How Veterinarians Contribute to Advancing Human Health - Dr. Susan VandeWoude, Dean of the College of Veterinary Medicine and Biomedical Sciences at Colorado State University

Hillary Acer: Hi, I'm Hillary Acer, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and health care.

The possible connections between animal and human health have received a lot of news attention recently because of the potential loss of U.S. government funding for a large study of aging in dogs. While it's unclear yet if that study will have to be put on pause, the intersection of human and animal health remains a rich subject of study, which is just one of the areas we'll be exploring today with my guest, Dr. Sue VandeWoude, Dean of the College of Veterinary Medicine and Biomedical Sciences at Colorado State University, ranked as one of the top programs in the nation. 

Before assuming that role, Dr. VandeWoude was the director of Colorado State's One Cure Institute, which facilitates research and teaching at the nexus of human, animal, and environmental health, one of several leadership positions she's occupied in her 23-plus year career at CSU.

As a researcher, she investigates disease spillover between wildlife and domestic animals, disease ecology, and translational medicine, areas that came to the forefront during the COVID pandemic. Dr. VandeWoude has also completed a postdoctoral fellowship in comparative medicine at Johns Hopkins University and was elected to the prestigious National Academy of Science in 2019.

Thank you so much for joining us today. 

Dr. Sue VandeWoude: Thank you. I'm really excited to provide this podcast for you all. 

Hillary: Yeah, so I'd love to start with learning more about you and your background and what first got you interested in animals and veterinary medicine.

Dr. VandeWoude: So I grew up, or at least from the time I was twelve, lived on a small farm in a town called Berryville, Virginia. It was kind of my dream as a twelve-year-old budding veterinarian to move from where we were in rural Long Island, New York, to a farm when my dad took a job in Maryland. And so that really was an exposure. My parents were very intrepid. They grew up in New York City, but then they moved me with my three younger sisters to a farm, almost like a Green Acres kind of situation. We joined 4-H. We all raised cattle and showed them at the fair. My species of choice was chickens, so I raised chickens from eggs. It was just a really fun, spectacular way to grow up in the country. We had a ton of barn cats, which kind of fed my future ambition of working with cats. 

But I also had a side of really enjoying science and being very involved in clubs in my high school. I went away to college and got a degree in chemistry from California Institute of Technology, so not a pre-vet school whatsoever. But when it came time to decide what to do when I was finishing up my undergraduate career, the potential of going to veterinary school kept popping up on my radar. Ultimately, I applied to the Virginia Tech Vet College that had opened recently and was admitted there, and that was my chosen profession because at that time, it seemed like it provided me with so many career opportunities. I'd been exposed to, you know, cats, farm animals, and then the science. And so all of those fit into veterinary medicine. I think I did a great job in choosing that without a lot of probably learned consideration, but it's been a great profession for me. 

Hillary: Well, we share a little bit of a background in growing up around a lot of animals. My mom is also a veterinarian, as I shared. And I recall, yeah, having eggs in the incubator and hatching the chickens and caring for them and having lots of animals around. So, it's wonderful that you found your way into this career. You landed on specializing in virology with a particular focus on cats. What led you to focus on that, and what do you enjoy about exploring that space?

Dr. VandeWoude: Yeah, so I, as I mentioned, I had a pretty strong scientific background. After I was in private practice for about a year, I ended up doing a postdoctoral fellowship at Johns Hopkins University in comparative and translational medicine. So it was really about, how do we compare diseases of animals to those of people and learn in ways that improves the health of both animals and humans. There are many similarities between the biology, physiology, and disease portfolio of animals and humans. I really enjoyed that concept, and that's why I ended up at one of the world's premier medical schools. 

But at that school, I had a fellowship research project, and it ended up being in virus discovery. That one actually ended up being more of a virus of horses and sheep. When I left that fellowship position and got a job at Colorado State University, I really wanted to continue to pursue research. I was a staff veterinarian at the time -- so I was providing veterinary care for animals that were being used in research studies or in the research realm -- and then was able to develop my own line of interest, which gravitated back towards my love of cats and knowing that many of our barn cats were always sneezing and getting sick. There is a great group of virologists at CSU studying feline leukemia virus in cats, which we have, fortunately, a very durable vaccine for, so it's less of an issue. But a cat getting that infection can end to high morbidity and mortality. In other words, it can be a fatal infection for many animals. 

I was also involved about the time where the AIDS pandemic was starting, and we knew that was a retrovirus, a lentivirus, caused by the human immunodeficiency virus. And right around that time when I was in vet school, a similar virus of cats -- feline immunodeficiency virus -- was discovered actually at UC Davis in California. And the group I was working with in the feline retrovirus world expanded their studies to FIV. I just fortunately got hooked up on a project that was looking at FIV, not only in domestic cats, which turns out has been in the domestic cat population for quite a while, but it also turns out it's in about a dozen species of non-domestic cats. It's in a lot of lions. It's in a lot of mountain lions or panthers. So the Florida panthers had an infection with that. It's in bobcats. 

So, I just really luckily and coincidentally got connected with groups doing studies about the infections in those animals and that really drove the rest of my research career by being able to just kind of fall into that area of study.  Most recently, my lab is studying SARS infection of cats because they are quite susceptible and we've looked at how many of them are probably getting infected in the people's homes and whether their infection could lead to new variants emerging. And I've along the line utilized new diagnostic and analytical tools in my lab that then can be applied to other infections. 

So I really, it turns out, I really love working with students who have that curiosity that lends to research and promoting research careers for many veterinarians. I've also had quite a lot of administrative appointments in my career here at CSU. I've been here for 34 years, more or less, and I've had about seven different jobs, and now for about the last year and a half, I've been the dean of our great college, just kind of building my interest areas, as my career has matured.

Hillary: You've covered a lot of ground in those years and had a lot of impact and we'll come back to the One Cure initiative in a moment, but there's some really interesting virology research obviously that's happening post-covid and I would love to talk more about how those two intersect and maybe what each of these areas can learn from one another. But before that, let's talk a little bit more about your research first since you've chosen more of an academic path in your career as opposed to being a clinician. Why did you make that choice and what has that path yielded for you?

Dr. VandeWoude: Yeah, I think you know that harkened back a little bit to my curiosity that I've always had about why things happen and even as an undergrad I worked in a lab that was working on a human disease called beta thalassemia. That's an inherited blood disease and I was working in a laboratory that was looking for the gene associated with that heritable disease and it was long enough ago that we used pretty primitive methods compared to what we do now to look for those kind of things.

I just remember the first time I got a result -- that's back in the day where you had to develop photographs in a dark room -- and I was doing that and I developed the photograph and I saw the result of my experiment and it struck me that I know something about this particular area that nobody else in the world knows. It's surprising how many scientists in the world know about this particular area and it's surprising how many scientists have an early “a-ha” moment like that that really drives their career because understanding that you have knowledge that you've created that is answering a piece to the puzzle. 

What I discovered in that moment was not a huge piece of information that was going to contribute to the cure of that disease, but it was a clue to what we would do for the next step and that really kind of set the seed for me and I was able to always look for careers that combined my interest in animal health and biology and working with animals with discovery and science, and that harks back to the veterinary medicine providing you with so many opportunities 

I've kind of forged my career pathway that way and also tried to share that with students who often go to vet school because they have a lifelong dream of working in a vet clinic -- and that's what many of them do of course -- but for those that find that same passion figuring out how to keep that passion fulfilled and to help them find career paths where they can contribute in that way.

Hillary: Yeah, very similar to medical clinicians or professionals who can have variety in their day-to-day. I think veterinarians faced similar challenges with everything from student loans to burnout. I think there's even some trends in how things like online reviews for clinicians can affect their well-being and so there's a lot that they're facing so I think you know making sure that they can find what they're passionate about and also have some variety is probably a good thing for them. 

So, inspiring and, as we talked about in the beginning, you've held various leadership roles at CSU over the years and you're actually the first woman to lead CSU's College of Veterinary Medicine so, first, congratulations. I'm sure there have been some ups and downs along the way, so can you talk a little bit about the challenges and opportunities of leadership and academics and also just what you're hoping to accomplish as the dean?

Dr. VandeWoude: Thank you very much for the congratulations. Sometimes people want to provide me condolences, too, because it is an awfully big job. As you noted there have been some real high points and then really some challenges, obviously. and I think over time what I've learned -- and I think also is really important for anybody coming into this field or other academic fields -- is to be resilient and figure out a way to pick yourself up when something's not working. Maybe I can go back to talking about the research field. Oftentimes experiments don't work and then you have to go back and figure out why they didn't. Or you can write a grant or a paper that will get rejected and that can feel really bad when it happens, but then you can find it within yourself to say, “Okay, how can I use this as a learning moment? What is it I can do better or what is it that caused this experiment to fail? What question might I even answer by knowing it didn't work?” I think that certainly happens in the administrative framework. 

What's exciting about the position that I have now is it has more authority to try to forge directions to help develop our culture for the modern needs of our students and for our faculty and responding to many changes that are occurring in our profession of veterinary medicine. That's exciting to be in the position of using all the knowledge I've gained over the years and what I've learned from being at CSU to try to make the best decision when that's feasible. 

But there's, of course, many things that are out of my control and one of the ones that probably is predictable that we're always struggling with, especially in a public institution that is dependent upon state funding as one of our major sources, is the whims of how much money will we be given by the state legislature and how will that be partitioned at the university level. 

I love to be a collaborator and I've kind of made my mark in research by having a lot of collaborative teams. I really enjoy that at the university level in terms of working with the other deans at the other seven colleges here and trying to do that within a competitive environment can sometimes be challenging. I think right now, there's a lot of unprecedented changes external to our university. Everybody working in a sector of some type of employment is faced with external pressures. Of course, we've got our whole election coming up in 2024 that's going to cause a lot of anxiety; there's a lot of global tensions around things that you just can't keep from seeping into the workforce. 

One thing that I've been thinking about is artificial intelligence. I was able to go to a conference this summer about impacts of artificial intelligence on medical education and delivery and research. It’s just the overwhelming impact that those technologies are having on the world and I think we're continuing to analyze how much those technologies are going to impact our profession. I just was at a conference last week with many other deans from other vet colleges and we're all kind of waiting for a big wave to hit us. We know we're not going to be prepared for all the changes and we really think there are going to be dramatic changes that are going to be led by younger generations, and so that's exciting. It's going to provide so many opportunities for increased efficiency and probably better diagnostics and better treatments for our animals and for people. But there's also a lot of unknown there that keeps a lot of additional stress and burden on people who are already dealing with a lot of change. 

Hillary: I'm glad you mentioned emerging technologies. Osmosis is part of Elsevier, which I'm sure you're familiar with. But there is a lot of work being done to make sure that whatever AI solution gets integrated is responsible, it's accurate. Of course, that takes time and it has to be continuously followed up on and cross-checked with experts like yourself. So, I think we're kind of cautiously optimistic. We're very excited about how it can reduce some of these burdens on clinicians and even caregivers or pet owners or patients themselves. But we've got a little ways to go. It's just…can we keep up with it? 

Dr. VandeWoude: Yes, exactly. 

Hillary: Yeah. You mentioned some of the ups and downs, and I just want to come back to one thing you talked about with research that, of course, a number of your experiments don't actually yield positive results, but they still teach you something really important. When I was in undergrad doing a little bit of research in neuroscience, one of the things that I'd hoped for was a database of failed research experiments, actually, because I thought that there's so many labs that are doing similar research, but they're not necessarily sharing their findings when they know something doesn't work. So, it's interesting. I'd love to see maybe that's something AI can help with, too, is how do we actually share what are thought of as negative results with other folks that can continue to learn from it. 

Dr. VandeWoude: Right. Yeah, I think that's a great point and there are journals that are devoted to reporting good experiments that didn't result in some proof of a very exciting hypothesis. But it's just the nature of how we reward things in our system right now. You're not necessarily rewarded for the experiment that was done well and disproved your hypothesis. There's a more open archive type of databases and my students are better at using those and searching them than I am. So, I feel like we potentially will get to something like that. 

In fact, during the pandemic, there were a lot of non-peer-reviewed postings in bioRxiv and other similar repositories. It seems like that's slowed down a bit since the pandemic, but that was a way to really facilitate, OK, this is in the pipeline, and yet it isn't peer-reviewed, so take it with a grain of salt or a bit of caution. But you know other folks are working on this issue and hopefully, you'll hear from them in a more refined way relatively soon.

Hillary: That's great. I think the pandemic did accelerate a lot of those changes and collaborations as there was just a dire need for it. Let's jump to this topic of the One Cure initiative, because there's so much to talk about in the intersection of human and animal health. CSU is leading one of these programs, so what can you tell us about the One Cure initiative for health professionals or for really anybody who's listening? 

Dr. VandeWoude Yes, that's great. Thank you for giving me this platform. It's one of my favorite topics to talk about. So One Cure…I think what you're referring to is a specific program within our Flint Animal Cancer Center, which is I would think, one of the most progressive and advanced veterinary oncology centers in the world. It's part of our veterinary health system and teaching hospital here at CSU. And the premise of One Cure - or One Health in some contexts, or translational medicine -- all these terms refer to the fact that animals get diseases all the time that mimic diseases in people. I think this is something that's really obvious to veterinarians, because in vet school, that's what we learned about. We learned that dogs get cancer or cats will get allergic arthritis or horses get osteoarthritis. And we know that the drugs and the treatments and everything are scaled up or down, but they're often very similar to what people are treated with. We know this because we're humans, so we have this kind of natural inclination to be comparative scientists and to be thinking about things in that comparative framework. 

So, the idea of One Cure or similar programs is to harness this knowledge that we can create at a college of veterinary medicine, where we have academicians who are these research veterinarians that I've been referring to, who are on the lookout for the reasons behind the diseases and open to innovative solutions for managing those diseases often with input from medical doctors, human clinicians, who may also have cutting edge therapies that they're working on. 

Traditionally, we think of research using animals as being standard laboratory animals-- mice, rats, and some other species, rabbits sometimes -- and those can be very beneficial in moving something from an artificial cell-based system into an actual animal that has all the organ functions that would mimic similar things in people. So, a mouse has a liver, just like a person, and it is one of the organs that would metabolize drugs in the mouse so we can see how a drug delivered to a mouse might be metabolized, for example. Those are really important first steps, but they often lack a lot of authenticity in mimicking natural disease processes. 

An example for One Cure would be at our Flint Animal Cancer Center, we’re one of the number one referral centers for animal cancer and one common one is a disease called osteosarcoma. This occurs usually in large breed dogs, usually in mid age or even younger animals, and it's on one of their limbs and often requires amputation of the limb. It's also a disease that if you were to look under a microscope of that tumor in a dog, and the similar tumor in a human -- and these usually happen in young, younger children - they're indistinguishable. You would not be able to say that's a dog bone or a human bone that's got a tumor in it. And if you look at the genetic changes that occur in the tumors, they're also similar. 

So, the idea is let's take this relatively common disease in dogs and use it as a test bed for therapies that will impact the health of the pets that are unfortunate enough to get this disease, but also can be applied to humans. So we have a group here -- and there are multiple groups who collaborate at other veterinary colleges -- who have looked for drugs that are already in use in people and in dogs and seeing if they can be added to augment the treatment of that terrible disease in dogs.

First this was done in a tissue culture and it looked promising. So then they tested in a mouse model to see if this drug could augment the course of tumor progression and it did. So then they scaled up the dose in dogs and there was some really early clinical evidence that metastasis that had occurred in these dog canine patients could be significantly deterred by adding a drug that was already on the market. 

And so now, there's a clinical trial with our medical doctor, pediatric oncologist, down at UC Denver that is supported by some of our work to see if the same therapies can be used in the metastatic disease in children who have not responded to the standard of care. So, it's very exciting and it's just a great example of where we seek to make progress in many different realms. 

Another area that we do a lot of studies in is osteoarthritis in horses, a very common disease. How do you treat those with relatively non-invasive surgery or stem cell or other biological therapies and what's the mechanism behind those? We have folks working on seizures in dogs and how you might try different drugs for those. There are also studies underway to look at new biomarkers or predictors of disease outcomes for various diseases. For example, trauma in horses or post-traumatic events in dogs, which is often being hit by a car. What are some of the ways you can predict by looking at novel markers by doing a blood test of whether those dogs will go on to have more severe recovery issues?

So, those are, you know, just a laundry list of things that many of our clinicians are working on and I think it's where we as a veterinary teaching hospital can really advance our field beyond treating the client-owned animals that come through our doors with very advanced modalities. It's how we can help our profession and that's really what our faculty here are aimed to do. 

Hillary: Fascinating, and I definitely will be following more closely some of the research that comes out of CSU and some of your collaborators. My family owned Irish Wolfhounds for a number of years and so we're very familiar with the osteosarcoma. 

Dr. VandeWoude: Yes.

Hillary: Unfortunately some devastating events. It's so interesting because I mentioned that my mom is a veterinarian. She did go to Kansas State, so not a CSU alum, but worked with many CSU alums and I am very lucky to have benefited from her knowledge because so much of her training and her education parallels medical education, actually. So, she was able to keep me informed and educated and know what questions to ask and there's just so much overlap there. So, I really look forward to seeing those two spaces come together more in the future. 

Dr. VandeWoude: Yeah, I know my children sometimes were not thrilled that I was a veterinarian and they tell the stories of me listening to their heartbeat or giving them medicine for cats. A lot of it is exaggerated, but it is kind of a pediatrician's nightmare. Probably your mom was the same, because I'd go in there loaded with knowledge and ask questions a typical client did not. 

Hillary: Most definitely, and I'm laughing because -- I'm not sure how much to share on the podcast -- but certainly, I know an antifungal cream is probably not that different for humans or dogs or whatever it might be. So yeah, that's probably a secret life of a veterinarian's child that we can have a special podcast about. 

Going back to CSU, you're obviously overseeing one of the top programs but maybe for those who are interested in veterinary school or interested in learning more about the program or supporting the program potentially, what are CSU's strengths? What's on the roadmap for the next several years? What should our learners know? 

Dr. VandeWoude: Well, I could spend another half an hour talking about that. So, when I took my job about a year and a half ago I took over a number of projects that were quite mature at the time. One of our big initiatives is to modify our curriculum very substantially so that our students are gaining more hands-on learning versus being in a classroom all the time. There's only so much knowledge you could learn in the traditional didactic way and we're really trying to follow the evidence that there are better ways to train people. We're working towards that, which is going to be a very big lift, but we know it's what we need to do to be preparing the best graduates from our program. 

In order to incorporate that, we determined we needed to really modify our teaching infrastructure. So, we're about to break ground on one of the biggest transformational construction projects on the CSU campus and that's to develop what we're calling a veterinary health education complex. It will include a brand new primary care clinic where people with quote-unquote ordinary problems with their small animals can come through the door and see staff to get their animals vaccinated, spayed, neutered…kind of the more standard primary care issues you'd go to your general practitioner about and that will really be managed by students.  

The way that the building will be configured, there'll be observation rooms for the clinicians. The board licensed veterinarians will be watching the students interviewing the client taking the notes and then they'll come and confer with them about their treatment plan that they're putting together. We're very excited about the opportunities that's going to afford not only serving our community more broadly but providing our students with that very competency-based training so that when they're graduating they can have more confidence. 

We are also expanding and refurbishing the 1978 Tertiary Care Center where a lot of our advanced work goes on, and that will be a phase two. We're building a new livestock hospital that conforms to what the livestock community needs right now and that will also be kind of a byproduct of the new construction to the primary care center. So, those are all things in our veterinary medical side. 

We also have a whole biomedical side, and that's one of the reasons we're so highly ranked because we have about half of our faculty teaching undergraduate students and doing really important research on various diseases on two other campuses. We've also got projects underway for improving the facilities and figuring out ways to enhance collaboration between our basic science faculty and our clinical faculty. And then, of course, incorporating the new technological tools into the way we're practicing and educating is a big component of that, too. So, there's a lot on our plate.

Our faculty are doing the best they can to manage all this change, but it's a very exciting future and I'm very fortunate to be at the helm during this time. 

Hillary: It sounds like you all are leading the way in many ways. I want to be respectful of your time. I know you have to go soon, so I'll just mention that it's interesting to see some of the changes in clinical medical education for human medicine are similar. It sounds like getting students clinical exposure and experience early on and having that competency-based curriculum. So, more to discuss later on. I'll just ask you one final question if you have a moment. 

Dr. VandeWoude: Sure.

Hillary: So we have a lot of early health professionals and hopefully increasingly more veterinary health professionals joining our platform. We're a teaching and learning company, so what would you advise them as they go on in their career? Or what would you say to them as they're meeting some of the challenges of veterinary medicine today? 

Dr. VandeWoude: Yeah. What I usually say to any of the students I'm mentoring is to just find what leads your heart. We're kind of a cerebral profession. You know, we're book smart and we're all competent at learning lots of facts, but we also are human beings that have a heart and a gut. I don't know which of those emotional things are more important.

But, if I'm saying this from my own perspective, that when I find things that are exciting for me I feel like I should take a leap. Trust that intuition or bounce it off your mentor to make sure it's not that harebrained of an idea, because it often leads you to something that's really exciting. 

There's no sense in trudging along with a job that you're not excited about if there's something else out there that you think would bring you more rewards personally. And that's a really important part to keep us healthy in our profession. 

For some folks that'll be working in a really busy clinic. For other folks, it might be working in a lab. For others that might be working for a publishing company and using your knowledge in that way. I know students that are considering careers in editing and writing, and I think they can bring a lot to the table with the knowledge that they have. 

I will mention, since you brought up medical education, we also are in our third year of a program that collaborates with the medical school down at the Anschutz campus south of us in Aurora, where they're training about twelve students per year in medical curriculum up here, and eventually we'll have all four classes up here. So, that's exciting. It's kind of housed within our college, and it provides more opportunities for that kind of medical doctor-doctor of veterinary medicine collaboration. It's really fun. 

Hillary: Wow. Well, hopefully this isn't the only conversation we get to have because clearly there's a lot more to dig into. I love the advice of following your heart and really listening to what's pulling at you and what's capturing your interest at the time. That's advice that all of us can take forward. Thank you again for joining us, Dr. VandeWoude.

Dr. VandeWoude:  Thank you, Hillary. I've had a great time talking to you. 

Hillary: I'm Hillary Acer. Thanks for checking out today's show. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.