Long-term Treatment of Equine Sarcoid in a Mare
A 19 year old female intact Warmblood presented to the Cornell University Large Animal Surgery Service for surgical debulking of multiple sarcoids. This was her sixth surgical procedure for this problem over a 13 year history of treatment. On presentation, the patient was afebrile, and temperature, pulse, and respiration were within normal limits. The sarcoid tumors were large, pendulous, ulcerated, and necrotic in many areas. The regions where the sarcoids were most prevalent were those persistently affected since the start of the disease, namely her left flank/inguinal region, and her right axilla. Smaller, individual, fibroblastic sarcoids were present on her pectoral region, and above her right eye. Under general anesthesia, the exuberant components of most lesions were sharply removed. Following debulking, intralesional chemotherapy using cisplatin and carboplatin in a lipid emulsion was also performed. The patient was recovered without incident. Prior to this surgery, the mare had been treated at CUHA and by local veterinarians with a variety of medications and procedures including cautery, various immunotherapies, autogenous vaccines, intralesional and systemic chemotherapy, and 5 other debulking surgeries. Her history of equine sarcoid began in 2001, when a small, flat (occult) sarcoid was found on her left flank. No treatment was instituted at that time. However, after a hock injury in 2002 that left the mare on stall rest for a year, the sarcoid quickly became more aggressive. It soon became clear that this was not an ordinary case of equine sarcoid, as the tumors spread to other areas of the body to include the right axilla and right ear base. The tumors grew very rapidly as they spread, and began to transition quickly from occult to malevolent sarcoids. This presentation will focus on the origin, types, and various treatment modalities available for the treatment of equine sarcoids. The ethical implications of invasive long-term management of disease in animals will also be discussed.
Equine; Equine Sarcoid; Long-term treatment; Case studies
dissertation or thesis