New drug, eBAT, may help save dogs with deadly cancer hemangiosarcoma | Dr. Justine Lee, DACVECC, DABT, Board-certified Veterinary Specialist
One of the toughest parts of working in the ER is the constant barrage of bad news that one has to deliver. Unfortunately, cancer is one of the top causes for presentation to the veterinary ER, and the leading cause of death in dogs in the United States.
In the emergency room, the most common type of cancer that I see is hemangiosarcoma. This is a very aggressive type of cancer that loves bloody organs: the spleen, liver, heart, and blood vessels. This vascular tumor often results in acute internal bleeding in popular, large breed dogs like Golden retrievers, Labrador retrievers, German shepherd dogs, and mixed breed dogs.
Unfortunately, hemangiosarcoma is a type of cancer that manifests acutely. In other words, one day your dog is normal, and the next day he may present acutely collapsed and be diagnosed with metastatic cancer. When cancer invades normal tissue, it destroys the blood flow to that area, and can result in necrosis. This may result in rupture of the tumor. With hemangiosarcoma, rupture of the tumor results in severe internal bleeding secondary to a ruptured organ (typically on the spleen). Clinical signs of internal bleeding include:
- Panting excessively
- Acute collapse/generalized malaise
- Weakness/inability to get up
- Pale gums
- Vomiting
- Signs of shock (e.g., elevated heart rate, pale gums, a low blood pressure)
- Increased thirst
- Inappetance/anorexia
- A distended abdomen
- Acute death
When this occurs, an emergency trip to the veterinarian is imperative. Immediate treatment and stabilization is necessary, including IV fluids, IV protein, and blood transfusions. Once a patient is stabilized, surgical removal of the bleeding tumor can be performed. However, the prognosis – even with surgery and chemotherapy – is quite poor, with the average survival being days to months (typically 1-6 months). According to oncologists, less than 50% will survive 4-6 months, with only 10% surviving to one-year after the initial time of diagnosis.
Thankfully, there has been a new drug called eBAT that was recently discovered at University of Minnesota that shows some promise. eBAT was invented by Daniel Vallera, Ph.D., professor at the University of Minnesota Medical School and Masonic Cancer Center; this was recently published here. In a dog trial, this new UMN-developed drug showed improved survival rates for dogs diagnosed with hemangiosarcoma. You can read the press release here.
According to co-author of this study, Dr. Jaime Modiano, VMD, PhD, Professor in Oncology at the University of Minnesota College of Veterinary Medicine, “This is likely the most significant advance in the treatment of canine HSA in the last three decades.”
eBAT works to specifically “target tumors while causing minimal damage to the immune system.” According to the lead study author, Dr. Antonella Borgatti, DVM, MS, DACVIM (Oncology), DECVIM (CA), Associate Professor at the University of Minnesota College of Veterinary Medicine, this drug helps provide a better chance of survival. “In this trial we aimed for a sweet spot by identifying a dose of eBAT that was effective to treat the cancer, but caused no appreciable harm to the patient. Essentially we’re treating the cancer in a safer and more effective way, improving quality of life and providing a better chance at survival.”
In the trial that was performed at University of Minnesota, 23 dogs (of various breeds) that were diagnosed with hemagiosarcoma of the spleen were treated with eBAT. All the dogs had surgery to remove the tumor on their spleen, and then received three treatments of eBAT (and prior to conventional chemotherapy). In these 23 dogs, the use of eBAT improved the 6-month survival rate to approximately 70%, while 5 of the 23 dogs survived to more than 1 year! (450 days!)
Better yet, if there is success with this drug in treating hemangiosarcoma in dogs, there may be use for it in human medicine. According to Dr. Modiano, “this drug was invented here at the University of Minnesota, developed here, manufactured here, tested here and showed positive results here. We would also like this drug to achieve positive outcomes for humans here.”
If your dog was diagnosed with cancer, know that you have many options and factors to consider. Some options include seeking a veterinary oncologist’s opinion (BTW, just because you make an appointment with an oncologist doesn’t commit you to having to do chemotherapy! It just lets you learn about your options, which I always recommend!), doing palliative care, keeping your pet on pain medication, humane euthanasia, or more aggressive in treatment (options like include surgery, chemotherapy, or radiation therapy, etc.). When in doubt, talk to your family, your veterinarian, and your veterinary specialist to find the best option for you and your pet. More importantly, discuss the possibility of new life saving treatments like eBAT with your veterinary oncologist.
Part of this blog was previously published on www.PetHealthNetwork.com.
What class of drugs is eBAT in? NK1? TKI? Other?
You can find more info here:
http://mct.aacrjournals.org/content/early/2017/02/13/1535-7163.MCT-16-0637
Is this therapy commercially available?
Unfortunately, not yet. But check with your veterinary oncologist.
My dog has external tumors that were removed and then they found one under his skin as well as a 4 cm growth next to his intestine that they are afraid to aspirate due to bleeding concerns. How do I make arrangements for you to see my dog as he has been diagnosed with hemangiosarcoma but all doctors are confused about tumor next to instestine. There is no spleen tumor. I am so confused. He started chemo this week. Thanks tom
I’m afraid i’m not an oncologist, but I would recommend going to the ACVIM website to find a specialist in your area for an abdominal ultrasound. It sounds like he may have cutaneous hemangiosarcoma and abdominal hemangiosarcoma, and surgery may be warranted?
Hi. I was sorry to hear that eBAT is not available commercially yet. My dog was just diagnosed with hemangiosarcoma after a bleed event and an emergency splenectomy. I have also heard good news about I’m-Yunity from the clinical trials at UPenn. I was wondering what your thoughts are about that direction.
I’m so sorry to hear about this – it’s such a horrible diagnosis. Yes, definitely worth trying ImYunity as it’s very benign. It’s really expensive but worth trying. Also, try Yunnan Ba Yao too.
The active ingredient in I’m Yunity is Turkey Tail mushroom which is available from numerous sources, many of which are cheaper than I’m Yunity. Penn uses I’m Yunity in its studies because the company funding the study is the company that manufactures I’m Yunity.
Do your own research, of course, but from what I can tell the only thing that distinguishes I’m Yunity from other brands is a price that callously exploits desperate dog owners and a willingness to fund studies that raise their product above more affordable competitors. This is not to say that Penn’s results are bogus, especially given that turkey tail mushrooms have been shown elsewhere to improve outcomes in human studies. It is simply to say that if you are interested in pursuing this for your dog, you are not restricted to I’m Yunity.
My dog had a splenectomy five days ago and I immediately went shopping for turkey tail. I chose Nature’s Defense, a reputable brand founded by the esteemed mycologist Paul Stamets. Stamets believes turkey tail following chemotherapy saved his mother’s life. Natures’ Defense is not cheap but it’s not prohibitive either. Today I received confirmation of the worst. Let’s hope it helps.
I wish you all the luck in the world with your beloved companion.
Mushroom Science sells a high-potency turkey tail supplement. https://mushroomscience.com/coriolus-super-strength/
I just realized I misnamed the brand of turkey tail capsules I use. The brand is Host Defense, not Nature’s Defense. I would be very grateful if the blog moderator would correct my original comment.
Mike Girard – any updates? My lab had a splenectomy a week ago and has hemangiosarcoma. I just started her on the Host Defense mushroom pills yesterday. I am giving her 8 pills a day – she is 80 lbs.
Thanks for any updates.
Hello, my dog AJ was diagnosed with HSA Feb 1, 2018. He had emergency surgery, his spleen removed, he developed a heart problem post surgery so his oncologist will not administer DOX, she is using Epirubicin. He is very sick from it even with Cerenia and Zofran. Is there any way to get the eBAT ? I know its not for clinical use yet, but i am desperate as we all are with this horrible diagnosis … They will not take him for their study because he is not a purebred. He is a labradoodle. Any ideas ?
My dog was diagnosed recently as well as the other comments above. Cells are floating in the fluid in her abdomen and lungs, but 2 ultra sounds and 2 x-rays show nothing. She is only 7 years old and I am reaching out for just a chance that maybe this could work for her. Just making sure I have tried every avenue before its too late.
are there any updates if there is a way to get ahold of eBat?