'Controversial' topics spark ACVIM Forum

Dallas -From the legalities of compounded drugs to the efficacy of enalapril in dogs with heart conditions, organizers of the 20th Annual American College of Veterinary Internal Medicine Forum boasted a program as big as Texas, May 29-June 1.

More than 2,700 veterinarians, specialists and technicians who attendedcould select from 350 generalist and specialist sessions, 100 poster presentations,a host of special interest groups and workshops.

"The program was on par with previous ACVIM meetings," saysDr. Mary Ann Crawford, Forum program chair and 20-year veteran of the ACVIMmeetings. She says she appreciated the selection of controversial topics,such as a human hepatologist's perspective of viral hepatitis in people.

Hot potato

Former board chair Dr. Mark Kittleson, dipl. ACVIM, of the Departmentof Medicine and Epidemiology at the University of California, Davis, saysthe "political hot potato" of the meeting was the session on enalapril,in which reportedly more than 680 veterinarians attended.

Clarke Atkins, DVM, dipl. ACVIM, reported on the results of the "VeterinaryEnalapril Trial to Prove Reduction and Onset of Failure" (VETPROOF)trial. This study, the second to test veterinary use of enalapril, evaluatedsmaller breeds of dogs with a heart murmur, due to myxomatous mitral valvedisease (endocardiosis), which had not yet reached heart failure. The 139dogs were given either enalapril or a placebo to determine if enalaprilwould delay the onset of heart failure.

The previous study (conducted in Sweden) as well as the new report providedevidence to suggest that enalapril does not slow the progression of heartfailure, since neither study showed a difference between placebo and drug(p-value was reported to be 0.07 in the latest study), Kittleson notes.

"Their conclusion was that there was a trend toward a significantdifference between drug and placebo. However, trend is a term generallyreserved for small studies that generate pilot data and this study was designedto provide definitive information," he says. "However, the studymay have been a bit underpowered with only 139 dogs so there is a chancethat enalapril may provide a modest effect, but they were not able to showthat."

Veterinarians commonly use the drug to treat dogs that have a heart murmuror have significant heart enlargement on their thoracic radiograph, accordingto Kittleson.

Compounding matters

A late addition to this year's event was a special interest group oncompounding pharmacies, prompted by a listserv discussion among veterinarians.The panel included small and large animal practitioners, a compounding representative,an approved drug manufacturer and a spokesperson from the FDA. An interactivediscussion posed questions about legalities of compounding.

During the discussion, Gloria Dunavan, director of compliance, FDA Centerfor Veterinary Medicine, addressed a recent Supreme Court decision barringthe FDA from banning pharmacists who advertise human-related drugs reformulatedfrom bulk supplies. She says to watch for the "ripple effect"this may have on veterinary product promotion.

Kirk Award

Neurology specialist Cheryl Chrisman, DVM, dipl. ACVIM, is the 2002 recipientof the Robert W. Kirk Distinguished Service Award, which recognizes accomplishmentsfor the College of Veterinary Internal Medicine.

Chrisman received her DVM at Michigan State University. She is currentlyprofessor and chief of Neurology Service at the University of Florida, Gainesville.

Chrisman is honored for her contributions in research and publicationsin the field of veterinary neurology.

She is past president and chair of the Board of the College of VeterinaryInternal Medicine.

Consensus panels

In the closing session, ACVIM hosted two consensus statements, chosenby the Board of Regents, on the risks, species and testing methods for WestNile virus, and on the diagnosis of canine hypothyroidism. Both were presentedat least one year prior to publication in the Journal of Veterinary InternalMedicine.

Helping Hands contest

Winners of the ACVIM Helping Hands Work Better Together Contest wereannounced at the meeting. The contest helps foster awareness between practitionersand animal owners and consulting board-certified specialists.

First place: "Boogioo" Ehlert, a 5-year-old Border Colliepresenting with diarrhea, submitted by Laura Boogie, DVM, and Anne Mattson,DVM, MS, dipl. ACVIM.

Second place: "Heather" Teal, an 11-year-old spayedShetland Sheepdog, presenting with halitosis, submitted by Pamela NersesianDuMont, DVM, and Sarah Sheafor, DVM, dipl. ACVIM.

Next year's meeting is slated for June 3-7 in Charlotte. For more information,e-mail acvim@acvim.org.