Page 1289 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

1264 CHAPTER 12

VetBooks.ir 12.59 Sarcoid: general management
considerations
Given the uncertain outcome, the horse owner
should be made very aware of the seriousness of the
problems that can arise from this disease. Treatment
should involve a full discussion of treatment options,
the likelihood of successful treatment and the likeli-
hood of prolonged or repeated treatment that, while
containing the condition, may not fully resolve it. In
addition, the client should be reminded to consider
benign neglect because there are known cases of
spontaneous full and permanent self-cure, especially
with the occult and verrucous forms.
Fig. 12.59 Mixed, verrucous, fibroblastic and occult
forms of sarcoid occur in the periorbital region and Assessment
histopathology may be necessary to distinguish them An assessment should be made on the following
from neurofibroma. grounds:

• The value of the animal – economic or
Diagnosis sentimental.
The presence of more than one form of sarcoid is • Previous treatment and history.
almost self-diagnostic. • The cost of each avenue of treatment and the
likelihood of a successful outcome for that
MALEVOLENT SARCOID type of treatment (e.g. repeated single local
medication may eventually be much more
Definition/overview expensive than surgical removal, radiation
This is a recently identified variation of sarcoid therapy or cryosurgery).
showing increased malignancy. • If at all possible, the results of biopsy should be
known before the final prognosis is given.
Clinical presentation • Likelihood of further spread of the condition if
This sarcoid may result from other types of sarcoid treatment is (a) not undertaken, (b) delayed or
subject to repetitive injury, medication or surgery. (c) incorrect.
Occasionally, with no previous history of interfer- • The possibility of a sarcoid with a contagious
ence, they spontaneously develop into multiple nature, resulting in transmission to other horses
tumours locally and/or metastasise to lymphatics in the group.
and lymph nodes. Cords of tumour extend into the
lymphatics. This is a particularly dangerous sarcoid Treatment modalities
around the eyelids. Ligatures
Elastrator rings, lycra or even heavy elastic bands
Differential diagnosis can be used. Application is easy. This works best on
SCC; subcutaneous mycosis; lymphangitis; glanders; single sarcoids where loose skin on the body or neck
enzootic lymphangitis; cutaneous histoplasmosis. is available to allow proper placement of the ligature
(i.e. skin-only pedicles).
Diagnosis
Clinical changes to the original sarcoid are sugges- Local medication
tive, as is invasiveness of regrowth from a previously This can be moderately successful for single small
treated sarcoid. sarcoids: