Data_Sheet_2_Case report: Resolution of malignant canine mast cell tumor using ketogenic metabolic therapy alone.PDF

BackgroundMast cell tumors (MCT) are common neoplasms in dogs and are similar to most other malignant cancers in requiring glucose for growth, regardless of histological grade. Ketogenic metabolic therapy (KMT) is emerging as a non-toxic nutritional intervention for cancer management in animals and humans alike. We report the case of a 7 years-old Pit Bull terrier that presented in 2011 with a cutaneous mast cell tumor under the right nostril.MethodsThe patient’s parent refused standard of care (SOC) and steroid medication after initial tumor diagnosis due to the unacceptable adverse effects of these treatments. Following tumor diagnosis, the patient’s diet was switched from Ol’Roy dog food to raw vegetables with cooked fish. The tumor continued to grow on this diet until July, 2013 when the diet was switched to a carbohydrate free, raw calorie restricted ketogenic diet consisting mostly of chicken and oils. A dog food calculator was used to reduce calories to 60% (40% calorie restriction) of that consumed on the original diet. A total of 444 kilocalories were given twice/day at 12 h intervals with one medium-sized raw radish given as a treat between each meal.ResultsThe tumor grew to about 3–4 cm and invaded surrounding tissues while the patient was on the raw vegetable, cooked fish diet. The tumor gradually disappeared over a period of several months when the patient was switched to the carbohydrate free calorie restricted ketogenic diet. The patient lost 2.5 kg during the course of the calorie restriction and maintained an attentive and active behavior. The patient passed away without pain on June 4, 2019 (age 15 years) from failure to thrive due to an enlarged heart with no evidence of mast cell tumor recurrence.ConclusionThis is the first report of a malignant cutaneous mast cell tumor in a dog treated with KMT alone. The resolution of the tumor in this canine patient could have been due to the diet-induced energy stress and the restriction of glucose-driven aerobic fermentation that is essential for the growth of most malignant tumors. Further studies are needed to determine if this non-toxic dietary therapeutic strategy could be effective in managing other canine patients with malignant mast cell tumors.

背景犬类肥大细胞瘤（MCT）是犬类常见的肿瘤，其生长依赖于葡萄糖，与大多数其他恶性癌症在组织学分级上相似。酮症代谢疗法（KMT）正作为一种无毒性营养干预手段，在动物和人类癌症管理中崭露头角。本研究报告了一例2011年出现的7岁比特犬，其右侧鼻孔下方出现皮肤肥大细胞瘤。方法在肿瘤诊断后，患者的家长因无法忍受标准治疗（SOC）和类固醇药物的不良反应，拒绝接受这些治疗。在肿瘤诊断后，患者的饮食从Ol’Roy狗粮转变为生蔬菜和熟鱼。在采用这种饮食后，肿瘤持续生长，直至2013年7月，饮食转变为一种不含碳水化合物的生酮饮食，主要由鸡肉和油脂组成。使用狗粮计算器将卡路里摄入量减少至原饮食的60%（40%卡路里限制）。每天两次，每隔12小时提供444千卡路里，并在每餐之间提供一块中等大小的生萝卜作为零食。结果在患者采用生蔬菜、熟鱼饮食期间，肿瘤增长至约3-4厘米，并侵犯周围组织。当患者转换为不含碳水化合物的卡路里限制生酮饮食时，肿瘤逐渐消失。在卡路里限制过程中，患者体重减轻2.5公斤，并保持警觉和活跃的行为。患者于2019年6月4日（15岁）因心脏扩大而导致的生长失败去世，无疼痛感，且无肥大细胞瘤复发的证据。结论这是首次报告使用KMT单独治疗的犬类恶性皮肤肥大细胞瘤。该犬类患者的肿瘤消退可能归因于饮食诱导的能量应激以及限制葡萄糖驱动的需氧发酵，这对于大多数恶性肿瘤的生长至关重要。需要进一步的研究来确定这种无毒性饮食治疗策略是否可以有效地管理其他患有恶性肥大细胞瘤的犬类患者。