Carl Osborne, DVM, PhD, a diplomate of the American College of Veterinary Internal Medicine, is recognized as a pioneer in One Health and comparative medicine. Over the span of his career, he has received 53 honors and awards, including the Norden Distinguished Teaching Award in 1975, 1987, 1997, and 2002; Ralston Purina Small Animal Research Award for contributions to nephrology and urology in 1982; Bourgelat Award in 1983, which recognizes outstanding international contributions to small animal practice; Distinguished Practitioner in Veterinary Medicine from the National Academies of Practice in 1985; and the 1999 Osborne Award from the International Renal Interest Society for lifetime achievements in nephrology, inspiration to academicians, and dedication to improving the health care of animals. He has also been honored with Honorary Doctor of Science Degrees from Purdue University and the University of Gent, Belgium.
Profiles Online: How would you define One Health?
Obsorne: You have to put it into context. If you are talking about One Health in terms of the context of a university with a medical school and a veterinary school, then One Health becomes obvious. Although humans can speak and store and collect data, animals can’t. Otherwise, fundamentally we are not all that different from higher mammals. Thus we can share information if we are careful not to extrapolate without proper caution. That to me is One Health. And the goal is to shoot for health.
Profiles Online: And when you say “share information,” what do you mean? Share information with human medicine?
Osborne: Yes, but not limited to human medicine. We share information across species, including humans—not exclusive, however, to mammals. We do that to help humans and mammals mainly, and we also do it because animals are models for humans.
Profiles Online: What is the origin of One Health in your experience?
Osborne: It is not a new concept to me. It’s like saying, “human-animal bond.” People put a name on something so they can define and study it. So, I presume, but I am not sure, that One Health was coined by a group that emphasized the similarities between humans and mammals. And this has many, many applications. The one that comes to mind most quickly is pain. We assume that, barring evidence to the contrary, pain experienced by humans can also be experienced by dogs, cats, horses, cows, pigs, etc. And that is put into practice right away. In fact, at this University, when you want to do a study, you have to prepare a plan that is reviewed by your peers. One of the main things they look for is whether your study involves animals, and if so, what is done to eliminate or control pain. There is a lot of crossover between human medicine and animal medicine.
Profiles Online: There always has been crossover, but veterinarians and physicians were never really considered equal partners. Has that changed?
Osborne: That’s right. When you put a name on it, you look at it from a different angle. It’s kind of like looking at my hand, and you asking me to describe it when it is like this (palm up) or this (palm down). They are different, but when you put the word hand on it, then all features are covered.
Profiles Online: You are considered a pioneer in One Health because you were the first person in the world to develop the protocol to dissolve struvite stones. Please tell us about that.
Obsorne: Veterinary medicine has changed so much. I came here in 1964, and the College of Veterinary Medicine operates under the mantra, “The best veterinary medical teaching hospitals in the world not only use contemporary information, but they also create it.” So when you are in a university setting you are supposed to teach, you are supposed to serve society, and you are supposed to develop research projects. If I hadn’t done that, I would be telling you about 1964 medicine right now. There would be no change. Given the time and resources to influence change, you can define problems and propose solutions to see if they work. I believe in the concept that we create new information. Because of that belief we have evolved the protocol that dissolves struvite stones, or uroliths.
Chemically, struvite stones are magnesium ammonium phosphate. Struvite in cats developed for entirely different reasons than struvite in dogs. So we first developed the model in dogs. That’s the key model because once you can dissolve stones in one species, it opens up the dissolution of stones in all species.
We started the Minnesota Urolith Center on a shoestring in 1981. Since then, we have been able to fund the center and have analyzed 750,000 stones sent from around the world. We now receive about 80,000 stones a year. Donald Griffith, a physician at Baylor College of Medicine, began analyzing our stones in 1981. In 1982, we enlisted the help of a graduate student from Nigeria, Shehu Abdullahi, and later Eugene Nwaokorie from Nigeria and Hassan Albasan from Turkey. These graduate students have been working in the center ever since we developed this stone dissolution protocol.
Originally our funding came from the Paralyzed Veterans of America. That’s because paralyzed veterans had indwelling catheters and they developed urinary tract infections that led to the formation of struvite stones. The Morris Animal Foundation also funded several projects. Mark Morris Associates played a key role in this as well. In fact, we developed key contacts at Hills, including PhD nutritionists, who subsequently helped us develop diets that were not only effective, but they were also safe. The Food and Drug Administration requires that if you market a therapeutic agent that it be both safe and effective. It can’t be one or the other. It has to be both. If I were a dog or a cat, I would be eating that food if I had a stone. Our funding today mainly comes from the pet food industry because pet food companies want to keep abreast of these developments. That’s been our main funding for the last 20 years. It’s interesting they call it Science Diet because so much science—millions of dollars worth—goes into it.
In veterinary medicine, Jody Lulich, a clinician here, pioneered the concept of lithotripsy. Litho means stone and tripsi means to break apart. Lithotripsy uses laser technology to break stones apart. And that’s where we are today. Some stones we dissolve medically, predominately by diet. Sometimes we have to add an antibiotic to that. Some stones we can’t eliminate that way, so we use lithotripsy, and if that doesn’t work, we go back to the time-honored surgery. However, urolithiasis is no longer predominantly a surgical disorder. For cats it so effective that I would say if a veterinarian didn’t know about diet for cats with struvite stones and didn’t use the technology, he or she would be bordering on negligence and maybe malpractice.
We have eight technicians analyzing stones every day from 7:30 a.m. to 4:30 p.m. It shows us what the trends are in stones, and we have the owners’ names and phone numbers, so we can enlist animals in studies if we think it might help them. We have all kinds of clinical trials going on all the time.
Profiles Online: Do all animals with urinary stones need treatment? Could you comment on how your work relates to One Health?
Osborne: Some animals can live with a stone and don’t need anything. They are asymptomatic. Why make them symptomatic? We ought to live by this mantra: Is the proposed solution compatible with what you would choose for yourself? If not, why not? Justify the treatment.
Our center does not collect a monetary fee for stone analysis. We charge for information. Owners have to fill out an application, which we subsequently use to determine risk factors. Struvite stones, for instance, are very common in female cats and just as common in male cats between the ages of two and seven. Calcium oxalate stones develop later in life in most cats and dogs. So we have developed a whole list of risk factors that we have identified.
And that’s where the crossover comes in with humans. Dogs eat like their owners eat. So we are looking for risk factors in dogs and asking our physician colleagues if this data is of value to them. Unfortunately at the University of Minnesota Medical School, although they manage stones by lithotripsy, there is no one there to cooperate closely with us, so we have to go outside the University to get that collaboration. We go wherever the evidence leads us. We are in a global society now, so we look globally for our answers.
The leading cat disease is urinary tract disease. The males obstruct. From the time of obstruction to the time of death is four days. It’s a painful death. We need to keep working on this.
Profiles Online: How do you think One Health has changed veterinary medicine?
Osborne: Veterinary medicine has changed due to the number of people now available to investigate diseases. The key issue is person power. Look at all the graduates we have now from 24 schools. When I graduated in 1964, there were 18 veterinary schools. Now there are accredited veterinary schools in Australia, England, the Netherlands, the U.SA., and Canada. From a scientific standpoint, this has improved the amount of new knowledge we have.
The graduate programs here are in clinical medicine. In other words, you can get a PhD in clinical medicine. That’s not true of all schools. Some argue clinicians can’t do good research and that they need to do basic research. Not true. This is one of the leading universities to have promoted PhD work in a clinical program starting back in 1951. George Mather, Ed Usenik, and Don Low all started PhD programs. They carried a big part of the teaching load and didn’t have the opportunity to do research, so the fact that their names are not identified with major breakthroughs is just through the luck of the draw—when they came along in the scheme of time. There was no College of Veterinary Medicine before 1947. Where did the veterinary world come from? Textbooks and personal opinion. People were high on personal opinion with no facts to back them up.
Now there are more people then ever to do the studies. The internship program has expanded tremendously. The residency program has expanded tremendously. Trained diplomates have started their own research programs and are expanding the body of knowledge that’s available. And the pet-owning public is more affluent than it used to be, even though the country is having economic difficulties. Time has shown people will take care of their pets whatever the cost because they love them. Our philosophy is like that, too. We do not use any animals to create disease. We use clinical trials to get our answers.
Profiles Online: Do you think veterinary medicine has become more reputable in the eyes of physicians through the One Health concept?
Osborne: Have veterinarians become more scientific? Do they advance ideas through evidence-based medicine? Yes, more so than ever. Are veterinarians and physicians working more closely together than ever before? Yes. God feeds birds. He didn’t throw seed in the nest. The birds have to go out and glean the seed, right? Well if you want to work with people in the medical community, you could sit here for 40 years waiting for them to come and knock on your door, and they will never come. You have to go over there and show them what you have.
Profiles Online: Do you think One Health has changed human medicine?
Osborne: Both veterinarians and physicians have to be receptive to new developments. We are constantly reviewing the literature. For instance, in veterinary medicine, we have identified the gene that is abnormal for cystanuria, an inherited disorder, and this provides a model for physicians to study. Humans don’t get too many struvite stones in the 21st century, but at the turn of the 19th century, struvite stones were very common. Then they stopped being so common, and calcium oxalate stones have become more common in humans, dogs, and cats due to affluence. They get overweight and they get diseases. The dogs are just as fat as humans and waddle around. Veterinary medicine is light years ahead of human medicine in applying stone-dissolution technology.
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