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Equine sarcoids are the most common tumors seen in horses, accounting for nearly nine out of ten skin tumors. They are not malignant (in the sense that they do not spread throughout the body), but they do grow larger and frequently spread and multiply locally. Their presence can irritate the horse, cause tack interference (hemorrhage), and result in a loss of value. When their surface is knocked or rubbed, it bleeds, causing fly worry and local infection.

What do sarcoids look like?

Sarcoids can appear anywhere on the body, but they are most commonly found on the head (especially around the eyes), the abdomen (especially around the sheath), the chest, ears, and lower limbs. Sarcoidosis can appear as a single tumor or as a cluster of tumors in one area or all over the body.

Sarcoids can resemble other skin tumors (e.g., fibromas, mast cell tumors, and non-pigmented melanomas), so a sample (biopsy) or the entire tumor must be sent to a laboratory for analysis in order to make a precise diagnosis. It is usually preferable to remove the entire tumor for laboratory examination in the first instance if possible. This eliminates the need for a second surgical procedure after diagnosis, as well as traumatizing the tumor while it is still ‘in situ,’ which could encourage it to spread.

Why do sarcoids occur?

Sarcoidosis is thought to be caused by a virus infection, according to strong evidence. This theory explains how sarcoids get started and spread. Some genetic families appear to be more susceptible to developing sarcoids than others, but susceptibility does not differ between horses with different coat colors. It’s possible that some breeds are more vulnerable than others.

Sarcoids can develop from ‘proud flesh,’ which is the exuberant granulation tissue that often develops in healing equine wounds.

What treatments are available?

Sarcoidosis can be treated in a variety of ways, and more than one treatment can be used at the same time. The most important thing to remember is that sarcoids have a high proclivity for recurrence, either at the removal site or nearby. Several factors will influence the treatment option:

  • The number and size of sarcoids in the area
  • The horse’s affected body part
  • The drugs and facilities that are available
  • monetary considerations

What methods of treatment are there?

Using rubber rings or ligatures
Some sarcoids, particularly those with a short stalk or neck, can have their bulk removed by tying a tight ligature around their base or using ‘elastrator’ rings. The ligature cuts off the tumor’s blood supply, which causes it to die or fall off within 10 to two weeks. This method is effective for controlling large sarcoids on the inside of the hindlimbs or abdomen in the short term, but it does not usually provide long-term relief. The most common method is to use a special applicator to apply small strong rubber rings (elastrator rings). After they are applied, there may be some local swelling, but this usually goes away once the sarcoid is removed.

The process of freezing (Cryosurgery)
Liquid nitrogen or another appropriate freezing agent can be used to freeze the sarcoid, causing the tissue to die away. If the sarcoid is particularly large, the bulk of it can be removed first (de-bulking), leaving only the base to be frozen. This method is more effective than surgery alone at preventing recurrence, but it frequently results in patches of white hair due to damage to hair follicles.

Laser surgery is a procedure that involves the use of
Surgical laser treatment, when available, allows the bulk of the sarcoid to be removed and the base eroded in one step or after the main mass has been de-bulked. Because the tissues are burned, there is little bleeding, but healing can be slow. Scars will appear, but the color of your hair will usually be unaffected.

Beads or wires that are radioactive
This highly specialized technique is not widely used, but it can be effective, especially in cases of eyelid sarcoids where the eyelid must be saved. The tumor shrinks as a result of the radioactive treatment, but the eyelid may be disfigured. This type of treatment must be carried out under the supervision of a licensed professional.

BCG (bacillus Calmette-Guérin
BCG is a bacterium that is used to make a vaccine. Mycobacterium bovis is a type of bacteria. to protect against tuberculosis immunization It can be injected into the sarcoid tumor(s) and has a good track record. It’s possible that you’ll need several injections over the course of a few weeks or months. The goal of this treatment is to get the horse’s immune system to destroy or reject the sarcoid tissue. It’s most commonly used to treat eyelid tumors because, if successful, it saves the eyelid. It may take several weeks after the first injection to see a response. Following injections, there is often swelling and skin damage, and in rare cases, death has been reported as a result of an anaphylactic shock reaction to the vaccine. Anti-inflammatory drugs should be given to horses being treated with BCG before each treatment.

It can take months to remove some sarcoids, regardless of which treatment option is chosen, and the effect may not be permanent. If new sarcoids appear, treatment may need to be repeated or changed. It is possible that such treatment will be costly.

Should I buy a horse with sarcoids?

In addition to welfare considerations, sarcoids affect the potential value of a horse or pony in two main ways:

  • If they interfere with tack or are knocked during exercise, they reduce the ability of that horse or pony to perform. If a mare has sarcoids between her back legs or on her udder they might be knocked or sucked when the foal nurses.
  • They may be expensive to remove or be treated if prolonged or repeated treatments are required.
  • These considerations must be considered against the value of the horse and its other qualities or potentials.

Conclusion
Sarcoids are much more significant than ‘just a few lumps’ and can be difficult and costly to deal with. If you think your horse or pony may have one or more sarcoids, you should ask your veterinarian for advice. Best results are achieved when a diagnosis is made and appropriate treatment is started early. Scarring is less obvious when the sarcoids are removed or treated when they are small.

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