SCOUTED: Kitty CAT scan: More vets use high tech

[Ronn! Blankenship]

Kitty CAT scan: More vets use high tech

WASHINGTON (AP) --Dr. Bill Bush cradled the weak little cat in his arms and suddenly spun around in a circle. When Bush stopped moving, Buffy's eyes didn't -- they continued twitching in the direction of the spin.

That simple clue showed Bush what weeks of increasingly frantic and expensive visits to other veterinarians had failed to find: Something very bad was happening in the back of Buffy's brain, not in her liver, like other doctors had speculated.

A nighttime visit to an MRI machine that by day scans sick people uncovered a large and very rare type of cancer pressing on Buffy's brain stem, poised to kill her.

Only a few years ago, Buffy's owner would have had just one option: euthanasia. In fact, in Lenore Gelb's quest to find out what made her cat too weak to stand, other veterinarians brushed aside her inquiries about an MRI, those scans so crucial to human medicine but still very hard to get for an animal. Don't waste the money, one advised, because nothing can be done if it's a brain disease.

Pushing the boundaries

Brain surgeons for cats still are a rarity -- there are 100 veterinary neurologists in the country and not all operate -- but they're out to put such notions to rest.

"Veterinarians in general aren't always aware we can get good results, and the general populace has no idea," said Bush, who performs the delicate surgery in a suburban Washington animal hospital. "I would like people to know there are things we can do."

Indeed, pet owners like Gelb are urging veterinarians to push the boundaries of animal medicine -- and no pet is too small. A goldfish just received radiation for cancer at Tufts University's School of Veterinary Medicine, therapy costing thousands of dollars.

Americans spend about $11.1 billion on veterinary medicine each year, according to the American Veterinary Medical Association. Most is out of pocket: Fewer than 1 percent of the nearly 60 million households with pets have pet insurance.

Limited options

When pet owners do track down rare specialists, a lack of animal-appropriate equipment and infrastructure can limit treatment options even for the wealthy, cautioned Dr. Steven Rowell, director of Tufts' veterinary hospital.

"People say to us, 'I'll pay anything,' but that still doesn't mean we have the ability to do whatever they want," he said.

Those $1,500 MRI scans are just one example. Even though Tufts is a leading veterinary school, doctors there until recently had to get up at 2 a.m. two days a week to scan ailing pets on a machine devoted to humans the rest of the time. Now Tufts shares with two other animal hospitals a van that brings a $1 million MRI machine to its hospital three days a week, one of less than two dozen pet-only MRIs in the nation.

Ethical issues abound

Then there are ethical issues. A handful of animal hospitals offer feline kidney transplants, but only if the sick cat's owner finds and adopts another cat suitable to donate one of its kidneys, ensuring the donor a good home, Rowell said.

There's little research proving which treatments work best for which diseases and which species, research important in guiding pet owners on when to pursue cutting-edge therapy and when to let go. The $10,000 kidney dialysis that vets had hoped would save pets who drink antifreeze, for example, is producing mixed results, Rowell said.

And most owners want some guarantee that brain surgery that can cost up to $5,000 will work. But "the hardest part of the job is predicting the outcome," acknowledges Bush, the Gaithersburg, Maryland, neurosurgeon.

Buying quality time

So was it worth the gamble for Buffy? Cats do survive brain surgery better than dogs, for unknown reasons. But, unable to hold up her head, the 14-year-old cat was deteriorating fast -- and Bush suspected she had a highly unusual cancer, called a plasmacytoma, growing through her skull into the brain.

So Bush tried a trick -- a dose of a drug called Mannitol. The next day, he greeted Gelb "like a kid in the candy store," she recalled, gleefully opening the door to reveal Buffy running around.

The drug had temporarily eased tumor-caused pressure on Buffy's brain, simulating what would happen if Bush could cut out the cancer. Gelb immediately agreed to surgery.

Privately, the doctor was nervous. He'd never wielded a knife so close to the brain stem, the spot literally responsible for life or death. Drilling through Buffy's tiny skull, Bush cut away bone and almost a half-inch of diseased cells beneath it before healthy brain tissue finally came into view.

Beating cancer

A day later, Buffy was playing, a bald spot her only sign of sickness.

Then the tumor analysis came back: Buffy likely had a particularly bad form of plasmacytoma, called multiple myeloma. It was time for chemotherapy, a pill every day.

Four months later, there's no sign of cancer, although Bush can't predict how long that will last. Her owner only cares that Buffy's happy again.

"I'm getting quality time," Gelb says. "That's what I was looking for, as long as it lasts."


Copyright 2002 The Associated Press.

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