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SARCOI DS
WINTER 2014 ISSUE
EQUINE MATTERS
10
1)
BCG therapy
The tuberculosis vaccine, which, when
injected into sarcoid tissue, stimulates
the body to destroy the tumour. This
treatment can be extremely effective at
removing sarcoids around the eye, when
a series of three or more injections are
given over several weeks (figures 4
and 5). BCG is not suitable for treating
sarcoids elsewhere on the body.
Medical Treatments
1)
Surgical removal
Surgical removal of a sarcoid, either
under sedation or general anaesthesia
should only be undertaken after ruling
out all other options. It is impossible to
tell where the true boundaries of the
sarcoid lie, due to the microscopic
infiltration of normal tissue with sarcoid
cells. A large margin of normal skin
should be removed, followed by
careful reconstruction of the remaining
surgical wound.
Surgical Treatments
The University of Liverpool manufactures
and supplies this cream to veterinary
surgeons. Only a veterinary surgeon can
handle and apply the product, which is
widely considered to be one of the most
effective treatments for a wide range
of sarcoids.
There are several other topical
chemotherapy creams that are used,
either alone or in conjunction with other
therapies in the treatment of certain
sarcoids.
2)
LUDES cream
The application of a tight rubber band
can in some cases eliminate individual
sarcoids. Only clearly defined sarcoids
with good margins of loose skin should
be treated by this method (figure 6).
2)
Rubber banding
3)
Other chemotherapy creams
Destroying sarcoid tissue by freezing it
using liquid nitrogen is an extremely
effective treatment. Areas with excess
loose skin, such as between the front
limbs can be treated using cryotherapy,
allowing some surrounding normal skin
to be frozen. Cryotherapy is usually
undertaken under sedation, although
inaccessible areas can be treated under
a short general anaesthetic (figure 7).
Liquid nitrogen spray is applied to an
area larger than the actual sarcoid, killing
the tissue which then falls off several
weeks later (figure 8).
3)
Cryotherapy
There are currently only three equine
hospitals in the country that offer this
option, where radioactive wires are
inserted into the sarcoid, emitting
radiation which kills the tumour cells very
effectively. Patients require hospitalisation
and strict quarantine during the period of
treatment. This expensive treatment is only
used on a small proportion of sarcoids.
4)
Radiotherapy
This destroys sarcoid tissue using heat
rather than cold. As with cryotherapy,
the process results in a wound which is
monitored during healing.
4)
Laser surgery
Figure 4
Figure 5
Figure 7
Figure 8
Figure 6
Aftercare
It is important for an owner to understand
that each treatment option will have varying
degrees of aftercare requirements. Surgically
and chemically induced wounds will need
management to control pain and infection,
sometimes using antibiotics and painkillers.
Monitoring will also be necessary for several
months to identify any signs of regrowth.
Conclusions
Whilst there has been a tendency to
monitor non-problematic sarcoids, it is
now recognised that prompt treatment
of sarcoids, before further growth and
spread, is usually a more appropriate
means of managing a patient. There are
numerous effective therapeutic options,
which, when used as the first treatment,
can successfully cure many patients.
Repeated treatment using over the
counter products can reduce the
effectiveness of subsequent treatments
and increase the risk of recurrence.
To avoid compromising the outcome,
always seek veterinary advice before
attempting treatment of a sarcoid.