“I don’t do test tubes,” says Etienne Côté. “I’m a clinical researcher. I want to translate information directly to helping patients, to doing things that mean something to individual owners, and for pets that are thought by their veterinarians to have heart problems.”
He’s felt that way for quite a while. “I knew I wanted to be James Herriot,” laughs the cardiologist and internal medicine specialist. “I always had a dog and a cat around when I was growing up in Montreal. I’m a city guy but I remember keeping health report cards for my guinea pig—things like that. And, of course, reading Herriot when I was about 10. That pretty much sealed it. I was hardcore set to get into veterinary school when I left home, first to Rutgers for animal science and then to Cornell.
“I thought I needed some large animal experience so I worked for three years in the university dairy. I was certain I was going to go into mixed practice—farm calls in the morning, small animal hospital in the afternoons. But I went to California for further training and ended up working on the pets of the stars.”
The decision to come to AVC, says the Assistant Professor in the
Department of Companion Animals, came after stints in Boston,
Montreal, LA again, and a six-month lectureship in South Africa. The move to PEI was in large part due to “the opportunity to teach and oversee students who are finding their feet. I love that, especially when it is combined with clinical work and research.“
But research—which he began in Los Angeles—remains important to him as well. “Nowadays, our mentality has changed from ‘an animal is an object’ to ‘an animal is a member of the family.’ Yet, despite the importance of our animals, clinical research is sometimes not seen as important in terms of research funding.” But the need is clearly there, he argues. “For some reason we’ve taken decades to apply a lot of knowledge—some of which has been known about people for quite a while—to veterinary medicine.
“My heart lies in cardiology, so one of my projects is a simple canine stress test, to evaluate whether certain types of exercise-testing help us identify subtle abnormalities in the cardiovascular system of dogs that wouldn’t be apparent otherwise. If I have a heart problem I go to my cardiologist who will put me on a treadmill, right? We haven’t done that for dogs—probably because most veterinarians don’t have treadmills. Even if they did, historically only about a third of the dogs will tolerate treadmill testing. So we use stairs with portable EKG monitors which let us evaluate the heart rate when the dog is resting, exercising, and recovering afterwards. I don’t know of anybody else who is doing this.”
Another project involves a known phenomenon involving the vagus nerve that once again is used in current patient evaluations, yet has not been investigated extensively. “It’s part of the body’s internal control mechanism. It is possible to stimulate it just by pressing lightly on the sides of the throat or on the closed eyelids and, once stimulated, the heartbeat slows down. Very little is known about the way this works in sick hearts versus healthy hearts.
“The point is: light pressure—historically a vagal manoeuvre—over the neck can gradually slow down the heart. It’s something we do in dogs and cats and can be very useful in identifying certain types of heart problems. But no one ever looked at how much it slows the heart rate; what is normal and what isn’t; do dogs respond more than cats; is the response greater if you press the neck or the eyes—nobody knows.
“We’re analyzing the data now. It gives us a baseline. We can study it in patients who have heart disease and maybe this eventually can allow us to identify patients who are sicker than others, or who might need medications where others don’t.
“There’s a very dedicated dog-breeder locally who has identified a problem in a certain breed of dogs over the last 10 years. Some of the puppies seem to suffer a cardiac problem that manifested as a sudden fatal heart attack which produces identifiable lesions at post mortem. But it was devastating because there are no external symptoms—these puppies get adopted into families and then four to six months later they die. The breeder carefully tracked fatal cases.
“This is brand new; nobody has ever seen this exact lesion in other breeds of dogs. Maybe we can identify what it is they have in common so we can characterize the problem and then learn how to identify it. If we can determine that certain animals shouldn’t be bred we can perhaps see that the problem isn’t perpetuated. That’s a long way off; we’re just at the very beginning of even trying to characterize this.”
But it is this concern for a step-by-step approach to disease in dogs and cats that helped in Côté’s most recently completed project, the 1,702-page Clinical Veterinary Advisor: Dogs and Cats.
“My mentor in California, the author of one of the best-known veterinary textbooks in the world, was approached by his publisher with a request to do a more user-friendly sort of veterinarian’s manual. He declined but gave them my name. I wrote about a fifth of the material and edited the rest.”
Published by Elsevier, the book differs from most other texts.
“Historically, veterinary textbooks have used a body system approach.What is unique is that there are five other sections on procedures and techniques, differential diagnosis and laboratory tests, and access to an online companion work that includes a searchable drug formulary. The publisher promotes it as being six books in one,” he says. When it was unveiled at a major veterinary meeting, it immediately sold more copies than any other text at a single meeting.
Côté is busy with three co-authors in the United States on another book, this time on feline cardiology.
