The Beating Of Canine Heart

‘Only a few diseases disqualify a dog from breeding, but cardiological diseases are not included in this group, although they should be,' says dr hab. Agnieszka Noszczyk-Nowak from the Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats at the Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences.

At the doorstep of the waiting room at the Clinic of Veterinary Cardiology, I am stopped by a yatting small mutt who springs up at me from under the chair. But when dr hab. Agnieszka Noszczyk-Nowak emerges from the surgery, the dog immediately stops barking. It obviously trusts her.

Not long later, the 15-year-old bitch Sonia-for this is the mutt’s name- patiently endures examination. Several months earlier, Sonia has been diagnosed with cancer, but medication she has been receiving may weaken her heart. That is why prior to each chemotherapy session the dog needs to undergo USG and ECG examination. Sonia sits patiently when the doctor attaches electrocardiographic electrodes to her skin. Then, the ultrasound monitor shows the picture of her pounding heart. The dog is nervous, but as the doctor proceeds with examination no slightest snarl escapes Sonia’s mouth. ‘It’s all fine, she may take another series of medication,’ says doctor Noszczyk-Nowak.

And to me she turns with a smile: Animals sense that this is the place where we want to help them. They show us trust and some kind of gratitude. I once treated a gravely ill dog whose breed is considered dangerous. At one of the visits, he placed his head on my lap, lay down and exposed its belly, which is an act of submission. His owner was left speechless as the dog had never before allowed to be touched by any stranger.’

To treat and to discover

Dr hab. Agnieszka Noszczyk-Nowak has always wanted to become a doctor. As a teenage girl she started to practise horseback riding. And inspired partially by this passion and partially by her other personal experiences she made a decision: I will be a veterinarian, I will treat animals.

In 2005, she graduated from the Faculty of Veterinary Medicine at the Wrocław University of Environmental and Life Sciences, and only three years later she received her doctoral degree. In January 2015 she received her habilitation from the council of the Faculty of Veterinary Medicine. She is shy to admit that she is the youngest holder of this degree at the university. ‘Let me put it this way: I belong to a small group of academics who received their habilitation before turning 55,’ she says embarrassed. But when she starts talking about her scientific activity, her eyes start to sparkle.

Doctor Noszczyk-Nowak specializes in three areas. The first one, the subject of her habilitation, concerns the usage of new diagnostic methods allowing to prognosticate dogs with heart disease, more specifically: markers, namely, the results of the ECG and blood tests. For instance, biochemical markers are substances that can be found in blood. Their concentration, increase or decrease, may indicate whether the dog survives or not, independently of the method of its treatment. We may have four canine patients, treated in the same way and with the same diagnosis. Three of them respond to the treatment, and the fourth one fails to survive.

‘In human medicine, more and more innovative discoveries and data are used to solve this issue. Not all of them may be simply used for the purpose of canine examination. Some of them may. In the case of others new norms need to be developed, suitable for particular animals, and some unfortunately do not prove effective,’ explains Doctor Noszczyk-Nowak. ‘I have found several such parameters and determined their norms for canines.

A small gene in giant breeds

Doctor Noszczyk-Nowak has focused on the examination of dogs diagnosed with dilated cardiomyopathy. This is a genetic heart disorder whose symptoms remain latent for a long time. They appear in mature organisms, in the fourth, fifth year of age. The disease is more prevalent in the so-called giant canine breeds, for instance in Boxer or Great Dane. What is remarkable is that some of its symptoms show in blood indicators; they may be

also found on ECG. ‘If breeders are unaware of the fact that certain canine breeds are susceptible to this disease, they do not bring their dogs to examination. What is more, they keep breeding the diseased dogs,’ says Doctor Noszczyk-Nowak. ‘Nowadays, in the case of the two aforementioned breeds, this is a serious problem.’

These are polygenic diseases, that is, diseases caused not by one faulty gene, but a few. In the case of i.e. arrhythmogenic right ventricular cardiomyopathy, a form of cardiomyopathy occurring in Boxer dogs, as many as 141 mutations in eight genes have been discovered in its human variant. So far, researchers have found that in Boxer dogs the disease is caused by one mutation in one gene. ‘This example proves how little we know of this disease. Each thing which allows for its early diagnosis and excluding the dog from breeding, prolong its life, is very valuable,’ adds dr Agnieszka Noszczyk-Nowak, highlighting that the breeders’ awareness of this disease has been growing, but still remains too low. A number of breeders examine their dogs at our clinic every year, watch over them, exclude the diseased ones from breeding, but others keep breeding their diseased dogs because they look well and collect awards at various exhibitions, which makes them want to have their offspring. And because this business brings good money,’ she adds.

Swine heart in the service of Man

Another field dr Agnieszka Noszczyk-Nowak is devoted to concerns experimental models of animal heart disease.

The research is an example of interdisciplinary cooperation between veterinarians, human doctors, biochemists and molecular biologists, and it has been performed on swines with artificially induced heart failure. ‘We had the opportunity to examine each stage of the disease development in each swine tissue. For instance, we euthanized animals at the early stage of disease and examined their central nervous system, which would be naturally impossible in the case of human patients with the same diagnosis, ‘ explains the young researcher. ‘This allowed us to examine all metabolic traces, which may be important for the progression of heart failure. Animals were models used in service of human beings.’

While preparing for the research, dr Noszczyk-Nowak completed a number of trainings, courses and internships at cardiological divisions of clinical hospitals, most notably in Wrocław and Warsaw. She has been taught to analyse Holter monitor readings (a device used for 24-hour monitoring of heart’s activity) by dr Dorota Zyśko from the Medical University. On top of that she is offered continuous scientific support from dr Adam Fuglewicz, cardiologist from the 4th Military Clinical Hospital in Wrocław.

My husband Christopher is a ‘human’ cardiologist. It is nothing unusual for us to engage in the so-called kitchen table talks devoted to the arrhythmia of my canine patients,’ says the veterinarian, laughing. In fact, it was my husband who inspired my team to introduce non-pharmacological methods of treatment of arrhythmia in dogs by means of ablation. ‘We are one of the two clinics in Europe where this method is used.’

Dr Noszczyk-Nowak also participated in a scientific project devoted to cardiological research in wild animals, with special emphasis on European hare, initiated by Professor Józef Nicpoń.

I pursue my passion, I do not waste time

55-year-old dr hab. Agnieszka Noszczyk- Nowak has so far produced over a hundred scientific papers. She coordinated and participated in several projects. She completed internships in such cities as Berlin, Hannover, Brno and Warsaw, and holds a diploma in research project management and commercialization of research at the Wrocław University of Technology.

She is a reviewer of scientific periodicals and co-tutor of the Student Science Club (SKN), not just in theory. Her students may boast original publications in magazines listed in the ISI Master Journal List, she is also a lecturer of full-time and postgraduate education programmes.

Besides, she is a wife and the mother of 11-year-old son Mikołaj and 2-year-old Nadia. Our conversation at the clinic is frequently interrupted by a telephone ring. The owners of her patients are calling to make appointments for consultations, examinations. Her life energy is so great that she could easily share it with several people.

‘This is the way I am. This job is my passion,’ she laughs. Having decided to work here, as a researcher, I try to do my job the best I can. I cannot allow myself to waste time. I use every moment to the fullest.

When I tell her that there are people who remain in one place for years, who do not develop as scientists and whose only purpose is to secure a cushy career, she springs up out of the chair in anger. ‘For me this would be impossible. I am working in the best laboratory of veterinary cardiology in our country, I want to be good at what I’m doing, and constantly improve my skills. Besides, you cannot beat the market. If you are not the best, you may quickly say goodbye to your job. If you are not a good teacher, students will not come to learn at our Faculty. If there are no students, what is the point to be a scientific worker,’ says dr hab. Agnieszka Noszczyk-Nowak.

She invokes the example of Professor Urszula Pasławska, her immediate superior. ‘I try to use the opportunity of working with her the best I can, she has taught me so much. She had to face many challenges completely by herself. My task is much easier. But this is also a great commitment,’ she adds.

This autumn, Professor Urszula Pasławska will be appointed as head of the Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats. Dr hab. Agnieszka Noszczyk-Nowak will take over some of her responsibilities at the Laboratory of Veterinary Cardiology. I am already preparing to do this. ‘My idea is to develop a new research project and if I manage to obtain the necessary funding, my aim would be to partially recruit my own team of researchers. I know who I should look for. The recruitment of a good research team is a long-term task, ‘ she says confidently.

Tomasz Wysocki