Antibiotics are still the first line of treatment for infections in animals and humans, but as these drugs are overused, many bacteria become resistant to them.
Now, for the first time, an Israeli Persian cat has undergone personalized bacteriophage therapy that uses its genetic profile to guide decisions made for disease prevention, diagnosis, and treatment.
Bacteriophages (“phages” for short) are natural viruses that can selectively target and kill bacteria. They are considered to have a high therapeutic potential for the treatment of severe bacterial infections, especially those that cannot be treated with antibiotics.
The therapy is personalized because the specific phages used are tailored to the individual patient's infection, as determined through bacterial culture and genetic analysis.
In 2010, the first report of a veterinary clinical trial of a phage-based infection treatment was published. Ten dogs with chronic ear infections were treated with a cocktail of six phages active against the bacterium P. aeruginosa.
The technique has also been used in cows, chickens, and other farm animals. The US Food and Drug Administration (FDA) has approved the use of general phage therapy in the food industry, largely in the dairy and meat industry, to combat bacterial growth.
But this was only a general—not personalized—treatment that did not involve tailoring the phage to the animals’ genetic profile, so it was not very successful.
A new study led by Prof. Ronen Hazan and his team from the Faculty of Dental Medicine at the Hebrew University of Jerusalem (HUJI), in collaboration with the team of Vet Holim – the Veterinary Medical Center in Kiryat Anavim just outside Jerusalem – has achieved a significant advancement in the treatment of antibiotic-resistant infections in animals.
Interestingly, unlike common situations, this case was performed on an animal based on doctors’ insights from treating humans first.
Therapy has been published in veterinary medicine journal
The team just published their innovative therapy in the journal Veterinary Quarterly under the title “Successful phage-antibiotic therapy of P. aeruginosa implant-associated infection in a Siamese cat.” The team included Ron Braunstein, Goran Hubanic, Ortal Yerushalmy, Sivan Oren-Alkalay, Amit Rimon, and Shunit Coppenhagen-Glazer.
Their treatment involved a five-year-old Siamese cat named Squeaks who suffered from an infection with Pseudomonas aeruginosa bacteria (that infects humans as well as canines) after undergoing arthrodesis surgery on a damaged joint cartilage to fuse two leg bones together. After the surgery, the area of bone where the joint was positioned is no longer capable of motion, and the pet is relieved of severe pain.
Squeaks, initially treated at the Kiryat Anavim veterinary hospital for injuries sustained from a high-rise fall, developed a severe infection in the right hind leg following multiple operations. This infection persisted despite various antibiotic treatments over four months.
Facing a potential implant-replacement surgery, the team turned to the new treatment which involved a meticulously designed combination of a specific anti-P. aeruginosa phage, a virus that kills bacteria, applied topically to the surgical wound, with ceftazidime (an injected, broad-spectrum third-generation cephalosporin beta-lactam antibiotic) administered with a needle into the muscle. After receiving instructions, the cat’s owners gave Squeaks most of the treatment doses of phages and antibiotics at their home.
The integration of phage therapy with antibiotics was aimed at targeting the pathogen effectively and directly at the site of infection, leveraging the phage’s ability to be applied topically, which simplifies administration and maximizes its concentration at the infection site. This approach allowed the surgical wound, which had remained open for five months, to fully heal after 14 weeks of treatment.
The successful outcome of this case underscores the critical need for novel therapeutics like personalized phage therapy to cope with the growing concern of antibiotic-resistant infections that affect up to 8.5% of surgical sites following orthopedic surgeries in pets. These infections pose significant health risks to the animals and increase the suffering, deaths, and costs involved in these procedures.
Recent studies suggest that phage therapy, already showing high success rates in human medicine for treating orthopedic infections and chronically infected wounds, can offer a promising solution for similar issues in veterinary practice. Moreover, the successful treatment of this cat by its owners at home highlights the practicality and efficacy of personalized phage therapy, which could be extended to treat other pets facing similar antimicrobial resistance challenges, the authors wrote.
The positive reception from veterinarians and pet owners regarding phage therapy indicates growing awareness and acceptance of this treatment option. “As the new treatment continues to be explored in veterinary settings, it not only improves the health and well-being of pets but also offers valuable data that contribute to the broader application of phage therapy in both animals and humans,” they continued. This bridging of data can enhance treatment protocols and outcomes across various bacterial infections, potentially changing the landscape of infection treatment in both veterinary and human medicine.”
Braunstein told The Jerusalem Post that the vet hospital treated Squeaky for free because it was the first case and that the team is ready to accept any pet—even a snake, dog, gerbil, rabbit, or others—for treatment if it suffers from a persistent bacterial infection that is not healing after being treated with antibiotics.