- The Washington Times - Tuesday, September 24, 2002

Greater Washington area pet dogs and cats who may be rescued from local pounds for as little as $25 may find themselves diagnosed for medical woes with a million-and-a-half-dollar, state-of-the-art magnetic resonance imaging (MRI) machine that has been operating since March in Vienna.
Cost, of course, isn't always an issue when pet owners, under the direction of local veterinarians, want answers to complicated problems besetting four-footed family members many of which are also expensive pedigreed breeds used to, well, top-dog care.
Applying such advanced technology on these animals ideally prevents the need for exploratory surgery, according to Dr. Dan Carey, director of technical communications at Iams Research & Development in Dayton, Ohio. The Iams Co., a manufacturer of pet care products, funded the Vienna facility, called the Iams Pet Imaging Center. The center's medical director, Dr. Julie Smith, is one of the country's few board-certified veterinary anesthesiologists.
The pet imaging center, which accepts patients only on referral, is one of possibly a total of 15 of its kind in the country, says Dr. George Siemering, managing partner of the SouthPaws Veterinary Referral Center in Springfield. Dr. Siemering says it is "the only one of that quality on the East Coast for animals and humans, the first one easily accessible for any veterinarian."
State laws control the number of MRI machines per population and whether the same machine can be used for both animals and humans. Virginia doesn't permit this double use.
In helping reduce the need for surgery, the MRI procedure which costs $1,200 and involves anesthesia to keep the animal still for 30 minutes can reduce expenses down the line. CT scans X-ray-computed tomography cost about $600.
"We don't just lightly say, 'Go get an MRI,'" insists Dr. Siemering, who says his office may account for as many as 50 percent of the center's patients. "We look at the whole patient and weigh the odds with the information we are given. We have to have a good reason to put an animal under anesthesia." Anesthesia used in the procedure, however, is less than what is needed for surgery.
Neurologists Mike Knoeckel and Betsy Dayrell-Hart on staff at SouthPaws (so named because the founding partners were all left-handed) are the vets most inclined to call for an MRI, Dr. Siemering notes. "It helps in confirming a herniated disc to see where it is and where to operate."
MRIs don't replace biopsies in exploring for cancer, but they can detect a lot about a tumor and, according to Iams' Dr. Carey, a veterinarian, "You can say with a high degree of confidence what kind of tumor [you think] it is and whether it has to come out."
Animals with neurological problems are at greater risk when put under anesthesia, which is why a veterinary specialist in this field is in charge at the center.
More than 250 images, depending on the case, are produced by the machine and transferred to a veterinary radiologist at Iams in Ohio, who then contacts the local veterinarian involved in the case. If the local vet still recommends surgery, the surgeon who will do the work will have the kind of detailed information that could result in a shorter, more successful operation.
Dr. Carey recalls a recent visit to the center to see a guide dog with a shoulder problem getting an MRI.
"X-rays suggested this was a problem requiring extensive surgery," Dr. Carey says, "but after the MRI, the problem was seen as more akin to what we call rotator cuff injury that requires much simpler surgery. The dog was back in service within a few days. With longer surgery, it might not have been able to go back into service at all."

The machine, which is shaped like a donut, can hold the largest size dog or the biggest cat say a Siberian tiger weighing several hundred pounds. A large magnet inside the machine affects atoms in the body tissues in particular the hydrogen ions that change ever so slightly without harming the patient, Dr. Carey explains. The effect of the magnet on these tiny ions develops the image in a process heavily dependent on computers. Unlike X-rays, this process does not involve radiation.
"If you have a dog with a seizure problem that may be in the brain or upper spinal cord, you can't biopsy the brain," he says. "But if you do an MRI and scan the tissue around it, you see what could be abnormal in that spot. You can rotate the images in the computer and say, 'That appears to me to be such and such and here are landmarks to get the biopsy instruments in.'
"Sometimes things don't show up on ultrasound and X-rays, which are better at showing bone in two dimensions and not soft tissue. MRI shows bone and soft tissue. You can rotate and gradually move through tissue as though you were taking slices through the animal. If you are expecting to do any surgery, it gives you a road map of what to take out and what to watch out for."
Kelly Price Gray of Hamilton, Va., was referred to the center by Dr. Susan Leonard of Leesburg's Animal Emergency Hospital and Referral Center. Ms. Gray's dog Desi, a Dalmatian-terrier mix that was a rescue dog nine years ago, had a tumor at the base of his brain. He was in pain and losing a great deal of weight. A myelogram an X-ray using injected dye that also requires a pet to be anesthetized showed the tumor but did not reveal enough to indicate whether it was operable.
If the tumor had invaded the dog's spinal cord, it might not be advisable or even useful to operate. If so, Desi's pain could be moderated only with drugs. Ms. Gray, a nursing student at Marymount University, had spent $3,200 by then, including the cost of the MRI.
"I'll do anything to keep him alive," she said.
On the Friday before last, Desi walked painfully and haltingly into the spanking-clean facility in Vienna, which has separate entrances and waiting areas for dogs and cats. He looked almost resigned to yet another round of needles.
Not so little Toby, a pug dog who had been suffering from brain seizures. The pug nipped Dr. Smith on the hand while he was being prepared for the MRI. For protection, the seasoned veterinarian, who doesn't wear gloves, taped a clear plastic ball over Toby's head to restrain his movement until the catheter insert for the anesthesia was in place.
Despite such encounters, Dr. Smith the "parent" of two dogs that often accompany her to work says "the biggest thrill of the job is the interaction with the client and pet, and being able to give them an answer within 24 hours."
Desi's scan was completed at 11:30 a.m. By 12:30 p.m., Toby lay head down in the MRI machine, called the Magnetron, under the straps that position an animal in place. Technician Tiffany Garrison was at the controls behind a plate-glass window in an adjoining room.
The center handles up to five cases a day, with a 6-month-old puppy with developmental problems and an 18-year-old tan dog being the youngest and oldest pets seen there to date. The staff even has scanned a hawk used in falconry, and Dr. Siemering of SouthPaws, who does pro bono work for the National Zoo, has used the facility to inspect one of the zoo's 30-pound tree kangaroos when it had an infected tooth.
"We're seeing more older dogs," says Dr. Smith, who came to Vienna from a teaching post at Louisiana State University. "They live longer, like people. Pets are better fed and cared for than ever."
Desi, meanwhile, awakened in a groggy state, having been given some medicine to relieve his pain for a few hours. He seemed to feel no aftereffects from the procedure, not even from having been positioned back-down with all four legs splayed out and tubes extending from several parts of his body for measurements of heart and blood pressure, IV fluids and the anesthetic.
Dr. Smith reassured Desi as he got up from a resting mat on the floor, Ms. Gray by his side, to make his way slowly out of the recovery room.
Early last week, Ms. Gray heard from surgeon Tommy Walker at the Leesburg hospital that part of Desi's tumor was on the outside of the spine and the rest was inside. Last Tuesday, in consultation with Dr. Walker, she decided to go ahead with surgery at least to do a biopsy of the tumor and take out as much of it as possible to relieve pressure on the spine.
"Then depending on what kind of tumor it is, there could be other therapies available to help," she said, reacting to the news and trying to be upbeat. "The worst thing is, you can't tell him what is going on. We'll probably have him with us for a month at least or, depending on the behavior of the tumor, for several years."

WHAT: Iams Pet Imaging Center
WHERE: 328 Maple Ave. E. Vienna, Va. 22180
WHEN:
8 a.m. to 5 p.m. Monday through Friday, by referral of local veterinarians.
PHONE:
703/281-9440


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