Tower Equine

Veterinary Surgeons

 

Sarcoid Laser Treatment - January 2014

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Sarcoids are the most common tumour in the horse. Usually benign skin tumours, they can however spread over many areas of the body becoming malignant in some cases.

First recognised in equine veterinary medicine in 1936, more recent research has shown the link between the Bovine Pappillomavirus (wart-virus) BPV types 1 and 2 and sarcoid development. Research done in 2005, and confirmed in 2008 by Bogaert et al, showed that infection alone with the virus did not cause a tumour to develop, so we assume that there must be a skin wound/defect present to enable the virus to colonise the skin and cause the tumour to develop. This links with the probable spread of virus by flying insects, such as flies and midges, that can land on broken skin and seed the virus in place.

For horse owners, sarcoids can be very problematic if they start to develop where tack/harness lies, spread uncontrollably, or cause an issue in a Pre-Purchase examination (vetting). They can also become a concern in the summer months when flies may spread them to other horses in the vicinity, especially when the sarcoid is inflamed or ulcerated.

There are many different treatment options available. As vets, we weigh the type, position and number of sarcoids present with financial considerations to advise on the best treatment options:

Topical Cream Application.

There are various creams available which vary in cost and effectiveness. The Liverpool Cream (AW4-LUDES) can be a very effective treatment option, especially when the horse/pony has a few superficial sarcoids. Unfortunately howeve, this treatment can be quite expensive: only vets are allowed to administer the cream as it contains heavily toxic metals hence increasing your vet bill. Additionally, the sarcoid areas can become inflamed and painful during treatment and horses will often require sedation towards the end of a treatment regime in order for the cream to be applied. Other creams, such as Bloodroot, Xxterra, Sarc-off, Aldara and Efudix are designed to affect the immune response and activate the killing of the tumour cells when applied. These may be less effective but are safer to use, hence owners can apply the cream itself. These creams can also be used in difficult locations, such as around the eyes.

Cryotherapy

Cryotherapy, or freezing with liquid nitrogen, can be an effective and reasonably cheap treatment for individual, small and superficial sarcoids. However, there is no guarantee that all the sarcoid cells will be killed at each treatment.

Chemo/Radiotherapy

Chemo/Radiotherapy are both quite expensive treatment options and as yet are still in the early stages of investigation. In the case of radiotherapy, horses may require multiple general anaesthetics for administration.

Surgical Removal

Surgical removal can be effective in certain cases depending on the position of the sarcoid and provided there is plenty of skin available to suture the wound. Unfortunately, it can be easy to leave some sarcoid cells in position when trying to close up the wounds.  Wounds may also be difficult to heal and research shows that up to 30-50% of these tumours may recur within 6 months of removal.

Laser therapy

Tower Equine held their first Laser Sarcoid clinic at Tower Farm, Grimsthorpe on 27 November 2013 in conjunction with Rossdales Equine Hospital, Newmarket.

Laser therapy uses a high intensity diode laser to cut out the sarcoid, leaving an open wound of normal healthy tissue in place. This method is usually a one-off treatment and can be used for most sarcoids around the body. Richard Payne MRCVS from Rossdales Equine Hospital came to Tower Equine to perform laser therapy on some of our sarcoid cases. Some were fresh cases that had not had treatment before and others were existing cases where other forms of sarcoid treatment had been unsuccessful.

Most of the treatments done at Tower Equine were performed with the horses heavily sedated and a local anaesthetic administered to numb the sarcoid. The laser was used to cut out the sarcoid tissue and, after some pain relief and antibiotics, all patients went home that day with minimal side-effects or complications.

Before and after:

The above horse was treated for a ventral sarcoid with Liverpool cream in Spring 2014. During treatment, an area of skin on the horse's muzzle, originally rubbed by his flash noseband, became infected with the virus - probably spread by flies from the original sarcoid. The sarcoid tissue was laser treated by Richard Payne MRCVS and six weeks later, following a standard course of antibiotics and pain relief, is fully healed.

Recent evidence on sarcoid diode-laser therapy suggests that if a horse has 5 or less sarcoids removed by laser surgery alone, recurrence will occur in less than 1 in 10 horses. Where a sarcoid may recur, it will usually do so within 12 months of the treatment. This is a significant improvement on previous sarcoid treatments.

Holly Applewhite BVetMed MRCVS

Tower Equine are very pleased to be able to offer further sarcoid laser treatment clinics with Richard Payne MRCVS in 2014. For further information please contact the office on 01778 591082 or discuss with one of our vets.