within 10 minutes of the attack, Bill and LP arrived atDr. Kurt Fredrickson’s veterinary clinic. “Basically, thelaceration went from the middle of the back and entireleft side to the lower abdominal area,” Dr. Fredricksonsays. “There were smaller puncture wounds andlacerations.” Dr. Fredrickson debrided the wound, placeddrainage tubes and ran blood work to determine if LP’skidney function was normal. Fortunately it was.

Dr. Fredrickson took LP to surgery to close the wound.After the procedure, he shared the guarded prognosiswith Bill because of the extensive damage to the skin andLP’s age. The possibilities existed that the skin would notheal and that LP could develop kidney problems. LP spentthe weekend at the clinic and came back for a recheck onAug. 24. Four days later, LP required another surgerybecause the sutures broke open despite the fact that Deewas confining LP and carrying him outside to go to thebathroom.

On Sept. 7, Dr. Fredrickson took LP to surgery for thethird time. The sutures opened again six days later.“Although I had tried several techniques, doing what wewere doing just wasn’t working. So I needed to get themto K-State where there were more options and expertise.This was our only chance because we were losing skineach time we tried.”

Dr. Dirsko von Pfeil, assistant professor of small animalsurgery, recalls the first time he examined LP on Sept.18. “He had a large wound on the left lateral abdomen,”he says. “Typically, granulation tissue (visible when skin isnot present) is red and very vascular in appearance witha cobblestone pattern, but LP’s wound was white-beige in

tone and the surface was flat. Healthygranulation tissue is necessary for an openwound to heal.”

“We evaluated LP for Cushing’s Disease, anendocrine disease that occurs when thebody produces too much cortisol, but thatwas negative,” Dr. von Pfeil says. “Then wesubmitted cultures for typical and atypicalbacteria. We ran all possible culturesincluding fungal, and everything came backnegative. Next we submitted a biopsy forhistopathologic analysis. The diagnosis waschronic, non-healing wound with noapparent etiology (origin). Radiographs ofLP’s chest and ultrasound of the abdomenwere within the limits of normal for a seniordog.”

Yet there was nothing normal about a 5½-inch wound that failed to respond totreatment and three attempts at closureby LP’s veterinarian.

Dr. von Pfeil removed debris from thewound then scraped the surface toencourage blood flow and stimulateformation of granulation tissue. “We keptthe wound covered using a tie-overbandage that usually helps with theformation of granulation tissue and pulls theskin in. It’s a technique that encourages‘mechanical creep.’ ” (It stretches the skin,thus decreases tension when attaching wound edges.The latter is one of the most important things forsuccessful wound closure.)

Within four to five days of conventional wound treatment,healthy granulation tissue typically starts to form.However, after treating LP’s wound and changing thebandage twice daily for five days, there was noimprovement. A perplexing question loomed: Whywouldn’t LP’s wound close?

A more aggressive approach was needed so LP wastaken to surgery where the surgical team removed a 1½-inch layer of adipose (fatty) tissue. “We removed theadipose tissue to encourage blood flow from theunderlying musculature,” Dr. von Pfeil says. “Followingsurgery, we strategically placed elasticized Velcro stripsdown LP’s back to decrease tension around the woundedges, which would help when eventually closing thewound. We changed the bandages and tightened thestrips two times a day in the hopes of producing

mechanical creep. While the woundedges appeared to come closertogether, there was still nogranulation tissue forming during thefollowing days.”

Despite all the tests and effort, LP’stwo problems persisted: The woundwouldn’t close; and no granulationtissue was forming. On Oct. 2, LP’s16th day in the hospital, the woundwas re-cultured and a variety oftopical medications were used toincrease the formulation ofgranulation tissue. Still noimprovement.

What else could be done?

Dr. von Pfeil had successfully treateda patient with vacuum-assistedclosure (VAC) while completing hisresidency at Michigan StateUniversity. Because the techniquehas been used almost exclusively inhuman medicine, a modification wasneeded for veterinary patients.Sterilized speaker foam, heexplained, is ideal because of itsporous composition. The open-airfoam is sealed air tight with a plasticsheath, and when negative pressureis applied, subatmospheric pressure

is evenly distributed over the wound area. This literallypulls blood vessels to the wound surface and providesthe factors necessary to create a uniform granulation bedand wound healing to occur.

Dr. von Pfeil talked with Dee and Bill about the benefits ofVAC therapy. Dee’s initial reaction: “You’re going to dowhat?” Dee was scared, but she knew this could possiblybe the only way to save LP. Bill, Dee and LP havetraveled more than 2 million miles together on the openroad; they weren’t about to give up because of an openwound.

“We were at a point where nothing had worked, and LPcouldn’t live with that wound,” Dee says. The decisionbecame easier when the couple realized that LP’smedical team, now consisting of two additional surgeons,Dr. Emily Klocke and surgery resident Dr. StephanieLister, had conducted extensive research, and believedthey had the answer. “We trusted everything they saidand we told them, ‘Just fix our dog and we’ll be happy.’ ”

Bill, Dee and LP have traveled more than 2 million miles together on theopen road; they weren’t about to give up because of an open wound.

ROADTO

RECOVERY

A vacuum-assistedsurgical technique usedfor the first time at the

Veterinary Medical TeachingHospital (VMTH) brings closure toa dog’s wound and a trying ordeal

for a Salina, Kan., couple.

Dr. von Pfeilhad

successfullytreated apatient withvacuum-assisted

closure (VAC)while

completing hisresidency atMichiganState

University.

AnimaLIFE / pg. 15AnimaLIFE / pg. 14

The Referring Veterinarian

Two decades after purchasing a practice, Dr. Robert Johnson isheading into a new phase of life, which includes an architect.

Dr. Johnson graduated from the College of Veterinary Medicine in 1984and worked as an associate for two years at a practice in Baldwin City,Kan. “I received great training my first few years out of school,” hesays. “I knew I wanted to call the shots, and you can’t do that when youwork for someone else. I saw an advertisement about a practice forsale and decided to look at it.”

In 1987, Dr. Johnson bought a mixed animal practice in Berryton, Kan.,just outside of Topeka that he renamed Paw Prints Animal Hospital.“Everything fell into place,” he says.

Life was great for the next five years until he sustained back injuriesresulting from a serious car accident in 1992. Dr. Johnson underwentsurgery and was forced to limit his practice to small animals only. Healso had to give up Taekwondo his “exercise andoutlet” after becoming a third degree black belt.“Now I just do cardio and lift weights, Dr. Johnsonsays. “I try to eat a healthy diet and get regularexercise. I just turned 50 and feel better than whenI was 40.”

That’s great news because his practice, and thenumber and size of animals living in his clinic aregrowing: he has five office cats and an Africanleopard tortoise named Wilbur who needs morespace. Dr. Johnson is currently working with an

“If I couldn’thelp my patient,I called theteachinghospital.”

architect to develop plans for an addition. “We will double the size ofour clinic, and I’m hoping to get things going this fall,” he says. “Thereare times when all 11 of us (employees) are here, and we are bumpinginto each other in the halls.”

There’s little doubt as to why his practice has grown. “Always behonest,” he says of his philosophy in working with clients. “If I couldn’thelp my patient, I called the teaching hospital,” he says. “I cannot tellyou how many cases I’ve referred and how many times I’ve called there.I have gotten great support from all the specialists. My clients are in aweof the hospital, and I can’t think of one client who was disappointed. Ithink everyone at the teaching hospital is just wonderful.”

His attentive nature and desire to continue learning are qualities thatDr. James Roush, professor and head of small animal surgery at theVeterinary Medical Teaching Hospital, truly respect. "Dr. Johnson is avery conscientious veterinarian who wants only the best care for his

patients and who is quick to refer unusual caseswhen his clients can benefit from specialty care atthe teaching hospital. In doing so, he also helps ustrain the next generation of veterinarians bysupporting the teaching caseload.”

Dr. Johnson’s daughter Sarah, 20, is studyingpsychology at the University of Kansas. HisBerryton home, located on 5 acres along with theclinic, is bustling with sons, Ethan, 8, Dominic, 5,two house cats, Galahad and Merlin, and Maddie, aWelsh Corgi.W

Red paint on Wilbur’s middle scutehelps Dr. Johnson locate the Africanleopard tortoise when playing outside.

Story and Photos by Patrice Scott

After two days of VAC therapy, the moment of truth wasat hand. “There was significant improvement of thewound appearance with nice granulation tissue showingwhere the area was covered with the VAC,” Dr. von Pfeilsays. “In order to improve upon the initial result, we optedto add two days of VAC. The end result was stunning,really” – the wound was ready to be closed. Due to thepreviously applied tie-over bandage and Velcro straps, itwas not necessary to use special wound closurereconstruction. The wound edges could be apposed afterplacement of regular “walking sutures,” which also help todecrease tension at the wound edges.

On Nov. 19, after 53 days in the hospital, LP went home.

Dee and LP have not been able to return to the road withBill since this happened due to a variety of issues. Bill islonely but he looks forward to calls from Dee. “I have tomake a living,” he says. “I miss them, but I try not to let itbother me. Dee puts on the speaker phone and LP ‘talks’to me.” Bill believes if you are in tune with your pet, they’lltell you what to do. “Read your puppy’s eyes, they cantalk with them. Love ‘em and treat ‘em good.”

Dee’s positive attitude and sense of humor helpedeveryone involved in the situation. Laughing, she explainshow they are handling life since this incident. “We’rehaving a blast,” she says. “We just enjoy every day wehave together. It was all worth it.” LP is healthy and happyto be back at home among his beloved family.

Family was also the reason that Dr. von Pfeil left KansasState University this summer. He says, “I think that myenthusiasm for wound treatment was transmitted to bothstudents and other veterinarians when treating LP. I amhappy to know that VAC with its amazing effects onwound healing will be available and of great value forfuture patients at the Veterinary Medical TeachingHospital.”W

On Nov. 19, after

53 days in the

hospital, LP went

home. ”We are

having a blast,”

Dee says.“

1. 2.

Justin Voge, senior veterinary student, LP andDr. Dirsko von Pfeil.

3.

A quick overview of LP’streatment and VACVacuum-assisted closure (VAC) wound therapy hasbeen used successfully in humans for the treat-ment of acute and chronic wounds of theabdomen, thorax, and limbs for more than 18years. This method involves the placement of asterile, open-foam dressing over the wound,sealing the area with an adhesive drape, and thenapplying controlled subatmospheric pressureuniformly to the wound.

1. LP’s open wound at admittance to VMTH.

2. Velcro strips help reduce tension on wound edges.

3. The open foam dressing. Note the redvacuum hose that supplies the suction.

4. Justin and LP at a follow-up appointment.

ROADTO

RECOVERY

AnimaLIFE / pg. 17AnimaLIFE / pg. 16

Commitment.That’s why Dr. David Hodgson spent six months in Afghanistan teaching veterinarystudents last year. And that is why he went back this summer.

Dr. Hodgson, professor of anesthesiology, spent May through November 2007 at theSchool of Veterinary Medicine at Kabul University (KU). There, he witnessed a country inchaos, where battles are both internal and external. Amid the shattering realities of warand deep-rooted conflicts between East and West, old and new, students are learning.Women, despite their husbands’ protests, are seeking an education. Language barriers,substandard or nonexistent textbooks and equipment were no match for the hopeDr. Hodgson saw in the eager faces of students who want a better life. This, it turnsout, is something we have in common.

They say it’s not possible to be in two places at once. However, look into the eyes ofDr. Hodgson, and you’ll see an educator whose heart now belongs to two countries andtwo very different groups of students. “I saw this as an opportunity to live my values,”says the soft-spoken, unassuming Dr. Hodgson.

While veterinary students at K-State and in Afghanistan will someday share the sameprofession, their physical surroundings, educational experiences and lifestyles are polaropposites. Each week, Dr. Hodgson e-mailed a two-page letter summarizing the week’s

events to his colleagues at K-State. Throughthese letters, readers became connected tohis work, supported his efforts throughdonations, and silently wondered if they coulddo what he was doing.

He wrote about vicious fighting dogs thatneeded emergency treatment – but caregivers had no equipment to restrain theanimals. He shared the heartbreakingeuthanasia and burial of Riko, a retired minedetection dog that suffered from acute kidneyfailure. Surgeries were completed inrudimentary surroundings using only naturallight. Meanwhile, military convoys rumbledthrough the streets, and bus bombs killed atleast 44 people in less than 10 days.

His words best describe the realities.

KABUL-ING IT TOGETHER

Dr. Hodgson works witha student using a micro-scope. Lab equipment,such as a microscope,is a luxury at theschool. Much of theequipment needed forteaching is substandardor nonexistent.

Introduction by Patrice ScottPhotos by Dr. David Hodgson

Veterinary students observe partial forelimb amputation. Student treats donkey with colic using parafin oil via nasogastric tube.

Dr. Hodgson usesnew ophthalmoscopefor first time.

AnimaLIFE / pg. 19AnimaLIFE / pg. 18

July 25:We are getting so low onsupplies and drugs that wecan scarcely provide carethat requires vaccines,antibiotics, anesthetics andvarious other products. If Ican’t get products to keepthe clinic functioning, Icannot teach students andmy presence here is ofvery limited or no value.Some days I would just bethrilled to find a second rollof adhesive tape in theclinic! To find ways to re-energize myself for thedifficulties ahead, I onlyhave to look to thestudents that I amprivileged to work with.I start each day with theresolve that I will just try

and make the best of whatever situation I encounter and to try to make asmall but positive difference.

Aug. 10:There are so many opportunities to teach students, and I take fulladvantage of the teachable moments whenever they arise. It reallyenergizes me to have this time with the students and to have gooddiscussions about important veterinary issues. The students have beenappreciative and attentive to all of my efforts. I have three more monthsto effect progress and have ideas for ways that I may be able to makethose changes when the new semester starts and have recentlyproposed afternoon skills labs for the 5th year students.

Sept. 15:This morning at the clinic we started off with eight sheep presented withvarious problems. Primarily, afflictions were respiratory infections andinternal parasites. We had three excellent small animal cases that gaveample teaching opportunities. The students’ lack of core knowledgenever diminishes their enthusiasm to be involved and committed.

Donations from you (College of Veterinary Medicine faculty, staff,students and friends) are used to enhance the diagnosis and treatment ofanimals at the Kabul University Clinic. The donated books are resourcesthat I use daily and the drugs and anesthetics have enhanced patientcare. It is amazing to me how well animals respond to basic antibioticslike penicillin.

Sept. 24:This has been an interesting and generally productive week inAfghanistan. We have had many excellent teaching cases, and I havetried to serve as ophthalmologist, dermatologist, internal medicineclinician, surgery consultant and an anesthesiologist this week. I havefound my diverse veterinary background to be very useful, but at timesinadequate to address all of the challenges that I am confronted with.

Often it is necessary to review basic anatomy, physiology and other corecourses to help students understand what they need to know in order togive good medical advice and treatment. The students continue to be myinspiration each day. The difficulties I encounter are erased by the energyand enthusiasm the students bring to the clinic.

Sept. 28:I had the 4th year class in the clinic on Wednesday. We started themorning with a kitten that presented from Tigger House (a humaneshelter) for treatment. I discussed all of the facets of doing a thoroughphysical exam with the students. When they were done, I asked theresponsible student the sex of the kitten. Neither he nor anyone elseknew, so I gave each student an opportunity to re-examine the kitten.I then took a ballot and the vote was split! This necessitated furtherdiscussion and review of basic feline anatomy. We had some lightmoments, and I think the entire exercise was a good learning experience.

Oct. 8:Every day I am reminded of how fortunate I am to have such greatcolleagues and friends at the Kansas State University College ofVeterinary Medicine. Each clinical case in our clinic in Afghanistan is thebeneficiary of the gifts of books, equipment and supplies that you havesent. I took one book, “Popesko – Atlas of Topographical Anatomy ofDomestic Animals” to a faculty member I admire. He had a copy ofPopesko that was buried outside in a trash heap during the war years.He found and retrieved it later, but it was severely damaged. He teachesanatomy and this is truly a treasure in his eyes.

The purple anesthesia waste gas adaptors and blue corrugated hose willallow me to more adequately vent the waste isoflurane out the window.The lack of heat in the clinic will get progressively worse. Eventually aswinter arrives, the guards will bring a small, crude stove into the clinic toheat the office and small animal exam room. Fortunately for now thesunshine helps take the chill off by midmorning.

Wow, was I impressed with the new Welch-Allen ophthalmoscope,otoscope combination instruments. I believe there is absolutely everyWelch-Allen diagnostic accessory included. The extra light bulbs and a220 volt charger should keep this instrument functional for years. I ameager to start using this equipment with the students.

There’s no place like homeFollowing semester exams in November, Dr. Hodgson returned toManhattan. (Kabul University closes each November because there is noelectricity to heat classrooms. Courses resume in the spring.) Before heleft, he surprised each 4th year veterinary student during a ceremonywith an unheard of gift: a stethoscope. “It was important for me that theyrealize that all the gracious people who support K-State are nowsupporting them,” he says of the corporate and private donors whomade gifts to buy the stethoscopes.

Looking back, Dr. Hodgson says, “I’m committed in a way I didn’tenvision. I wanted to represent everyone at K-State really well becauseI’m just an extension of everyone here. Other than being in the military inVietnam, I haven’t had any international experience. There’s a time andplace in a person’s life when you can do something like this. To do that,you have to have support from the people you work for.”

And, the right person to commit.W

Local market

“We have hadmany excellent teaching cases, and I have tried to serve as ophthalmologist,

dermatologist, internal medicine clinician, surgery consultant and an anesthesiologist this week. I

have foundmy diverse veterinary background to be very useful, but at times inadequate to address

all of the challenges that I am confronted with.”

Before Dr. Hodgson left, he surprised each 4th yearveterinary student during a ceremony with an unheardof gift: a stethoscope.

The following excerpts were selected from Dr. Hodgson’s weekly Afghanistan updates:

Equine patient at clinic for lameness examination. Sheep arrive at clinic for examination.

Nonprofit OrganizationU.S. POSTAGEPAIDPermit #4Manhattan, KS 66502

Kansas State UniversityVeterinary Medical Teaching Hospital

Mosier Hall1800 Denison Ave.Manhattan, KS 66506

The largest veterinary hospital in Kansas and one of the largest in the nation.

Kansas State University Veterinary Medical Teaching Hospital1800 Denison Ave. • Manhattan, KS 66506

• Small Animal & Exotics: 785.532.5690 • Equine and Agricultural Practices: 785.532.5700 • www.vet.ksu.edu/depts/VMTH

I t’s a tradition to give gifts when attending a birthday party. However, Frances andTom Dudley of Topeka, Kan., asked party goers (pictured below) to direct gifts tothe equine section of the Veterinary Medical Teaching Hospital. It was there that their

horse, Bob, received advanced medical care that enabled him to reach an importantmilestone: his 30th birthday. (Bob and Frances are sixth from the left.)

In a letter to attendees, Dr. Beth Davis, associate professor and equine section head,writes: “We were delighted and overwhelmed when Frances and Tom Dudley informed usthat together you raised an amazing $6,307 for the equine section. Thank you! WhenBob was treated at our hospital in 2007, we quickly understood what a special horse hewas. We had no idea what great things Bob had in store for us.

“Because of Bob and your generosity, we will be able to purchase several items for theequine section that include a stall side lactate analyzer, an arthroscope telescope,upgrade our foal alert system, and provide enhanced patient service with bench seatingnear our lameness platform. This equipment will not only help with patient care, it willprovide immeasurable teaching opportunities for students. For us, treating and teachingare inseparable concepts, and we deeply appreciate your investment in both.”

THANK YOU BOB, FRANCES and TOM!

Happy BirthdayBob