By Sarah Carey
GAINESVILLE, Fla. - Eleven years ago, a registered quarter horse named Dyna's Plain Special spent three days in the University of Florida's equine neonatal intensive care unit - born prematurely and so sick she was unable to stand.Today, she flies. In December, Dee Dee, as her breeder Linda Jones calls her, raced to victory in the Wrangler National Finals Rodeo in Las Vegas, becoming the first mare to win the world title in 40 years.
"This horse is so fast," said Jones of Bowling Green, Fla. "Her heart is so big and she has so much 'try.' After she won, I just had to call Dr. (Rob) MacKay at UF to tell him that the little baby that could not get up is now the world champion barrel horse."
During her first days of life in the foal unit, the filly was treated with penicillin and other drugs while her nursing habits were carefully monitored. In addition, she received physical therapy on her front legs to strengthen them. Before she was sent home with the Joneses, Dee Dee was standing, walking, drinking water and taking her mother's milk.
The college's equine neonatal intensive care unit opened in the early 1980s, then the only such facility in the world. Today there are still only a handful of veterinary hospitals that offer intensive care services for foals.
"We started our neonatal intensive care unit in 1985, modeling it after Florida's program," said Mary Paradis, D.V.M., an associate professor of large animal medicine at Tufts University's School of Veterinary Medicine.
Last year, approximately 120 foals from all over Florida were admitted to UF's equine neonatal intensive care unit for treatment of problems ranging from angular limb deformities (bent legs) to breathing disorders associated with prematurity to severe life-threatening bacterial infections.
"Horses born prematurely are at greater risk than other species, so in many cases the availability of care can mean the difference between life and death," said Rob MacKay, B.V.Sc., Ph.D. "In many cases, we are unable to follow our cases beyond the initial period after hospitalization, so it is tremendously gratifying to have a client go out of her way to tell us a happy story about a horse that not only survived but went on to become a top performer."
Jones tells Dee Dee's story as if she were recounting the life of one of her own children. First there was the filly's initial health scare. Then there was Dee Dee's recovery and the racing that started in 1996 when Dee Dee turned 4 and a friend of the Jones family, Kim Thomas, began competing with her in barrel racing events - and winning. Toward the end of that year, Thomas caught the eye of barrel-racing aficionado Tracy Johnston during an event in Oklahoma. Johnston's boss, Jud Little, an oilman from Ardmore, Okla., had taken an interest in the sport and was looking to buy Johnston a new ride.
"On New Year's Day of 1997, Jud told me, 'It's a done deal,'" Jones said. "I began to cry because I was losing my baby, who would not come home. Kim cried, because she was losing her mount. And Tracy cried because she felt sorry for us! That poor man had three women crying on the phone with him."
In the years that followed, Little kept in close touch with the Joneses. A new rider, Janae Ward, whose mother and grandmother both performed in national barrel racing championships, began competing with Dee Dee in August. In a few short months, Janae and Dee Dee had advanced from 26th in the world to 14th, having amassed more than $43,884 in earnings and the opportunity to compete in the finals.
"Jud called me up. 'This is your travel agent,' he said." "The place was totally sold out, but he'd gone on the Internet and gotten us tickets," Jones laughed. Jones then asked her husband Gary to cut some mane from Dee. Dee's dam Dyna Snow and her sire Special Feelins, who reside at the Joneses' farm, to place in a silver locket. The couple gave the locket to Ward to wear for good luck.
"I told Janae I would really like Dee Dee's mama and her daddy to be with her," Jones said. On the day Dyna's Plain Special was officially crowned the champion, Little called Jones, overcome with emotion. "Miss Linda, I know I'm a grown man," he said. "But I've got to tell you that I cried."
Dyna's Plain Special was featured on the cover of the January issue of Barrel Racer News and the Women's Professional Rodeo News.
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UF experts say little-used procedure could help identify male bladder cancer patients at risk of recurrence
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By Tom Nordlie
GAINESVILLE, Fla. - A diagnostic procedure sometimes used to monitor male bladder-cancer patients after radical surgery may not be any more accurate than doctors' observations in identifying those who would benefit from an additional operation. But a University of Florida study found the procedure may help doctors answer a more basic question: After surgery, which patients are most likely to suffer further disease progression?
Patients monitored after bladder and prostate removal with a cancer-detecting procedure known as urethral wash cytopathology often undergo a second operation to remove the urethra - the tube through which urine is eliminated from the body - if the procedure indicates some cancer cells remain, said William Murphy, M.D., a professor of pathology at UF's College of Medicine and the senior author of the study, published in the current issue of Cancer/Cancer Cytopathology.
The additional surgery is believed to reduce the risk of disease progression in the urethra or elsewhere in the body, he said. But Murphy and co-author Jacquelyn Knapik, M.D., a UF assistant professor of pathology, found no difference in the long-term outcomes for patients who had their urethras removed after a positive result from the urethral wash compared with patients who did not receive the procedure but had their urethras removed.
"You would think in those situations where a urethral wash was done that we would pick up the neoplasms faster than if we waited, which would help the patients because then we could do a urethrectomy sooner - but according to our data that is not the case," said Murphy, an internationally known expert on pathology of the kidney, bladder and urinary system. "What the study says ... is that the risk for the patient has been determined pretty much by the time that the (bladder and prostate removal) is done."
Consequently, a positive result from a urethral wash should perhaps be viewed as a warning sign that tumors may develop elsewhere in the body, rather than being considered an indicator that the urethra should be removed, he said. Bladder cancer is the fourth most common form of cancer among U.S. men, diagnosed in 38,000 individuals each year, according to the National Cancer Institute. It is the eighth most common form of cancer in U.S. women, with 15,000 diagnoses annually.
In the United States, surgery known as cystoprostatectomy, which removes the bladder, prostate and seminal vesicles, is used to treat men with bladder tumors that do not respond to other therapies or have spread beyond the bladder, Murphy said. He estimated about one-fourth of U.S. men who develop abnormal bladder tissue growths - which often develop into cancer - eventually have this operation.
Usually, a portion of the urethra is left intact to simplify surgery and reduce blood loss, he said. If a new tumor is suspected or detected in the urethra, the only treatment option is surgical removal of the urethra.
UF researchers reviewed 176 cases, involving every patient who received a cystoprostatectomy at Shands at UF medical center from 1990 to 2001. The patients were, on average, 67 years old. Urethral wash cytopathology was used on 48 patients - 27 percent -as part of their follow-up, which lasted an average of 3 years.
The study showed no statistical difference in the rate of disease progression between patients monitored with the urethral wash and those who were not. But UF researchers found an unexpected distinction within the group of patients who received the procedure: Only 14 percent of those with a negative result had cancer recurrence during follow-up, compared with recurrence in 54 percent of patients who had a positive result, he said.
"That's something that ought to be emphasized," Murphy said. "You should do urethral wash cytopathology not only to find out who's at higher risk ... but also to find out who is at lower risk because that's good news for them - at the very least they may not need to have (the urethra removed)."
Urethral wash cytopathology is a simple, inexpensive procedure, Knapik said. Specimens are collected by passing a straight catheter into the remaining urethra as far as possible, then injecting a small amount of saline solution into the catheter to wash the urethra. Cancer cells dislodge fairly easily from the lining of the urethra into the saline. The fluid is collected as it drains from the urethra, run through a centrifuge to separate cells from the saline, then cells are placed on slides and stained to make them easier to examine. Finally, a pathologist evaluates the cells under a microscope.
The biggest hurdle to using urethral wash cytopathology to assess patients' risk for cancer recurrence is that many pathologists are not sufficiently familiar with the technique, said Zev Wajsman, M.D., a UF professor and chief of urological surgery.
"This methodology requires a high level of expertise," Wajsman said. "Not every pathologist in the country is trained to use cytopathology, especially for urethral washing for diagnosis follow-up of bladder cancer...But it's a very, very, very useful technique."
Few research studies have been conducted on urethral wash cytopathology, Murphy said. The UF study cites a handful of papers on the subject. Urologic surgeon Guido Dalbagni, M.D., of New York's Memorial Sloan-Kettering Cancer Center, said he was not surprised the UF study showed men with negative results had the lowest rates of disease recurrence.
"(In our study), the patients who presented with symptoms did not do any differently than patients that were picked up by having a wash," said Dalbagni, the senior author of a 2003 article on urethral wash cytopathology. "However, the number of patients that we had was very limited, and we have to interpret that with caution."
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