Annual Report 2017

College of Veterinary Medicine Learn Discover Heal Protect

In 2017, the MSU College of Veterinary Medicine continued to advance and fulfill each facet of its mission:

LEARN. DISCOVER. HEAL. PROTECT.

These four cornerstones are the foundation of the College, andall its education, research, outreach, and development are done with these concepts at the forefront. This annual report highlights some of our proudest accomplishments of the last year in each area.

In 2016, the College began the process of reinventing the DVM curriculum, which has had no major revisions since 1992. The goal is to create a cost-effective, learner-centered program that accounts for student welfare while preparing career-ready graduates who are highly valued by potential employers and competent on day one of employment. Upon graduation, students will be ready to holistically and dynamically connect and collaborate with colleagues, clients, and the broader discipline of veterinary medicine.

The reinvented four-year curriculum will be competency based and feature an integrated sequence of courses, with opportunities to practice technical, cognitive, and clinical skills during the first three years. This will prepare students for career-specific emphasis in their fourth year.

“The first and second years will be mostly systems based; the length and the content of individual courses will be guided by competencies,” explains Dr. Jon Patterson, professor for the Department of Pathobiology and Diagnostic Investigation and member of the Curriculum Reinvention Steering Committee. Patterson also led the Student Assessment Working Group during the first year of planning for the reinvented curriculum. “The third year emphasizes developing clinical reasoning skills, honing technical and diagnostic skills, and selecting appropriate treatments. The fourth year focuses on developing proficiency in an area of career interest. The reinvented curriculum includes a total of 54 weeks of clerkship experience.”

“Other colleges of veterinary medicine are watching us. Others have revised their curricula to emphasize more active learning strategies, but the scale of our curriculum reinvention is unprecedented.”

After the College faculty approved the curriculum model proposal in April 2017, the Competencies Working Group compiled more than 800 competencies as suggested by the faculty and organized them into proposed new courses. The College Curriculum Committee decided on the order of the courses and the number of credits for each course; the number of credits is based on the number of competencies assigned to a course while taking into consideration the amount of time devoted to a given topic or body system in the current curriculum. Course moderators and teams have been identified for all year-one courses, the development of which will be completed by June 2018; the new curriculum starts for incoming first-year students in fall 2018.

“Other colleges of veterinary medicine are watching us,” Patterson says. “Others have revised their curricula to emphasize more active learning strategies, but the scale of our curriculum reinvention is unprecedented.”

Improved learning and animal welfare are just a couple benefits of the Haptic Cow and Haptic Horse, two simulation models that allow students to carry out virtual reproductive and abdominal exams in a risk-free environment.

Bovine veterinarians routinely perform bovine rectal palpation as part of a clinical exam for pregnancy diagnosis and fertility assessment. In horses, rectal palpation is used to diagnose several colic conditions including pelvic flexure impaction, twisted intestinal tract, and displacement of the large colon. The virtual touch technology in the haptic models make palpation highly realistic, which creates better prepared and more confident students.

“Students can work through the mechanics of the exam on the model before they touch a live animal,” says Dr. Jennifer Roberts, assistant professor for the Department of Large Animal Clinical Sciences. “From an animal welfare standpoint, we’re using fewer live animals during teaching and we’re also making the students more proficient when they move on to examine a live animal.”

“From an animal welfare standpoint, we’re using fewer live animals during teaching and we’re also making the students more proficient when they move on to examine a live animal.”

Though the exteriors of the models look simplistic—basically a hollow back end of a cow or horse—Roberts says the shells are important for placing students in the context of being behind a live animal, giving them the mindset that they are examining a real animal.

Each model starts out with a basic scenario, which can be made more complex as students advance. In the Haptic Cow, the most basic level includes just the pelvis and the cervix. When students become comfortable locating and palpating those structures, the uterus can be added, then pregnancy and other scenarios.

The College is one of only two veterinary schools in the United States to purchase these models for student education. All first-year veterinary students used them, and their feedback was overwhelmingly positive, according to Roberts.

The cost of earning a DVM degree has risen dramatically within the past 15 years, even as starting salaries for veterinarians stagnated after the recession. In the past few years, salaries have started to increase and seem to be on an upward trajectory. Still, the average level of student debt for an MSU DVM graduate is $175,441—which is nearly double the average starting salary for new graduates. The College is addressing these issues from several angles. In addition to the reinvented curriculum that aims to make students immediately employable at a higher level upon graduation, the College also is offering more financial aid and scholarships. The Matilda R. Wilson DVM Scholars Endowment is one example; when fully funded, it will offer as many as 13 in-state students $5,000 per year, which may be renewed for up to four years. With even greater awards for out-of-state students, this scholarship will be available to all veterinary students in good academic standing who have financial need.

Campylobacter bacteria is the number one cause of bacterial diarrheal illness in the United States, according to the Centers for Disease Control and Prevention. Approximately 1.3 million people are affected each year. In most cases, people become sick from eating raw or undercooked poultry, drinking contaminated water, or consuming unpasteurized milk. Campylobacter jejuni is the species responsible for most human illness, and has been the focus of Dr. Linda Mansfield’s research for many years.

“By studying enteric pathogens that cause GI disease, we can look at the genes that cause virulence and how they evolve in the host,” Mansfield explains. “This can give us a better understanding of how these bacteria can trigger acute and chronic diseases.” Mansfield, a University Distinguished Professor who also is an Albert C. and Lois E. Dehn Chair, developed a diagnostic test for C. jejuni and used it to demonstrate how the bacterium can lead to autoimmune diseases, such as inflammatory bowel disease and Guillain-Barré Syndrome, which causes pain, peripheral neuropathy, respiratory paralysis, and sometimes death. While Guillain-Barré Syndrome has only a 5 to 10 percent mortality rate, the time it takes a patient to recover varies widely. Patients also may have permanent nerve damage.

“By studying enteric pathogens that cause GI disease, we can look at the genes that cause virulence and how they evolve in the host. This can give us a better understanding of how these bacteria can trigger acute and chronic diseases.”

Mansfield’s goal is to find options for future drug development, both therapeutic and preventive. She’s using a mouse model to locate a biomarker in C. jejuni patients that may help scientists predict whether a person will develop Guillain-Barré Syndrome. Her team used high-throughput sequencing and two mouse models—one with conventional mouse microbiota and another with stable human gut microbiota—to see if the structure of the gut microbial community alters the hosts’ GI inflammation or autoimmune response after a C. jejuni infection leads to colitis or Guillain-Barré Syndrome.

“The data we collected showed that human gut microbiota alters the host-pathogen interactions in the model,” Mansfield says. “In these mice, there were increased colonization of Campylobacter and increased autoantibodies and autoimmune responses, meaning that microbiota composition is another factor that affects susceptibility to Guillain-Barré Syndrome.”

Dr. Bo Norby, associate professor for the Department of Large Animal Clinical Sciences, also studies bacteria, though his focus is antimicrobial-resistant bacteria in dairy cattle and how farmers can reduce transmission of the pathogens as well as reducing the resistance to antibiotics.

In the past, many farmers that produced food animals mixed antibiotics in the animals’ feed to promote growth and for feed efficiency. While this practice has stopped, farms that did use antibiotics in feed are slow to recover from antibiotic-resistant bacteria in herds. The more time it takes for antibiotic resistance to diminish, the higher the risk of resistant bacteria transmission among animals and between animals and people. Ultimately, the resistant bacteria make treatment of bacterial disease in all species more difficult.

“Unfortunately, the prevalence of drug-resistant bugs isn’t going to just drop off right away in most instances, but I want to find out if there’s a way to speed up the decrease in prevalence of resistant bacteria, instead of potentially waiting for many years or decades to pass,” Norby says. “The question is, can we speed up the process, and if we can, which new protocols can we implement to aid in that pursuit?”

“. . . As we learn more about antibiotic resistance and how to prevent and reduce it, we can create novel therapies, develop farm management practices, and
implement reductions in antibiotic use that will make the world a healthier place for everyone.”

To speed calf recovery from resistant E. coli bacteria, Norby developed a probiotic therapy that decreased bacteria numbers by 90 percent. He’s also working with dairy producers to identify how they can reduce antibiotic use with the goal of easing build-up of antibiotic resistance in the first place.

“Investigating new therapies like this probiotic can accelerate the reduction of antibiotic-resistant bacteria in herds and could lead to improved health for animals and food safety for humans,” Norby says. “It can be hard to change behaviors, even when there is economic incentive to do so—at MSU, I’m working with my fellow faculty and members of other colleges and MSU Extension, as well as primary care practitioners and producers, to navigate the human and social dimension of this problem. As we learn more about antibiotic resistance and how to prevent and reduce it, we can create novel therapies, develop farm management practices, and implement reductions in antibiotic use that will make the world a healthier place for everyone.”

Research requires funding. As state and federal research dollars have diminished, the College is extremely appreciative of donors who see the value of supporting both basic and applied research to further its mission.

In 2017, Jim and Barb Edgett received the College’s Philanthropist of the Year Award. The Edgetts established the Daisy Edgett Ophthalmology Room in the Veterinary Medical Center’s Small Animal Clinic to support the Comparative Ophthalmology Service, led by Dr. Simon Petersen-Jones, section chief and Myers-Dunlap Endowed Chair in Canine Health.

The room, named for the Edgetts’ beloved German Shorthaired Pointer who went blind from cataracts, means the College has one of the best-equipped veterinary ophthalmology services in the country. The Edgetts hope the room and equipment will help other family pets avoid blindness.

“We are extraordinarily fortunate to have friends and benefactors like Jim and Barb,” Petersen-Jones says. “They make it possible for us to provide the most advanced treatment for our clients today and to conduct research that will provide the ground-breaking treatments of tomorrow.”

The sacrum, a small triangle-shaped bone between the iliums, links the pelvis to the spine via the sacroiliac joints. Sacroiliac luxation or fracture (SIL/F) is often seen in pets after road traffic accidents. Most commonly, SIL/F repair surgery involves gluteal dissection and displacement of the ilium so the surgeon can see the sacrum and drill a hole through it. The joint is then put back into place and a screw is used to reattach the ilium to the sacrum. This approach, known as open reduction and internal fixation (ORIF), while regularly successful, is complicated and often results in poor screw placement that could lead to complications.

“A lot of dogs with SIL/F are not operated on because of the surgical complexity and fear of complications. Many dogs are simply ‘cage rested,’ which needlessly prolongs recovery and discomfort,” explains Dr. Loïc Déjardin, professor and head of orthopedic surgery for the Department of Small Animal Clinical Sciences.
Fifteen years ago, a minimally invasive procedure was proposed to improve screw placement accuracy and reduce complications. Here, the joint is reduced from the outside under fluoroscopic guidance, then kept in place by an assistant or with a temporary pin through the ilium and into the sacrum. A small gluteal incision allows the surgeon to insert an iliosacral screw to secure the joint in place. While this technique is somewhat more reliable than ORIF, maintaining accurate screw orientation is challenging. Also, the surgery must be done using intraoperative radiography, which exposes the surgical team to ionizing radiation.

To overcome these shortcomings, Déjardin has invented a new surgical technology to repair SIL/F in small animals. The sacroiliac luxation instrument system (SILIS) allows accurate and reliable screw placement while eliminating radiation hazard to the surgical team.

“This novel instrumentation and surgical technique has allowed our team to be more precise, more consistent, and faster in treating SIL/F than ever before.”

“This novel instrumentation and surgical technique has allowed our team to be more precise, more consistent, and faster in treating SIL/F than ever before. The procedure is easier and safer for the surgical team who is not exposed to dangerous radiation,” Déjardin says.

The SILIS consists of three components: 1) six-axis arms that can be deployed in any direction, then locked in place, 2) reduction handles to manipulate bones, and 3) a minimally invasive lucent aiming device (MILAD) attached to another arm for accurate screw positioning. The surgeon couples the reduction handle(s) and MILAD to their respective arms, reduces the SIL/F, moves the MILAD over the sacrum, and then locks the arm(s). With everything secured, the surgical team moves away, avoiding exposure to deleterious radiation, while radiographs are taken to check reduction and MILAD location and orientation.

“The MILAD acts like a scope on a rifle,” Déjardin says. “It allows the surgeon to accurately orient the screw very quickly. Because everything is locked into place, confirmation radiographs can be taken without the surgeons in the OR.”

Traditional surgery takes about one to two hours. Déjardin’s invention has cut that time to 10 to 20 minutes at most while improving accuracy, reducing patient morbidity, and eliminating exposure to radiation.

Clinicians in the College have long used endoscopy to examine horses’ larynxes and upper respiratory systems to diagnose various illnesses and conditions. Still, if a symptom only occurred during exertion, the horse had to be put on a giant treadmill with the endoscope inserted in an attempt to simulate the problem. In 2017, the College acquired a new dynamic respiratory endoscope, which allows endoscopy to be performed while the horse is being exercised or trained under natural conditions.

“With this new unit, we can put the horse under saddle and evaluate the airway under the specific conditions that caused the problem,” says Dr. Marc Kinsley, assistant professor for the Department of Large Animal Clinical Sciences. “We use it on all disciplines of horses—race horses, dressage, any type.”

The dynamic unit is similar in size to a traditional endoscope, but is self-contained. The flexible tube of the scope attaches to the horse’s halter, which holds the scope in place. The other end of the scope attaches to components in the saddle pad that transmit video of the airway via Bluetooth technology to a monitoring screen and recording unit about the size of a small shoulder bag. This allows a veterinarian to see what’s happening in the airway in real-time and also go back and rewatch the video

“It’s very exciting to have this equipment. It allows us to collaborate with local veterinarians and provide more advanced care to our patients and horse owners.”

The portability of the dynamic scope allows clinicians to take into account all the external factors that may be affecting a horse’s respiratory function, including the influence of the ground, rider, reins, etc.

“It’s very exciting to have this equipment,” Kinsley says. “A number of veterinary schools have invested in this technology, and realize that local practitioners may not have it. It allows us to collaborate with local veterinarians and provide more advanced care to our patients and horse owners.”

Clinicians, residents, and students at the MSU Veterinary Medical Center use imaging machines to diagnose patients every day. Thanks to an anonymous donor and Susan and Paul Bloom (DVM ’76), that treatment got a little bit faster, a little bit clearer, and a lot more cool in 2017.

The Hospital is the first college of veterinary medicine to acquire a GE Revolution EVO 64 Slice CT Scanner and table. The anonymous donor’s gift provided the scanner and the Blooms’ gift provided the table.

The scanner offers more spatial resolution and distortion reduction, less radiation exposure for patients, and increased workflow efficiency with more automation. It also allows faster scan times and lighter sedation instead of general anesthesia.

“These are true gifts for our students and our patients,” says Dr. Bari Olivier, chair for the Department of Small Animal Clinical Sciences. “Our patients will receive even better care and our students now have access to new technology, which will enhance their clinical experience.”

Dr. Bloom operates the Allergy Skin and Ear Clinic for Pets in Livonia, MI and serves as an adjunct faculty member for the College. Some of the College’s students spend their dermatology rotation in his clinic.

Nearly two million people die from tuberculosis (TB) every year. Current antibiotic treatments work slowly; if the TB bacterium isn’t drug resistant, it can take six months for the antibiotics to work and the side effects—nausea and liver toxicity—can be severe. Because of this, many people diagnosed with TB stop treatment early. At the same time, some countries have limited or no access to treatment. Both scenarios mean that the disease is not fully treated, which is how drug-resistant TB develops. TB also can become dormant, making it difficult to diagnose or treat, which can lead to drug resistance.

The research of Dr. Robert Abramovitch, assistant professor with the College of Veterinary Medicine within the affiliated Department of Microbiology and Molecular Genetics, focuses on treating TB in a different, faster way with the goal of reducing drug-resistant TB while creating treatments that are more tolerable.

Abramovitch discovered that artemisinin, a compound derived from the sweet wormwood plant used in traditional Chinese medicine to treat malaria, can block TB dormancy by stopping it from registering low oxygen levels.

“TB goes dormant when it senses a lack of oxygen, so we’re disabling that sensor,” says Abramovitch. “It’s like dandelions. Instead of mowing over TB with an antibiotic, we’re trying to dig it up at the root.”

Artemisinin, a compound derived from the sweet wormwood plant used in traditional Chinese medicine to treat malaria, can block TB dormancy by stopping it from registering low oxygen levels.

Mycobacterium bovis (M. bovis), which is closely related to the bacterium that causes TB in humans, causes bovine tuberculosis. While bovine TB has been nearly eliminated from the livestock population in the United States, sporadic outbreaks continue to plague producers, leading to expensive quarantines and culling. Wild deer are a major cause of bovine TB outbreaks. In the past, cows passed the disease into the environment, making it endemic in deer. Now, free-roaming deer can pass the disease back to beef and dairy cattle herds.

According to Abramovitch, M. bovis also can establish dormancy, living in the environment and getting into deer through ingestion. It’s possible that the bacterium also can survive in silage and be transmitted to cows through feed, so Abramovitch is working to use the same biosensors in human TB to study M. bovis survival in animal feed.

In March 2017, the MSU Veterinary Diagnostic Laboratory, part of the College (formerly known as the Diagnostic Center for Population and Animal Health), was awarded Level 1 laboratory status in the National Animal Health Laboratory Network (NAHLN).

A cooperative effort between two US Department of Agriculture agencies and the American Association of Veterinary Laboratory Diagnosticians (AAVLD), the NAHLN is a nationally coordinated network of federal, state, and university-associated laboratories that provide animal health diagnostic testing to detect biological threats to the nation’s food animals, thus protecting animal health, public health, and the nation’s food supply. NAHLN labs perform surveillance and response testing for both endemic and foreign animal diseases. Laboratories must be approved to test for specific diseases and follow NAHLN standard operating procedures. In addition, laboratories must successfully complete proficiency testing administered through the National Veterinary Services Laboratory’s reference laboratories on a regular basis.

Based on the 2017 NAHLN assessment, the MSU Veterinary Diagnostic Laboratory (VDL) met the criteria to be awarded Level 1 status. Criteria include: full AAVLD accreditation; more than 1,000 square feet of Biosafety Level 3 laboratory space; a lab information management system that can actively message test results to the NAHLN; 5 or more individuals authorized to perform foot and mouth disease (FMD) and avian influenza (AI) testing; surge capacity for more than 750 tests per day for FMD and AI; NAHLN approval for testing 5 or more diseases; and testing more than 10,000 surveillance samples per fiscal year.

In 2017, there were 14 Level 1 laboratories, 28 Level 2 laboratories, 8 Level 3 laboratories, and 1 affiliate laboratory. The NAHLN assesses laboratories annually.

“This year, surveillance for CWD here in Michigan and outbreaks of avian influenza in Asia and Europe, as well as the United States, underscored the need for laboratories such as ours to protect animals and the public from biological threats.”

Nationwide, 24 NAHLN laboratories are approved to test for chronic wasting disease (CWD) by immunohistochemistry and/or enzyme-linked immunosorbent assay (ELISA). The MSU VDL is one of only nine labs approved to test by both methods. The lab’s ability to test for CWD has proven to be incredibly valuable to the Michigan Department of Natural Resources’ efforts in increasing surveillance after a free-ranging white-tailed deer was positively confirmed with CWD in May 2015.

“We are honored to be recognized as a Level 1 laboratory,” says Rachel Reams, director for the Laboratory. “This change in status reflects the quality of our testing; our commitment to having staff authorized to test for AI, FMD, CWD, scrapie, swine influenza, and other agents that pose a significant risk to agriculture; the level of surveillance testing we provide for the region; and our active involvement in NAHLN-related activities. This year, surveillance for CWD here in Michigan and outbreaks of avian influenza in Asia and Europe, as well as the United States, underscored the need for laboratories such as ours to protect animals and the public from biological threats.”

Alumnus Richard Witter (DVM, ’60) is an internationally renowned researcher and member of the National Academy of Science, and served as director of the US Department of Agriculture’s Avian Disease and Oncology Laboratory in East Lansing from 1980 to 2002. Witter helped to develop vaccines for Marek’s disease, a highly contagious viral disease in chickens that nearly destroyed the poultry industry in the 1960s. Witter recognized the need to foster veterinarians to study the control of critical diseases and infections in animals to protect both animal and human health. In 2005, he and his wife, Joan, created an endowed scholarship to support veterinary students at MSU in summer research experiences to encourage them to pursue research careers, particularly careers studying poultry or other food animal infectious disease. The scholarship is awarded annually. The Witters also have another endowed fund to support PhD training for veterinarians.

“Perhaps one of the most important roles of the veterinarian, generating new knowledge to protect human and animal health, may also be one of the most overlooked,” says Dr. Vilma Yuzbasiyan-Gurkan, associate dean for Research and Graduate Studies for the College. “Dr. Witter understands the importance of this need, and we are grateful he has chosen to help MSU develop experts in the field.”