{"id":18820,"date":"2019-10-10T14:31:35","date_gmt":"2019-10-10T14:31:35","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=18820"},"modified":"2022-03-29T19:08:55","modified_gmt":"2022-03-29T19:08:55","slug":"smart-medicine","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/news\/smart-medicine\/","title":{"rendered":"Smart Medicine"},"content":{"rendered":"<p class=\"p1\"><span class=\"s1\">Mars Inc. is a $35 billion empire that makes some of the world\u2019s most popular candies, including Snickers, M&amp;Ms, Milky Way, and Twix. It is also in the pet-health and pet-care business. And for the past several years, scientists at Mars Petcare have been working on developing predictive diagnostic tools using its vast repository of anonymized pet medical records and machine learning. RenalTech, which can predict chronic kidney disease (CKD) in cats 2 years prior to the patient showing any signs or symptoms of the disease, is the first one to be released. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">RenalTech was created through a collaboration led by the Mars Petcare family of companies, including the Waltham Centre for Pet Nutrition, Antech Diagnostics and Imaging, Royal Canin, VCA Animal Hospital, Banfield Pet Hospitals, and the Mars Advanced Research Institute, along with several outside partners. Mars says RenalTech has been shown to be more than 95%\u00a0accurate. Antech Diagnostics released the tool in September free of charge to its customers. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">CKD is the number 1 cause of death for cats over the age of 5 and affects 30% to 40% of all cats over the age of 10. The associated nephron damage is progressive and irreversible, even though some cats with CKD have stable serum creatinine concentrations for months and, in some cases, years. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Feline renal disease is usually diagnosed by looking at the level of two biochemical byproducts in the bloodstream, blood urea nitrogen (BUN) and creatinine, in conjunction with the urine specific gravity (USpG). Tests to measure the blood levels of other substances, such as potassium, phosphorus, and calcium, as well as the cat\u2019s red and white blood cell counts, help to determine the extent of failure and the best course of treatment. A cat\u2019s survival often depends on early diagnosis of CKD.<\/span><\/p>\n<h3 class=\"p2\"><b>A New Approach<\/b><\/h3>\n<p class=\"p1\"><span class=\"s1\">\u201cTraditionally, the cat is diagnosed when the owner notices their cat isn\u2019t doing well and takes it to the vet,\u201d says Kay O\u2019Donnell, vice president of Waltham Centre for Pet Nutrition, a Mars Petcare science institute located in the UK. \u201cThe vet diagnoses CKD through blood and urine tests. The gold standard for diagnosis is GFR, which is glomerular filtration rate. By the time [CKD] has become noticeable, the cat is in trouble. Between 40% and 70% of kidney function can be lost. At that point, it is a place of management of the disease, making modifications to the diet to try and increase quality of life.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cThe advantage to RenalTech is that you can pick it up much earlier,\u201d says O\u2019Donnell. \u201cIt gives us a chance to change the outcome.\u201d <\/span><\/p>\n<h3 class=\"p3\"><span class=\"s1\"><b>How It Was Developed<\/b><\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\">A research team evaluated 20 years of data from 150,000 cats treated at Banfield Pet Hospitals and looked at 35 possible parameters, such as age, sex, breed, signalment, and various lab values. In the end, the researchers narrowed it down to 6 laboratory parameters that appeared to be the most important for identifying cats at high risk of CKD development\u2014BUN, creatinine, USpG, urine protein, urine pH, and white blood cell count\u2014plus the cat\u2019s age to predict whether a cat will develop CKD within the next 2 years. Essentially, researchers used artificial intelligence to develop a predictive modeling tool that indicates when CKD is in a cat\u2019s future. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cWe are very fortunate that we can access this data,\u201d says O\u2019Donnell. \u201cThe data originally comes from 150,000 cats and 750,000 patient visits from those cats. Essentially, you\u2019re looking at all the data you have and making associations. You\u2019re looking at what happened with the cats that developed CKD and those that didn\u2019t.\u201d<\/span><\/p>\n<h3 class=\"p3\"><span class=\"s1\"><b>How It Works<\/b><\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\">RenalTech measures the 6 lab values at 2 different time points and compares those values with each other (the tests should be run about 3 to 6 months apart).<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">After Antech runs a complete blood cell count, chemistry panel, and urinalysis, RenalTech uses that information to determine whether a cat is likely to develop CKD in the future. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cBy identifying those cats at very high risk of disease development, this will allow vets and owners to intervene early,\u201d says O\u2019Donnell. \u201c[RenalTech] will allow us to take a more proactive approach. Treatment of disease is typically reactive. The pet gets sick, you take them to the vet, and the vet treats it. The approach is changing.\u201d <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cThere is no downside to intervening early for cats identified as high risk,\u201d says O\u2019Donnell. \u201cSo far, the feedback [in pilot cases] has been very good.\u201d <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">As additional patient information is added to the database, researchers should gain a better understanding of CKD and how to treat it in cats. <\/span><\/p>\n<h3 class=\"p3\"><span class=\"s1\"><b>What\u2019s Next?<\/b><\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\">\u201cThe key is having the data and being able to connect the data and integrate that data,\u201d says O\u2019Donnell. \u201cWhat can we understand about early disease identification? My prediction is that we will see more tools developed that will assess the risk of disease development. We will be able to pick up diseases much earlier and then intervene earlier.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">As for applications for specific diseases, O\u2019Donnell says there are a number of opportunities. \u201cDiabetes is another area [where this type of tool could predict the development of diabetes] in cats and dogs,\u201d she says. \u201cIt has a major impact on quality of life. It\u2019s difficult to manage. Can we intervene earlier so the diabetic stage doesn\u2019t ever develop?\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">O\u2019Donnell says that predicting disease isn\u2019t the only application for a tool like RenalTech. \u201cWe should also start to be able to identify when things are going well, and the pet is in a healthy stage,\u201d she says. \u201cHow can we monitor that over time to keep the pet in a healthy stage? We will see a world in the future where it is a standard part of wellness plans. We are on the edge of something quite remarkable that will increase the quality of life for the pets that we serve.\u201d <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>For the past several years, scientists at Mars Petcare have been working on developing predictive diagnostic tools using its vast repository of anonymized pet medical records and machine learning.<\/p>\n","protected":false},"author":9,"featured_media":18815,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":24,"footnotes":""},"categories":[336],"tags":[],"class_list":["post-18820","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-november-december-2019","column-beyond-the-clinic","clinical_topics-news","clinical_topics-technology"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Smart Medicine | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"description\" content=\"Scientists at Mars Petcare have been working on developing predictive diagnostic tools. 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