Tin Man is teaching WesternU College of Veterinary Medicine students valuable lessons long after his flawed heart gave out.
Fourth-year CVM student Kelley Black fostered Tin Man during her second year of school. He was among a group of kittens brought to the Upland Animal Shelter. Like the Tin Man in the “Wizard of Oz,” the gray kitten needed a new heart. He had a loud heart murmur, and under normal circumstances would have been euthanized. She decided to foster him.
“Tin Man was the sweetest kitten in the world,” Black said. “When you held him, you could feel the roughness of his heart murmur. It was so loud if he was sitting in my lap in a quiet room, you could hear it without a stethoscope.”
Black fostered Tin Man for about six months. For the first four or five months, he was just like any other kitten – super playful and loving to snuggle. But in his last months, he went downhill quickly, she said. VCA provided free diagnostics and even offered to perform surgery for free, Black said.
“We were trying to have him gain weight so he could be big enough for a surgical intervention, but he couldn’t get above 2.8 kilograms,” Black said. “It was all his giant heart could handle. He went into congestive heart failure, and in a matter of weeks his quality of life was almost nonexistent. Tin went from being a normal, playful kitten to one barely wanting to move. Euthanasia was the only fair thing we could do for him.”
CVM Associate Professor Pedro Diniz, DVM, PhD, developed a Problem Based Learning case in collaboration with Black based on Tin Man. Further study of the kitten’s heart showed a hole between two chambers, valve issues, and an aorta routed the wrong way. Diniz decided to go into greater detail and utilize cutting-edge technologies to bring Tin Man’s case to life.
Diniz collaborated with Dr. Justin Allen from VCA West Los Angeles, Tin Man’s original veterinary cardiologist, to obtain images from Tin Man’s cardiac ultrasound and angiograms. Diniz worked with WesternU Multimedia Specialist Joe Marilo on a series of instructional videos posted to YouTube, and collaborated with the College of Dental Medicine to get a high-resolution CT scan of Tin Man’s heart. CVM Instructor Ken Noriega prepared Tin Man’s heart for imaging. Radiologist Andrew Fox, DVM, DACVR, with California Veterinary Specialists in Ontario, was instrumental in obtaining additional high-quality MRI scans of Tin Man’s heart.
WesternU 3D Educational Technologies specialists Jeff Macalino, Gary Wisser and Sunami Chun helped create the 3D heart — which is 300 percent larger than an actual kitten heart, so that students can better see Tin Man’s four congenital defects. They also can view a 3D rendition of the heart online: https://sketchfab.com/models/f888681533a04aa88d16a11feaabb7af.
“People can interact with it, zoom in and out,” Diniz said. “The videos explain step by step each diagnostic, each ultrasound of the heart, showing normal and abnormal. Students absolutely love it.
“This is the first time we have used this technology,” Diniz said. “The result was excellent.”
Diniz surveyed CVM students after they completed Tin Man’s PBL case. Of the 138 respondents, 81 percent found the videos available in this case to be “extremely helpful.” Several mentioned the interactive 3D heart as their favorite part of the case. They also praised the thoroughness of the supplemental materials and found the case to be heartfelt and insightful.
Interacting with the 3D version of Tin Man’s heart and watching videos where the ultrasound is slowed down so Diniz can point out anatomy and physiology helped her solidify concepts as a third- and fourth-year student that she had trouble grasping as a second-year student, Black said.
“I give Dr. Diniz so much credit. He went so much above and beyond what I could have imagined for this case,” she said. “Because of how complex Tin Man’s heart condition was, it would be easy for students to get overwhelmed. Those videos and 3D model helped me tremendously – even as a fourth-year student. I’m so glad future students will get to learn from Tin Man and I’m so grateful for Dr. Diniz’s hard work.”
Diniz has shared the PBL case with his CVM colleagues to highlight the technological resources available on campus.
“My hope is this demonstrates we can enrich cases just by tapping resources on campus,” Diniz said.
Black carries a 3-D replica of Tin Man’s heart with her.
“When he was alive I remember putting my hand on Tin Man’s chest, feeling the whole outline of his heart, and this model is exactly life size. It’s gorgeous,” Black said. “Having it with me on clinical rotations helps remind me why I chose to enter this profession, and to keep pushing myself every day.”