Page 12 - Equine Matters - Winter 2014

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Winston,
a four year
old TBx presented with
multiple sarcoids on his
head, neck, chest and
inside his hindlegs.
Winston's sarcoids were verrucose, nodular
and mixed verrucose-nodular. They had
appeared quite quickly, so required aggressive
treatment before they got out of control. It is
important that the first treatment applied is
effective because each failed treatment
reduces the chances of being able to cure
the sarcoids completely - some types of
sarcoid will become more aggressive once
traumatised or ulcerated.
We used AW4-LUDES cream as this has a
good success rate. AW4-LUDES is a mixture of
chemotherapy medications and toxic heavy
metals, so must be used only under strict safety
precautions. For this reason it can only be
supplied to and applied by a vet. The cream
kills the cells in any living tissue it touches.
The body reacts to this by producing an
inflammatory response to remove the dead
and dying tissue. This causes a lot of swelling
and can be painful. Anticipating this, we gave
phenylbutazone ('bute’) for pain relief at the
same time as the first cream application. 'Bute’
cannot be used in horses that may enter the
human food chain so section IX of Winston's
passport was signed to exclude him
permanently from the human food chain.
Following advice from the University of
Liverpool Equine Hospital, the AW4-LUDES
cream was applied five times at intervals of
24, 48, 72 and 120 hours after initial
application. Winston came to the clinic for
his cream to be applied, as this was a more
cost effective means than five visits.
Winston was re-examined six weeks after the
last application of cream to check that the
sarcoids had reacted as we would expect.
The sarcoids had all swollen up and formed
a tight scab - this is the normal reaction to
AW4-LUDES cream that we want to see at
this stage (figure 4).
The scabs sloughed over the next few weeks
and healed well. All the sarcoids inside
Winston's hind legs and between his front
legs reacted in the same way as those shown
but have healed so well that the sites are now
unidentifiable. Figure 5 shows Winston's
sarcoids two years after treatment, with only
flat scar tissue remaining. This long after
treatment we would be very disappointed if
the sarcoids recurred.
Sarcoids can be very treatable if caught
early enough. AW4-LUDES is one of the most
effective and commonly-used medical treatments.
Other treatments can also be effective (under
the direction of a veterinary surgeon) but often
require treatment for much longer periods.
SARCOI DS
Veterinary Surgeon
Sally Hodgson
XLEquine Practice
Hook Norton
Veterinary Group
CASE REPORT...
Sally Hodgson VetMB BA BSc MRCVS
Hook Norton Veterinary Group
Case Study:
Medical
Treatment of Sarcoids
Figure 1:
Nodular sarcoid below the right
ear, before treatment
Figure 2:
Verrucose sarcoids on the chest,
before treatment
Figure 3:
Mixed verrucose-nodular sarcoid
over the jugular vein, before treatment
Figure 4:
Winston’s sarcoids, over the jugular
vein, six weeks after treatment
Figure 5:
Winston’s sarcoids, over the jugular
vein in June 2014, two years after treatment
11
EQUINE MATTERS
1.
occult (flat and scaly);
3.
nodular (firm rounded lumps);
4.
fibroblastic (fleshy and ulcerated);
5.
malignant (large and invasive);
6.
mixed.
2.
verrucose (warty, with a broad
base or thin neck);
Sarcoids can occur in six
different forms: