Having The Heart For Veterinary Cardiology

Dr. Michele Borgarelli has become a leader in the veterinary field with all of his contributions to the profession.

Michele—pronounce that Ma-KAY-lee—Borgarelli, DVM, Ph.D., Dipl. ECVIM (cardiology), has been studying cardiovascular disease in dogs for more than 15 years. Most of his studies and research have been in Italy, his home country, but he now resides in the U.S. and is an associate professor of cardiology at Kansas State University’s College of Veterinary Medicine.

“People should know that cardiovascular disease in small animals is very common but they are not terminal diseases,” Dr. Borgarelli said. “With the available treatment today we are able to manage patients and we can provide them a good quality of life for a long time.”

Borgarelli has a string of research studies under his belt. For instance, during a period of five years, Borgarelli and his research team conducted two population studies involving more than 300 dogs. One, published in 2008, involved dogs that had mitral valve disease at different stages. Another study involved dogs with the mild form of the disease. Borgarelli expects this study to be published shortly.

“Dr. Borgarelli has contributed substantially in the field of veterinary cardiology in many ways,” said Jens Haggstrom, DVM, Ph.D., Dipl. ECVIM (cardiology), professor of internal medicine at the Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences in Uppsala, Sweden. “If I had to pick [one important one], it would be his work on normal and abnormal heart valves in dogs, and the clinical trial he is now conducting.”

Dr. Haggstrom, who has known and worked with Borgarelli in various capacities since 1994, is referring to an Italian study that Borgarelli started last year. The double blind, placebo-controlled, multicenter study has two goals:

* To evaluate the efficacy of spironolactone in combination with benazepril therapy on delaying time of onset of clinical signs in dogs with advanced pre-clinical degenerative mitral valve disease; and

* To evaluate wheth-er any biomarker, including brain natriuretic peptide, or BNP, can be used to identify patient risk.

Other studies are looking at BNP, but there is no longitudinal study looking at the diagnostic effect of BNP in identifying patients with higher risk of developing heart failure, Borgarelli said.

The Italian study is expected to conclude in 2015.

Borgarelli is also involved with another study that just began at K-State’s College of Veterinary Medicine Teaching Hospital. The study, sponsored by Boehringer Ingelheim Vetmedica of St. Joseph, Mo., is applying a new noninvasive technique called contrast echocardiography to evaluate noninvasive myocardial perfusion.

Researchers plan additional studies using new 3D technology to further evaluate the mitral valve.

Do all these studies keep him overly busy? Borgarelli shrugged the question off with a chuckle. Hagg-strom, who was also one of Borgarelli’s advisers for his Ph.D. thesis work, summed up Borgarelli’s work ethic a little more clearly.

“Dr. Borgarelli works hard and long hours,” Hagg-strom said. “He always manages to get things done, even though the time seems impossible. This was especially evident when he was working on his thesis. He is always cheerful and friendly, and befriends people easily.”

Finding the Right Path

Like many veterinarians, Borgarelli knew he wanted to care for animals at an early age.

“It was a very early decision in my life,” he said.

Borgarelli said he read books by James Herriot as a teenager, and after high school went straight to veterinary school at the University of Torino in Turin, Italy, where he also later earned his Ph.D. In Europe, high school graduates can focus on veterinary studies right away, Borgarelli explained. The high school and veterinary programs are typically five years each, a little different from the United States, he said.

It wasn’t until he met his mentor Claudio Bussadori, DVM, Dipl. ECVIM (cardiology), in a postgraduate course that Borgarelli started to take an interest in cardiology.

“That’s the strange thing, because when I was a student I really hated cardiology,” Borgarelli said. “I met [Dr. Bussadori] at the time he was teaching a postgraduate cardiology course I was enrolled in. He had such a lot of passion in describing what he was doing that it made me think about cardiology seriously for the first time. I think anytime you meet somebody who is able to raise an interest in you for something you didn’t think about before, is great.”

Bussadori invited Borgarelli to visit his practice, which he did about once a week. An informal residency soon ensued. Everything fell into place afterward, he said.

When a residency opportunity became available at Kansas State University, Borgarelli and his wife decided to move to the U.S. in 2007, bringing with them their two daughters. He later became associate professor of cardiology at the school.

Moving Cardiology Forward

When it comes to bettering the field of veterinary cardiology, Borgarelli some areas need improvement. For instance, Borgarelli said, veterinarians often see dogs and cats with congenital heart disease too late in their lives.

“If we make a diagnosis earlier, we can correct the defects and [the animals] can lead normal lives,” he said, adding that this can be achieved by taking the time to recognize the presence of a murmur. “I think we are surrounded by technology and sometimes we forget that the physical exam is still very important and can provide a lot of information.”

Veterinary cardiology can also advance by having bigger, multicenter trials investigating the most common cardiovascular diseases, Borgarelli said. There are thousands of small studies, which can be useful, but the field really needs to move forward on a larger scale, as in human medicine, he noted.

All in all, though, it comes down to teamwork in getting things done.

“I’m a strong believer in teamwork,” Borgarelli said. “You cannot do this job by yourself. You need to work with other teams and I’m very thankful that I could collaborate over the years with great people. … It’s very important to develop this type of collaboration, otherwise you feel isolated and you would never go anywhere.”


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