Medical science is developing all the time. Some of that development takes place in laboratories, some in the minds of true experts like ours and some in hospital environments like our own. At North Downs Specialist Referrals we have assembled a team of Specialists who are among the most highly-trained and experienced veterinary surgeons in the world. This expertise allows our Specialists to both design and collaborate in critical clinical research projects, often enabling us to offer treatments which are not accessible elsewhere.
Clinical trials are research projects which involve real patients. They may be testing a new surgical technique or testing a new medicine or medicine combination. Sometimes participation in a clinical trial would require that something different happens compared to the normal management for a patient with the same condition. Sometimes, the only difference might be that additional tests are performed on samples, like blood samples for example, that would have been obtained as part of the normal management plan. In all circumstances, there would be a detailed explanation of the project before participation. Choosing not to participate in a clinical trial would NEVER change our commitment to finding the best treatment for each individual owner and pet.
Clinical trials which are currently being undertaken at North Downs Specialist Referrals include:
Immunotherapy for canine osteosarcoma
Dogs suspected of having appendicular limb osteosarcoma are referred for diagnostic imaging and biopsy (usually by image-guided fine needle aspirate of the bone lesion). For confirmed cases, an immunotherapy agent is implanted directly into the tumour. After 4-14 days amputation and chemotherapy follow according to standard osteosarcoma management practice. This trial is only partially funded.
Metronomic Chemotherapy in Aggressive Canine Mammary Neoplasia
Metronomic Chemotherapy in Aggressive Canine Mammary Neoplasia. Mammary tumours are actually very common in dogs in many parts of the world. In the UK, the more or less routine spaying of bitches dramatically reduces the prevalence of this cancer. However, malignant mammary tumours do still arise and we really lack a proven medical therapy for these patients. In this trial, patients who have had surgery for either an aggressive mammary carcinoma with spread to the local lymph node or an aggressive (grade 3) mammary carcinoma without spread will receive one of three medical treatments. Every one of the treatments is an active therapy. NO PATIENTS IN THIS STUDY WILL SIMPLY RECEIVE A PLACEBO. Patients are re-evaluated relatively frequently including completion of a quality of life evaluation. Many of the re-evaluations can be performed at your local veterinary surgery. This trial is only partially funded.
Previous clinical trials have led to some fabulous discoveries and have made meaningful differences to our understanding of illness in cats and dogs. In medical circles, when we have conducted a project we try to publish it in a ‘peer-reviewed journal’. Successful publication results in the dissemination of our work across the entire world, allowing other experts and practitioners to learn from what we have done.
These are some of our recently completed clinical trials:
Pinheiro D, Chang YM, Bryant H, Szladovits B, Dalessandri T, Davison LJ, Yallop E, Mills E, Leo C, Lara A, Stell A, Polton G, Garden OA (2014) Dissecting the regulatory microenvironment of a large animal model of non-Hodgkin lymphoma: evidence of a negative prognostic impact of FOXP3+ T cells in canine B cell lymphoma. PLoS One 9 (8) e105027
This trial investigated how the immune system is activated in dogs with lymphoma. The discoveries made provided a justification for the investigation of immune-based therapies in canine lymphoma. We have undertaken further related clinical trial work since and are at the stage of analysing the results.
Summerfield NJ, Boswood A, O'Grady MR, Gordon SG, Dukes-McEwan J, Oyama MA, Smith S, Patteson M, French AT, Culshaw GJ, Braz-Ruivo L, Estrada A, O'Sullivan ML, Loureiro J, Willis R, Watson P (2012) Efficacy of pimobendan in the prevention of congestive heart failure or sudden death in Doberman Pinschers with preclinical dilated cardiomyopathy (the PROTECT Study). Journal of Veterinary Internal Medicine 26, 1337-1349
This trial changed our understanding of how best to treat a particular form of heart disease where the heart muscle becomes weak and unable to pump blood effectively. The new treatment approach led to marked improvements in quality of life and survival for dogs with this disease.
Vail DM, von Euler H, Rusk AW, Barber L, Clifford C, Elmslie R, Fulton L, Hirschberger J, Klein M, London C, Martano M, McNiel EA, Morris JS, Northrup N, Phillips B, Polton GA, Post G, Rosenberg M, Ruslander D, Sahora A, Siegel S, Thamm D, Westberg S, Winter J, Khanna C (2012) A randomized trial investigating the efficacy and safety of water soluble micellar paclitaxel (Paccal Vet) for treatment of nonresectable grade 2 or 3 mast cell tumors in dogs. Journal of Veterinary Internal Medicine 26, 598-607
This trial evaluated the impact of a novel formulation of a chemotherapy agent that is now one of the most widely used chemotherapy drugs in human medical practice. It has previously not been safe to give it to dogs but the new formulation allows safe administration and this trial proved that the new formulation was superior to the previous ‘gold standard’ therapy.