september / october 2005:

dr. dolittle, meet your match
Renee Kaswan did the unimaginable. She took a drug for dogs and discovered it could be used for something totally different: Saving sight in humans. After a long battle over the patent she emerged victorious, a wealthy woman. Now she’s working to create the most advanced animal hospital on the planet.

Story by Benyamin Cohen, Photographs by Fernando Decillis


t the moment, the doctors are performing brain surgery. Straight out of a scene from ER, the sterile surroundings are full of the usual hospital hustle and bustle. Nurses are running around in the background preparing an I.V. for another patient. An orderly is mopping up a small puddle of blood from the otherwise spotless floor. And right here, in Surgery Room #3, the bright white lights are shining down as the doctors are working feverishly to remove a brain tumor the size of a walnut from the patient — a 7-year-old Persian cat named Snuggles.

Yes, we realize this isn’t your typical emergency room. In fact, Georgia Veterinary Specialists stands alone as one of the country’s few fully equipped critical care centers for animals. Numerous signs to different departments (Neurology, Ophthalmology, Dermatology, Cardiology) direct visitors to various wings of the two-story building. An edifice, we might add, that sits on a lush seven acre plot of land in Sandy Springs nestled amidst a nature reserve complete with picnic tables, bridges (built by the Eagle Scouts), and not just one, but two waterfalls.

Of course, some might call it a bit ostentatious. But they haven’t met Dr. Renee Kaswan. After all, this $4 million “pet project” (which has nearly 100 employees including neurosurgeons that are on call 24 hours) is nicer than most human hospitals. But with the pet industry raking in more than $35 billion a year (that’s billion with a ‘b’), and the fierce loyalty so many pet owners feel towards their animals, it doesn’t take a rocket scientist to see its financial and emotional appeal.

But it did take Kaswan, a veterinary researcher, to see the project to fruition. And speaking of foresight, it was Kaswan’s wild medical discovery in the field of ophthalmology that turned her into an icon for just about every eye doctor in America.

It’s a recent rainy Tuesday afternoon and Kaswan is giving a visitor a tour of the facility. Dressed in a blue sweater, brown pin-striped pants, and a pair of stylish pumps, the tall strawberry blond Kaswan looks a good decade younger than her age.

As we meander through the halls of the 20,000 square foot building, she points out different spots of interest: The CAT-scan (no pun intended), the radiology department, and to a small pug who’s having chemo. It’s the Mayo Clinic of animal hospitals.

This is not your parent’s vet office. Indeed, Kaswan’s hospital doesn’t even perform the normal functions of a vet — no neutering, no routine checkups, no flea and tick medicine for sale. The hospital, as Kaswan explains it, is only meant to be above and beyond what normal vets do. “We don’t want to be stealing patients from them,” she explains. In fact, most of the patients at Kaswan’s hospital are referred by vets who just can’t handle the complexity of the medical issue at hand. “It’s a relationship that we have to nurture.” After all, with a price tag of $3000 for something like canine back surgery, Kaswan doesn’t need to worry about the guy whose dog hasn’t pooped since Monday.

Indeed, these days Kaswan doesn’t worry much about the nitty-gritty at all. She rarely sees patients (she found the late-night calls grueling) and is instead spending her time immersed in the bigger picture — like scouring the country for a leading oncologist to run the new 10,000 square foot cancer treatment center she plans to attach to the existing building within two years.

To relax, Kaswan attends to her two dogs and five horses at her Sandy Springs home. A voracious horse lover, she recently returned from a riding trip on the beaches of Mendocino. And when she can’t get to California, she simply rides Daisy, her Tennessee walking horse, right through her subdivision off of Johnson Ferry Road to the surprise of most of her neighbors. Her other three horses, two of which were born to Daisy (both with fathers unknown), live in Kaswan’s backyard. “Yeah, I know,” she says, coming clean. “I’m kind of an enigma.”

But life wasn’t always suburbia and stallions.

The discovery of cyclosporine in the 1970s began a new era in immunopharmacology. Its primary function was to prevent organ rejection among transplant patients. The drug, discovered by a company called Sandoz (now known as Novartis Pharmaceuticals), transformed transplantation from practical impossibility to routine surgery.

At about the same time, Kaswan was debating what to do with her life. After considering being a doctor, a dentist, and an architect, Kaswan ended up in vet school. After finishing the core four years, she enlisted for four more to become a veterinary ophthalmologist and immunologist.

Always the maverick and outside-the-box thinker, Kaswan, who was teaching at the University of Georgia vet school, decided that the worldview of dry eye was too limited. Bucking the conventional wisdom, which was simply replacing or conserving tears, she decided why not revive the tear glands and restore their function? Just because they aren’t working doesn’t mean they can’t be fixed. She made a series of revolutionary assumptions: 1) In the vast majority of dry eye dogs and people, the tear glands were being gradually destroyed by autoimmune processes. 2) If a drug could interrupt the self destructive process, maybe normal tissue could regenerate. 3) Cyclosporine held a profoundly unique potential to disrupt the immune destruction and 4) rather than giving cyclosporine orally and subjecting the patient to severe side effects (let alone expense) just put a small drop in the eye — treat only the target, not the whole body. It took 25 years and a lot of battles, but she proved herself right on all four points.

It wasn’t a surprise that Sandoz laughed at her when she initially brought them the idea. “They thought I was a quack,” she recalls. “They didn’t see it as a profit center and they certainly didn’t see it as a veterinary tool. They weren’t interested in doggie ophthalmology.”

And, to top it off, the FDA was giving her a hard time since there was no existing approved drug for this disease. “It was a little like inventing the wheel,” she admits. Obstacles have a way of multiplying, as Kaswan learned. “Your friends come and go but your enemies accumulate,” she says. “It’s a good thing I was young and naïve to the difficulties ahead of me. It was epic.” To this day, it remains one of the most profitable technologies ever to come out of UGA.

But she didn’t stop there. Kaswan had the wild idea that the drug could help humans as well. Although chronic dry eye is not an exotic disease it’s a common one. With the help of Kaswan’s drug people can tear again — which helps with their ability to read, drive, and in some cases actually saves sight. It was nothing short of a medical breakthrough.

It was virtually unheard of that a drug first developed for veterinary use would later be approved for use in humans. Among the first trial patients was Kaswan’s husband. (They’re now divorced. Go figure.) Her research netted her the university’s Creative Research Medal in 1992 and its Inventor of the Year Award in 1997.

The drug, which goes by the brand name Optimmune for use in dogs, is currently marketed in more than 35 countries. The human version of the product, called Restasis, is approved for use in the United States and its manufacturer is seeking to expand its approval and distribution worldwide as well. “Now Novartis has acquired an ophthalmic division and is kicking themselves because their crown jewel is not one of their products,” Kaswan says with a sense of irony.

After a two-hour tour of the grounds, we end up in the break room, with a breathtaking view of the patio and surrounding forest. A nurse comes in to microwave a late lunch. Kaswan plops down on a nearby seat to relax and the conversation shifts to the personal. “While I’m very successful in business, I have mixed success personally,” she admits.

Currently single and on her own (her 20-year-old son David is in college in St. Louis), Kaswan has reached an interesting crossroads in her life. “Evolution isn’t working as fast as our cultural changes and men are programmed to be the hunter, the provider,” she says. “I can accomplish a lot of things but I can’t change that.”

Her friends call her instinctively kind and a generous person. “She’s a female mensch,” says old friend Vincent Coppola. “Beneath the gruff New Jersey businesswoman exterior, she’s big hearted.”

When asked about her Jewish involvement, Kaswan doesn’t miss a beat. “Rabbi Kranz is my hero.” When she first moved to Atlanta, the Temple Sinai rabbi personally tutored her son for his bar mitzvah. “He helped me at the time of my divorce to raise my son,” she says. “He was a role model for my son at a critical time in his development.”

And speaking of her divorce, she admits that it was her medical work (both with the drug and the hospital) that helped her through the tough times. “That was my therapy from my divorce. This was me doing something positive with my life at a difficult time. It keeps you alive. It’s fun. I need to do things that have an impact so I can feel that I’ve done something worthwhile.”

Worthwhile is an understatement. She has decades of medical work and thousands of happy patients under her belt — including Snuggles who, for the record, survived the surgery. She went home the next day, brain intact, and tumor in the trash.



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