Telemedicine, 3-D printing, radiology and biotechnology are among the terms that could dominate the veterinary technology landscape in the years to come.
“I see huge potential for 3-D printing in veterinary medicine,” said Diane McClure, DVM, Ph.D., Dipl. ACLAM, an associate professor in laboratory animal medicine for the College of Veterinary Medicine at Western University of Health Sciences in Pomona, Calif.
Orthotic and prosthetic applications for 3-D printing technology are at the proof-of-concept stage, and they will become more conventional in the future, said Denis J. Marcellin-Little, DVM, Dipl. ACVS, Dipl. ECVS, Dipl. ACVSMR.
Dr. Marcellin-Little, a professor of orthopedic surgery at the North Carolina State University College of Veterinary Medicine, collaborated with the Center for Additive Manufacturing and Logistics and the North Carolina Aquarium in Roanoke Island in the 3-D manufacture of a custom brace for a green sea turtle that suffered an open fracture to its right radius and ulna.
The brace enabled the turtle, Augie, to eventually heal. According to those caring for Augie, the turtle became well enough to swim without the brace but was not yet ready to be released into the ocean.
“3-D scanning and printing will revolutionize the field,” Marcellin-Little said. “It is only a matter of time.”
Steve Joslyn, BVMS, Dipl. ECVDI, a member of the Royal College of Veterinary Surgeons, is excited about what 3-D printing could bring to veterinary medicine in the coming years.
Dr. Joslyn, a clinical assistant professor in the department of veterinary clinical medicine at the University of Illinois, envisions a time when complex orthopedic conditions will be imaged with a CT scanner at a practice and the scan sent to a radiologist and orthopedic surgeon team for a consult.
“They diagnose the problem, print bone models, but also print metallic surgical guides that allow the local vet to follow physical surgical instructions to repair the limb tailored to that specific patient,” Joslyn said.
3-D Coming to a Clinic Near You
Royal College of Veterinary Surgeons member Steven L. Marks, BVSc, Dipl. ACVIM, believes that 3-D printing applications will soon move far beyond the field of prosthetics and that the initial steps into other areas of medicine have been made.
Dr. Marks is associate dean and director of Veterinary Medical Services for the North Carolina State veterinary college, where two years ago medical personnel saw a dog that had a hole in the roof of its mouth.
The doctors did a CT of the head to show the dimensions of the defect in the hard palate, and then made a replica and filled the hole, Marks said.
Airway repairs may be one of the purposes for which veterinarians turn to 3-D printing, a technique used in human medicine with a child’s defective windpipe. Doctors at the University of Michigan teamed up with an engineer in the 3-D printing laboratory to make a device that held open the child’s airway until the windpipe could work on its own.
“We’ll be able to look at a dog that has a tracheal collapse or an airway collapse and make a stint that’s custom-fit for that patient,” Marks said.
Telemedicine, Radiology, Biotechnology, Teaching
Annette N. Smith, DVM, MS, Dipl. ACVIM, expects big steps in biotechnology in 2015 and beyond.
“Biotechnology, especially the development of small-molecule inhibitors and monoclonal antibodies for disease treatment, are probably the biggest things on the horizon,” said Dr. Smith, an oncology professor at Auburn University’s Bailey Small Animal Teaching Hospital. “Personalized medicine has become a reality, and many drug companies are recognizing the power of the human-animal bond and the lengths that owners will go to for their pets, so there is a market for these kinds of drugs.”
The only FDA-approved drug for cancer in animals is Palladia, and only one USDA- approved immunotherapy (Oncept) exists for animal cancer, Smith said. However, she said, multiple drugs are conditionally approved and being used in animals. She said veterinary medicine will continue to follow advancements in human medicine.
“Many of these are adapted from human medicine and have revolutionized therapy for diseases like lymphoma [with the drug Rituximab],” Smith said. “We would expect to see similar results in our veterinary patients. One Medicine at work.” Joslyn has great hopes for telemedicine and radiology.
“I think we will be seeing more telemedicine referral options,” Joslyn said. “Teleradiology is already allowing veterinarians access to radiologists located anywhere in the world instantly. As a radiologist here in Illinois, a colleague can send me an X-ray/MRI/CT study from Australia in a matter of minutes. I can pull up the exact digital copy of that study and help them with the case as if I were in the same room.”
While he believes veterinary radiology will continue to be closely tied to the human medical imaging field, he noted that pathologists recently developed a system for transferring histopathological slides digitally.
These slides are notoriously too big to transfer digitally. However, some companies have tackled the problem and can transfer slide samples digitally to remotely located pathologists almost instantly, Joslyn said.
Making existing technology better and faster are as important, if not more so, than creating technology, in the eyes of North Carolina State’s Marks. The improvements being built into imaging systems will lead to more advanced diagnostics and therapeutics, he said.
“Our diagnostic technology changes on a very frequent basis,” Marks said. “Each generation of that equipment that comes out is better.”
Faster CTs, for example, enable dogs and cats to be sedated rather than anesthetized when radiologists and veterinarians get images, he said, adding that 10 years ago a dog hit by a car may have required multiple body X-rays compared to a whole-body CT scan today.
“That technology has changed the standard of care, specifically for trauma patients,” he said.
Even existing technology has the potential to make some of the most profound changes in the field, Marks said.
Hospitals like the one where Marks works at North Carolina State have access to state-of-the-art technology that is available to only a few, but he believes that as equipment becomes more affordable and new technology arrives, cutting-edge devices will make their way into more general practices.
“You’re going to see more availability of imaging equipment, like ultrasounds, more CTs and different types of endoscopes that in the past that has been only avail to specialists,” Marks said.
He spends a few days a year teaching general practitioners how to perform endoscopy procedures through courses taught at the Western Veterinary Conference’s Oquendo Center in Las Vegas.
Veterinarians are excited about new technology, Marks said. It’s that enthusiasm and interest in expanding one’s profession that he says has brought—and will bring—more technology to veterinary medicine.
“You don’t want to do the same thing every day for a 40-year career,” he said. “It’s a core component of veterinary medicine, because they want to push the envelope for their patients, and that means you have to be invested in technology.”
Marks said that mindset will push the way medicine is learned, with more online courses and with veterinarians taking a greater interest in learning about areas once thought to be only within the realm of specialists.
Joslyn agreed and said a paradigm shift in the way veterinary medicine is taught is nearly upon us.
“I also think the traditional model of veterinary teaching will change drastically over the next few years,” Joslyn said. “Information is accessible all over the world, and onsite necessity may be less important until the final preclinical and clinical years.
“Universities are now facing the growing problem of caseloads with referral centers popping up everywhere,” he added. “How do you teach students with reducing caseloads? Off-site clinical models are being explored in the United Kingdom with what appears to be great success.”