Book draws parallels between veterinary, human medicine
Barbara Natterson-Horowitz, MD, had an opportunity that few physicians get to experience. In the spring of 2005, she was called in to consult on a breaking case involving a critically ill monkey at the Los Angeles Zoo.
The monkey was being examined for heart failure and it was during this procedure that Natterson-Horowitz learned of the veterinary diagnosis of capture myopathy. She realized this disorder was very similar to a human form of stress and fear-related heart failure. What was fascinating to her was that while the disorder has been recognized and studied by veterinarians for decades, the human "version" of it was only identified in 2000.
Before this "ah-ha moment" as Natterson-Horowitz calls it, she didn't realize the extent of the overlap between the non-infectious diseases of humans and animals. In medical school, she was taught that the intersection of animal and human health was mostly about zoonoses. The commonalities in cardiovascular disease, cancer and psychiatric syndromes were never presented—so she started researching them herself.
Her investigation soon led her to science journalist Kathryn Bowers, who was also extremely interested in the relationship between animal disease and human disease. They began to collaborate.
The result of her interest, released in June of this year, was "Zoobiquity" (Knopf), a book by both women that contains case study after case study demonstrating the parallels between veterinary and human medicine. The descriptions in the book include cases of self-harming, sexually transmitted disease and breast cancer.
"The point of the book is that human medicine has a great deal to learn from the veterinary approach to the same problems," Natterson-Horowitz told DVM Newsmagazine. "There are many examples of this in 'Zoobiquity.' For example, the comparative approach, a central aspect of veterinary education, is not a part of the clinical conversation at the human bedside. Physician ignorance of the vast array of non-human species with the same disorders narrows our perspective."
The research Natterson-Horowitz conducted for "Zoobiquity" is closely aligned with the concepts of One Health, a "worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of healthcare for humans, animals and the environment," says Bruce Kaplan, DVM, a member of the One Health Initiative. Kaplan says the goal of One Health is better collaboration and communication between the fields to improve healthcare for all species by accelerating research and expanding the scientific knowledge base.
Kaplan says One Health has published case studies similar to what fills the pages of "Zoobiquity." Kaplan says recent research performed by George Lees, DVM, MS, DACVIM, found that Alport syndrome in people and hereditary nephropathy in dogs are both caused by similar genetic mutations.
Natterson-Horowitz says she believes the comparative methods veterinarians are taught from the first stages of their careers allows them to make connections between animal species and within groups of animals. "Traditional human medicine has, at times, looked at patients as relative clones of one another," Natterson-Horowitz says. "Very recently there has been a shift to individual medicine which recognizes heterogeneity between patients. Veterinarians, perhaps because of the comparative perspective, benefit from a deeper appreciation of differences between patients."
The book outlines how much the veterinary approach could help physicians take care of their patients, and not only in the treatment of physical illnesses. "Given the overlap in psychopathology between animals and humans, I also think the fields of psychiatry and psychology could benefit from learning behavioral approaches used by animal experts to deal with similar issues in animal patients," Natterson-Horowitz says. "Traditionally, human medicine has used talk therapy and psychopharmaceuticals. But behavioral interventions can be very powerful. There's a tremendous amount of expertise on behavioral interventions among animal experts on the other side of the species divide."
Natterson-Horowitz says she's seen a spike in interest in collaboration from all sectors of animal and human medicine since the book's publication, and has increased her efforts to get the word out—she's helped coordinate a "Zoobiquity" conference for physicians and veterinarians and developed Evolutionary Medicine Month at the University of California-Los Angeles. Additionally, she designed a medical narrative course for pre-veterinary and pre-medical students, also at UCLA.
Her efforts have cemented an interest. "Many physicians have contacted me to find out how they can engage with veterinarians in their communities," she says. "I'm encouraging human cardiologists to reach out to veterinary cardiologists in their communities—same goes for oncologists and other specialists. Medical students seem particularly interested, and this dovetails with increasing interest in global health concerns among physicians in training."
Natterson-Horowitz notes obesity in the wild as one of the most interesting diseases she studied in the course of her research. "On the one hand, it's obvious that periodically there's abundance in nature, and animals overindulge and put on weight," she says. "On the other hand, I had somehow assumed that in the wild animals would never overeat."
Natterson-Horowitz says her interest and research won't stop here. She hopes to publish more books, put on more conferences and continue educating doctors and veterinarians on the benefits of One Health.