26/02/2025
How do we treat sarcoids?
Video in the comments - *Warning potentially graphic content of blood and minor surgery*
In 2024 Jim presented the first ever clinical paper on the treatment of equine sarcoids with minimal excision surgery followed by combination therapy. We have been using this method for over 6 years now and have had outstanding results treating clinical sarcoid cases. It is always easier when the horse has not been previously treated by a different method as we don’t have extensive scar tissue to contend with. Also some sarcoids definitely get worse if they don’t get better with a lot of other treatments. These can then be very refractory to treatment.
So we thought we’d show you what the treatment looks like. This is a case that came in on Tuesday for the first surgery. We first saw the horse a month ago and put it on a course of an immune stimulant drug to try and damp down the growth rate. This treatment as far as we are aware is unique to us and there are no literature reports of its use. We have used the treatment in about 10 of our most difficult sarcoid cases over the past 2 years and currently all of the others are stable, in remission or clinically resolved.
This particular horse has some very unusual sarcoid locations including one on the inside of the nostril in a structure called the alar fold. Access to this area is very restricted so it gave us a bit of a challenge. There were also sarcoids on the external skin directly above this lesion, inside the forelimb and on the sheath. Previously suggested treatments included laser surgery, which in our view would be virtually impossible in the alar fold area without potentially causing massive wound healing issues.
It is really surprising but we were able to remove most of the sarcoids by blunt dissection following really good sedation and local anaesthesia. This results in a much shorter wound healing time and much less scarring than conventional treatments. This method of surgery/blunt dissection we call minimal surgical excision. You will note that the wounds created are really small compared to any other form of surgery. This results in a much shorter wound healing time and much less scarring than conventional treatments. Most horses can be ridden the week after treatment.
Conventional wisdom says that the sarcoids will regrow if you don’t take a wide margin of incision. The problem with this is you create a big wound that can take months to heal with significant scarring. We reduce the risk of regrowth of the tumour by a combination of cryotherapy and chemotherapy instead which has very little side effects and excellent treatment results. This horse will need more than one course of treatment, but we will report back in 4 weeks with how it is progressing
Dukes Equine Vets Ltd is an Equine only vet practice in Aboyne and Banchory, Aberdeenshire. We aim to provide a personal yet knowledgable service for all types of horses.