Case Study Courtesy of
Dr Rob Silver, USA, DVM, MS, CVA, FACVBM
Case Study Courtesy of
Dr Rob Silver, USA, DVM, MS, CVA, FACVBM
Grover was a 12 year old neutered male black Labrador Retriever when he came to me for his cancer diagnosis of hemangiosarcoma. In March of 2022, on a routine visit for vaccinations, it was noted to the vet that Grover had been observed to have episodic periods of weakness and lethargy. Blood tests at that Banfield Veterinary Hospital indicated elevated liver enzymes, but a normal hematocrit. 10 days later, he collapsed, and a dual cavity ultrasound was performed at this same facility. The ultrasound found in the abdomen a cavitated mass on the spleen suggestive of splenic hemangiosarcoma; no lesions were observed in the thorax. At that time a splenectomy was recommended, but the owner was reluctant to pursue.
Grover’s parents reached out to me for an integrative approach in April of 2022, and I recommended an immediate splenectomy, which the owner declined, not wanting to subject Grover to the stress and recovery of surgery when his survival time was questionable. Statistics suggested he might not live longer than 30-60 days. I agreed with their reasoning, but felt that if integrative care was to be successful, the presence of the diseased spleen and hemoabdomen would be a liability to the potential for better longevity. I also suggested they consider euthanasia versus treatment given that the diseased spleen was a “ticking time bomb” that might defeat our efforts.
I agreed to work with Grover’s parents without him being splenectomized, although I was very uncomfortable doing that, as I had never had a patient before that was not splenectomized prior to initiating integrative therapeutics. I explained this to Grover’s parents but they remained steadfast in not allowing the splenectomy. Grover’s plan follows, which his parents followed religiously.
GROVER’s PLAN: 12 yo;27 kg; NM
Grover thrived on this program for 8 months, and during that time, maintained his appetite and activity, although his parents were cautioned to avoid any uncontrolled activity. Following excessive activity he would be observed to be a bit lethargic, indicating that the activity had precipitated a bleed from the still-present splenic mass. Finally, after 8 months of this success, Grover’s excessive activity caused a significant hemoabdomen, and the decision was made to euthanize him at home.
Medicinal mushrooms have been in use for centuries if not millenia by humans to address their cancer diagnoses. The use of medicinal mushrooms in veterinary species is relatively new. A study published in 2012, when Grover was 2 years old, looked at establishing an effective dosage of a liquid mycelial extract from Turkey Tail (PSP) in dogs with hemangiosarcoma.
This was a Phase 1 study exploring dosages and proof of concept that this extract could impact the course of the disease. The study groups were small, only 5 dogs in the three different tiers, and the results were remarkable, in that the highest dosing tier of 100 mg/kg BID of PSP provided median survival times for the dogs in this group that exceeded historical survival times for dogs that were splenectomized and who received concurrent chemotherapy. Those results got everyone’s attention and many pet parents and veterinarians started using this very expensive patented extract from the liquid culture of turkey tail mycelium.
10 years later, a clinical trial with 101 dogs was published in 2022 that produced different results, due to the larger sample size that produced more accurate results. This trial included chemotherapy with a placebo PSP, PSP alone, and chemotherapy with PSP. They were unable to find statistically significant results showing that PSP was able to match or exceed the anti-neoplastic effect of chemotherapy. It also found that outcomes were different for males (better) versus females (worse), and that the hematocrit, if it was greater than 30% was a positive prognosticator, as was the staging of the progression of the hemangiosarcoma metastasis. So males, presenting with hematocrits of 30% or greater, and in the early stages of the disease had better survival times. 240 day median survival time for this cohort, for dogs who just received the PSP and did not receive chemotherapy.
Grover presented with a hematocrit of 35%, he was male, and although staging was not performed, catching this problem relatively early in its progression, means he was of a lower stage, probably stage 1. His survival time equaled the median survival time of dogs who were splenectomized and who received the PSP patented extract, although he was NOT splenectomized, and he did NOT receive the PSP extract but instead received the full-spectrum hot water extracted turkey tail mushroom extract.
Grover’s case supports the use of integrative therapeutics combined with the Turkey Tail mushroom extract at substantially higher doses.