New veterinary centre of excellence is the only one of its kind in Canada

Using cutting-edge technologies including endoscopy, angiography and fluoroscopy, the CEMI is unique in Canada. In the United States, there are only three such centers with this equipment.

Using cutting-edge technologies including endoscopy, angiography and fluoroscopy, the CEMI is unique in Canada. In the United States, there are only three such centers with this equipment.

Credit: Amélie Philibert, Université de Montréal

In 5 seconds

As the story of Stella the schnauzer illustrates, UdeM's new Centre of Excellence in Interventional Medicine is well-equipped for specialized, minimally invasive procedures.

A year ago, Stella, a 6 1/2-year-old miniature schnauzer, underwent surgery at a veterinary clinic to remove bladder stones. A few days later, recuperating at home, she jumped off a couch and her wound reopened. The result was pain, bleeding and another trip to the vet. 

Eventually, more stones formed in the Stella's bladder, but the dog's owners didn’t want to put her through the same operation again. That's when their vet told them about a new, minimally invasive procedure at the Centre hospitalier universitaire vétérinaire (CHUV) in Saint-Hyacinthe. 

Last February 22, Stella came under the care of Dr. Marilyn Dunn, the driving force behind the CHUV's new Centre of Excellence in Interventional Medicine, known by its French acronym CEMI. Dunn is also a founding member of the American College of Veterinary Nephrology and Urology and of the Veterinary Interventional Radiology & Interventional Endoscopy Society. 

A $1-million donation from pet food company Royal Canin Canada and a $200,000 donation from the Boehringer Ingelheim pharmaceutical company made it possible to buy the medical equipment for CEMI. The gifts were made as part of the university's recently launched L'heure est brave fundraising campaign.

Ongoing care and training

Muni d’une table de fluoroscopie, d’un système d’écrans, d’un système d’anesthésie intégré et d’autres infrastructures, le CEMI sert aussi à former les étudiants en médecine vétérinaire, ainsi que les vétérinaires de partout dans le monde.

Equipped with a fluoroscopy table, a screen system, an integrated anesthesia system and other infrastructure, the CEMI also serves to train veterinary students, as well as veterinarians from across the world.

Credit: Amélie Philibert, Université de Montréal

CEMI is equipped with state-of-the-art technology including endoscopy, angiography and fluoroscopy, making it the only centre of its kind in Canada. In the U.S., there are only three such facilities.  

At CEMI, Dunn and her colleague Catherine Vachon perform a range of diagnostic and therapeutic procedures for the respiratory, cardiovascular and urinary systems of pets, wildlife, zoo animals and farm animals. Their minimally invasive approach makes it possible to treat more patients. 

With its fluoroscopy table, system of screens, integrated anesthesia system and other equipment, CEMI is also used to train veterinary students as well as "veterinarians from around the world who want to specialize in or familiarize themselves with these types of procedures," said Dunn.

Less invasive

La Dre Marilyn Dunn

Dr. Marilyn Dunn

Credit: Amélie Philibert, Université de Montréal

Thanks to the devices and equipment acquired with the donations, the veterinarians are able to perform minimally invasive procedures and watch their manoeuvres on the screen in real time. This is how resident Corentin Treich performed the procedure on Bella, under Dunn’s supervision.  

"The image-guided procedure involved inserting an endoscope through the animal's urinary tract to the bladder in order to locate the stones and fragment them with a laser," explained Dunn. “That makes it easier to remove the stones through the natural pathway, without having to make an incision."

To make sure all the stones were gone, a C-shaped X-ray machine rotated around Bella while she lay on the fluoroscopy table, sending a video of her insides to another screen.  

Unlike Stella’s first operation and subsequent recovery, which was trying for her and her owners, the CEMI procedure left no trace. 

"Typically, surgery to remove bladder stones requires a 14-day convalescence with painkillers and a cone to keep the dog from biting the wound," said Dunn. “With the endoscopic procedure, there is no wound. In Bella's case, she was discharged from the hospital the same day and could have gone to the dog park that evening."

Centre meets a need

Watch the video in which another dog, Peggy, was also treated at CEMI, this time for an ectopic ureter.

Credit: University Veterinary Hospital Center of Université de Montréal.

An UdeM professor since 2002 and specialist in internal medicine for companion animals, Dunn was interested in interventional medicine even before it was practiced at the Faculty of Veterinary Medicine. 

"We had a patient with a collapsed trachea that wasn't responding to treatment, so we asked doctors we knew for expired stents they'd used to clear the bronchial tubes in babies," she related. “We tried this on our patient and it worked!" 

It was the first tracheal stenting performed on an animal in Canada. 

That case spurred Dunn to go further and specialize in image-guided diagnostic procedures for animals, a relatively new field at the time. In 2008, she was awarded a fellowship at the University of Pennsylvania under the direction of Dr. Chick Weisse and Allyson Berent.  

On her return, Dunn set up the Interventional Medicine Department at the CHUV’s pet hospital. 

"With time, we found that our equipment limited for what we could do,” she recalled. “So in 2016, we came up with the idea of creating an interventional medicine centre of excellence. We drew up a budget and reached out to clients and businesses to raise the funds." 

The rest is history. But CEMI owes its existence, first and foremost, to the needs expressed by pet owners, Dunn said. 

"Our clients are our best ambassadors. They’re the ones who ask us to operate on their pets in the least invasive way possible. Interventional medicine helps improve our patients' comfort while reducing their recovery time." 

To watch the video in which Peggy, another dog suffering from bladder stones, underwent the same procedure at CEMI, click here.

  • En salle préopératoire, la patiente est anesthésiée puis intubée.

    In the preoperative room, the patient is anesthetized and then intubated.

    Credit: Amélie Philibert, Université de Montréal
  • Elle est ensuite installée sur la table de fluoroscopie, avant d’être recouverte d’un drap qui ne laissera apparaître que la zone pelvienne.

    It is then installed on the fluoroscopy table, before being covered with a sheet which will only reveal the pelvic area.

    Credit: Amélie Philibert, Université de Montréal
  • L’intervention s’effectue par la voie urinaire.

    The procedure is carried out via the urinary route.

    Credit: Amélie Philibert, Université de Montréal
  • Les calculs, comme celui que l’on voit à l’écran, sont fragmentés par un laser, ce qui permet de les extraire plus facilement.

    Stones, like the one seen on the screen, are fragmented by a laser, making them easier to extract.

    Credit: Amélie Philibert, Université de Montréal
  • La Dre Marilyn Dunn (à gauche) avec le résident Corentin Treich (assis), accompagnés d’une partie de l’équipe médicale.

    Dr. Marilyn Dunn (left) with resident Corentin Treich (seated), accompanied by part of the medical team.

    Credit: Amélie Philibert, Université de Montréal
  • La table de fluoroscopie permet, à l'aide de rayons X, de s'assurer qu'il ne reste plus de pierres dans la vessie de la patiente.

    The fluoroscopy table uses X-rays to ensure that there are no stones left in the patient's bladder.

    Credit: Amélie Philibert, Université de Montréal

On the same subject

veterinary medicine training donors