Three-month-old Nix the miniature donkey was regularly collapsing because of a severe heart condition. To treat this usually fatal ailment, veterinarians at the Cornell University Hospital for Animals successfully implanted a pacemaker in her.

Nix the miniature donkey (Photo courtesy of Darcy Rose via  Cornell University College of Veterinary Medicine).

Nix’s owners, Mindy and Carlton Lockwood, struggled to watch her suffer. “It was either do nothing and Nix would continue to get worse and possibly have a painful death — or the pacemaker,” expressed Mindy Lockwood, in a university release.

Beginning in fall of 2020, Nix experienced collapsing episodes and lethargy at just several months old. The Lockwoods had their regular veterinarian, Joan Ayers, DVM, of Genesee Valley Veterinary Hospital, examine the miniature donkey on her farm in Canandaigua, New York, where Nix resides.

Ayers, in tandem with Lockwood and Barbara Delvescovo, DVM, MRCVS, DACVIM, clinical fellow in the Section of Large Animal Medicine at Cornell, worked together to diagnose Nix’s condition. Initially they thought she may have epilepsy or have suffered a traumatic injury to her neck or skull, but these conditions were ruled out.

In February 2022, Nix was falling again, now from a standing position, and she staggered even more when walking. “When she fell, she was dazed for a few seconds and then would get back up. Several times she fell and rolled out of the pasture fence, which caused us even more concern for her safety,” Carlton Lockwood said, in the release.

Nix was referred to Cornell, where veterinarians did an echocardiogram and placed an ECG on her, to record her heart’s rhythm. There, Nix’s care team diagnosed her with third degree atrioventricular block, meaning her atria and ventricles weren’t communicating, so her heart’s rhythm was very slow and irregular.

 There were frequent pauses of 20-30 seconds with no heartbeats or blood flow to her body, enlarging her heart. With a lack of blood to her brain or around her body for long periods, Nix was experiencing the clinical signs of this condition (ie, collapse, episodes of weakness, and severe exercise intolerance).

According to the release,there are 2 types of arrhythmias: physiological, meaning they happen normally when horses are relaxed but go away with stress, excitement or exercise; or pathological, meaning they are abnormal, dangerous, and can result in poor performance. Nix had pathological arrhythmia.

“This is a pathological arrhythmia that we see pretty uncommonly in horses, but a little more occasionally in donkeys, and especially mini donkeys,” shared Katharyn Mitchell, DVM, PHD, BVSc, ACVIM (LAIM), assistant professor in the Section of Large Animal Medicine, who oversaw Nix’s case at Cornell. “Given the severity of the arrhythmia and the frequency of collapse, medication will not be effective, so we only had the choice of placing a pacemaker or euthanasia, given the high risk of continued self-trauma.”

Because Nix is young and has no underlying problems, she was an excellent candidate for a pacemaker. Once discussed with the Lockwoods, they gave the care team the OK to give her this surgery. 

In a collaborative effort between Mitchell, Delvescovo from the large animal internal medicine service, Lawrence Santistevan, DVM, of the cardiology service, members of the large animal soft tissue surgery service, the anesthesia service, and various hospital staff members, the complex procedure to implant Nix’s pacemaker went successfully. “There are a few mini donkeys around the world with pacemakers, but certainly it’s not common,” Mitchell noted. “It was great teamwork.”

There was quick improvement after surgery and now Nix has enough blood flow to her brain to walk normally, without fainting or lethargy. After 7 to 9 years, the pacemaker must be replaced. In the meantime, it’s important Nix stays calm and has limited exercise. Dangers can arise if the pacemaker lead pulls out of the heart muscle or becomes infected. “We will keep her calm for the first month to lower these risks, and if everything looks okay, then we will increase the pacemaker’s rate a little bit so she can get up some speed and play with her mum in the paddock,” Mitchell added.

Annually, Nix will visit Cornell for rechecks, but currently she’s in a small pasture with her mom to keep her activity low while she gets better, Lockwood says. “She has been much more alert, she’s vocal and has her spunk back.”

At her recheck appointment this month, the pacemaker was working well and she had just a slight reaction to the pacemaker lead. She did have some skin problems, likely associated with biting flies, so she is remaining in the hospital a few days to receive intravenous antibiotics.

Her next recheck will be next month, but now the Lockwoods are happily celebrating Nix’s second birthday.

Cordova MG. Mini donkey gets big boost from pacemaker. Cornell University College of Veterinary Medicine. August 11, 2022. Accessed August 12, 2022. https://www.vet.cornell.edu/news/20220811/mini-donkey-gets-big-boost-pacemaker

Articles

First surgery of its kind in a large animal species at Cornell 

Mini donkey successfully receives pacemaker to manage fatal heart condition 

Good morning dvm360 readers! We hope you had a fantastic week and are ready to unwind and have fun this weekend. Did you know that our Fetch dvm360 Kansas City conference is about 2 weeks away AND that it is not too late to sign up? Join us in Kansas City on August 26-28 to learn from key industry leaders and participate in our first CE game show dvm360 Unleashed. Register 

As you prepare to end your work week and start your weekend, here is what was trending this week at dvm360.com:

 that 23-year-old hippo Bilbi gave birth to a healthy, full-term male hippo on August 3, 2022. This new addition to the family is welcome also by the happy hippo’s world-famous sister, Fiona.

The dvm360 product report for August is now 

! Check out our monthly rundown of notable and new veterinary products.

 of The Vet Blast Podcast, Adam Christman, DVM, MBA, sits down with Joya Griffin, DVM, DACVD, to get a behind-the-scenes look at her hit Nat Geo Wild show, 

 with dvm360, Janice Huntingford, DVM, DACVSMR, CVA, CVPP, CCRT, explained her own oath to studying integrative medicine, plus its different techniques and what diseases these courses of treatment can help.

 of dvm360 Live! aired this week! Check out Christman as he is joined by Turpin Mott, Chief operating officer at National Veterinary Association as Mott offers tips and tricks to help you tune into your well-being on multiple levels.

News wrap-up: This week’s headlines, plus Cincinnati Zoo welcomes baby hippo 

The American Veterinary Medical Association (AVMA) recognized Mike Nolan, DVM, PhD, DACVR, professor of oncology at the North Carolina (NC) State University College of Veterinary Medicine, as the winner of the 2022 American Veterinary Medical Foundation (AVMF)/EveryCat Health Foundation Research Award.  

“Dr Nolan has been instrumental in important discoveries that are changing our understanding of the development and treatment of cancer in cats and controlling pain in feline cancer patients,” expressed Lori Teller, DVM, DABVP (Canine/Feline), CVJ, president of the AVMA, in an association release.

 “Dr. Nolan’s vision and innovative approach to the treatment of feline cancer makes him extremely deserving of this award.”

Dr Mike Nolan (Photo courtesy of the AVMA). 

Nolan achieved a PhD in radiation and cancer biology at Colorado State University and is board certified in radiation oncology from the American College of Veterinary Radiology. He has made significant contributions to feline cancer. Additionally, he dedicated his skills in radiation oncology to collaborative work in feline gastrointestinal cancer and feline urinary interstitial cystitis.

 Nolan arrived at NC State in 2013, and developed a research program with a focus on comparative oncology. He has been granted over $1.7 million in external funding, including receipt of a prestigious National Institutes of Health MERIT award, and he has published over 50 peer-reviewed publications, with others in the works.

Nolan has also contributed significant teaching responsibilities. He created course materials in general oncology for the core veterinary student curriculum, and in radiation oncology for elective courses. Additionally, Nolan is key in graduate student training. Recently, he has finished work with his first doctoral student, who was granted a government scholarship from the Taiwanese Ministry of Education to work specially with Nolan on the treatment of feline squamous cell tumors of the tongue. Their work was honed in on the control of tumor growth and pain control of this feline tumor, according to the release.

Nolan’s work on companion animals has allowed him to develop new treatment procedures that have displayed promise in the human field. He has also played a major role in the development of C3O, a comparative oncology program that links the Duke Cancer Institute and the NC State College of Veterinary Medicine, and is a primary member of the board that oversees this program.

A 2009 graduate of the Virginia-Maryland College of Veterinary Medicine, Nolan has been recognized with the Outstanding Recent Alumni Award from his alma mater, the Early Career Investigator Travel Award from the Radiation Research Society, the NC State Coat of Excellence (twice). This year, he was appointed as an N.C. State University Faculty Scholar.

Dr. Mike Nolan named recipient of 2022 AVMF/EveryCat Health Foundation Research Award. News release. American Veterinary Medical Association. August 6, 2022. Accessed August 12, 2022. https://www.avma.org/news/press-releases/dr-mike-nolan-named-recipient-2022-avmfeverycat-health-foundation-research

Award initiated in 2009 celebrates a candidate's efforts to accelerating feline health through their research 

Dr Mike Nolan receives 2022 AVMF/EveryCat Health Foundation Research Award

Tabitha, an 18-year-old, sweet-natured feline was struggling to move comfortably around the household. Her owner had exhausted many of the options offered to help ease the pain she was experiencing from her arthritic joints. Acupuncture was suggested to Tabitha’s owner and, despite being a slight skeptic about the true benefits this treatment could offer, she scheduled a first acupuncture appointment for Tabitha.

Acupuncture therapy is used on a feline patient. (Photo courtesy of Dana Koch, VMD, CVA, MLAS)

Tabitha was a very cooperative patient and seemed to enjoy her acupuncture visits. After about 6 sessions, Tabitha’s owner noticed a little pep her step and improved movement with less stiffness. The treatments were continued over the course of the year, and the owner observed that Tabitha’s daily life improved as she began to groom better, sleep more comfortably, navigate into the litter box with more ease, and had an increased appetite. Amazingly, Tabitha did not require any pain medications while receiving her acupuncture treatments, and she was able to celebrate her 22nd birthday. Tabitha was a model display of the true benefits acupuncture could provide to our furry companions.

Acupuncture has been around for thousands of years. This treatment originated in China, and traditional Chinese veterinary medicine not only includes the practice of acupuncture but also herbal medicine, food therapy, and Tui na (medical manipulation). Approximately 173 acupoints exist in animals and 361 in humans. Acupuncture generally involves the insertion of thin sterile needles into discrete and specific points on the body to cause a therapeutic effect. There are other methods utilized to enhance the effects of acupuncture, including electrical stimulation and moxibustion. Moxibustion utilizes dried plant materials called moxa, which are burned near the surface of the skin to help with treatment of certain conditions. Electroacupuncture uses a mild and gentle electric current to pass between the needles placed, causing a stimulation to help enhance the effects of acupuncture for certain conditions.

In terms of the effectiveness of acupuncture, there have been several studies that have demonstrated that the stimulation of acupoints leads to the release of β-endorphins, serotonin, and other neurotransmitters. Studies have further indicated that acupuncture can help with pain relief, promotion of tissue healing processes, regulation of gastrointestinal motility, immunoregulation, anti-inflammatory effects, and hormone regulation. 

The best part of acupuncture therapy is that the treatment is extremely safe and rarely causes any adverse effects. Some results can be seen immediately, but others will require several treatments. Most animals handle the acupuncture needles very well and often even show a relaxation effect from placement of some of the points. The body has many channels that interconnect and can be stimulated through acupuncture therapy. Many veterinarians who practice acupuncture can use these channels to help several areas of the body, with only a few acupoints.

Practicing veterinary care with acupuncture

To become a certified veterinary acupuncturist, a practicing veterinarian must undergo extensive training to understand the history of acupuncture, the proper diagnosis of a patient, and the channels and meridians used in acupuncture therapy. There are several tests these trained professionals must complete to become proficient and certified.

A canine patient receives acupuncture treatment. (Photo courtesy of Dana Koch, VMD, CVA, MLAS)

In practice, I will often have owners offer an animal’s favorite treat or meal to make it a positive experience during acupuncture sessions. Most sessions will last between 15 and 30 minutes. Some of the most common conditions acupuncture is used for in animals includes musculoskeletal and neurologic injuries, gastrointestinal disorders, allergic dermatitis, lick granulomas, epilepsy, and chronic pain conditions.

For those interested in pursuing this treatment for a pet, I would recommend finding a certified veterinary acupuncturist nearby. They will want to review your pet’s full medical history and perform a thorough examination prior to any acupuncture treatments. The acupuncturist may also suggest diet changes or herbal medicine to treat your pet’s underlying issues.

I have found the most success with an integrative approach to treating my patients using elements from both traditional Western medicine (eg, radiographs, ultrasound, antibiotics) and Eastern medicine (eg, acupuncture, herbs). We are fortunate, at the present time, to have numerous options available to help our animals live longer and more comfortable lives.

 is medical director of the HousePaws hospital in Morrisville, Pennsylvania, which offers acupuncture services. She received her veterinary degree from the University of Pennsylvania and a master’s degree in laboratory animal medicine from Drexel University, both located in Philadelphia.

This nonpharmacological form of treatment, rooted in Eastern medicine, can help with a variety of conditions

Acupuncture therapy in pets

The first Lear's macaw chick was born in situ (in its natural habitat), in Brazil, from birds born and raised ex situ (outside of their natural habitat), at Loro Parque Fundación (Loro Park Foundation) under human care.

Lear's macaw pair with it's baby (Photo courtesy of Loro Park Foundation). 

 along with surviving in their natural habitat and adapting to the environment, the reintroduced birds have also been able to reproduce. Over 40 birds have been born in the foundation's breeding center, 19 have been sent to Brazil, 8 of which were successfully introduced into the wild.

Through its efforts, the Loro Park Foundation has succeeded in updating the category of this species on the Red List of the International Union for Conservation of Nature (IUCN) from "critically endangered" to "endangered.” This accomplishment marks salvation from the species’ impending extinction. The foundation has been able to achieve with 10 species to date.

Protecting and preserving the Lear's macaw has been an extensive process. The Brazilian government transferred 2 pairs of this species to the Loro Park Foundation 16 years ago with the goal of breeding and saving a species in a vulnerable situation.

With the devoted contributions of the Loro Park Foundation, the species’ numbers currently surpass 1,200 individuals.

Loro Parque Fundación achieves a new milestone in the reintroduction of the Lear's Macaw in Brazil. News release. Loro Park Foundation. August 12, 2022. Accessed August 12, 2022. https://www.prnewswire.com/news-releases/loro-parque-fundacion-achieves-a-new-milestone-in-the-reintroduction-of-the-lears-macaw-in-brazil-301604676.html

The work of Loro Park Foundation has helped the species succeed in going from “critically endangered” to “endangered” 

Lear's macaw reintroduced into wild and flourishing   

In 2020, people spent $109.6 billion with a B dollars.

Incredible. Do you think it's going to be rising?

It is going to be rising. And I think $34 billion of that was veterinary care. So those numbers are projected to increase in 2021. I think those numbers are probably going to push $112 billion. But those numbers continue to rise as the importance of pets in people's lives continues to escalate as well. And we know how important people pets were, excuse me, to people over the pandemic, from a mental health standpoint, and I think we're learning more and more about how relevant pets are in the health of people in general.

Yeah. Another great finding from the lifetime of care research, too, Peter is over the course of year 1—just year 1—pet owners can expect to spend upwards of $2,800. Dog owners can expect to spend between $1300 to $2100 in the first year, and cat owners $960 to $2500 in the first year. That's impressive. That really is. I didn't realize that in the first year, you think of preventive care, it adds up, really adds up, right?

Well, if you if you look at that first 6 to 9 months or a year in the cost of of raising a puppy or kitten, you've got all the well-care needs, the vaccinations, the deworming, the microchips, the deflea medications, the heartworm medications, and then you have the desexing surgeries that come along in that first year. It all adds up. And then you throw in the unexpected vomiting, diarrhea, something they shouldn't have eaten, you know, whatever the problems that occur in that first year, none of those numbers should be surprising to us as veterinarians. It's when you actually look at them on paper that says, "Oh, my god, does it really all add up to that much?" And it does.

It really does. What, I mean, I want to ask you, what was one of the most surprising things you uncovered? For me when I read that I was really surprised that 45% of dog owners 38% of cat owners thought they were financially ready for pet expenses, but we're not.

Yeah, I think that number and the the price points were the 2 points that indicated to me that we have had a very fortunate situation in veterinary care and veterinary services that we're able to take care of pet owners, and we're able to take care of their pets. But what we don't know is are we really taking care of them and understanding their concerns and what kind of sacrifices pet owners make, just to be able to take care of their four legged family members? So I think those numbers indicate a greater need for us to have even greater empathy and compassion for the sacrifices our pet owners make, to be able to provide optimal care for their pets.

I've had so many pet owners that would actually save up knowing that they were hoping to get an income tax check return, just to provide the care. And we were noticing a large uptake of wellness visits and the April, May area of dental cleanings and so forth, just because they want to invest. If it's either putting food on the table, sometimes for their kids, there's so many options that they have to think about, but they're willing to invest in the care of their fur baby, when they'll do whatever means they can for that. I think that's really impressive. And so how many veterinarians did you work with on this research?

I believe there was 100 to 120 veterinarians that actually screened the research, reviewed the surveys and made sure that the information in the data was was accurate. There's a...if you go to pet lifetime of care.com, you can get an look at that study. And it shows a bubble graph of the most significant concerns, what diagnoses what treatments would cause what medical issues had the greatest...caused the greatest anxiety for pet owners, things like hit by car, emergency visits, and things of that nature. So it helps you, as a veterinarian, understand where the pet owners are coming from, where their greatest concerns are. And it may, it may change the way you have a conversation, knowing that, okay, hit-by-car pet owners are going to have a great deal of concerns from a medical standpoint. But also how much is this going to cost standpoint, right?

Yeah, absolutely. So there are about 1200 pet owners who that were based on that study as well. So so how does this differ from other cost of pet ownership data that's currently available?

I think you can get individual ownership data and pet cost of care data, you can get it from the American Pet Products Association that looks at that's where that $109 billion came from. They do some of those studies, but I don't think anybody has done a cumulative study of all of the different silos in veterinary care and animal care, that include the food and the toys and veterinary services and grooming , and other things. So it's probably the most inclusive study that was donethat I've seen from that standpoint.

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