Electrochemotherapy Helps Puggle at Foster Hospital

An unexpected converging of paths set the lives of April Burke and a puggle named Lily on a new trajectory. A friend had asked Burke to watch the puggle (a pug and beagle mix), whose owner was sick with cancer.

"I didn't like this dog when I first got her. Then I had her for a week and knew this is my heart dog; she warms right in there," recalls Burke, who fostered Lily through Never Give Up Animal Rescue before adopting her.

Lily, seven years old at the time, was 20 pounds overweight, suffered from skin and yeast infections, and had a foul odor to her. She was lethargic, spending much of the day sleeping. She also had a softball-sized mass on her cheek.

Burke took Lily to Second Chance Community Veterinary Hospital in Worcester, where she was diagnosed with an allergy-related skin infection and hypothyroidism. Her thyroid did not produce enough hormones, which explained Lily's weight. She was put on medications to address both issues. The mass on her face was biopsied and found to be a squamous cell carcinoma, a type of cancer that starts as a growth of cells on the middle and outer layers of skin.

After the initial appointment at Second Chance, Never Give Up Animal Rescue, Lily was brought to Luke and Lily Lerner Spay/Neuter Clinic at Cummings School of Veterinary Medicine at Tufts University for further treatment. The mass and a small mass on her eye were surgically removed.

Burke was impressed by the attention and care Lily received at Lerner Clinic. "I had a phenomenal experience at the Lerner Clinic—they went above and beyond to make Lily comfortable. When I came to Cummings School's campus, I thought this would be a great place to work."

By the following spring, she was hired. Burke now works as a clinical services coordinator at the Henry and Lois Foster Hospital for Small Animals (FHSA) at Cummings School, and she credits Lily for her career change.

Several months after the visit to Lerner Clinic, Burke noticed that the tumor on Lily's face was growing again. The cancer treatment options were cost-prohibitive, and Burke worried she was out of options. Lily's situation came up in a conversation one day with Dr. Carrie Wood, D.V.M., DACVIM (oncology), assistant clinical professor in the Department of Clinical Services at Cummings School. Dr. Wood asked Burke to bring Lily into FHSA.

"If the tumor hadn't spread, she would be a good candidate for electrochemotherapy. More superficial tumors towards the skin's surface respond well to treatment," says Dr. Wood.

Electrochemotherapy (ECT) is a cancer treatment that combines an injection of chemotherapy into the tumor or bloodstream with an electrical pulse to improve its effectiveness in penetrating the cancer cells.

Cummings School acquired the ECT machine two years ago to provide an additional option for those patients who cannot afford radiation therapy. ECT can be used to treat any animal diagnosed with cancer. So far, it's been used at FHSA to treat tumors in cats, dogs, and a bearded dragon, and at Hospital for Large Animals for horses with cancerous tumors since they are too large to fit into radiation units.

"We hadn't treated anything of this size and scope before," says Dr. Wood. "The tumor was quite large. Lily is different in that when most dogs that get a squamous carcinoma, it's usually smaller. This is an unusual tumor in an unusual location, but one that's ideally suited to electrochemotherapy."  

According to Dr. Wood, ECT has undergone many advances in the past few years, including reduced side effects and better-pulsing control. ECT is used more commonly in Europe, where radiation units are less readily available for dogs and cats than in the United States. Radiation therapy is also considerably more expensive than ECT.

"There's not enough time in the day to treat every dog and cat that needs radiation therapy. Oncologists have increased the use of ECT because of the limited access to radiation therapy," says Dr. Wood, noting that there are only two veterinary radiation units in all of New England, including the one at FHSA.

Treating Lily also presented an opportunity for Cummings School veterinary students to gain experience using the ECT machine, especially with a larger-sized tumor.

The Zeus Varis Fund covered Lily's treatments. A generous benefactor to Cummings School, Agnes Varis, set up the fund after her cat, Zeus, had been treated for cancer at FHSA to help owners who cannot afford to treat their pets for cancer.

Lily underwent three ECT treatments in the oncology service at FHSA over a few months, starting early last winter. The results have been positive.

"Right now, Lily is feeling great. The tumor is about nickel size; before, it was a large pancake. She responded well to treatment. She's like a new dog," says Dr. Wood.

"She has more energy than I can keep up with. She's definitely adventurous and creative," says Burke. "She will jump up on a chair to the kitchen table, get a salad dressing bottle, twist off the top, and lick it all up. Then she'll put her ears down, tuck her tail between her legs, and slink away. She keeps me on my toes."

Lily will continue the ECT treatment if the tumor regrows, but so far, so good.

"The oncology team is so compassionate; you can tell they love what they do. I trusted them with Lily. It was such peace of mind knowing that working together, we could give Lily a chance for a good quality of life," says Burke.

In just a year and a half together, Lily has lost 20 pounds, her skin has cleared up, and the mass on her face is now just a scar. Burke has been enjoying her job for over a year now at Tufts, liaising with clients who come into Foster Hospital for Small Animals. "Lily did all this."