Case Presentation
A 13-year-old spayed female Spitz was presented for a second opinion regarding a maxillary squamous cell carcinoma.
In December 2020, swelling was first noted in the gingiva surrounding the left maxillary canine tooth. In April 2021, the dog was presented to another veterinary hospital with oral bleeding, nasal discharge, and sneezing. A mass involving the left maxilla was identified, and cytological examination was performed. Histopathological examination subsequently confirmed a diagnosis of squamous cell carcinoma.
The dog was subsequently referred to our hospital for a second opinion.
Clinical Findings and Treatment
On presentation, the oral mass was raised and eroded. Crusting and alopecia were also observed over the left nasal bridge, directly overlying the gingival lesion, raising clinical suspicion of local extension of the tumor into the nasal cavity. Routine blood testing revealed no marked abnormalities.
On 8 May 2021, palliative medical treatment comprising toceranib and piroxicam was initiated, with misoprostol for gastrointestinal protection. Huaier glycan TPG-1 was started concurrently as an adjunctive nutritional intervention.
During the subsequent treatment period, serial clinical photographs showed changes in the gross appearance of the lesion. Surface ulceration and bleeding appeared to decrease, and the previously irregular lesion became flatter.
Figure 1. Serial clinical appearance of the maxillary lesion during treatment.
(A) 8 May 2021, at the initiation of treatment.
(B) 29 May 2021.
(C) 12 June 2021.
Serial photographs demonstrate changes in the gross appearance of the maxillary lesion during combination treatment with toceranib, piroxicam, and Huaier glycan TPG-1. Surface ulceration and bleeding appeared to decrease, with progressive flattening of the lesion. Because multiple treatments were administered concurrently, these changes cannot be attributed to any individual intervention.
Bleeding from the left nasal bridge, considered to be associated with secondary infection, was subsequently observed, and orbifloxacin was added to the treatment regimen.
Huaier glycan TPG-1 was discontinued on 26 May 2021. During the following weeks, reduced appetite and weight loss were noted, and administration of Huaier glycan TPG-1 was resumed on 12 June.
By early July, reduced appetite had become more pronounced and was suspected to be associated with the antineoplastic treatment. Toceranib was therefore discontinued on 4 July.
On 31 July, the remaining oral medications were discontinued, while Huaier glycan TPG-1 was continued. An improvement in appettite was subsequently recorded.
Thereafter, the disease followed a gradually progressive clinical course, with fluctuations in appetite and general condition. Management was primarily directed towards maintaining food intake and quality of life. Huaier glycan TPG-1 was continued even during periods when administration of other oral medications was difficult.
The dog died on 24 January 2022. The specific cause of death was not documented in the available clinical record.
Clinical Timeline
| Date | Clinical Course |
| December 2020 | Swelling noted in the gingiva surrounding the left maxillary canine tooth. |
| April 2021 | Oral bleeding, nasal discharge, and sneezing developed. A left maxillary mass was identified and cytological examination was performed. Squamous cell carcinoma was subsequently confirmed by histopathology. |
| 8 May 2021 | Erosion of the oral tumor, with crusting and alopecia over the left nasal bridge. No marked abnormalities on routine blood testing. Toceranib, piroxicam, misoprostol, and Huaier glycan TPG-1 were initiated. |
| 26 May 2021 | Huaier glycan TPG-1 was discontinued. |
| 12 June 2021 | Reduced appetite and weight loss were noted. Huaier glycan TPG-1 was resumed. |
| 4 July 2021 | Toceranib was discontinued because of marked appetite reduction suspected to be treatment-related. |
| 31 July 2021 | Other oral medications were discontinued. Huaier glycan TPG-1 was continued, and appetite subsequently improved. |
| 24 January 2022 | Death. |
Discussion
This case describes the adjunctive use of Huaier glycan TPG-1 during the palliative management of an elderly dog with maxillary squamous cell carcinoma and suspected local extension into the nasal cavity.
Following initiation of combination treatment with toceranib, piroxicam, and Huaier glycan TPG-1, serial clinical photographs showed an apparent reduction in surface ulceration and bleeding, together with flattening of the visible lesion. However, because these interventions were initiated concurrently and no objective tumor measurements or imaging-based response assessments were available, the contribution of Huaier glycan TPG-1 to these local changes cannot be determined.
Of clinical interest, reduced appetite and weight loss were recorded following temporary discontinuation of Huaier glycan TPG-1, and the supplement was subsequently resumed. Later in the course, appetite improved after discontinuation of the other oral medications while Huaier glycan TPG-1 was continued.
These observations should be interpreted cautiously. In particular, the improvement in appetite cannot be attributed specifically to Huaier glycan TPG-1 because withdrawal of potentially treatment-related medications occurred during the same period. Similarly, no objective assessment of immune function or validated quality-of-life scoring was performed.
Accordingly, this single case does not establish a direct antitumor, immunomodulatory, or survival benefit of Huaier glycan TPG-1. Rather, it documents its use as an adjunctive nutritional intervention during ongoing palliative management and provides a clinical basis for further prospective evaluation using predefined measures of tumor response, appetite, treatment tolerability, and quality of life.