Equine Sarcoid Treatment Recommendations, WEVA 2008

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.

About the Author

Stacey Oke, DVM, MSc

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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