Abstract

In small animal practice, squamous cell carcinoma (SCC) is a tumor that has a guarded prognosis due to metastasis and extensive local invasion.⁹ The few reported cases of oral neoplasia in Atlantic bottlenose dolphins have been diagnosed as squamous cell carcinoma.^3-7 The etiology of SCC is unknown but viral and possibly infectious etiology (papilloma, herpes, gamma) are suspected as either the direct cause or to be otherwise implicated. Reported cases involving both free ranging and captive dolphins demonstrated mixed histological components of papilloma virus and squamous cell carcinoma suggesting malignant transformation.^1,2 Treatment in dolphins has included de-bulking the tumor to attain local control, surgical laser, intra-lesional chemotherapy, cryotherapy and permanent iodine-125 seed implantation.^3-5,7 Necropsies of dolphins with squamous cell carcinoma have shown widespread metastasis in the lung, liver, kidney, pulmonary and mediastinal, prescapular lymph nodes, pleura and diaphragm.²

In 2001, oral lesions were found in an approximately 48 year-old, 500 pound (227 kilogram) female Atlantic bottlenose dolphin (Tursiops truncatus). By 2007, there were multiple, chronic diffuse oral lesions consisting of red, 1–3 mm mucosal lesions; a nodular swelling in the lower right mucosa (floor of the mouth) about 1 cm diameter, 2 cm long and an open, non-healing ulcer in the throat region on the left side which had been worsening over time. The nodular and ulcerated lesions were highly suggestive of squamous cell carcinoma and papilloma. Other problems reported were chronic gastrointestinal issues occurring primarily in the summer and chronic eye problems.

Numerous treatment regimens were considered including surgical excision and cryotherapy but because of the animal's advancing age and the fact that she was not uncomfortable, the decision was made to opt for noninvasive, alternative treatment. In Nov. 2004, a Traditional Chinese Veterinary Medicine (TCVM) formula, Wei Qi Booster was given at 1 TBSP (7 g) twice a day. In 2007, Max's formula was given at 1 TBLS (7 g) twice a day, starting at one-third dose and gradually increasing. Wei Qi Booster is indicated for the treatment of chronic illness, chronic viral infections and anemia, post chemo or radiation management, general health improvement, and prevention of upper respiratory infections. Wei Qi Booster contains Bai Hua She She Cao (Oldenlandia), Ban Zhi Lian (Scutellaria), Chen Pi (Citrus), Dang Gui (Angelica), Dang Shen (Codonopsis), Huang Qi (Astragalus), Wu Yao (Lindera). Max's formula contains Bai Zhi (Angelica), Da Huang (Rheum), Jie Geng (Platycodon), Mu Li (Shu) (Ostrea), Tian Hua Fen (Trichosanthes), Xia Ku Cao (Prunella), Xuan Shen (Scrophularia), Zhe Bei Mu (Fritillaria). Max's formula is indicated for treatment of neoplasia, tumors and nodules in geriatric or deficient animals.¹⁰

Over the years, other TCVM herbal formulas were used including Jade Lady, Equine Yin Qiao, Wu Wei Xiao Du Yin, Stomach Happy, Myco Forte (mushrooms) and Yunnan Bai Yao. In conjunction with the herbs, numerous conventional medications were given including antibiotics, Megestrol acetate (Megace), and omeprazole (Prilosec). Nutritional supplements administered before and after the herbs included Imuno-2865 (an immune stimulator), ShaNa (a supplement of botanical extracts, amino acids and vitamins used for neoplasia in humans), acidophilus, grape seed, and topical manuka honey.

The dolphin was euthanized in 2011 for reasons not related to the squamous cell carcinoma. On necropsy, multiple, diffuse mucosal, 2–6 mm, ulcerative and vegetative raised areas were noted in the mouth, under the frenulum of the tongue, on the sides of the tongue, and on the soft palate. Histopathologically, the mouth lesions were associated with dysplasia and transformation to squamous cell carcinoma and no metastasis of the SCC was found in the body.

There is limited information or experience on the use of Chinese herbs in dolphins. This case study illustrates the long term use of multiple Chinese herbal formulas as a complementary non-invasive treatment for squamous cell carcinoma in a geriatric dolphin. Concurrent use with conventional medications did not affect the efficacy of either methodology nor incur side effects. Advances in the treatment of squamous cell carcinoma are continuing with some success reported with cryosurgery and surgical excision.⁸ This dolphin was not a candidate for conventional therapy, yet she lived nine high-quality years and on necropsy no metastasis was found. Hopefully, this case will encourage the evaluation and treatment of dolphins with TCVM.

Acknowledgements

The authors would like to thank Dr. Gloria Weintrub for introducing TCVM and Dr. Xie to the Dolphin Research Center, Jing Tang herbals for their generous donation of products, Dr. Mike Renner and the DRC staff for their tireless and diligent work with Theresa, who enriched the lives of so many during her life at DRC from 1968 until 2011.

References

1.  Bossart GD, et al. Orogenital neoplasia in Atlantic bottlenose dolphins (Tursiops truncatus). Aquat Mamm. 2005;31(4):473–480.

2.  Bossart GD. Emerging diseases in marine Mammals. Microbe. 2007;2(11):544–549.

3.  McKinnie CJ, et al. Permanent i-125 seed implant in the treatment of squamous cell carcinoma in an Atlantic bottlenose dolphin, Tursiops truncatus. IAAAM 38th Annual Conference, Orlando, FL; 2007:72.

4.  McKinnie CJ, Dover SR. Diagnosis and treatment of lingual carcinoma in an Atlantic Bottlenose dolphin (Tursiops truncatus).IAAAM 34th Annual Conference Proceedings, Kohala Coast, HI, 2003:164.

5.  McKinnie CJ. Treatment of oral squamous cell carcinoma in an Atlantic bottlenose dolphin (Tursiops truncatus) IAAAM 32nd Annual Conference Proceedings, Tampa, FL; 2001:38.

6.  Newman SJ, Smith SA. Marine mammal neoplasia: a review. Vet Pathol. 2006;43:865–880.

7.  Renner MS, et al. Sublingual squamous cell carcinoma in an Atlantic bottlenose dolphin (Tursiops truncatus). J Zoo Wildlife Med. 1999;30(4):573–576.

8.  Renner MS. Personal communication; 2012.

9.  Tilley LP, Smith F. The 5-Minute Veterinary Consult, Canine and Feline, 2nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2000:1220.

10. Xie H, Preast V, Liu W. Chinese Veterinary Herbal Handbook, 2nd ed. Reddick, FL: Chi Institute of Chinese Medicine; 2008:76–77,155.