Internal Medicine

Photo: Flyer for Clinical Trial for Dogs with Hyperlipidemia

Below, please find links to all of the clinical trials involving internal medicine. The studies include a multitude of information, including (but not limited to) the study’s purpose, benefits for participating, and financial incentive information. If you have any questions, please contact the individual outlined at the end of each trial summary.

Please visit the Internal Medicine service on the Veterinary Medical Teaching Hospital (VMTH) website if you would like to learn more about the amazing things that our veterinarians can do for you and your animal.

Exotic Animals

Healthy Pet Lizards: Studying Fungal Pathogens on the Skin

Title: Screening of Companion Lizards for fungal pathogen on the skin

Purpose: Nanniziopsis guarroi is a non-zoonotic fungal pathogen of many lizard species and is the causative agent of "yellow fungus disease" in the bearded dragon. There is little known about the prevalence of Nannizziopsis guarroi in the general population, and only a few case reports of clinical infection including diagnostics and treatment have been reported. The purpose of this study is to evaluate the prevalence of Nannizziopsis spp., a fungal pathogen, on the skin of companion (pet) lizards. This study is in collaboration with the University of Illinois.

Contact: Make an appointment with the UC Davis Companion Exotic Animal Medicine & Surgery service or the University of Illinois Veterinary Teaching Hospital

Participation Requirements:

  • Any pet lizard
  • Ineligible: Lizards who do not accept being held for swabs or who are too sick and cannot handle additional stress

Initial Evaluation for Participation: Make an appointment with the UC Davis Companion Exotic Animal Medicine & Surgery service or the University of Illinois Veterinary Teaching Hospital

Procedures: We will swab your lizard’s skin for fungal DNA during your lizard’s physical examination.

Benefits: The study will cover all costs of the swab. While there is no direct benefit to your lizard, we hope to use this data to see how prevalent this fungus is among captive lizards and determine if its presence is linked to health of the animal. This information can help understand the epidemiology of the disease, and help in future cases for diagnostic and treatment purposes.

Owner Responsibilities: You will be responsible for bringing your lizard in to see the Exotics and Avian Services. The results of the test unfortunately will not be available, since the samples will be stored and process at a later time. If you think your lizard has “yellow fungus disease”, we will have to perform additional diagnostic tests, for which fees you will be responsible.

Printable Flyer (PDF)

Horses & Ponies

Acute Kidney Injury: Evaluating Early Markers in Blood and Urine

Title: Measurement of Plasma and Urine Levels of KIM-1, SDMA, NGAL, Cystatin C for Acute Kidney Injury

Purpose of Study: The purpose of this study is to evaluate the usefulness of certain compounds in the blood and urine as biomarkers for kidney disease. These biomarkers (KIM-1, SDMA, NGAL, or Cystatin C) may be able to alert us to acute kidney disease before our currently available biomarkers (creatinine) can alert us.

Contact:

Participation Requirements: Horses receiving medications that have potential kidney side effects, such as Non-Steroidal Anti-Inflammatory Drugs (Banamine, phenylbutazone, Equioxx) or aminoglycoside antibiotics (gentamicin or amikacin), or oxytetracycline.

Initial Evaluation for Participation: A blood test and kidney ultrasound are required to ensure your horse does not already have kidney alterations and determine eligibility.

Procedures: If you choose to have your horse participate in this clinical trial, and your horse is eligible to be included during your horse’s hospitalization, we will monitor biomarkers of kidney function daily in blood and urine. To do this, we will collect blood and urine daily and repeat the kidney ultrasound on the last day of relevant medication administration.

Benefits: The study will cover all costs associated with the study including the kidney ultrasound and the sample collections of blood and urine. If your horse develops phlebitis (inflammation of the vein that occurs rarely with blood collections), the study will cover costs for medical treatment, including topical anti-inflammatory therapies.

Your horse will receive a full kidney ultrasound, which could detect early kidney disease if indicated.

Owner Responsibilities: Your horse will be a part of this study for a minimum of three days and a maximum of the duration of his or her hospitalization in which NSAIDs or aminoglycosides for the primary condition are administered. You will be responsible for covering the costs of your horse’s required hospitalization and associated treatments, but not for the samples collected for this study.

Printable Flyer (PDF)

Cats

Fungal Disease: Exploring New Diagnostics

Title: Evaluation of two point of care tests for detection of crytococcal antigen in dogs and cats

Purpose: The purpose of this study is to investigate new, rapid diagnostic tests for fungal diseases.

Contact: Dr. Krystle Reagan at 530-752-1393 and make an appointment with Internal Medicine 

Participation Requirements: Cats with a suspected Cryptococcus infection

Initial Evaluation for Participation: Make an appointment with Internal Medicine at the VMTH.

Procedures: If you agree to let your cat participate in this study, we will collect a blood sample and analyze the blood using the standard Cryptococcus test and two new fungal tests.

Benefits:  The study will cover the costs of the Cryptococcus latex agglutination blood test.

Owner Responsibilities: If you allow your cat to participate in this study, you will be responsible for:

  • Keeping all scheduled appointments
  • Covering costs of all other recommended diagnostics and therapies recommended by your veterinarian beyond the Cryptococcus latex agglutination test

Printable Flyer (PDF)

Diabetic Remission: Assessing a New Therapy for Maintaining Remission

Title: Exenatide Extended-Release for extending remission time in diabetic cats

Purpose of Study: The purpose of this study is to evaluate the benefit of Exenatide-ER for maintaining diabetic cats in remission (in an insulin-independent state).

Contact: Dr. Chen Gilor at cgilor@ucdavis.edu or 530-752-1393 to make an appointment

Participation Requirements: 

  1. Inclusion Criteria: Cats that are in good body condition (i.e., not underweight) and diagnosed as diabetic with a recent onset of remission according to the following criteria:
    • Previous diagnosis of diabetes mellitus based on clinical signs and a high serum fructosamine
    • Treated with insulin (any type) for at least 2 weeks
    • Has not required insulin treatment for at least 4 but no more than to 12 weeks
    • Has no current evidence of diabetes relapse (normal serum fructosamine and no clinical signs such as increased drinking, urination or appetite)
    • Your cat must be routinely fed a diabetic diet (a high protein, low carbohydrate diet such as Hill’s m/d, Purina DM etc.).
  2. Exclusion Criteria: Cats -
    • Recently given (within the last 2 months) oral hypoglycemic agents
    • With significant concurrent disease (any disease that may require exogenous steroid administration, reduce life-expectancy to <12 months or require intensive management, e.g. gastrointestinal, pulmonary, cardiac, hepatic, neoplastic, or renal disorders [CKD IRIS Stage 3 or higher])
    • With overt evidence of peripheral neuropathy (plantigrade stance, inability to jump), acromegaly and/or untreated hyperthyroidism. Cats will not be excluded if they have controlled hyperthyroidism or are receiving methimazole and/or ACE-inhibitors.

Initial Evaluation for Participation: Blood tests (complete blood count, biochemistry panel, serum fructosamine concentrations T4, spec fPLI and IGF-1) and urinalysis

Procedures: If the exams, tests, and procedures show that your pet can take part in the study, and you choose to enroll them, then the following will happen as part of the study:

  • Randomly placed into one of the two treatment group: Exenatide-ER (Bydureon®) or placebo. After receiving the first injection (of exenatide-ER or placebo) we will schedule your next recheck for the next month (in 27-32 days).
  • At each monthly recheck, a blood sample will be drawn to measure blood glucose levels and if needed, serum fructosamine.

Benefits: The study will pay for one third of the cost of the first office visit as well the full cost of screening tests (including urinalysis and blood tests – CBC, Chemistry, Total T4, spec fPLI and IGF-1) as well as all drug expenses and all follow-up visit expenses. After every recheck exam that you bring your cat in, the study will give you a $35 gift card (for a maximum total of $805).

Participation in this trial may help to increase duration of remission (i.e. increasing the time until diabetes relapses and your cat becomes dependent again on insulin injections), increase numbers and improved function of cells that secrete insulin in the pancreas, and help with weight loss (if your cat is over weight).

Owner Responsibilities: If you wish to have your cat participate in this study, you will be responsible for bringing your cat in to be rechecked once a month until your cat is no longer in remission for up to 24 months.

Printable Flyer (PDF)

Feline Upper Respiratory Tract Disease: Understanding the Disease

Title: Efficacy of famciclovir for control of clinical manifestations of feline upper respiratory tract disease

Purpose of Study: The purpose of this study is to evaluate the utility of a new technique called quantitative PCR (qPCR), which measures the number of viruses and bacteria in the nose, to identify a role for these organisms in cats diagnosed with feline upper respiratory tract disease. We also aim to evaluate the efficacy of famiclovir in combination with standard therapy with an antibiotic for treatment of upper respiratory tract disease.

Contact: Contact Dr. Lucy Kopecny for details at lkopecny@ucdavis.edu or call (530) 752-1393 to make an appointment

Participation Requirements: Kittens with acute upper respiratory tract disease displaying signs of sneezing, ocular or nasal discharge for less than 3 weeks that have not received prior treatment

Initial Evaluation for Participation: The investigators will determine eligibility for inclusion in the trial following consultation.

Procedures: If you agree to let your cat participate in this study, the following will happen:

  • Prior to treatment – Completion of a survey about your cat’s clinical signs, sample collection from the eyes and mouth using a Q-tip
  • Treatment – Oral administration of an antibiotic (doxycycline) alone or in combination with an antiviral drug (famciclovir) for 3 weeks. During this time, you will be asked to score the severity of your cat’s clinical signs daily
  • 3 weeks post treatment – Completion of a survey about your cat’s clinical signs, sample collection from the eyes and mouth using a Q-tip

Benefits: The study will cover costs associated with the quantitative PCR, medications, and visit costs to obtain samples.

Results from this study may help to identify the most appropriate diagnostic tests to use in this disease process and optimal treatment of affected cats.

Owner Responsibilities: You will be responsible for bringing your cat to all scheduled appointments, completing the surveys and administering medication twice daily during the 3 weeks of treatment.

Printable Flyer (PDF)

Fungal Disease: Examining a Treatment

Title: Voriconazole efficacy in cats with fungal disease

Purpose of Study: Voriconazole is a broad spectrum anti-fungal that is the treatment of choice for systemic aspergillosis in people and also used for variety of other fungal diseases. Drug treatment options in cats are limited because of little information of effect of anti-fungal medications on cats. The purpose of this study is to examine the efficacy of voriconazole against serious systemic fungal diseases like aspergillosis, cryptococcosis, sporotrichosis, histopalsmosis and others.

Contact: Dr. Jane Sykes at jesykes@ucdavis.edu or (530) 752-1393

Participation Requirements: Cats with fungal disease that did not respond to existing anti-fungal options (e.g., fluconazole, itraconazole, amphotericin B) or did not tolerate the adverse effects of the above-mentioned medications

Initial Evaluation for Participation: An appointment with the VMTH Internal Medicine service

Procedures: If you agree to let your cat participate in this study, the following will happen:

  • Your cat will be treated with voriconazole by mouth on day 1, and then again every third day.
  • On days 14, 30, 60 and 90 of treatment and then every 60-90 days until exit from study, we will do a physical examination and collect blood to measure voriconazole levels and test liver function.
    • NOTE: If your cat will require dose adjustments, he/she may need to be seen more frequently for blood sampling and rechecks.
  • We ask that you complete a monthly questionnaire and keep a journal to document any adverse effects that occur during the period of the trial.
  • In the unfortunate event of death, we will request that you will allow us to perform a necropsy of your cat (free of charge).

Benefits: Results from this trial may lead to a better disease outcome for your cat since voriconazole is a very efficacious and broad spectrum anti-fungal medication, and cats worldwide being treated with this medication.

Owner Responsibilities: If you allow your cat to participate in this study, you will be responsible for filling out a questionnaire once a month, recording all adverse effects in a journal, and keep all scheduled appointments. You will be responsible for covering all aspects of the care for your pet.

Ureteral obstructions: Evaluating Post-Surgery Outcomes

Title: Evaluation of Post-operative Outcome in Cats Undergoing Ureteral Stent Placement to Relieve Ureteral Obstruction

Purpose of Study: The purpose of this project is to record the intra-operative and postoperative complications associated with the procedure and determine the outcome of the procedure based on objective measures.

Contact: Dr. Culp at wculp@ucdavis.edu or (530) 752-1393

Participation Requirements: Cats with benign ureteral obstruction

Initial Evaluation for Participation: Contact Dr. Culp for details at wculp@ucdavis.edu or (530) 752-1393

Procedures: Cats with a diagnosis of benign ureteral obstruction will be enrolled in the study. Bloodwork values that can be utilized to determine the function of the kidney (should improve with the passage of urine) as well as variables such as the size of the kidney collecting system and ureter (should decrease with passage of urine) in cats both pre- and postoperatively will be evaluated. Lastly, the change in the urine output of cats with ureteral stents will be assessed to determine if the stents improve output.

Benefits: Some of the pre- and post-stent placement bloodwork and pre- and post-stent placement ultrasound evaluations will be paid for by the study.

If this therapy proves to be beneficial, it will have important clinical applications for other cats with the same condition.

Owner Responsibilities: You are responsible for returning with your cat 2 weeks and 3 months after stent placement.

 

Dogs

Hyperlipidemia: Assessing a New Treatment

Title: Efficacy and safety of fenofibrate in treating hyperlipidemia (increased blood fat levels) in dogs

Purpose: The purpose of this study is to investigate the use of fenofibrate for the treatment of hyperlipidemia (increased serum cholesterol, triglycerides, or both) in dogs

Contact: Dr. Matthew Munro at mjmunro@ucdavis.edu 

Participation Requirements: Dogs diagnosed with hyperlipidemia with no changes in diet or medication in the last month (NOTE: Patients with either primary or secondary hyperlipidemia and no diabetes mellitus can be enrolled.)

Initial Evaluation for Participation: To determine eligibility, your dog will need blood and urine analyses (complete blood count, chemistry panel including cholesterol and triglycerides, comprehensive thyroid panel, urinalysis and urine protein creatinine ratio) and an abdominal ultrasound.

Procedures: If the exams, tests, and procedures show that your pet is eligible to participate in the study, and you choose to enroll them, the following procedures will occur:

  • Physical examination;
  • Administration of fenofibrate by mouth once a day for 21 days (three weeks);
  • Blood and urine collection repeated after 21 days (three weeks) of treatment; and,
  • Repeated physical examinations, blood/urine tests, and an increase in drug dose every 3 weeks (maximum of 63 days after the first visit) if hyperlipidemia has not resolved and adverse effects have not occurred.

Benefits:  The study covers the cost of the fenofibrate for the duration of the study.

Participation in this trial may help improve or resolve your dog’s hyperlipidemia and reduce the risk of hyperlipidemia-associated complications (e.g. reduce risk of pancreatitis, elevated liver values, gallbladder changes, urine protein loss, ocular disease and even neurologic signs).

Owner Responsibilities: If you choose to participate in this trial, you will be responsible for:

  • Keeping all scheduled appointments;
  • Administering fenofibrate tablet/s, once daily, in the morning, with food;
  • Maintaining your pet on the same diet, medications or supplements throughout the study period; and,
  • Covering costs of the initial consultation and diagnostics in order to determine eligibility, recheck diagnostics, and costs of any medical care required because of an adverse event during the study.

Printable Flyer (PDF)

Fungal Disease: Exploring New Diagnostics

Title: Evaluation of two point of care tests for detection of crytococcal antigen in dogs and cats

Purpose: The purpose of this study is to investigate new, rapid diagnostic tests for fungal diseases.

Contact: Dr. Krystle Reagan at 530-752-1393 and make an appointment with Internal Medicine 

Participation Requirements: Dogs with a suspected Cryptococcus infection

Initial Evaluation for Participation: Make an appointment with Internal Medicine at the VMTH.

Procedures: If you agree to let your dog participate in this study, we will collect a blood sample and analyze the blood using the standard Cryptococcus test and two new fungal tests.

Benefits:  The study will cover the costs of the Cryptococcus latex agglutination blood test.

Owner Responsibilities: If you allow your dog to participate in this study, you will be responsible for:

  • Keeping all scheduled appointments
  • Covering costs of all other recommended diagnostics and therapies recommended by your veterinarian beyond the Cryptococcus latex agglutination test

Printable Flyer (PDF)

Hypothyroidism: Evaluating Current Treatment Strategies

Title: Crossover clinical study to evaluate two doses of levothyroxine for thyroxine replacement therapy in hypothyroid dogs

Purpose:  Hypothyroidism is a commonly diagnosed hormonal disease in the dog. Thyroid hormone supplementation is the treatment of choice for this disease and is routinely started at a dose of 0.02 mg/kg administered every 12 hours. Recent clinical experience suggests that some dogs may respond to lower doses of thyroid hormone supplementation. We are currently investigating whether dogs with hypothyroidism can be successfully treated using a lower dose of thyroid hormone and the best way to monitor this treatment.

Contact: Dr. Sean Hulsebosch at shulsebosch@ucdavis.edu 

Participation Requirements: Dogs diagnosed with hypothyroidism

Initial Evaluation for Participation: None.

Procedures: If you are willing to have your dog participate in this study, the following will happen:

  • You will need to administer one dose of thyroid hormone orally twice a day for a month.
  • A month after initiating treatment, you will need to bring your dog back to the VMTH to spend a 12-hour day in the hospital. During this time, we will be obtaining a blood sample upon arrival, and then multiple blood smaples through the day following administration of the thyroid hormone.
  • A new 30-day supply of thyroid hormone supplement will be dispensed. You will need to administer this dose twice a day for one month. The same blood sampling will be performed 30 days later as outlined above.

Benefits:  If you choose to enroll your dog, the study will cover the cost of all tests discussed above (thyroid panel, additional subsequent TSH and T4 levels for two months while enrolled in the study), and day case hospitalization. Upon completion of the study, a six month supply of thyroid hormone supplement at the appropriate dose for your dog will be dispensed to you and covered by the study.

Results from this study may help to improve assessment and treatment of hypothyroidism and allow for a customized dose adjustment thereby preventing unnecessary overdosing of medication.

Owner Responsibilities: If you allow your dog to participate in this study, you will be responsible for:

  • Giving oral thyroid supplementation at home twice daily (every 12 hour)
  • Bringing your dog in for the scheduled study visits
  • Covering the cost of the initial exam and any necessary lab work deemed necessary to determine if your dog is eligible

Printable Flyer (PDF)

Urinary Incontinence: Using a New Device for Treatment

Title: Use of radiofrequency urethral thermoplasty for the treatment of urinary incontinence

Purpose: Medical therapy using either phenylpropanolamine or synthetic estrogen, alone or in combination is currently considered first line medical therapy for urinary incontinence. While studies have shown that these medications are effective in some patients, both have potential side effects and life-long therapy is generally required. Various surgical treatment options have also been described for those dogs that do not respond to medical management or experience adverse effects from medications; however, these procedures are invasive, require considerable surgical skill to perform and are not always successful. Therefore, the purpose of this study is to test a new device, which uses heat to alter the structure of collagen in the wall of the urethra and thereby strengthen the wall and decrease leakage), to treat urinary incontinence in female dogs.

Contact: Dr. Bill Culp (wculp@ucdavis.edu), Dr. Carrie Palm (cpalm@ucdavis.eduor make an appointment by calling (530) 752-1393

Participation Requirements: Female dogs demonstrating signs of urinary incontinence

Initial Evaluation for Participation: To be performed by Dr. Palm or Dr. Culp

Procedures: 

  • Testing related to urinary incontinence, including bloodwork, abdominal ultrasound and possibly cystourethroscopy (camera evaluation of the urethra and urinary bladder)
  • Urethral procedure under general anesthesia once your dog is deemed a candidate

Benefits: The study will cover costs associated with anesthesia, the urethral procedure and hospitalization.

We hope that the data acquired in this study will allow us to advance the treatment of our canine patients.

Owner Responsibilities: This study requires 1-year time commitment, although future follow-up may be recommended. You will be responsible for covering costs associated with initial diagnostics including bloodwork, abdominal ultrasound and cystourethroscopy, keeping all scheduled appointments and follow-up visits, and filling out a urination diary throughout the study.

Printable Flyer (PDF)

Fungal Infections (Aspergillus spp) in German Shepherds, Rhodesian Ridgebacks, and Hungarian Vizslas

Title: Genetic analysis of the susceptibility to systemic Aspergillus infections in dogs

Purpose: Systemic fungal infections such as aspergillosis are rare in animals with a competent immune system; however, certain dog breeds (namely the German shepherd, Rhodesian ridgeback and Hungarian vizsla) are reported to have a higher risk of this uncommon disease. A genetic etiology is suspected to cause this over-representation. We propose to use a technique called genome-wide association analysis to evaluate the differences in the genetic material of affected dogs (dogs infected with Aspergillus spp.).

Contact: Dr. Jonathan Dear, DVM, DACVIM at jddear@ucdavis.edu

Participation Requirements:

  • German Shepherds with systemic Aspergillus spp. infections
  • Rhodesian Ridgebacks with systemic Aspergillus spp. infections
  • Hungarian Vizslas with systemic Aspergillus spp. infections

Initial Evaluation for Participation: None.

Procedures: The only procedure required is the collection and submission of a blood sample for DNA extraction. For more information about submitting samples, please contact Dr. Jonathan Dear (details above).

Benefits: Results from this study will hopefully lead to the development of DNA tests that would identify dogs at risk for developing systemic aspergillosis. These tests would help simplify the diagnosis of the disease by identifying at risk individuals and allow breeders to avoid producing affected dogs. Furthermore, if the genetic traits responsible for this disease in dogs are shared with human patients, precision medicine can be used to help develop targeted therapies to treat this life-threatening disease.

Owner Responsibilities: You or the referring veterinarian needs to collect and submit a blood sample and medical records.

Printable Flyers

  • German Shepherds (PDF)
  • Vizslas (PDF)
  • Rhodesian Ridgebacks (PDF)

On Hold Until Further Notice

Cystine Bladder Stones: Investigating an Oral Nutraceutical Treatment

Title: The effects of an oral nutraceutical on the solubility of cystine in canine urine

Purpose: 

  • Cystine bladder stones are common in both dogs and humans. This disease occurs due to a genetic predisposition, which occurs in many breeds of dogs. Therapeutic preventive strategies are limited.
  • Clinical signs can be mild or result in urethral obstruction in male dogs.
  • In a collaborative effort between the University of California San Francisco and The Buck Institute, the aim of this study is to evaluate the effects of an oral nutraceutical on cystine solubility in the urine.
Variety of Tumors: Assessing Minimally Invasive Tumor Ablation in Dogs and Cats

Title: Thermal ablation of cancer

Purpose of Study: The purpose of this study is to evaluate the outcome of treating veterinary patients with minimally invasive tumor ablation technologies including cryoablation and microwave ablation. These methods are growing in the treatment of a variety of cancers in the human medical field, but information in veterinary patients is currently very limited. To date we have completed a study on cryoablation in nasal tumor patients, and this technique has been very successful in reducing tumor volume in nasal tumor patients – although there are no more spots in the formal nasal tumor study, because of this success, we continue to offer this technique as a clinical service to nasal cancer patients, and are expanding the types of cancer that we are evaluating.

Variety of Tumors and Diseases: Improving Operative Detection of Tumors in Dogs and Cats

Title: Fluorescent imaging of cancer

Purpose of Study: Near-infrared fluorescent imaging utilizes special wavelengths of light to identify important structures, and is used in surgery to improve surgical decision making. The fluorescent light is generated by a special contrast agent (a “fluorophore”) that is injected into the patient. When a special light source is used to illuminate the surgical site, any tissue in which this fluorophore is located will glow, aiding the surgeon in identifying the location or extent of disease. Based on early experiments in rodents and human clinical trials, this very sensitive tool has the potential to improve surgical decision-making and improve overall treatment for a wide variety of diseases. The purpose of this study is to evaluate the efficacy of this imaging modality in veterinary patients presenting with naturally occurring neuroendocrine tumors disease processes.

Ectopic ureters: Evaluating Laser Ablation as a Treatment Option in Dogs

Title: Evaluation of the Use of Cystoscopic-Guided Laser Ablation in the Treatment of Canine Ureteral Ectopia

Purpose of Study: To evaluate urethral pressure profiles (UPPs) in patients undergoing laser ablation of their ectopic ureters. The goal is to determine if pre-treatment UPP values can help to predict continence rates after laser ablation.

If you cannot find what you are looking for, please email us or call (530) 752-5366.