a golden Labrador named Sam sits on a linoleum floor
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Sam’s Case Study

By Kristen Kellar-Graney, M.S.
Photos provided by Kubanda Cryotherapy

Sam’s lipoma, pre treatment.
L dropcapabradors and lipomas go hand in hand, or, in Sam’s case, leg. This eight-year-old, outgoing, sweet pup had an 18-month history of a slow-growing mass on his left forearm measuring four by two centimeters. Sam’s owner was relieved to learn, following fine needle aspiration (FNA), that the tumor was a benign lipoma but was still concerned that it was growing. Conflicted by knowing that it might ultimately cause pain or mobility issues yet wanting to avoid surgical resection for the benign mass, Sam’s owner turned to a new-to-veterinary medicine option; subcutaneous cryoablation.

Sam underwent this outpatient procedure in 2023 as an enrollee in an AVMA Animal Health Study listed “Percutaneous cryoablation to minimize growth in benign and malignant canine and feline tumors” at Johns Hopkins Hospital. Prior to enrolling in the trial, pre-procedure blood work and a three-view chest radiograph series with radiologist interpretation were performed to ensure that Sam was an ideal candidate for the trial. With a clean bill of health, Sam was scheduled for the procedure.

Undergoing cryoablation procedure. Note the ice ball that has formed within the lipoma.
Using the carbon dioxide-powered device, an eight-gauge penetrating probe was inserted into the lipoma once Sam was anesthetized, and his tumor underwent a three-minute-and-twenty-second freeze, a three-minute thaw, and a four-minute freeze before a spontaneous thaw cycle and the probe’s removal. His puncture wound did not require a stitch nor a staple, and he was discharged home with the anti-inflammatory medication carprofen and an Elizabethan collar, as prescribed in the study protocol.

Approximately one day after his cryoablation, his owner reported that he showed no discomfort and that the lipoma had shrunk considerably. His puncture site was scabbed, clean and dry. Sam recovered well during the post-treatment period, though six months and 10 pounds of weight-gain later (attributed to family lifestyle), some regrowth of his lipoma was noted.

Sam was a pioneer in this percutaneous cryoablation trial, and now general practice patients are treated under light sedation plus local anesthetic numbing with a seven-minute freeze, five-minute thaw and seven-minute freeze cycle. These doses are determined by palpating the ice ball that grows during the procedure as well as visually inspecting the skin to minimize cutaneous frostbite.

Although forms of cryoablation have been used in human medicine for centuries, its application in veterinary medicine has been limited to topical treatments, primarily due to cryogen gas costs and storage capabilities. Carbon dioxide-based cryotherapy freezes to temperatures as cold as -70oC, which is much colder than established lethal temperatures for most cell types significant in veterinary medicine.

A clinical trial using subcutaneous cryoablation for the treatment of canine mammary tumors is anticipating publication later this year. Many other benign and malignant subcutaneous masses are being treated with cryoprobes as a part of the veterinarian’s armamentarium. And, just this past January, cryoablation as an adjuvant therapy for marginally excised tumors was mentioned in surgical oncology continuing education lectures.

When considering patients who may need to forgo surgical resection, subcutaneous cryoablation offers a new option for tumor treatment in general veterinary practices.

Lipoma site one day after cryoablation.
When considering patients who may need to forgo surgical resection, subcutaneous cryoablation offers a new option for tumor treatment in general veterinary practices.
Kristen Kellar-Graney is a tumor biologist and clinical researcher who has been with Kubanda Cryotherapy since early 2023. As the clinical research coordinator, Kristen has managed clinical trial recruitment and worked with the clinical team on the execution and analysis of animal studies. Kristen has an extensive background in tumor biology, veterinary medicine, and translational clinical research, with a concentration on prospective and retrospective comparative and human oncology research. Her previous work included many publications in the discipline of orthopedic oncology. Kristen earned her bachelor’s degree in Biological Sciences from the University of Pittsburgh and her Master’s in Tumor Biology from Georgetown University.