Dr Penny Watson – Associate Professor of Small Animal Medicine, Queen’s Veterinary School Hospital, Cambridge

 

What or who inspired you to become a vet?

This is a difficult question! I came to the decision rather late when I was applying for University courses. I was really most inspired by my A level biology teacher and knew I wanted a job in that area. I wrote to the Institute of Biology asking what biology graduates usually do, and they said that most ended up in business. My dad was a banker and I definitely didn’t want an office job like his, so I looked for something more vocational which would guarantee a practical biology job. I couldn’t deal with sick people and, as I lived in rural Sussex on the edge of Romney Marsh with many and varied family pets, veterinary medicine seemed the ideal job. I was keen to work with sheep and horses so intended to be a large animal vet all through my course. In the end, after a year of large animal work in North Wales, I moved to East Anglia where there are fewer farm animals and discovered that I really enjoyed small animal work.

What is your current job? Do you hold clinics as well as carrying out research?

I am currently Associate Professor of Small Animal Medicine at the University of Cambridge and an RCVS and European Specialist in Small Animal Medicine. I spend about a third of my time on small animal medicine clinics in our referral hospital and the rest of the time in teaching and research. It can be difficult and stressful juggling my time, but all three complement each other: my research is very clinical and it is the challenging cases which drive me to do more research. Both clinics and research bring fresh perspective to both my student and CPD teaching.

What drew you to your field of study and what motivates you to continue?

I became a gastroenterologist initially by accident. As a new resident at Cambridge, I was always given the chronic diarrhoea cases because no one else wanted them. I was forced to learn more and became very interested. My interest moved from gut to liver and pancreas disease as a result of cases I saw as a resident. My lifelong obsession with chronic pancreatitis stemmed from a single challenging case: a wire-haired Fox Terrier with diabetes and unexplained weight loss. Sadly, she lost so much weight that in the end she was euthanased. A post-mortem examination showed end-stage chronic pancreatitis and suggested she had exocrine pancreatic insufficiency, which at the time we did not recognize in older dogs with diabetes, only really in young German Shepherd Dogs with pancreatic acinar atrophy. I realized we could have diagnosed and treated her weight loss and began to wonder how many similar cases we were missing. This started me on my doctorate studies of chronic pancreatitis in dogs. There is a cross-over with my passion for liver disease because again I focus on chronic, fibrotic liver diseases.

My motivation to continue is that there is still so much we don’t know about the causes and treatment of both chronic pancreatitis and chronic hepatitis in dogs, and every study just throws up more questions. To date, I have focused on canine liver and pancreas disease but going forwards, I have an MDR student who will start to try and unravel some of the mysteries of feline chronic biliary tract disease. Liver disease in cats is even less well understood than in dogs. The enthusiasm and energy of young residents and researchers is another strong motivation to keep going.

Discuss the impact your research has had on the profession. How have those in general or referral practice benefited from your research?

I hope I have raised the profile of pancreatitis so that practitioners recognize it more and treat it better; particularly the more low-grade, chronic cases which are less obvious than the severe acute disease. Chronic pancreatitis not only causes severe weight loss in end-stage cases, but also has a significant negative impact on the welfare of pets by causing chronic pain which can go unrecognized. I hope our work has helped vets recognize and treat chronic pancreatitis more effectively. In addition, we have begun to unravel some of the breed predispositions to disease, particularly in Cavalier King Charles Spaniels (CKCS) and English Cocker Spaniels. In cockers, we have shown that chronic pancreatitis is part of a multi-organ immune-mediated disease which is the first step in helping recognition and treatment in the breed.

Has your research served as the foundation for other studies or developments in the field, and what will happen after your study is complete?

Our work on autoimmune chronic pancreatitis in English Cocker Spaniels has already led to some small-scale studies of the genetics of the disease and we hope that this will continue in the future. The breed society has been very supportive of our research, including raising much needed funds to help with our work. We are also planning a more structured study of immunosuppressive treatment in affected dogs to try to improve our evidence base for this. The work on chronic pancreatitis in CKCS has uncovered a more generalized problem with organ fibrosis in the breed, particularly affecting the kidneys as well as the pancreas. A group of motivated cavalier owners (‘Cavalier Matters’) has helped us a great deal with the collection of tissues post-mortem which facilitated all our histological studies. We are now investigating the potential role of serotonin in driving CKCS organ fibrosis and are using BSAVA PetSavers money to try to develop a urine test which would make testing much easier and allow us to look at more dogs.

Tell us a little about your own experience. What does your research mean to you personally and what have you gained from it?

Clinical research is tremendously important to me and is the main reason I stay in academic referral practice. I have gained an enormous amount from working with incredibly talented academics and clinicians in this setting. My doctorate studies in chronic pancreatitis gave me training in histopathology, particularly of the liver and pancreas, which has brought a new perspective to my clinical work as I can look at the biopsy sections from my patients with our pathologists, helping to optimize treatments by facilitating discussions between pathologists and clinicians. My research collaborations have put me in touch with veterinary and medical specialists all over the world. I am always inspired by the meetings I have with research scientists and medics and learn something new every day. I love the clinical work too but would get really frustrated if that was all I did and if I didn’t have the chance to try to answer some of the big, clinically relevant questions which bombard us every day on the clinics.

What does BSAVA PetSavers offer the profession in your opinion?

BSAVA PetSavers is invaluable. There is very little veterinary-specific funding available for research into diseases in dogs and cats, and funding from large non-veterinary grant awarding bodies is difficult to obtain for small animal clinical studies. I initially applied to some big human-orientated grant awarding bodies for funding into studies of chronic pancreatitis in dogs but was unsuccessful. PetSavers funding has allowed these studies to continue to the benefit of dogs and the profession. Looking back over the years since PetSavers was started, it is clear how much important work it has funded, improving the welfare of our small animal patients.

What advice would you give to vets considering carrying out clinical research for the first time?

Don’t be intimidated and follow your passion! There are so many questions which are best answered in first opinion practice rather than referral practice. Find a mentor to help and inspire you – they don’t have to be in your particular field, but could be someone who has had experience of clinical research and knows how to plan a study, apply for funding and write up the results. It is really helpful if you can go on a course on basic study design and statistics BEFORE you plan your research rather than after it! I was lucky to have access to a university course when I started my PhD which made such a difference. The BSAVA Masters in Clinical Veterinary Research provides a very similar firm basis. And don’t be disheartened when things go wrong or you don’t find the answers you wanted; some of the most interesting and important discoveries come from research failures.

Away from the practice and bench, how do you spend your spare time?

I love to be outdoors as much as I can. I enjoy gardening and I still love the countryside as much as I did before vet school, so walking is my main hobby. I have a young border collie (my third one) so a lot of time is spent walking him. I am lucky enough to have a house in the Alps in France which is my favourite place to be – if I could move Cambridge vet school to the Alps, I would do so in a heartbeat. As well as summer walks in the mountains, I learnt to ski in my 40s and really enjoy the mountains in winter as well. Of course, lockdown has kept me away from France, but we hope to get back this summer complete with vaccine passports and health certificate for the dog.