Melanomas- surgery worry

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RhiandRath

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Nov 27, 2017
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Over the past year, my 7 year old dapple grey mare has developed rather a lot of lumps all over her body. The vet came out and immediately diagnosed sarcoids, sent pictures to Liverpool and he came back with a treatment plan. However, on a follow up visit, I pointed out at least 7 more small lumps that had come up since he last visited (whilst I was waiting for the liverpool prescription). Vet sent more pics to Liverpool who came back and said he didn't think they were sarcoids and suspected melanomas.

The vet is coming back tomorrow to do an endoscopy to check if they are whether they have spread. He said they can cut out most of them doing standing surgery, however there is one that is on her tendon and I am freaking out. The vet seems to be saying she needs to go to the equine hospital and under a general anaesthetic and have the one on her leg removed, however I am really worried about her having this operation. There is literally no room for error in the location of this lump, plus the added worry of putting her through GA.

I am so confused about what to do for the best. There is still no definitive answer as to what the lumps actually are, none are in the typical location for melanomas either.

Has anyone else dealt with similar?
 
I can understand your worries, specially about the op. Can you have a chat again with your vet? Do you know them quite well, ie have you been with them a while? I have no experience of them being removed. My oldest mare has melanomas under her tail and (touch wood ) they don't give her any bother - but at 27 I'd not be getting them done under ga anytime. But of course I can see why the vet is suggesting it for yours at seven years old.
Hope someone else on here can suggest something.
 
Thanks for the reply. The vet is coming Weds and this was the last thing they sent to me:

As we discussed over the phone the surgery should be performed under GA as the lump in the metacarpal area is very close to important anatomical structures and technically it might be quite difficult to excise on standing horse. You can do biopsy of that lump but it is very difficult to predict what is gonna happen if we irritate those cells and leave the lump in situ. Sometimes they can start multiplying very rapidly and the lump will be getting bigger and this is why we recommend the surgical removal of the whole lump (excisional biopsy). Obviously, it may not happen at all and the lump wont get bigger after the biopsy.

We won't push you to do something that you don't really want to do. I think the most reasonable thing to do is to talk at the time of the visit and we can assess each lump once again to see whether we can try to do the surgery on standing horse or not.

To be honest she is my first horse so I haven't been with them a massively long time. I don't want to blindly follow the advice and send her for an operation if i can simply watch and wait on the one on her leg. But equally if I leave it and it grows huge and metastases because I haven't had it cut off I won't forgive myself. There is just so little extra skin on that particular area, I am really concerned about having it messed with...
 
Hmmm yes, I can see both points here. Is it worth ringing them for a chat and to put forward your concerns? I really wish there was someone on here who had been through this. Can't think of anyone off the top of my head though.
 
I have known a horse that came up in lumps - a light bay and subsequently another grey on the same yard. These proved to be allergy related. But only after investigation and at least one horse going in to horse hospital. Something like hives in a human. The investigations took some time.

Maisie the grey I rode for 8 years had sarcoids and died of cancer aged about 14.. They eventually turned cancerous near her eye and inside her mouth. I dont think any was operated on.
She was retired as a riding horse about two years before the vet put her down. Not ridden, because she grew spooky when partly blind in one eye and could not be bridled. However, it is all very subjective. The RS could not risk my riding (or any client riding) a horse that chucked off staff. Tho it was something she was prone to do throughout her life.

However, I am not sure I fully understand this problem about which you are posting. The horse (you imply) has many lumps. The vet says he cannot take a biopsy because that might aggravate them becoming malignant (even if they are currently not)
Operating and removing the one lump isnt going to make much difference therefore as you will be left with the general problem of all the other lumps?

In Surrey we have a specialist horse hospital and the thing most people would do is to get a second opinion from a specialist there. It might give you a more exact diagnosis.
And might be more illuminating on biopsies - as I too thought having a biopsy risked malignancy and then in a cancer ward, found they took samples any way.

And with this more specialist info you could then work out what to do.

On the side of risk versus care - Your neglecting to remove a sarcoid on a grey horse does not make you responsible if that sarcoid later becomes cancerous. It is the luck of the draw, some do, some dont. Same with humans - there isnt always good news. Maisie was loved to bits by me and the yard owner. A small fortune was spent on her recovery from a field injury. because that has a possible good outcome.

Cancer in animals is rather a different matter - different from humans I mean. On the yards where I ride, there is no insurance for the horses that belong to the YOs. That may mean there is less intervention and much lower vet bills. Nature took its course with Maisie's cancer. As a horse, she didnt know she was dying. She had two years of happy retirement. Unstressed.
 
Skib RhiandRath isn't talking about sarcoids but melanomas - they are different & so is the treatment.

My personal experience of a pony with melanomas is now years out of date. At the time cimetidine was being trialled as a treatment & we got him on that - it helped in that it slowed down the progression & even started to reverse some, but unfortunately some internal ones ruptured & we were left with no choice but to pts. He was an old boy though & there was no way we'd put him through surgery, particularly when the vet was fairly sure they were widespread inside too & those couldn't be operated on. I don't know if cimetidine is still used as a treatment.

I can understand why you're so worried & maybe the best thing is another chat with your vet. If it's any help if he's consulting with Liverpool then he's dealing with the very best in the field. General anaesthetics are a risk, but they've come a long way & she'll be in expert hands, for me the risk of operating on her leg while standing with a local would seem far higher than it being done under a general. She's not my horse though & so it's not my call.

Whatever you decide I wish you all the very best x
 
I wrongly thought that sarcoids were what later developed (in some horses) into malignant melanoma?
But then they just talked about Maisie having cancer, using the human word. Whatever the words, it developed from sarcoids.
And they were removed by the vet if they might be irritated by tack, halters etc. But otherwise, not.
 
Ziggy is grey and he has several melanomas. On the underside of his tail, around and inside his sheath. I believe these are typical places to get them.

Our most senior vet (a very egotistical and ponderous chap, but with a high reputation locally) treated him for something else, remarked on the melanomas as "normal for a grey, he'll be covered in them when he's in his 20s" and did not suggest any treatment at all if they didn't bother him.

I would want to understand why your vet thinks removal is the best option before doing anything else.
 
Our vets likened melanomas on a grey to icebergs , what you see on the surface is usually only the tip of the problem but never suggested attempts at removal.

My daughter's young competition horses has a sarcoid which cannot be treated by Liverpool ointment or laser surgery experts as it lies over a major artery , fortunatety it is flat and does not interfere with anything. Sarcoids do not lead to internal organ problems.

I would be asking for a second opinion on your vets view, possibly from a Vet hopital such as Oakham that offer treatment through vaccine for melanoma spread and others who also offer laser treatment for sarcoids.
 
I have no personal experience dealing with melanomas, known plenty of horses with them though.

If it were me I think I would be asking for a definitive diagnosis by biopsy of one of the easy to get to lumps, from that they should be able to tell you a lot more about how the other lumps will react to surgery and other treatments, have they been able to tell you how wide spread they are? i.e. are there more internally that you can't see, not sure if blood tests can give indication of that...just thinking out loud about the things I might ask a vet before going the surgery route, it a big decision and personally I'd want to be armed with all the information possible before making a decision :)
 
Not dealt with it but s other have said known horses with lumps.
Before anyone would be putting mine under GA it would be life or death first. This as it currently didn't sound like that.
I would want definite answers as to what they are first. Since they have popped up anyway, a biopsy may or may not spread them and you may get more pop up after.
 
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