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Histotripsy ultrasound therapy effectiveness on equine sarcoids

Purpose

To evaluate the effectiveness of histotripsy as a non-invasive therapeutic approach for treating equine sarcoids.

Background

Equine sarcoids are the most common skin tumors in horses, associated with bovine papillomavirus (BPV). These locally invasive tumors lead to lesions that cause discomfort, pain, and functional limitations, significantly impacting a horse’s quality of life. Sarcoids are persistent and prone to recurrence, making their removal essential for preventing complications like infections or interference with tack. Current treatments, including surgery and cryotherapy, can be invasive, inconsistent, and have high recurrence rates, emphasizing the need for novel, effective solutions.

Histotripsy is a non-invasive ultrasound therapy that uses focused ultrasound waves to create microbubbles that mechanically disrupt targeted tissue. Unlike thermal methods, histotripsy’s non-thermal mechanism ensures precise ablation with minimal damage to surrounding tissues. Developed for human medicine, histotripsy shows promise in veterinary applications due to its precision, real-time imaging, and adaptability.

Non-invasive therapeutics like histotripsy are vital for improving animal welfare, minimizing recovery time, and reducing risks associated with invasive procedures. For equine sarcoids, histotripsy could offer a safe, precise, and effective alternative that could transform treatment outcomes and set a new standard of care for equine cutaneous neoplasia.

Eligibility

  • Horses diagnosed with sarcoids with no previous treatment of the tumor within 6 months
  • Tumor located on the trunk, abdomen, or neck (in vivo)
  • Must be a candidate for surgical resection of the tumor
  • Note: Tumors will be accepted after evaluation of tumor photographs by an ACVS board-certified large animal surgeon

Exclusion Criteria

  • Occult (flat) tumors

Study Design

This clinical trial comprises two treatment pathways: an ex vivo option and an in vivo option.

Ex Vivo Treatment Option:
For horses that are not viable candidates for the in vivo portion of the study due to location or tumor size, an ex vivo option may be available. Clients in this category can have the sarcoid surgically resected by their veterinarian or at the Veterinary Teaching Hospital in Blacksburg. A care package will be provided to the attending veterinarian, including all necessary materials for tumor preservation and shipping. The resected tumor will be sent to our laboratory, where it will undergo histotripsy treatment and histopathologic analysis.

In Vivo Treatment Option:
Horses eligible for the in vivo portion of the study must be transported to the Veterinary Teaching Hospital in Blacksburg. Here, the histotripsy machine will be coupled to the horse for non-invasive treatment of the sarcoid. This approach will involve real-time imaging and precise ablation of the tumor directly on the horse. The next day, the sarcoid will be surgically resected.

Compensation

For horses selected for the ex vivo option:

  • Histopathology of the mass
  •  Initial consult fee
  • Up to $1500 of hospital fees if performed at the Veterinary Teaching Hospital in Blacksburg, VA.
  • Note: Follow-up chemotherapy may be needed pending histopathology but is not included in the compensation package.

For horses selected for the in vivo option:

  • Initial consult fee
  • Surgical professional fees
  • Surgical equipment and consumables
  • Operating room fees
  • Hospitalization for 24 hours
  • Histopathology of the mass
  • Note: Anesthesia, associated pain/antibiotic medications and follow-up chemotherapy (if needed) are not included

Contact

Carson Hoffman
CarsonLh@vt.edu

If your query is urgent, please call the Large Animal Hospital on 540-231-4621

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