Advancing Veterinary Ophthalmology: Dr. Andrew Lewin Shares a Glimpse Into the World of Veterinary Research

Outside of work, Dr. Andrew Lewin is likely road cycling, running, or enjoying time with his wife and friends. But most of the time, you will find him in the lab at Louisiana State University, where he is leading a clinical trial to determine the best treatment for feline herpesvirus in shelter cats. The research, which is sponsored by Morris Animal Foundation, is aimed at helping veterinarians more effectively treat this common disease. The results will improve eye health and the wellbeing of cats living in shelters prior to adoption.

Both Stokes Healthcare companies, Epicur Pharma and Stokes Pharmacy, are excited to be supporting the trial. We had the opportunity to talk with Dr. Lewin about the clinical trial and his background in veterinary ophthalmology.

How did you get into veterinary medicine? Why the specific route of veterinary research?

I am a comparative ophthalmologist at Louisiana State University, where I’m also an assistant professor. I graduated from Edinburgh Veterinary School in 2010, and since then I’ve worked in small animal private practice, low-cost practice, and charity practice. I did my ophthalmology residency at University of Wisconsin Madison, and since 2018 I’ve been working at LSU. I got interested in research during my residency at University of Wisconsin Madison, where I worked on some projects involving feline herpesvirus.

Any specific reason you chose to focus in ophthalmology?

To me, ophthalmology is an elegant discipline that has a mixture of medicine and surgery. You have cases that primarily are just treated with eyedrops and medications, and then there are other cases that benefit from surgical procedures, such as corneal reconstructions. There are glaucoma surgeries, cataract surgeries, and we also do eyelid surgeries. There are a lot of opportunities for research that can benefit animals and humans.

Tell us more about your work in the lab at LSU.

As part of my appointment at LSU, a portion of my time is devoted to research. We work through the veterinary clinical sciences group laboratory, which has space for performing all the necessary experiments. Louisiana State University also has a very robust research infrastructure and core facilities that allow us to perform high level research. The laboratory has numerous staff members, including research associates and veterinarian interns.

It seems like an exciting accomplishment to have a research lab named after you. Is that common practice in the veterinary research field?

It is common; it’s just to help people understand who the principal investigator is for the research though. It’s kind of convention to name it after yourself if you’re the head researcher. For example, there’s the Sones lab, the Withers Lab, and the Lewin Lab. It refers less to the physical space that we operate out of because it’s not just mine; it’s a shared space. It’s convention to say that things come out of so-and-so’s lab. This just means that your staff have worked on it.

How do you select the interns that get to work on your research? It sounds like it would be a competitive spot to receive. Do they get to be fully hands-on?

It’s an ophthalmology research internship. The doctor who held it from 2020 to 2021 was Dr. Melanie Mironovich from Ohio State, and she was integral in collecting samples for this current project. She did an equine rotating internship before coming to us. And she is now actually working with us in a three-year ophthalmology residency training program.

The internship is a highly competitive one-year research training program, where they gain skills in ocular examination, basic research skills, manuscript and presentation creation, and study design as well. These intern positions are steppingstones to the highly competitive residency positions, especially in ophthalmology, surgery, and other specialties.

Veterinary medicine is a deceptively competitive field! Tell us more about the studies done in the lab—how did you choose what you were going to study?

The direction of the research in the lab is led by me. I’m interested in ocular infectious disease, specifically viral ocular infectious disease, and some bacterial ocular infectious disease. And the reason that I was interested in performing this project was because cats very commonly get viral ocular disease, and there aren’t very many good treatments for it. With the treatments that are available, people don’t really know which one is the most effective.

I also used to work in animal shelters. We didn’t have too many good options for treating these animals with a very common eye condition. So, when I had the means to be able to investigate it more, I started writing grant applications for viral ocular disease in cats and other animals and then went from there.

How did Epicur Pharma and Stokes Pharmacy come be to be involved in your study?

We approached Mike Tursi, President of Stokes Healthcare, about providing medications for use in a clinical trial assessing three different antivirals for field treatment of feline herpesvirus ocular disease in cats. He was very generous and offered to provide the medications free of charge for use in the study. He ended up providing all of the medications that were required. The cidofovir was manufactured at Epicur’s facility, and the famciclovir, an oral medication, and ganciclovir, an eyedrop medication, came from Stokes Pharmacy.

Everyone at Stokes Healthcare has been great to work with; they were very accommodating and very generous to provide the drugs to support this trial.

Why did you choose to approach Stokes and Epicur about the medications you needed for the trial?

I’ve been aware of Stokes Pharmacy for a long time because they’re quite prominent in the field of veterinary compounding, so they seemed like a natural choice to approach for this this kind of request.

I previously used Stokes in my clinical prescribing because they carry a wide range of products that we used all the time. Their medications are high quality, sent on time, and reliable, and Stokes is easy to deal with. I also like that there is voluntary batch testing at the 503A facility. And, of course, with 503B manufacturing from Epicur, you have quite a good guarantee that medication is going to be a certain quality.

Was using a 503B manufactured drug a factor in your request to get the drugs from Stokes Healthcare, or was that an added benefit?  

I’ve actually learned quite a lot about the 503B process since then. At the time I approached them, I was only peripherally aware of the difference between 503A and 503B. There are certainly benefits associated with consistency in 503B compared to a 503A, which I know is something Epicur is working to help more people understand.

It’s going to take a bit of time, but I do think people are becoming more and more aware of the difference between the types of facilities, especially those that keep tabs on veterinary journals. Veterinary Ophthalmology just came out with a piece on the inconsistencies in formulations from 503As. So when I approached Mike about getting some certificates of analysis, he provided those with no fuss. He sent over a huge set of attachments for every single batch that we could use. That was very reassuring.

How’s the study going so far?

We have completed study enrollments, and we are currently working on preliminary analysis of the data. Everyone who works in the lab has contributed to this research, and it’s going really well. Research is a team sport. I just get to take the credit for it and have my name on it, but really everyone is important to each step, and so many others do the heavy lifting.

After this research is done, where do you plan to turn your attention?

We’ve been working on some other related projects. We are getting quite close to releasing some results for a trial where we investigated sources of viral infection in captive held cheetahs. We are also working on a USDA-funded project to investigate the ocular microbiome in cattle with various eye conditions, such as pink eye and cancer eye. There are other things, but they’re still on the back burner.

In addition to research, what else are you involved in as an assistant professor at LSU?

I primarily do research, but I also train residents and interns, teach students, offer service, and treat animals with eye disease. When I’m teaching, it’s part of the course on veterinary ophthalmology for undergraduate vet students. I also teach students on the clinical rotation in the final year at vet school.

There are always opportunities for students to become more involved with research too. We do have students come through our lab for that purpose. They work in the summer Scholars Program; we have had multiple summer scholars actually participating in this project. It helps improve their understanding of scientific process, manuscript creation, and presentation creation.

You’ve had such a variety of experiences in the veterinary field. Do you have a preference—research lab or private practice?

I like working at the university because it is a varied role, as opposed to private practice where primarily I would just be working with patients with eye disease. Here I get to work with patients with eye disease, but I also get to teach, do the research, and have a service component as well. There’s a lot of variety on a day-to-day basis. I also like the freedom to be able to explore your own questions. Some of them are questions that do come up during clinical practice, and then we can actually try and provide some answers to them. Being in research is good for satisfying your curiosity and advancing the field.

Thanks, Dr. Lewin! We’re looking forward to hearing the results of the study!