by Amy Olson

In the brightly lit operating room, all is quiet. Dressed in scrubs and protective gear, the surgeon looks through his surgical microscope. He carefully closes the incision in his patient’s eye after removing a cataract.
Under ordinary circumstances, a human patient undergoing this operation would be awake, given only local anesthesia to numb the pain. But this patient is a canine — and Stephen Bistner is a veterinary ophthalmologist.
Over the last few decades, specialty practices in veterinary medicine have grown.
While most veterinarians are general practitioners who begin practicing after graduation, some veterinarians specialize in orthopedics, ophthalmology, oncology or cardiology.
Like their counterparts in human medicine, veterinary specialists go through four-year training programs after veterinary school.
As people and pets age, both have more health problems. While human medicine is moving faster, both disciplines are developing comprehensive geriatric care.
Procedures like hip replacements and cataract surgeries not only prolong the lives of pets, they improve the quality of the pet’s life and the owner’s as well, said veterinary orthopedist Betty Kramek.
More and more pet owners seem willing and able to provide care for their pets. Ed Kosciolek, administrative director of the University’s Veterinary Teaching Hospitals, said the teaching hospitals have seen nearly twice as many patients this year as they did a decade ago. In 1987 about 14,000 patients visited the hospitals, while nearly 25,000 came in 1997.
As part of the College of Veterinary Medicine, Kosciolek said the teaching hospitals can offer animals neurology, dermatology, cardiology, oncology, ophthalmology and orthopedics — specialties most clinics can’t offer.
Veterinary oncology and cardiology are two of the newer specialties. Carrie Wood, a clinical specialist in veterinary oncology at the teaching hospitals, said veterinary oncology started about 12 years ago as an off-shoot of internal medicine, which has been a specialty for 25 years.
Wood is among approximately 180 veterinary oncologists world-wide. Although the number is growing, Wood said only about 10 veterinarians each year take the board exam to become certified in oncology.
While the goal of treating cancer in humans is getting a “cure,” Wood said veterinary oncologists try to ease suffering by getting the pet’s cancer to go into temporary remission, which may last a year or a year-and-a-half. Veterinary cancer patients usually go through 12 weeks of chemotherapy, followed by frequent checkups.
Wood said the most common form of cancer in dogs and cats is lymphoma, an aggressive form of cancer. Her average patient is between 8 and 12 years old.
The cost of chemotherapy treatment depends partly on the size of the dog or cat and the duration of the chemotherapy sessions. Kosciolek said the veterinary oncologists use the same chemotherapy drugs used to treat humans, and the average treatment costs about $50.
Although the treatments are expensive and might not seem to prolong the animals life very long, Wood said dogs and cats live shorter lives than humans. Without chemotherapy, Wood said most patients would only live four to six weeks after diagnosis — in pain.
Veterinary cardiology is another growing specialty area. Kristin Marshman, a clinical specialist in cardiology at the teaching hospitals, said the field offers care to pets that many owners think can’t be helped.
Unlike humans, dogs and cats do not suffer from the kind of heart disease which causes heart attacks. Certain breeds, including Dobermans and boxers, are genetically prone to heart failure not caused by heart attacks.
Marshman said as dogs age, their heart valves tend to thicken, which causes them to leak, leading to heart failure.
Cats can also suffer from heart problems as they age, Marshman said. Medications can help prevent heart failure for both cats and dogs.
Although open-heart surgery for animals is a long way off, Marshman said in the future, heart surgery combined with research might lead to better treatments for patients. Veterinary cardiologists now implant pacemakers into dogs to stabilize their heartbeats.
While old dogs and cats seem likely candidates to visit veterinary specialists, young dogs and cats can suffer from joint problems and cataracts. While these problems are often associated with elderly humans, dogs and cats can develop bad joints or cataracts as kittens or puppies.
Bistner said canine cataracts are caused by a number of factors, including heredity. The primary causes of cataracts in dogs, however, are diseases like diabetes and glaucoma.
Bistner said the oldest dogs he operates on are between 14 and 15 years old. The youngest dogs are between 6 months and 1 year old, and they are often born with congenital cataracts.
Although veterinary cataract surgery has been performed for three decades, Bistner said microsurgery techniques now enable veterinary ophthalmologists to perform the surgeries with a 90 percent success rate.
Dogs can also have joint problems at a young age. Kramek said her youngest hip replacement patient was a 10-month-old Newfoundland.
“We hate to replace hips on really young dogs because they’re knuckleheads and jump off decks,” Kramek said.
Kramek said some breeds of dogs, including German Shepherds, common retrievers and standard poodles, are all susceptible to osteoarthritis, a primary cause of joint problems in large dogs.
While human joint replacement patients often take weeks and even months to recover, Kramek said most dogs that have hip replacements are up and walking the next day. Many are able to run again, and the surgery has a 95 percent success rate.
Kramek said cats are less likely to need orthopedic surgeries because they weigh less and are less prone to joint problems.
Besides doing orthopedic surgery, Kramek sees patients with broken bones and operates on patients with head and neck problems.
While these specialties enable pet owners to prolong their pets’ lives, they are expensive. Bistner said cataract surgeries cost $1,100 per eye, and Kramek said hip replacements cost $2,600.
While some pet owners are able to afford the expensive surgeries, others have a hard time deciding when to stop treatments that are not guaranteed to return their pet to good health.
Human patients requiring similar procedures are often covered by health insurance or at least share the cost. Bistner said veterinary health insurance can alleviate the cost of procedures like cataract surgeries, but most pet owners do not have veterinary health insurance.