Calmly alert in the arms of a veterinary student--despite being surrounded by veterinary medical personnel in a tiny exam room--"Spikey" appears to be an unremarkable feline: three years old, female, gray, recovering nicely from surgery--and about to be released from the Veterinary Medical Teaching Hospital.
Yet Spikey's hospital stay is a bit unusual, and her trip home will be a long one. She and her owner live in Belgium. Clare Gregory, veterinary professor and director of the school's Renal Transplantation Program, states that Spikey is the first cat from Europe to undergo a feline kidney transplant since the program began.
Spikey arrived with her owner from Europe November 12. Two days of hemodialysis stabilized her system, and surgery was performed November 15. Four days later, Spikey is ready for a photo op with the kidney transplant team: surgeons Clare Gregory and Andrew Kyles--he is chief of the small animal surgical service--a veterinary specialty resident, three veterinary technicians and two senior veterinary students.
Also present is a larger gray cat named Homer, the donor cat to whom Spikey owes her recovery. As a requirement of the kidney transplant program, families of kidney recipients agree to give a permanent home to the donor animal. (In this situation, Homer won't need a passport; a friend of the school has adopted him.)
The School of Veterinary Medicine initiated the Renal Transplantation Program--the first of its kind--in 1987. Spikey is one of more than 350 cats and dogs that have received kidney transplants since the program's beginnings. In addition to performing the surgical procedure, faculty members at UC Davis have trained many of the surgeons who have developed kidney transplant programs in animal hospitals throughout the country.
Kidney transplants are prescribed to treat chronic and acute cases of renal failure. For example, either cats or dogs may become poisoned after ingesting engine antifreeze. Four years ago, a 5-year-old cat from Oregon named Bearen suffered acute kidney failure after licking antifreeze from the driveway, and thanks to a kidney transplant performed at the Veterinary Medical Teaching Hospital, the cat is still alive.
Most of the renal transplant surgeries at UC Davis are performed on cats, which are particularly prone to chronic kidney diseases. However, newer drugs--many have been tested for effectiveness and safety by veterinary school faculty--make canine kidney transplants more common. The goal of renal transplantation is to provide good quality of life to an animal that would otherwise be unable to survive. Veterinarians caution that a normal life expectancy may not be achieved, though some animals have lived many years after the procedure.
The program can handle about 24 kidney transplants per year. The cost, barring major complications, for renal transplantation is $6,500-$8,000 for cats and $9,500-$11,000 for dogs. Clients also pay for hemodialysis services, if needed, as well as veterinary visits, laboratory tests and immunosuppressive drugs, which must be administered for the life of the animal.
Each prospective client begins the process with a substantial long-term commitment to assure the ongoing health of the pet. The client's regular veterinarian works closely with the transplantation team to evaluate each candidate even before the animal's first visit to the Veterinary Medical Teaching Hospital. The transplant procedure, performed by two members of the faculty and a staff of veterinary technicians and laboratory staff, takes 2-3 hours to complete. The hemodialysis service, emergency room staff and the nursing team play integrals role in the care of each patient during its hospital stay.
Successful long-term survival requires the use of immunosuppressant drugs. Clients take on the daily task of administering pills to their pets and make ongoing follow-up visits with their veterinarians.
RESEARCH PROGRAM HELPS ANIMALS, PEOPLE
The success rate for renal transplants is approximately 75-80% in cats and 40% in dogs. An active research program contributes to clinical improvements to assure that the transplanted organ functions properly while preventing the recipient's immune system from rejecting the transplant. The Renal Transplantation Program, says Gregory, emphasizes development and testing of "better, safer drugs" to improve long-range survival--in humans. Gregory states, "Research on immunosuppressive drugs designed for human use gives us the opportunity to develop therapies for similar medical conditions in veterinary medicine."
Ultimately, these researchers aim to develop novel approaches for organ transplantation without reliance on lifelong immunosuppressive therapy. Gregory's team is also exploring how to diagnose kidney failure more quickly so that veterinarians can begin treatment sooner. Other aspects of the program's research include investigations into the higher incidence of cancer or diabetes in veterinary transplant recipients. On the human side, program leaders are proposing new animal models for transplantation, including the transplantation of islet cells into the liver for the control of Type I diabetes.
A return flight to Belgium may be uncomfortable for a cat, but for now, ensconced in the arms of a veterinary student, Spikey appears content, and her caregivers smile at her accomplishment--Spikey's health outlook is good. As research progresses, clinical therapies will continue to improve, and more animals like Spikey will receive this life-saving veterinary treatment.
For more details about the Renal Transplantation Program at UC Davis School of Veterinary Medicine, please visit:
*Hemodialysis services are described in this 2003 article in Veterinary Medicine News: