New veterinary specialty in nephrology and urology a big step closer to reality

Nephrology focuses on the diagnosis and treatment of diseases of the kidney, while urology deals with conditions related to the urinary tract. Together, they’re one step closer to being an official specialty in veterinary medicine. The American Veterinary Medical Association (AVMA) made it official last month when it granted provisional recognition to the American College of Veterinary Nephrology and Urology (ACVNU).

Their decision is thanks in large part to the decades-long effort of one man.

Larry Cowgill, DVM, PhD, DACVIM (SAIM), professor and associate dean at the UC Davis School of Veterinary Medicine, was an early pioneer in the fields of veterinary nephrology and urology and will serve as the ACVNU’s first president. Over the past 40 years, he has helped UC Davis evolve into a world leader in renal medicine and extracorporeal (outside of the body) therapies. He also established the first veterinary centers where clinicians can receive advanced training in kidney disease and procedures such as hemodialysis and therapeutic plasma exchange.

NEWStat asked Cowgill why nephrology and urology are finally coming into their own as a specialty in veterinary medicine.

“Nephrology and urology have been rapidly expanding fields in veterinary medicine for at least the past 20 years,” Cowgill said. “There has been a tremendous expansion of new knowledge, new diagnostics, and new therapies during this time. These have been amply documented in peer-reviewed journals, authoritative texts, and reviews, and dedicated continuing education demonstrating the vast amount of novel information directed at nephrology and urology every year.”

Essentially, Cowgill said, the ACVNU believes that nephrology and urology are sufficiently robust and distinct from all other specialties to provide valued expertise and to function with their own specialty designation.

And the AVMA’s provisional recognition obviously means they agree.

Cowgill noted that this provisional recognition is in full acknowledgement that other veterinary specialties, due to their overlapping interest and intersection with the urinary system, share some expertise and diagnostic and therapeutic purview with nephrology and urology.

And he said that goes both ways: “Similarly, the ACVNU would share some expertise and therapeutic purview with other specialties including internal medicine, surgery, critical care, cardiology, neurology, pathology, clinical pathology, and nutrition,” Cowgill added. “We propose to extend our focused expertise collaboratively with all specialty disciplines where there is mutual intersection for the overall advancement of urinary healthcare.”

The ACVNU’s training program will be unique compared to other residencies in that the ACVNU’s will require participants to already be board-certified in another specialty discipline or have four equivalent years of experience in nephrology and urology. Another difference: the option of virtual training  so candidates do not have to relocate to a traditional training center.

Cowgill pointed out that the establishment of the ACVNU does not preclude other veterinarians or specialists from the management of urinary diseases, just as it doesn’t preclude them from management of cardiovascular disease, skin disease, neurologic disease, or cancer: “It would, however, provide an advanced level of expertise for consultation or referral of patients with advanced needs.

“Historically, the management and clinical outcomes of patients with advanced or complicated organ dysfunction have been served best when attended by a boarded specialist—cardiologist, dermatologist, neurologist, or oncologist—who have advanced diagnostic expertise, clinical skills, or access to specialized therapies when compared to the highly qualified internist or criticalists who refer these patients.”

To find out what this news might mean for AAHA-accredited practices, NEWStat reached out to AAHA Diabetes Management Guidelines Task Force cochair Renee Rucinsky DVM, DABVP(F), Vice President, American Board of Veterinary Practitioners.

“The development of the nephrology and urology specialty highlights the amazing ongoing advancements in veterinary medicine, and dedication to providing state of the art interventions for our patients,” Rucinsky told NEWStat.

As the medical director at AAHA-accredited Mid Atlantic Cat Hospital in Queenstown, Maryland, Rucinsky has reason to be excited about the AVMA’s decision: “As a doctor who sees cats with a least some degree of renal disease several times a day, I look forward to what this specialty can contribute to primary care veterinarians.”

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