First Patients Treated in Veterinary Focused Ultrasound Trials

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In November 2017, the Focused Ultrasound Foundation launched a new veterinary program to develop focused ultrasound therapies for the treatment of companion animals. The Foundation is currently supporting trials to investigate treating cancer and promote wound healing in pets—and more studies are in the pipeline.

“Traditionally, animals have served as models in comparative studies before expanding innovative therapies to human trials,” Foundation Chairman Neal F. Kassell, MD said. “With this program, we are starting a virtuous cycle where veterinarians will have new, innovative therapies to offer clients, and we can apply the experience obtained using focused ultrasound in pets to accelerate the adoption of the technology for human applications.”

“New therapies are often slow to make their way into veterinary medicine, leaving veterinarians frustrated with the lack of options for their patients,” Foundation Veterinary Program Director Kelsie Timbie, PhD added. “We feel focused ultrasound could meet a critical need in veterinary medicine by both expanding and improving treatment for a range of conditions.”

The goal of this research program is to offer a variety of benefits over traditional therapies in animals. Focused ultrasound is a noninvasive therapy that can reduce the risk of infection and eliminate the need for stitches, making recovery safer and less painful for the animals. One to three focused ultrasound treatments can achieve the same results as traditional therapy, without the need for surgery or radiation, which requires as many as 30 treatments. Additionally, the major barriers to adoption that exist in human medicine—regulatory and insurance reimbursement hurdles—are not as restrictive in veterinary medicine.

Treating Canine Cancer

A study to treat sarcomas and mast cell tumors in dogs is now under way at the Virginia-Maryland College of Veterinary Medicine (VMCVM) at Virginia Tech in Blacksburg, Virginia. In the Foundation-funded trial, Clinical Assistant Professor of Radiology Jeffrey Ruth, DVM, and his team are investigating focused ultrasound therapy to noninvasively destroy tumors and stimulate the dogs’ own immune systems to fight the cancer. Researchers are using a device developed by French company Theraclion which was originally developed to treat breast and thyroid conditions in humans. However, its design allows it to easily be adapted for veterinary indications.

“These canine tumors tend to occur on the limbs and may recur if they are not entirely removed. As a result, often amputation is required,” Dr. Ruth said. “It is our hope that focused ultrasound will add to current treatment options by providing a way to non-invasively ablate the mass and also trigger an anti-tumor immune response.”

Accelerating Healing

Ashish Ranjan, BVSc, PhD, and his team have begun another study investigating focused ultrasound’s ability to speed wound healing at the Oklahoma State University Center for Veterinary Health Sciences. Non-healing wounds are caused by biofilm-forming bacteria and are difficult to treat, often requiring long-duration antimicrobial treatment, extensive surgical intervention, and in many cases, limb amputations. Dr. Ranjan and his team will use focused ultrasound to treat hygromas—a condition where repeated pressure on a bony joint produces significant swelling. These masses can become infected and painful and are very challenging to treat.

“Hygromas typically have poor blood flow and are slow to heal, so any incision during treatment can make the situation worse,” Dr. Ranjan said. “Focused ultrasound offers multiple benefits over traditional therapy—it can noninvasively reduce the bacterial infections, while simultaneously improving the local delivery, and therapeutic effects of antibiotics. We expect this combined approach to significantly improve healing time, and prevent infection recurrence.”

If successful, this application of focused ultrasound will not only be game-changing for veterinary medicine. The potential applications to human medicine are widespread as the therapy could be investigated for the treatment of bedsores, pressure ulcers and diabetic ulcers. In tandem with the work at Virginia Tech, researchers at the Oklahoma State University Center for Veterinary Health Sciences are also exploring the use of focused ultrasound for soft tissue tumors in dogs and cats. Dr. Ranjan leads the Laboratory of Nanomedicine and Targeted Therapy there, and to date, they have treated five canine and feline patients.

“Veterinary cancer types, site, growth and genetic features are comparable to those in human cancer,” Dr. Ranjan explained. “Realizing these benefits, we recently initiated the clinical trials in our hospital to investigate the immunotherapeutic potentials of focused ultrasound against canine cancers. Early data suggest that this approach is clinically feasible, and Oreo is the perfect example of success that comes out of it.”

Success Stories

Maddi Lynn is a 9-year-old Cocker spaniel

During a routine grooming appointment, a technician noticed a small growth on Maddi’s front leg. Her owner, Kitty Smith of Christiansburg, Virginia, acted quickly and arranged to have it examined by her veterinarian. A number of tests confirmed her worst fear: Maddi Lynn had a malignant sarcoma.

“There was no question in my mind that I would go to the Virginia Tech Vet School for treatment,” Smith recalled.

It was there that she learned about the new focused ultrasound trial. After some careful consideration and discussion with her family members, Smith decided that the trial offered the best options for Maddi. In late March, Maddi Lynn was the first patient to be treated in the trial at Virginia Tech.

Dr. Ruth and his team used focused ultrasound to shrink the tumor noninvasively, and then surgically removed the remaining mass. Now, a few weeks after treatment, Maddi Lynn’s outlook is positive. Follow-up appointments have indicated that she is cancer-free.

“Her aftercare was so easy,” Smith said. “The first two nights she was home, I gave her pain medication in order that she would be comfortable and rest through the night. She has recovered beautifully. I felt so fortunate that my Maddi was chosen to be the first dog treated in the study. To be perfectly honest, I don’t know if I could have afforded this treatment on my own. It would have been difficult to come up with funds to pursue this care.”

The trial is being funded by the Focused Ultrasound Foundation, and owners are not responsible for the majority of treatment costs.

Oreo is a 9-year-old Shetland sheepdog

Oreo’s owners sought medical care after noticing that he had developed a growth on his lower right lip. After a biopsy, veterinarians determined he had a plasmacytoma and traditional treatment options included surgery and/or radiation. However, researchers at the Oklahoma State University Center for Veterinary Health Sciences presented another option—a focused ultrasound clinical trial.

Oreo received two focused ultrasound treatments, each lasting less than five minutes. During the treatment, multiple ultrasound beams were focused on the tumor. Much like when you use a magnifying glass to burn a hole in a leaf, the ultrasound energy converges on the tumor and heats—and destroys—the tissue. Over the next several days, veterinarians noticed significant tumor regression, and the mass was completely gone after three weeks. Interestingly, the focused ultrasound also activated Oreo’s immune system, and immune cells were noted in the tumor margins. Today, Oreo remains cancer-free.

Pet owners who are interested in learning more about these studies should contact:

Virginia-Maryland College of Veterinary Medicine in Blacksburg, Virginia Mindy Quigley – Clinical Trials Coordinator, VMCVM (540) 231-1363 [email protected]

Oklahoma State University in Stillwater, Oklahoma Dr. Martin Furr, Interim Director, Veterinary Medical Teaching Hospital (405) 744-8751 [email protected]