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 Post subject: Sarcoids and Melanomas
PostPosted: Wed Oct 28, 2009 4:42 pm 

Joined: Fri Nov 07, 2008 2:02 pm
Posts: 1072
Location: UK Worcester/Hereford border
Sarcoids can be like icebergs, only a small percentage noticeable on the outside.
Treatments vary with the individual. Sometimes a tight tied tail hair will do the trick. More often this removes what is visible but may not remove multiplying cells below.
Fly repellents applied frequently, and preferably without poisons which require the animal to need detox or immune system restarts, or keeping out of biting flies, can be helpful as well as kind. Sarcoid is now believed transferable by biting flies introducing papilloma virus.
Turmeric can help.
There is much more detailed report availability from some of the Universities and Research Laboratories, although much is in medical jargon and lists small petri stage development.



Equine Sarcoid Treatment Recommendations, WEVA 2008
by: Stacey Oke, DVM, MSc
April 23 2009, Article # 14030
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The equine sarcoid is an unpredictable skin tumor capable of wreaking havoc on a horse's body. While not technically a "cancer" (neoplasm) in the pathological sense, sarcoids are often considered as such because they are a potential career- and even life-ending condition.

"Even the most benign-looking small lesion can erupt into a potentially catastrophic mass in a short period of time," reported Derek Knottenbelt, OBE, BVM&S, Dipl. ECEIM, MRCVS, from the Philip Leverhulme Hospital at the University of Liverpool in the United Kingdom at the 10th International Congress of World Equine Veterinary Association.

Despite the availability of multiple surgical, medical, and even holistic/alternative therapies, the sarcoid remains a clinical challenge because:

The cause of sarcoids remains undetermined;
There are six distinct clinical types of sarcoids each with different presentations;
Obtaining a definitive diagnosis via biopsy is not widely embraced because interfering with a sarcoid in any way can cause a massive and uncontrollable expansion of the lesion, and;
A myriad of treatment options exist, yet the prognosis is always "very guarded" and serious complications can arise secondary to treatment.
"Current treatment options include various surgical, medical, and alternative therapies," relayed Knottenbelt. "It should be noted, however, that the sheer number of therapies available is indicative of their success--no one treatment is invariably effective."

Knottenbelt even suggested that "no treatment is currently very effective at all."

According to Knottenbelt, factors to consider before selecting a treatment option are value of the animal, cost of treatment, site of the sarcoid on the body, previous treatment history, and what facilities and treatments are available locally.

A detailed description of "everything sarcoid" is available in Knottenbelt's research abstract titled, "The Equine Sarcoid" available for free from the International Veterinary Information Service.


Treatment Options
Treatment Option Description
Ligation Nylon thread or rubber elastrator band can be placed around the base of the lesion to cut off the blood supply.
Surgical Excision Removal of the lesion using a scalpel.
Cryosurgery Freezing the entire lesion without significantly damaging adjacent or underlying tissues.
Laser surgery CO2-yAG or diode laser is used to remove the lesion.
Cytotoxic/antimitotic compounds These compounds are applied topically to destroy the sarcoid.
Chemotherapeutic infiltration (cisplatin/5-fluorouracil) When injected intralesionally, can be used to remove the sarcoid on its own or in combination with surgery or electrochemotherapy.
Vaccines Vaccines can be created using pieces of the sarcoid. Not recommended.
Immunomodulation Proteins from bacteria such as Propionobacterium acnes are injected into the sarcoid.
Radiation therapy Widely considered the most effective treatment, various forms are available to treat various sarcoids.
Homeopathic and Other Therapies Typically applied topically to the sarcoid. Little evidence to support their use.





BEVA 2007: Face Flies and Sarcoid Spread?
by: Stephanie L. Church, Copy/Features Editor
January 10 2008, Article # 11046
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A U.K. veterinarian has possibly linked common face flies to the spread of sarcoids, one of the most commonly encountered equine neoplasias (tumors), and it is conceivable that the risk of spreading sarcoids could be minimized through horse management techniques. The research also further supports that bovine papillomaviruses (BPV) are involved in causing equine sarcoids in horses.

Jeremy Kemp-Symonds, MRCVS, a PhD student at the Animal Health Trust in Newmarket presented study results during the clinical research sessions at the 46th Congress of the British Equine Veterinary Association, held in Edinburgh, Scotland, Sept. 12-15, 2007.

"Despite being very common, there's a great deal that we don't understand about equine sarcoid," said Kemp-Symonds. "It appears to have a viral etiology, but an unresolved mode of transmission." He noted that fly vectors are mentioned often in the scientific literature about sarcoids, and he said there are numerous anecdotal reports of sarcoids developing at sites of previous injury and trauma. He also said it is common for horses to get sarcoids in the perigenital region, where flies often sit.

According to Kemp-Symonds, Musca autumnalis face flies feed on lachrymal (tearduct), oral, and nasal discharges, and wound secretions. "M. autumnalis is closely associated with predilection sites for sarcoids, and it's an important vector of veterinary diseases," he added. The researchers collected and froze more than 500 M. autumnalis flies infesting six sarcoid-affected Thoroughbred or Thoroughbred-cross horses from the Wye Valley area (encompassing the border of England and Wales). They ran a type of DNA assay called a polymerase chain reaction test on the flies and on tissue from sarcoid-infected horses.

"Ninety-eight percent were coming back positive for BPV-1 and BPV-2 (bovine papillomaviruses)," he said. These papillomaviruses are commonly accepted to be the causative agent of the equine sarcoid. "When we looked at the tissue samples … we got no amplification from any of the control tissue (tissue without sarcoids)." The BPV types were very similar, which is suggested of locally active subtypes of BPV.

These results also suggest that M. autumnalis could be a mechanical vector of both BPV-1 and BPV-2.

Additionally, if the potential exists for sarcoids to be spread through wounds, he suggested there might be "some iatrogenic involvement in these cases," meaning that sarcoids could be induced inadvertently by a veterinarian or by medical treatment or diagnostic procedures.

"You can try and minimize fly infestations, especially animals with open wounds, and post-surgical cases," he said. Control measures include equine housing, insecticides, repellents, and traps.

"My suspicion is there is horse-to-horse transmission," he said. "These horses were geographically very isolated from horses where there were cattle with BPV. When you look at the habits of flies, they tend not to fly great distances to go from one meal to another. About 3 km is as far as they go. So it's easy to fly from a sarcoid-infected horse to a horse with open wounds.

"Any fly potentially could do it," he concluded.



Sarcoid Therapy by: Stephanie L. Church, Copy/Features Editor
January 10 2008, Article # 11047

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Ask a roomful of horse people if they've ever seen a sarcoid, and you'll probably see a bunch of hands rise, and many knowing nods or eyerolls of owners who have dealt with these frustrating, usually benign tumors. Sarcoids are the most common skin tumor of equids for which there is currently no universally effective treatment, according to Zhengqiang Yuan, PhD, a research scientist in veterinary pathological sciences at the University of Glasgow's roduce. But because people don't tend to view sarcoids as a life-threatening condition, the economic viability of such a vaccine might be questionable. And without the participation of pharmaceutical companies, products like this never become commercially available. Interest in a vaccine to treat existing tumors, therefore, is a better bet from a financial standpoint.

Talking Treatment

Although slow-growing sarcoids often cause minimal trouble to a horse, if they appear in an area where tack or equipment might rub against them (for example, near the mouth where a bit would rest, or on the girth-line), they can crack and bleed frequently and can cause significant discomfort. Larger masses are even more troublesome, sometimes splitting and becoming infected by flies and maggots. There's always the possibility that a sarcoid tumor can interfere with normal functions, for instance, when one forms on an eyelid or ear.

For all of these reasons, you might want to consider treatment for your horse's sarcoids.

"It's best to at least get them evaluated, as soon as possible after you notice they've appeared,” recommends Carr. "Whether you pursue treatment depends on the size of the tumor and its location, but once they get past a certain size, or the tumor changes to malignancy, you may not have the option of treating them anymore. For most sarcoids, it's a good idea to explore treatment early on.”

The trickiest part of all this horses, which are not the virus' natural hosts, BPV seems to stimulate something far nastier. Whether the virus causes the sarcoids, or is just somehow associated with their growth, is unclear at this point. BPV has been demonstrated in lab situations to cause equine cells to develop tumor-like characteristics, but the viral infection is not enough to cause the actual development of a sarcoid (at least, not so far).

Researchers including Elizabeth Carr, DVM, Diplomate ACVIM, who currently is exploring treatment options for sarcoid tumors as part of a PhD project at the Department of Veterinary Surgery and Radiology, University of California, Davis, suspect that horses are a "dead-end host” for BPV. She thinks that the virus goes through an altered life cycle in equine cells, never managing to replicate and shed virus particles as it does in cattle. As a result, sarcoids do not seem to be contagious from horse to horse. It's more likely that the horses somehow contract the virus from the environment (not even necessarily from being in contact with a cow with warts). Regardless of how it gets there, however, it's very possible that BPV could act as the most significant initiating event in the development of a sarcoid.

"People have suspected for a long time that there's some relationship between this virus and sarcoid tumors in horses,” says Carr. "It's been demonstrated that more than 90% of sarcoids do have the DNAt of sarcoid tumors in horses. Different subtypes of the virus, BPV-1 and BPV-2, have been identified in individual sarcoid biopsies. It is not clear, however, whether BPV is present in all sarcoids. It is also unknown if the virus is found in other equine skin tumors or even in normal skin. A recent study from the University of California, Davis, attempted to answer these questions by looking for BPV DNA in biopsies of sarcoids and nearby normal skin from 55 affected horses. An additional 22 horses without sarcoids were sampled for comparison, as were several non-sarcoid skin tumors.

Almost every sarcoid tumor examined (98%) contained BPV DNA. Fifty-five percent of horses with sarcoids had sarcoids with BPV-2, while 20% of those horses had BPV-1, and 7% had both types of BPV present. More surprising was the finding that 63% of samples of normal skin from these horses contained BPV DNA. All of the biopsies from horses without sarcoids, as well as biopsies of other non-sarcoid tumors, were negative.

These findings suggest that BPV not only plays a role in sarcoid development, but is also capable of existing in a latent, non-virulent phase in normal skin. This might help explain why surgical removal of sarcoid tumors is rarely successful. Surgery might actually trigger the virus to leave the latent phase and begin formation of new sarcoids.

American Journal of Veterinary Research, 62(5), 741-744, 2001.

Editor's Note: No research has suggested any risk of sarcoids from housing horses with cattle or on land previously inhabited by cattle.




Bad Blood: Circulating Blood Cells Harbor Sarcoid-Causing Virus
by: Stacey Oke, DVM, MSc
July 26 2008, Article # 12367

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Aggressive research efforts to discover how the sarcoid-causing bovine papillomaviruses (BPV) are spread either within or between horses have resulted in the identification of BPV genetic material (DNA) in circulating blood cells. This novel finding suggests a possible mechanism by which horses prone to developing sarcoids become latently (invisibly) infected and potentially contribute to the spread of the virus.

Sarcoids are a common form of skin tumor in horses. While non-malignant, these growths can be problematic because they can spread to virtually any location on the body and can compromise the use and welfare of the horse. To date, there is no known cure and the mode of BPV transmission remains undetermined.

Until now, BPV DNA has not been detected in horses circulating blood cells (peripheral blood mononuclear cells--a particular kind of white blood cell). Because DNA from other type of pappillomaviruses has been identified in blood, the study authors re-visited this issue and chose to look for very small amounts of DNA.

The authors developed a highly sensitive polymerase chain reaction (PCR) test capable of detecting very small amounts of BPV DNA in the blood from sarcoid-infected horses. Blood from 66 horses was subsequently tested using this new PCR test.

The PCR test correctly identified the three sarcoid-infected horses, and was negative in the remaining 63 sarcoid-free horses. These results suggest that BPV lies latent in circulating blood cells in infected horses and is a reservoir for infection.

While this mechanism is not likely involved in the spread of infection between horses, it might explain how the virus can be spread in utero from infected mares to their foals and how multiple sarcoids can develop in individual horses.

Further research to further explore the biological and pathological significance of this discovery is ongoing.

The study, "Peripheral blood mononuclear cells represent a reservoir of bovine papillomavirus DNA in sarcoid-affected equines," was published in the June 2008 edition of the Journal of General Virology.



Sarcoids And Melanomas
by: Karen Briggs
June 01 1999, Article # 339

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Tumor. Now there's a word guaranteed to strike fear into anyone's heart. Loosely defined, a tumor is an uncontrolled or incorrect growth of cells, which can invade normal tissue and disrupt functions. It can be benign (meaning it's slow-growing and doesn't tend to spread) or malignant (a fast-growing, aggressive tumor that easily metastasizes, or spreads to other tissues). We're not immune to tumors, and neither are our horses.

The good news, if you can call it that, is that the vast majority of tumors that affect horses are of the benign variety. Cancer isn't nearly as common a killer in equines as it is in humans. In fact, the two most common types of tumors in horses—melanomas and sarcoids— usually are benign and often cause little disruption in a horse's daily life. Some horses have been known to live with these skin growths for upward of 20 years. Under certain circumstances, however, both of these types of tumors can be a nuisance and a health risk, not to mention unsightly. Let's take a look at each type of tumor, then examine some of the newest research ideas and treatment options.

The Sarcoid Scenario

You've probably seen a sarcoid tumor on a horse at some point in your travels; they're the most common type of skin tumor in equines, occurring in an estimated one out of every 100 horses. The word sarcoid is a contraction of the word sarcoma (a tumor originating from the connective tissue) and the suffix "-oid,” which means "like.” So, a sarcoid is a tumor "like a sarcoma.” The difference is that sarcomas generally are malignant, and sarcoids usually are not.

The average equine sarcoid is found on the skin surface and resembles a wart. Some are small and flat, with a crusty surface or a normal skin covering. This type (sometimes called a verrucous sarcoid) grows very slowly and might remain static for years at a time, or might even spontaneously disappear. Others, sometimes called fibroblastic sarcoids, are more aggressive and invasive. They have a raised, bumpy surface, might bleed or ooze serum if they're bumped or rubbed, and can rapidly proliferate into large, angry-looking masses.

Sarcoids can appear anywhere on the skin surface, and horses of any age, breed, or color can develop them, although they tend to show up in horses which are middle-aged or better. Some researchers have noted that Quarter Horses seem to show a predisposition. A tendency to develop sarcoids might run in families, although at this point there's no strong proof of that. The areas most frequently affected include the skin of the head (especially the mouth, eyelids, and ears), legs, tailhead, underside of the barrel, and any area where there exists a previous wound site or scar tissue.

Sarcoids can appear singly, but often they'll show up in several locations on a horse, a characteristic that leads many researchers to believe that there might be an infectious or viral cause for these tumors. There are precedents in human medicine, most notably a virus called HPV (for human papilloma virus), which has been strongly linked to certain types of cervical cancer in women.

Interestingly, most equine sarcoids are infected with a closely related micro-organism, the bovine papilloma virus (BPV). BPV causes ordinary warts in cattle—non-malignant and pretty harmless. In horses, which are not the virus' natural hosts, BPV seems to stimulate something far nastier. Whether the virus causes the sarcoids, or is just somehow associated with their growth, is unclear at this point. BPV has been demonstrated in lab situations to cause equine cells to develop tumor-like characteristics, but the viral infection is not enough to cause the actual development of a sarcoid (at least, not so far).

Researchers including Elizabeth Carr, DVM, Diplomate ACVIM, who currently is exploring treatment options for sarcoid tumors as part of a PhD project at the Department of Veterinary Surgery and Radiology, University of California, Davis, suspect that horses are a "dead-end host” for BPV. She thinks that the virus goes through an altered life cycle in equine cells, never managing to replicate and shed virus particles as it does in cattle. As a result, sarcoids do not seem to be contagious from horse to horse. It's more likely that the horses somehow contract the virus from the environment (not even necessarily from being in contact with a cow with warts). Regardless of how it gets there, however, it's very possible that BPV could act as the most significant initiating event in the development of a sarcoid.

"People have suspected for a long time that there's some relationship between this virus and sarcoid tumors in horses,” says Carr. "It's been demonstrated that more than 90% of sarcoids do have the DNA for the bovine papilloma virus, which is a recognized oncovirus (a virus capable of expediting malignancy in cells). We know we can create a tumor in a horse by injecting it (subcutaneously or intra-dermally) with BPV, but they tend to spontaneously disappear within a few weeks or months. That tells us there may be other factors at work which influence the viral expression.

"Histologically, sarcoid cells don't vary a lot,” adds Carr, "but clinically, there's a great deal of variation in the degree of aggression in sarcoid tumors seen in horses. We suspect that in some tumors, more of the oncogene is being expressed. As with any type of virus, the name of the game (from the virus' point of view) is to avoid recognition by the host's immune system. For the most part, BPV does a good job of going undetected. Our goal is to come up with a vaccination which would serve as a ‘wake-up call' for the horse's immune system, forcing it to recognize the presence of the virus and attack it.”

Work on a sarcoid vaccine is still in the very early stages at UC/Davis, Carr emphasizes, but she expects that a working version probably will become available within five years.

"Potentially, you could easily develop a vaccine, which could simply and effectively treat existing sarcoids.”

She suggests it would be just as easy to develop one which could prevent sarcoids—and such a vaccine wouldn't even be particularly expensive to produce. But because people don't tend to view sarcoids as a life-threatening condition, the economic viability of such a vaccine might be questionable. And without the participation of pharmaceutical companies, products like this never become commercially available. Interest in a vaccine to treat existing tumors, therefore, is a better bet from a financial standpoint.

Talking Treatment

Although slow-growing sarcoids often cause minimal trouble to a horse, if they appear in an area where tack or equipment might rub against them (for example, near the mouth where a bit would rest, or on the girth-line), they can crack and bleed frequently and can cause significant discomfort. Larger masses are even more troublesome, sometimes splitting and becoming infected by flies and maggots. There's always the possibility that a sarcoid tumor can interfere with normal functions, for instance, when one forms on an eyelid or ear.

For all of these reasons, you might want to consider treatment for your horse's sarcoids.

"It's best to at least get them evaluated, as soon as possible after you notice they've appeared,” recommends Carr. "Whether you pursue treatment depends on the size of the tumor and its location, but once they get past a certain size, or the tumor changes to malignancy, you may not have the option of treating them anymore. For most sarcoids, it's a good idea to explore treatment early on.”

The trickiest part of all this might be deciding which type of treatment is best. There are a bewildering number of options, all with pros and cons and variable success rates. Part of the difficulty is that no two sarcoids seem to be alike in how they respond to treatment. Tumors have been known to disappear spontaneously when nearby tumors are removed or treated. At the other end of the spectrum, an incomplete treatment might stimulate sarcoids to become wildly aggressive and invasive. There is no one single treatment that is uniformly successful in curing sarcoid tumors; in some cases, control is the best you can hope for.

Options for treatment, all of which have a moderate record of success, include the following:

surgical excision

cryonecrosis (freezing with liquid nitrogen)

radiation therapy

destruction by surgical laser

chemotherapy, usually in the form of drugs injected locally into the tumor

injection of immune stimulants, either systemically or locally into the tumor.

Frequently, veterinarians will use more than one of these methods in combination, depending on the size and location of the sarcoid and whether it is benign or rapidly growing. Surgical excision probably is the most common approach, although it works best with flat, wart-like sarcoids. Vigorously active tumors are more difficult to remove surgically, as they have a tendency to recur at the same site. Carr notes that sarcoid tumors tend to develop finger-like extensions into the normal tissue, so it can be next to impossible to ensure that all the tumor cells have been eradicated.

Often, surgery is used in combination with other treatment methods. Large tumors might need to be "de-bulked” (surgically reduced in size) before other methods can be applied successfully; for example, the visible parts of the tumor might be surgically trimmed as much as possible, then cryosurgery could be used to freeze the margins of the tumor site (the aim being to kill any remaining tumor cells).

Injection with immune-stimulant drugs is a useful approach with sarcoids that are in locations difficult to approach surgically (for example, on the eyelid) or when multiple tumors are involved. Cosmetically, this approach has the advantage of far less visible scarring than surgery, but its success rate varies from horse to horse. One approach that has been used over the past couple of decades is injection of a vaccine called BCG (bacillus Calmette-Gurein), also used to combat tuberculosis in humans. BCG serves as an immunostimulant, enhancing the body's response to tumor-specific antigens. Its usefulness seems to be limited to small tumors, and occasionally the treatment seems to stimulate sarcoids to become aggressive. As a result, BCG has fallen out of favor as a sarcoid treatment in recent years.

More promising is a chemotherapy drug called cisplatin, which Carr says has "about an 80%-90% success rate over two years, if owners are committed to the treatment regimen.”

Cisplatin can be injected intra-lesionally (directly into the tumor) if the sarcoid is small (one to two centimeters in diameter). If the tumor is larger, surgical "de-bulking” might be necessary first. Otherwise, a prohibitive quantity of the drug would have to be used, since the tissue's ability to diffuse cisplatin is limited. Although the research team at UC Davis uses cisplatin as its treatment of choice for many sarcoids, Carr notes that at the moment, sourcing the drug in an appropriate concentration is difficult.

"There are diluted forms readily available, but they're not nearly as effective, we think. The results are definitely connected to the concentration of the drug, and to it being administered regularly, every two to three weeks.”

Radiation therapy is another modality with which the UC Davis team has had good success, particularly with sarcoids that are very large or difficult to excise because of their location. By an owner's standards, radiation might seem a bit daunting. Because the horse must remain absolutely still for the treatments (which only last a couple of minutes each), he must be placed under a general anesthesia, and the usual regime is six treatments over a three-week period. That's quite a lot of anesthesia, and of course there's an extended hospital stay involved as well. However, if your horse has large or invasive tumors, radiation might be the most effective way to go. Not every university veterinary hospital is equipped to provide this therapy, so you might want to do some investigating to find the facility nearest you.

Regardless of the approach you use to tackle your horse's sarcoids, it's important to be realistic about the results. Sarcoids are tenacious, and frequently recur, sometimes within weeks of their apparent eradication. The treatment might only succeed in reducing the size of the tumor, or reducing the number or severity of the tumors. Cures are rare; control is a more practical goal.

Miserable Melanomas

Every owner of a gray horse lives in fear of melanomas, those characteristic black or brown nodules that so often appear on the skin around and under the tail. Rightly so, for estimates suggest that more than 80% of gray horses over the age of 15 will develop at least one melanoma tumor during its lifetime. The "why” hasn't been determined. We know that melanomas are tumors of the melanocytes, the cells that produce skin pigment. We know that in aging gray horses there appears to be a disturbance in the metabolism of melanin, which stimulates local over-production of dermal pigment. But why gray horses are particularly susceptible isn't yet clear. (One thing is reasonably certain—unlike melanomas in humans, which might be triggered by overexposure to ultraviolet radiation, gray-horse melanomas don't appear to be linked to an overdose of sun. The shady locations in which they tend to develop, and the fact that the skin of gray horses is black, and thus well-protected from U/V radiation, attest to this.)

Melanomas can be hard or soft, solitary or appearing in clusters. Often, they're subcutaneous when they first appear, covered by normal skin, but as they develop over time, they become more obvious, and their surfaces can become ulcerated and/or infected. Although they're generally dark brown, gray, or black in color, it's also possible for these tumors to be unpigmented (amelanotic), a situation which makes diagnosis considerably more challenging (microscopic examination of biopsy samples being the only way to identify these "invisible” tumors).

The underside of the tail, the perineal and peri-anal regions, and the penis and sheath in males are the most common locations for melanomas to sprout. They also can be found on the ear margins, elsewhere on the head, in the jugular region, and near or on the parotid salivary gland. It's quite possible for melanomas to spread internally as well, most commonly gravitating to the serosal surfaces of the liver, spleen, and lungs.

Much of the time, melanomas are fairly benign, slow-growing tumors, and are more unsightly than dangerous. They might remain that way for years or even decades. Within each tumor, however, lurks the potential for an overnight change to malignant growth, which swiftly can change the situation from a cosmetic nuisance into something life-threatening.

They might appear as rapidly spreading series of lumps or nodules, or even as vast, rippling sheets of black tumor masses across the tissue. Malignant melanomas can interfere with a horse's excretory functions, with breeding and foaling, or, if found in other locations on the body, such as the back or neck, with working under saddle or in harness.

Because malignant melanomas frequently appear in multiple sites, and because they have a high rate of metastasis, they can be very difficult to cure. Gray horses aren't the only ones affected; horses of other coat colors also can develop melanomas. The incidence in non-grays is much lower, but when melanomas do appear in these horses, the tumors are more likely to be aggressive.

All breeds of horses are susceptible to melanomas, but their incidence is probably over-represented in Percherons, Arabians, and Andalusians, all breeds in which the color gray is very common.

Melanomas in dogs and humans have a complex system of classification, but equine melanomas usually are characterized as benign or malignant. They can develop in one of three distinct ways:

a) The melanomas develop slowly, over a number of years, without metastasis, and can remain benign for 10 to 20 years (this is the most common scenario).

b) Benign melanomas that have existed for months or years suddenly assume malignant characteristics and begin to spread rapidly externally and/or internally.

c) Melanomas are malignant from their first appearance and readily metastasize. In rare cases, they might even be congenital (present at birth). Fortunately, this is the least common possibility.

Melanoma Management

As with sarcoids, sometimes melanomas require no treatment at all, if they're slow-growing and not interfering with any of the horse's daily functions. Many gray horses exist happily enough for years with benign melanomas that cause them little or no discomfort.

However, just because a tumor appears to be inactive doesn't mean you should stop monitoring it. There always is the possibility that something will trigger a change to malignancy, so it's important to examine tumors regularly for changes in size, number, or appearance.

"If you're the owner of a gray horse,” says Carr, "the best thing you can do is closely monitor him, from the age of about six on up. Melanomas will develop eventually. When they do, talk to your veterinarian early on and discuss treatment—don't leave it till they get very large.”

Treatments For Melanomas

A bewildering array of treatment options exists for melanomas, and again, as with sarcoids, no one method has emerged as having a uniformly rewarding success rate. Your veterinarian might want to try one or more of the following:

Surgical Excision—The simplest approach for slow-growing, small to moderate-sized tumors (less than three centimeters in diameter) in surgically accessible locations. Large "sheets” of melanoma tissue are not good candidates for surgery, as it would prove very invasive and the chances are slim that you'd be able to remove 100% of the tumor. Even with solitary tumors, rapid recurrence often is a problem, as it's difficult to tell whether you've been able to remove all the abnormal cells. Surgical excision might be used to "de-bulk” a large tumor mass in order to improve the chances of success of other treatment methods, such as one of the following:

Cryonecrosis—As with sarcoids, freezing with liquid nitrogen might help kill the remaining cells in the tumor "bed” after the majority of a large melanoma has been removed by surgery or with surgical lasers. The surface tissue is frozen to -20° Celsius, allowed to thaw, then frozen a second time. This procedure usually can be done with the horse standing and sedated. Combining surgical removal with "cryo” treatment rarely cures melanomas, but it very often can keep the tumors of a manageable size when the freezing is repeated once or twice a year.

Chemotherapy—Cispla-tin, the chemotherapy drug, also has been found to be useful for single, small-to-moderate-sized melanomas, injected intra-lesionally (into the tumor itself) every two weeks for a total of four treatments. (Systemic chemotherapy—in which the drug is injected into the muscle or a vein rather than into the tumor itself—has proven to have little or no effect on equine melanomas.) The results vary depending on how successfully the drug diffuses through the tissues (the injection technique usually involves using a fine-gauge needle and many applications of the drug, five to eight millimeters apart). Encouragingly, though, cisplatin has been used on pregnant broodmares and breeding stallions with no signs of toxicity. Tumors do tend to recur a few months after cisplatin treatment ceases, but horses develop no resistance to the drug, so the treatment can be repeated if necessary.

Radiation—Radiation therapy, similar to that used on sarcoid tumors, also is a possibility if you are lucky enough to have an appropriately equipped veterinary hospital nearby. Says Carr, "We've been using radiation therapy on some melanomas in awkward locations with pretty good success.”

Latest Therapy: Cimetidine

One of the most promising advances in the treatment of melanoma is the drug cimetidine (trade name Tagamet). Borrowed from human medicine, where it has been shown to treat malignant melanomas and some other types of tumors, cimetidine has been used with good success in horses since 1985. The drug often is able to reduce the size and number of a horse's tumors, although veterinarians caution there is no way to tell whether an individual horse will respond to the treatment until it is tried. It's estimated that 30%-50% of horses treated do respond to some degree. A good response is a 50% reduction in the size and/or number of melanomas, and no further progression of the disease for several years. (In a few cases, cimetidine has even been documented to cause tumors to regress completely, apparently curing the horse.)

Researchers aren't completely sure how cimetidine works on melanomas, but they do know that in an active melanoma, T suppressor cells are present to dampen the immune response to the abnormal cells. Cimetidine appears to block the activation of these T suppressor cells, thus helping stimulate the body's anti-tumor defense system. Not surprisingly, cimetidine works best on tumors that are actively growing. Results with tumors that aren't changing in size or appearance generally have been disappointing.

Although cimetidine is a ray of hope for many owners, it's an expensive and inconvenient drug, best administered orally at a level of 2.5 milograms/kilograms of body weight, at eight hour intervals, over a course of weeks or months. Giving the drug only once or twice a day doesn't appear to give nearly the same results. If your horse is going to respond to cimetidine, you'll start to see a change in the size and/or number of the tumors within two to seven weeks. If that occurs, your veterinarian will continue the therapy until he/she sees no further change for a period of two to three weeks. If your horse's tumors show no changes after three months of treatment, the therapy should be discontinued, as it will be evident by then that you'll get no response.

One of the positive things about cimetidine treatment is that, while it rarely cures a horse of melanomas, it can slow or even halt the progress of the disease for months or years after the treatment ceases, adding valuable time to your horse's life. If the tumors do become active again, they often respond well to a second course of cimetidine. The drug also can be used in combination with surgery, cryonecrosis, and chemotherapy (cisplatin), and no toxic effects have been recorded to date. But, says Carr, diligence and dedication are key to the therapy.

"The bottom line is that if it works (for your horse), you've got to keep using the drug throughout his lifetime.”

A Melanoma Vaccine?

The research team of Alain Theon, DVM, MS, at UC Davis currently is investigating the possibility of a vaccine for melanoma tumors, according to Carr. She notes, "Unless it's a virally mediated tumor (which melanomas are not), the best use of a vaccine is for picking up microscopic metastases, not for eliminating the tumor completely.”

Meanwhile, at the Veterinary Oncology Services and Research Center in West Chester, Penn., K. Ann Jeglum, VMD, Diplomate ACVIM (Oncology), offers a service currently unique in North America—she can produce a "custom-made” vaccine (technically known as an autochthonous vaccine) for your horse's melanoma tumors. When a tumor is excised surgically, the tissue can be packed on ice and sent to Jeglum's lab by overnight courier (the fresher the material, the better). On arrival, it is minced, placed in culture media, and the live tumor cells extracted. From this sample, for a base price of about $500 (plus the cost of shipping), a vaccine is created that is designed to help the horse's immune system recognize and attack his own tumor cells.

The recommended protocol for the vaccine is to administer it once every two weeks for a total of 12 weeks, then once every four to six weeks until the supply of vaccine derived from the tumor runs out (this depends on how many live cells were able to be extracted from the sample). Jeglum recommends that each dose of the vaccine be delivered along with an immunostimulant product such as Nomagen or EquiStim, and that the vaccine be injected intradermally, in front of a lymph node that drains to the tumor site. As for the success rate, certified veterinary technician Kim Wilkinson-Kahn, who does much of the vaccine production at Jeglum's clinic, says statistics have not yet been generated, but that "most clients report some response,” and that several horses have experienced regression of their tumors.

Magic treatment? No, but, when it comes to dealing with sarcoids and melanomas, there isn't one, simple answer that will suit every horse. The best recommendation is to keep your expectations realistic and explore all the treatment options with an open mind and the advice of as many veterinary experts as you can rally around you. In most cases, these tumors are anything but a death sentence—but that's no reason to stick your head in the sand.



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Potent Spice Works To Block Growth Of Melanoma In Lab Test
ScienceDaily (July 14, 2005) — HOUSTON - Curcumin, the pungent yellow spice found in both turmeric and curry powders, blocks a key biological pathway needed for development of melanoma and other cancers, say researchers from The University of Texas M. D. Anderson Cancer Center.


--------------------------------------------------------------------------------
See also:
Health & Medicine
Skin Cancer
Breast Cancer
Cancer
Plants & Animals
Molecular Biology
Mice
Cell Biology
Reference
Health benefits of tea
Metastasis
Carcinogen
Tumor suppressor gene
The study, to be published in the August 15, 2005 issue of the journal Cancer, but available on line at 12:01 a.m. (EDT) on Monday, July 11, demonstrates how curcumin stops laboratory strains of melanoma from proliferating and pushes the cancer cells to commit suicide.

It does this, researchers say, by shutting down nuclear factor-kappa B (NF-kB), a powerful protein known to promote an abnormal inflammatory response that leads to a variety of disorders, including arthritis and cancer.

The study is the latest to suggest that curcumin has potent anticancer powers, say the researchers.

"The antioxidant, anti-inflammatory and anti-carcinogenic properties of curcumin derived from turmeric are undergoing intense research here and at other places worldwide," says one of the study's authors, Bharat B. Aggarwal, Ph.D., professor of cancer medicine in the Department of Experimental Therapeutics.

At M. D. Anderson, for example, dramatic results from laboratory studies have led to two ongoing Phase I human clinical trials, testing the ability of daily capsules of curcumin powder to retard growth of pancreatic cancer and multiple myeloma. Another Phase I trial is planned for patients with breast cancer, and given this news of curcumin's activity in melanoma, animal studies will soon begin, Aggarwal says.

Ground from the root of the Curcuma longa plant, curcumin is a member of the ginger family. It has long been utilized in India and other Asian nations for multiple uses: as a food-preservative, a coloring agent, a folk medicine to cleanse the body, and as a spice to flavor food (two to five percent of turmeric is curcumin, for example).

While researchers had thought curcumin primarily has anti-inflammatory properties, the growing realization that cancer can result from inflammation has spurred mounting interest in the spice as an anti-cancer agent, Aggarwal says. He adds that another fact has generated further excitement: "The incidence of the top four cancers in the U.S. - colon, breast, prostate, and lung - is ten times lower in India," he says.

This work is just the latest by M. D. Anderson researchers to show how curcumin can inhibit cancer growth. "Curcumin affects virtually every tumor biomarker that we have tried," says Aggarwal. "It works through a variety of mechanisms related to cancer development. We, and others, previously found that curcumin down regulates EGFR activity that mediates tumor cell proliferation, and VEGF that is involved in angiogenesis. Besides inhibiting NF-kB, curcumin was also found to suppress STAT3 pathway that is also involved in tumorigenesis. Both these pathways play a central role in cell survival and proliferation."

He said that an ability to suppress numerous biological routes to cancer development is important if an agent is to be effective. "Cells look at everything in a global way, and inhibiting just one pathway will not be effective," says Aggarwal.

In this study, the researchers treated three different melanoma cell lines with curcumin and assessed the activity of NF-kB, as well the protein, known as "IKK" that switches NF-kB "on." The spice kept both proteins from being activated, so worked to stop growth of the melanoma, and it also induced "apoptosis," or programmed death, in the cells.

Surprisingly, it didn't matter how much curcumin was used, says the researchers. "The NF-kB machinery is suppressed by both short exposures to high concentrations of curcumin as well as by longer exposure to lower concentrations of curcumin," they say in their study. Given that other studies have shown curcumin is non-toxic, these results should be followed by a test of the spice in both animal models of melanoma and in human trials, they say.

###
The study was funded by the National Cancer Institute and the Department of Defense. Co-authors included principle investigator Razelle Kurzrock, M.D.; first author Doris Siwak, Ph.D. and Shishir Shishodia.


--------------------------------------------------------------------------------

Adapted from materials provided by University Of Texas M. D. Anderson Cancer Center.

Ingredient That Makes Curry Yellow Effective Against Melanoma Cells
ScienceDaily (July 11, 2005) — Curcumin, the yellow pigment found in the spice turmeric and a key ingredient in yellow curry inhibits melanoma cell growth and stimulates tumor cell death, according to a new study. Published in the August 15, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study also elucidates curcumin's intracellular mechanisms of action in this type of tumor.


--------------------------------------------------------------------------------
See also:
Health & Medicine
Skin Cancer
Brain Tumor
Lung Cancer
Plants & Animals
Molecular Biology
Cell Biology
Genetics
Reference
Tumor suppressor gene
Tumor
Metastasis
Heat shock protein
As well as showing antioxidant and anti-inflammatory effects, curcumin has been shown to have anti-cancer properties. In other tumors, it has been demonstrated to inhibit tumor growth and stimulate apoptosis, an intracellular mechanism for cells of all types to "kill" themselves. To evaluate the compound's efficacy in melanoma, researchers led by Razelle Kurzrock, M.D. of the University of Texas M. D. Anderson Cancer Center in Houston treated three melanoma cell lines with curcumin at different doses and for different duration.

Results show that curcumin treatment decreased cell viability in all three cell lines in a dose-dependent manner. Moreover, curcumin induced apoptosis in tumor cells at high concentrations for short periods of time and low concentrations for long periods of time--a new finding in the study of curcumin.

Curcumin was found to suppress two specific proteins normally part of an intracellular pathway that prevents apoptosis when stimulated. Curcumin partially inhibited NF-êB and strongly inhibited its upstream stimulator and another independent inhibitor of apoptosis, IKK. However, it did not suppress two other signaling pathways associated with melanomas and tumor proliferation, B-Raf/MEK/ERK and Akt pathways.

"Based on our studies, we conclude the curcumin is a potent suppressor of cell viability and inducer of apoptosis in melanoma cell lines," said the authors, adding "Future investigation to determine the effects of curcumin in animal models of melanoma and clinical trials are planned."

###

Article: "Curcumin-Induced Antiproliferative and Proapoptotic Effects in Melanoma Cells Are Associated with Suppression of IkB Kinase and Nuclear Factor kB Activity and Are Independent of the B-Raf/Mitogen-Activated/Extracellular Signal-Regulated Protein Kinase Pathway and the Akt Pathway," Doris R. Siwak, Shishir Shishodia, Bharat B. Aggarwal, Razelle Kurzrock, CANCER; Published Online: July 11, 2005 (DOI: 10.1002/cncr.21216); Print Issue Date: August 15, 2005.


--------------------------------------------------------------------------------

Adapted from materials provided by John Wiley & Sons, Inc., via EurekAlert!, a service of AAAS.

_________________
Susie xx
http://www.flickr.com/photos/piepony/


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PostPosted: Wed Oct 28, 2009 9:07 pm 
User avatar

Joined: Fri Jun 06, 2008 7:38 pm
Posts: 701
Location: UK
Hi Susie, just paying a quick vsit as I am still rushed with our move.

As six of our eleven horses are Pre horses and are grey that article could scare the S..t out of me. So I am going to stick with the wonderful calming advice of my vet who well past retiring age has many years of experience. On our recent discussion regarding melanomas he said most grey horses with melanomas die of old age and natural causes. I thought I found a very tiny one on Gman but my vet okayed that as being harmless, it was the size of a pin head but I don't miss much. Anyway I researched lots of different articles on the net regarding melanomas and they gave a more positive approach than the above. Sorry I don't have time to find them but if you google 'melanomas in the equine' you should find them.

Must rush

Love Eileen

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PostPosted: Wed Oct 28, 2009 11:13 pm 

Joined: Thu Feb 05, 2009 7:50 pm
Posts: 129
Location: Upstate New York, USA
I just remembered there is a salve for sarcoids and it was suggested by my vet. It is supposed to work excellent.
http://www.altcancercream.com/store/scr ... product=43

My Mirabell had a humongous sarcoid in her ear. I pretty much fed it out of her and had the growth removed. Nothing has ever come back.

Nina xx


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PostPosted: Thu Oct 29, 2009 1:01 am 

Joined: Fri Nov 07, 2008 2:02 pm
Posts: 1072
Location: UK Worcester/Hereford border
Nina, I agree salves are great additions to internal Turmeric, but there is a warning on many salves marketed. Although they may contain a small amount of curcumin, often this is miniscule and the marketing misleading and overpriced. FDA/Govt info suggests whilst some ingredients might help there are many fakes being marketed.
http://www.fda.gov/Drugs/GuidanceCompli ... 171057.htm
As with buying powder wholesale, rather than gel capsules, mix powder into kaolin or clay or with petroleum jelly/vaseline.
I did not put this thread to frighten, only to inform because a friend had recently been worried about her homebred 6 year old and there does appear to increased incidences with the spread of papilloma virus from biting flies.
Liverpool University in the UK has the fortunate expertise of Professor Derek Knottenbelt
http://www.liv.ac.uk/sarcoids/introduction/index.htm
http://www.liv.ac.uk/vets/research_old/ ... /derek.htm

_________________
Susie xx
http://www.flickr.com/photos/piepony/


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PostPosted: Mon Nov 02, 2009 6:25 pm 

Joined: Fri Nov 07, 2008 2:02 pm
Posts: 1072
Location: UK Worcester/Hereford border
http://www.sciencedaily.com/releases/20 ... 232338.htm
Potent Spice Works To Block Growth Of Melanoma In Lab Test
ScienceDaily (July 14, 2005) — HOUSTON - Curcumin, the pungent yellow spice found in both turmeric and curry powders, blocks a key biological pathway needed for development of melanoma and other cancers, say researchers from The University of Texas M. D. Anderson Cancer Center.


--------------------------------------------------------------------------------
•Metastasis
•Carcinogen
•Tumor suppressor gene
The study, to be published in the August 15, 2005 issue of the journal Cancer, but available on line at 12:01 a.m. (EDT) on Monday, July 11, demonstrates how curcumin stops laboratory strains of melanoma from proliferating and pushes the cancer cells to commit suicide.

It does this, researchers say, by shutting down nuclear factor-kappa B (NF-kB), a powerful protein known to promote an abnormal inflammatory response that leads to a variety of disorders, including arthritis and cancer.

The study is the latest to suggest that curcumin has potent anticancer powers, say the researchers.

"The antioxidant, anti-inflammatory and anti-carcinogenic properties of curcumin derived from turmeric are undergoing intense research here and at other places worldwide," says one of the study's authors, Bharat B. Aggarwal, Ph.D., professor of cancer medicine in the Department of Experimental Therapeutics.

At M. D. Anderson, for example, dramatic results from laboratory studies have led to two ongoing Phase I human clinical trials, testing the ability of daily capsules of curcumin powder to retard growth of pancreatic cancer and multiple myeloma. Another Phase I trial is planned for patients with breast cancer, and given this news of curcumin's activity in melanoma, animal studies will soon begin, Aggarwal says.

Ground from the root of the Curcuma longa plant, curcumin is a member of the ginger family. It has long been utilized in India and other Asian nations for multiple uses: as a food-preservative, a coloring agent, a folk medicine to cleanse the body, and as a spice to flavor food (two to five percent of turmeric is curcumin, for example).

While researchers had thought curcumin primarily has anti-inflammatory properties, the growing realization that cancer can result from inflammation has spurred mounting interest in the spice as an anti-cancer agent, Aggarwal says. He adds that another fact has generated further excitement: "The incidence of the top four cancers in the U.S. - colon, breast, prostate, and lung - is ten times lower in India," he says.

This work is just the latest by M. D. Anderson researchers to show how curcumin can inhibit cancer growth. "Curcumin affects virtually every tumor biomarker that we have tried," says Aggarwal. "It works through a variety of mechanisms related to cancer development. We, and others, previously found that curcumin down regulates EGFR activity that mediates tumor cell proliferation, and VEGF that is involved in angiogenesis. Besides inhibiting NF-kB, curcumin was also found to suppress STAT3 pathway that is also involved in tumorigenesis. Both these pathways play a central role in cell survival and proliferation."

He said that an ability to suppress numerous biological routes to cancer development is important if an agent is to be effective. "Cells look at everything in a global way, and inhibiting just one pathway will not be effective," says Aggarwal.

In this study, the researchers treated three different melanoma cell lines with curcumin and assessed the activity of NF-kB, as well the protein, known as "IKK" that switches NF-kB "on." The spice kept both proteins from being activated, so worked to stop growth of the melanoma, and it also induced "apoptosis," or programmed death, in the cells.

Surprisingly, it didn't matter how much curcumin was used, says the researchers. "The NF-kB machinery is suppressed by both short exposures to high concentrations of curcumin as well as by longer exposure to lower concentrations of curcumin," they say in their study. Given that other studies have shown curcumin is non-toxic, these results should be followed by a test of the spice in both animal models of melanoma and in human trials, they say.

###
The study was funded by the National Cancer Institute and the Department of Defense. Co-authors included principle investigator Razelle Kurzrock, M.D.; first author Doris Siwak, Ph.D. and Shishir Shishodia.


--------------------------------------------------------------------------------

Adapted from materials provided by University Of Texas M. D. Anderson Cancer Center.

_________________
Susie xx
http://www.flickr.com/photos/piepony/


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PostPosted: Mon Nov 02, 2009 9:55 pm 

Joined: Wed Jun 10, 2009 6:50 am
Posts: 321
Oh, my... I think I am definitely worrying now!

Honey has what I believed to be a rash/allergic reaction to fly bites/something similar on the top of his nearside front leg. (I had ruled out sarcoid, as it just didn't fit the descriptions... I searched around to try to find a match for what it might be, with no real results.) It doesn't appear to itch, or bother him in any way, so I haven't/hadn't considered it something urgent to deal with. Well, now I'm definitely not sure it is something minor.

It is a patch of little 'bumps' over an area of about 3 inches. Here is a photo...

Image

Image

Compare that to the photo at the link Susie posted to the University of Liverpool:
http://www.liv.ac.uk/sarcoids/appearance/index.htm (scroll to the bottom, photo of lymphosarcoma)

What do you all think? Should I be calling the vet out tomorrow?

Susie, thanks for posting this information! You just never know....

_________________
The deeper that sorrow carves into your being, the more joy you can contain. - Khalil Gibran


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PostPosted: Tue Nov 03, 2009 2:58 am 

Joined: Fri Nov 07, 2008 2:02 pm
Posts: 1072
Location: UK Worcester/Hereford border
I am not panicking, but my Daniel is a mostly white pony. He is also an itchy little cob.
Through the Summer he did have a small patch of warts or possible papilloma which have gone. He has a tiny lump near his navel and some granular - bit like mud reaction to legs , but I am mixing Turmeric into Vaseline, and feeding Turmeric. So if these do grow, change or not clear up, then my vet will check, otherwise it is possible, like my old horse Roger, a tiny patch of missed sweat, even from play with his buddies on a warm day, and he reacted in rashes and scabs, Dettol diluted was sufficient to prevent the problems.
(Sar-coff ? is I think what worked for my friend's mare.)
Next year I do intend to have very many fly traps for defense against horse flies.
Love Susie xx

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Susie xx
http://www.flickr.com/photos/piepony/


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PostPosted: Tue Nov 03, 2009 2:03 pm 

Joined: Sat Mar 08, 2008 12:45 pm
Posts: 108
Location: UK
Hi Shannan,

Personally I would get a vet out to look at it - with any luck they can put your mind at rest that it isn't anything sinister :pray:, but if not, at least you will know what you are dealing with and can decide the best course of action; and if it does need to be treated, you will have caught it early.

I am very wary of sarcoids now and treat them with the utmost respect. My TB had a sarcoid on the inside of his thigh when I bought him - I didn't know anything about them then, thought it was just a wart or something harmless. It initially looked like this:
http://bullocksvet.com/db5/00487/bullocksvet.com/_uimages/sarcoid.jpg
Then one day I found him with blood all down his leg - the sarcoid had suddenly 'erupted' and looked more like this:
http://www.kumeuvets.co.nz/Portals/6/Images/Leg%20Sarcoid.jpg

I tried various 'alternative' treatments, including homoeopathic Thuja, a herbal lotion/tincture, Hilton Herbs' Ditton cream, Global Herbs' Sarc-Ex....... None of these helped, so in the end I decided reluctantly to use Derek Knottenbelt's cytotoxic cream. However, we never got that far - my vet put a band round the neck of the sarcoid to de-bulk it prior to treatment, but his leg swelled up and we had to cut the band off. We decided to postpone the treatment until his poor leg had settled down again, but before that the lump just fell off, so we never needed to use the cream. That was a few years ago now and it hasn't returned so far (I gather this is very unusual though). A friend's horse had sarcoids, initially just one, then they seemed to spread all over - he must have had a more than a dozen in the end, some bigger than golf balls and continually bleeding :ieks:. He was treated by a homoeopathic vet, with very little impact as far as I could see :sad:. Apart from the discomfort etc. suffered by the poor horse, there was the risk to other horses, given that (according to current theory) they can be spread by flies.

I don't want to alarm you - it's quite likely that Honey's lesion is something much more benign - I certainly hope so :smile:. Good luck!

_________________
Orange.


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PostPosted: Tue Nov 03, 2009 2:45 pm 

Joined: Wed Jun 10, 2009 6:50 am
Posts: 321
Thanks, Orange! I have my fingers crossed. I did call the vet this morning, and he is going to fit me in tomorrow - just need to call him again tomorrow morning to confirm what time he can come out. I am hoping that it is something minor and easily treatable - but I've got to know one way or the other, whatever it is. I am very cautious of any kinds of problems, because I know that even small things can become big problems if left for any length of time... I'll let everyone know what the vet says after he sees Honey tomorrow.

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The deeper that sorrow carves into your being, the more joy you can contain. - Khalil Gibran


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PostPosted: Wed Nov 04, 2009 12:21 pm 

Joined: Wed Jun 10, 2009 6:50 am
Posts: 321
OK, so the vet was here this morning. The lump on the far front leg is a sarcoid, but he wasn't sure what the small bumps were on his near front leg (the ones in the photos above). He said that the only way to know for sure was to remove one and send it to a lab for analysis. Given Honey is only 4 years old, he thought that doing this was more extreme than was necessary at the moment. He said to keep an eye on them, and if they got larger or spread or changed in any way, to call him back out again and we would proceed from there.

I don't know that I am entirely happy with this... I was really hoping that someone with a more experienced eye could say whether it was something serious or not.

Trouble is, what if it is something serious like cutaneous lymphoma? Surely dealing with it sooner rather than later would be better? Of course, Honey doesn't have any other symptoms... he's not losing weight, he isn't lethargic. The area isn't itchy or bothering him in any way...

I guess I will just wait and watch...

_________________
The deeper that sorrow carves into your being, the more joy you can contain. - Khalil Gibran


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PostPosted: Wed Nov 04, 2009 7:21 pm 

Joined: Sat Mar 08, 2008 12:45 pm
Posts: 108
Location: UK
Hi Shannan,

It's really frustrating when there isn't a clear diagnosis, isn't it..... :huh:.

I'm not sure I understand why Honey only being 4 years old makes a difference to whether you should biopsy it - did the vet say? And what about the sarcoid - did he say what type it was, and did he recommend doing anything about it?

I'm hopeless at just "wait and see" :roll: :D but I know sometimes that IS the best course of (in)action :yes:. How long has he had the two lesions (the sarcoid and the other, unidentified one)? Has either of them changed during that time?

Quote:
I don't know that I am entirely happy with this... I was really hoping that someone with a more experienced eye could say whether it was something serious or not.
If you're still worried and don't want to wait, could you find a more experienced vet to give another opinion? Or maybe contact Derek Knottenbelt from Liverpool University? I emailed him a few years back when I was concerned about the horse I mentioned with multiple sarcoids and got a very helpful reply. Just something to consider, anyway.

Whatever you decide to do - good luck :f:, and let us know how you get on. These horses have so many ways of keeping us worrying about them, don't they..... :huh:!

Best wishes,

_________________
Orange.


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PostPosted: Wed Nov 04, 2009 10:02 pm 

Joined: Wed Jun 10, 2009 6:50 am
Posts: 321
Hi Orange & thanks! I really appreciate your concern and suggestions. I am definitely not any good at 'wait and see'... The sarcoid on his far front leg (armpit, really) is an occult sarcoid, oval in shape, hairless, flat and scaly, with slightly thickened skin. The thing on his near front (armpit area) is a patch of about 20-30 (or more) little hard 'nodules' under the skin (at least under the epidermis layer). They are 'in' the skin though, as you can move them over the underlying muscle. They haven't come through to the surface of the skin, though and most are still covered in 'normal' skin with hair (though there is some thinning of the hair around the nodules (as you can see from the darker 'spots' in the second photo - each little dark area is a bump.

He didn't recommend any treatment at all for either thing. For the sarcoid, he said treatment was possible, but not easy, and that it was likely to recur. And he seemed to indicate that it was best left alone unless it increased in size/shape or otherwise changed appearance (i.e. erupted, started bleeding, etc.). For the undiagnosed bumps, he seemed to think that they may resolve on their own and only if they cause a problem (i.e. start spreading or become painful or erupt through the skin, etc.) should we try to treat. Honey is an otherwise healthy, fit horse. No loss of appetite, no lethargy, no symptoms of any kind. I think this was his reasoning for 'doing nothing' - don't interfere and be too invasive or aggressive in treatment of a young, fit horse.

The vet that was out to see Honey is about as experienced as you can get! ... well past retirement age - he has been practicing since before I was born (and I'm no spring chicken!) but he was also very aware of the work Derek Knottenbelt has been doing at the University of Liverpool. He told me they were trying out a new 'heavy metal' treatment that is still in the trial stage - and they're doing this in conjuction with someone else at the University of Liverpool (I think he said).

I may just take up your suggestion of emailing Derek just to see what he thinks... At least then I'll feel like I'm *doing* something, rather than just waiting.

You know its funny. When I went to the field to get Honey to bring him up for the vet, he didn't want me to catch him, in fact, ran off a couple of times even though I had some cut apple one of his favourite treats. I put that down to me being anxious and tense about seeing the vet. But the weirdest thing was that afterward, when I was taking Honey back to the field, we walked out of my gate and after about 5 steps, Honey just stopped and stood there and didn't want to move forward. I finally convinced him that he did want to go back and see his buddies in the field, but all along the way he kept wanting to bite on my sweatshirt, giving it a tug (almost like a little kid does when trying to get your attention by tugging on your sleeve). He was fairly careful not to actually bite flesh, but he did this repeatedly all the way back to the field. I stopped twice off on the verge to try to pick up on what he was trying to tell me, but nothing came to me...

Perhaps it is time to call in Claire for her professional services?!

I may just do that...

_________________
The deeper that sorrow carves into your being, the more joy you can contain. - Khalil Gibran


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PostPosted: Wed Nov 04, 2009 10:36 pm 

Joined: Wed Jun 10, 2009 6:50 am
Posts: 321
Reading some more information on the University of Liverpool site, I can see why the vet may be hesitant about a biopsy and didn't recommend a treatment straight away...

http://www.liv.ac.uk/sarcoids/diagnosis ... /index.htm

this states:
Quote:
# Biopsy may also be contraindicated because some sarcoids become highly aggressive following any interference.

# Biopsy should not be taken without due consideration and in any case should only be taken where the diagnosis is doubtful and where the treatment selection that follows will be adjusted according to the findings. Thus if a biopsy is taken and this confirms a sarcoid is indeed present, and the decision is taken then to leave it alone, there is little benefit in the procedure. The decision of the attending vet should be accepted – usually there is a rational reason for a biopsy to be taken.


and as far as treatment goes:

Quote:
Failure of any treatment method is usually accompanied by the reappearance of a more aggressive tumour – and often in increased numbers. It is therefore important to select the best possible treatment as the first option.

_________________
The deeper that sorrow carves into your being, the more joy you can contain. - Khalil Gibran


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PostPosted: Thu Nov 05, 2009 7:20 pm 

Joined: Sat Mar 08, 2008 12:45 pm
Posts: 108
Location: UK
Quote:
The vet that was out to see Honey is about as experienced as you can get! ... well past retirement age - he has been practicing since before I was born (and I'm no spring chicken!)
Oh sorry Shannan :blush:, I misunderstood when you said that you hoped that someone with a more experienced eye could say whether it was something serious or not - I thought you meant that the vet wasn't very experienced. From what you say, it sounds like he's well clued up on sarcoids and clearly is abreast of Derek K's work, so that must be very reassuring :yes:. Given that, I'd be much happier with "wait and see" :D.

Quote:
Perhaps it is time to call in Claire for her professional services?!
What are these? - I'm intrigued.... :)

Best wishes,

_________________
Orange.


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PostPosted: Thu Nov 05, 2009 9:07 pm 

Joined: Wed Jun 10, 2009 6:50 am
Posts: 321
Orange, I see what you mean, it was my fault for writing it the way that I did. What I meant was I was really hoping that someone with a more experienced eye than me would be able to give a clear diagnosis. So I was disappointed with still not really knowing what the bumps were on the near front leg.

I think, being partially retired, he actually has the time to keep up with these things, and it sounds like the practice he has has been treating things like this - and using some of the more experimental treatments for quite some time. He said that not only are some of these things only available by prescription, they are specifically designed for a particular horse as part of a case study.

That said, I still wish I could do something other than 'wait and watch'!

Claire is an animal communicator, and as she's relatively close by, hopefully she can come out sometime in the near future and visit with Honey and me.

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The deeper that sorrow carves into your being, the more joy you can contain. - Khalil Gibran


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