Clinical trial leads to surprise diagnosis: “We have to consider the whole patient”
Gina Barrios enrolled her dog, Charlie, in a CSU Veterinary Teaching Hospital clinical trial to help other dogs. The trial not only treated his arthritis but also discovered a hidden tumor, leading to successful surgery and a promising prognosis.
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When Gina Barrios signed up her dog, Charlie, for a Small Animal Orthopedic Medicine and Mobility clinical trial at the CSU Veterinary Teaching Hospital, she thought they could help other dogs. Little did she know multiple veterinarians at CSU would end up helping Charlie.
Charlie is a 13-year-old Bernese-English shepherd mix who led the life of a professional athlete until he ruptured a disc about five years ago.
“I call him retired now because he used to participate in a lot of sports when he was younger. He even had his own agility course in the backyard,” said Barrios, who lives in Denver. “But one day, he flew into the air to catch a ball and ruptured a disc. Overnight, he was not able to use his hind legs.”
Like a retired wide receiver, Charlie was slowing down with age but recovered well from surgery at a Denver clinic to repair his spine.
This year, when he started having issues going up and down stairs, Barrios brought him to CSU, first to Neurology, and then to Small Animal Orthopedic Medicine and Mobility, where Charlie saw Dr. Gabriella Castro. “On exam, we found a combination of arthritis in his hips as well as some signs of neurologic disease,” said Castro, a second-year veterinary resident specializing in orthopedic medicine.
“They came back with the conclusion that, yes, he’s old, but also he had severe osteoarthritis, and they asked if I would be a participant in the clinical trial,” Barrios said. “At first, I was hesitant, but when I learned it was noninvasive — more looking at his daily life — I said I would love to contribute and provide data.”
The trial assesses the progression of osteoarthritis. Dogs get a whole-body CT scan and wear a collar to monitor their activity. “We elected to put him in our study which entailed doing a full body CT in order to monitor his orthopedic disease. While under sedation for his CT, we injected his hips with a steroid and joint lubricant to provide him some comfort,” Castro said.
Because arthritis can affect so many joints, a whole-body CT scan through the hospital’s Small Animal Diagnostic Imaging service gives veterinarians a full picture so they can more accurately measure arthritis progression.
“When you look at the whole body on CT you will find things that you may not have expected to find, many which are not clinically significant; however, sometimes we find things we are glad we caught in an early stage so that it can be addressed, such as the intrathoracic mass found in Charlie,” said veterinary radiologist Dr. Linda Dillenbeck. As she was reviewing Charlie’s scan, she found a small surprise. Charlie had a 4.5-centimeter diameter mass in his chest.
The benefit of a whole-body CT scan, which takes just seconds, is “you can look at the entire dog and sometimes you find unexpected problems that go beyond arthritis,” said Dr. Felix Duerr, professor and head of the Small Animal Orthopedic Medicine and Mobility service. “These tumors, when you catch them early, you can remove them and cure the patient. So, we were lucky to have caught this on the scan.”
In for a clinical trial, out with a cancer diagnosis Barrios went from thinking Charlie was helping other dogs to needing more help from CSU. “I wouldn’t have known. If we hadn’t done the clinical trial, we would have just walked away with Dr. Castro’s diagnosis of arthritis,” she said.
Castro sent them to CSU’s oncology service, where Drs. Deanna Worley and Surabhi Sharma diagnosed a cranial mediastinal mass known as a thymoma. On March 27, two weeks after the CT, he underwent surgery to remove the tumor in his chest.
Now, six weeks out from his surgery, Charlie’s prognosis is good. He won’t need chemo or radiation.
“Charlie is a sweetheart! Charlie shows why regular screening tests — like thoracic and abdominal imaging — are so important for our senior furry babies.” said Sharma, the surgical oncology fellow who operated on Charlie, along with Worley, a professor of surgical oncology. “The good news is that it’s a less aggressive form of thymoma. While we recommend regular monitoring for recurrence, the chances of this returning and causing issues for Charlie are low.”
Barrios found comfort in the detailed information provided by the CSU team. “I just felt at ease when I talked to the doctors. Everything they told me was always backed up with data,” Barrios said. “I’m very analytical, so it was music to my ears — like OK, I trust it.”
Her challenge now is to keep him calm while his incision heals, and to do all the old man things like be careful getting up and walking on slippery floors. “He just bounced back real quick. Like a true working dog, he’s ready to get back to work. I wish we lived in Fort Collins because I wouldn’t take Charlie anywhere else other than CSU. They are academic, super smart, caring individuals that are trying to do better for pets.”
Charlie’s case is a great example of the CSU Veterinary Health System at work, with multiple services pulling together to help him, and learning from his case to help others. “Collaboration of the different specialists within this hospital is wonderful and helps provide gold standard care to our patients,” Dillenbeck said.
That “gold standard” includes looking at the patient holistically and partnering with the owner to deliver the best possible care.
“I strive to evaluate my patient as a whole rather than only focusing on orthopedic disease,” Castro said. “This case was a good reminder that to have the best outcome for the patient, we have to consider the whole patient.”
What is a clinical trial?
Veterinary researchers use voluntary clinical trials to discover disease prevention methods and find new ways to improve detection, diagnosis, and treatment of animal illnesses. Participants receive compassionate care throughout their treatment period. And some trials can lead to applications in human health.
“There are benefits of being involved in a clinical trial beyond contributing to research, as it could identify other unexpected problems,” Dillenbeck said.
Charlie’s case demonstrates what CSU veterinary clinical trials are about: helping individual patients while collecting data that will help an even larger population of dogs and perhaps even their owners, said Duerr, whose research investigates treatments for musculoskeletal problems.
Learn more about CSU’s many clinical trials.
Veterinary Health System
Colorado State University’s Veterinary Health System is a community of veterinary professionals dedicated to providing exceptional service with passion and purpose. Our experts are animal and public health leaders working together to apply their diverse skills in veterinary care, diagnostics, and education. As a partner of CSU’s top-ranked academic veterinary program, the clinical team works with researchers and educators to advance the future of veterinary medicine.