David Sisson, DVM, Dipl. ACVIM (cardiology), loves cutting-edge technology. His residency project at the University of California, Davis, veterinary school in the early ’80s involved intravenous insertion of pacemakers into dogs at a time when the fix was rare in animals and almost always done surgically. Today, at Oregon State University’s College of Veterinary Medicine, where he started the small-animal program five years ago, his prize piece of equipment is a 64-slice CT scanner that he says is better than those used in most human hospitals. It can scan a dog’s entire heart, down to the last blood vessel, in 15 seconds. “There’s nothing like being able to see the problem to be able to solve it,” he says enthusiastically. This veteran academic and cardiologist built his career by balancing his technological interests with a very practical philosophy: He believes in developing and using the most advanced technology possible to enhance animals’ lives and health but at a cost that’s reasonable to clients and to society. In his mind, that means concentrating on minimally invasive, less-expensive techniques for solving problems such as congenital heart defects. An Amplatzer duct occluder can block a defective artery and be implanted without major surgery. “I think that people are extremely dedicated to their pets and will make a lot of personal sacrifices to treat their animals, if you can keep it within a reasonable cost,” Dr. Sisson says. “$40,000 for a heart transplant [for a pet] is going to be beyond most reasonable people’s means. But $3,000 for a procedure that is going to give your dog several more high-quality years of life—if that is someone’s priority, that is something that is within reach of many more people. I have always been more interested in solving problems that are applicable to a larger portion of the population.” Birth of a Specialist Piper and owner Denise MacDonald. Sisson, 60, began developing this philosophy years ago, not long after his 1975 graduation from the UC Davis veterinary program. Sisson did a year’s internship at Cornell University, then spent five years in private practice. But he soon realized that his interests lay not in the day-to-day challenges of general medicine but in developing a specialty. So in 1981 he headed back to California to begin a residency in cardiovascular medicine. The early ’80s were an exciting time. Specialties such as neurology and cardiology, and the diagnostic capabilities that fueled their development, were advancing rapidly on university campuses, he says. “In that era, new technology entered the universities first and then came to the private sector,” Sisson says. “Today there is just as much availability of technology in the private sector, and there are a lot more alternative ways to become trained and to indulge your interests in a specialization. So if I was in the same circumstances today I might have gone a different route.” Sisson’s early work with pacemakers led him to the creation of a program that would dramatically reduce the cost of the procedures in animals. In the ’80s, a pacemaker manufacturer approached Sisson to describe a problem: Pacemakers that sat on the shelf too long were going to waste because when the batteries got too old the devices couldn’t be used in humans. The solution: Donate them to animals. After all, a pacemaker with a reduced 10-year shelf life—unacceptable in most human patients—would last plenty long in a dog. Clearinghouse for Pacemakers In 1991, Sisson set up what became the non-profit Companion Animal Pacemaker Repository (CanPacers), administered by the American College of Veterinary Internal Medicine. The donated pacemakers and leads would be available to universities or practitioners for a small fee. The fees would be funneled back into cardiology teaching and research programs. “It was win-win,” he says. Sisson administered the program for several years while a faculty member at the University of Illinois veterinary school before he was lured to launch Oregon State’s program. In Corvallis, Ore., Sisson has concentrated on developing a well-rounded small-animal program with strengths in surgery and oncology as well as cardiovascular disease. Because the college’s hospital unit accepts referrals from veterinarians as far away as Seattle and Northern California, it was important to consider what pet owners might need and what they might be able to afford when specialty programs and procedures were developed, he says. Such practicalities are necessary in an era when education costs are spiraling and state governments are often unable to increase university allocations. Indeed, having spent most of his career in academia, Sisson is well versed in the economic challenges facing students and universities, and he has a few ideas on how to address them. “I have thought for years that it would make tremendous sense to have a small, dedicated sales tax on pet food, just 1 or 2 percent, and dedicate that tax money to veterinary schools for training future veterinarians,” he says. “It would be a very logically directed user tax, in that the people who would be deriving the benefit, the pet owners, would be the ones who are paying the tax.” He has considered launching a statewide campaign in Oregon to test the idea, he says. Sisson also sees value in developing a formal apprenticeship system if education costs can be controlled so most students didn’t leave school tens of thousands of dollars in debt. In his vision, new graduates could be paired with mature practitioners to get the sort of extended education that’s now experienced by a limited number of residents and interns in highly specialized programs. An experienced general practitioner, Sisson explains, may not know the latest wrinkles in genetic research, but he or she has developed a vast store of practical knowledge that would help a new graduate develop into a well-rounded veterinarian. “You could expose (young veterinarians) to a broader, better base of training that they couldn’t get in another way,” he says. This article first appeared in the June 2010 issue of Veterinary Practice News. Click here to become a subscriber.
