Veterinarian Matthijs van Wart consulted a Friesian mare with a strange wart on her head at the head. De Drie Hoeves horse training. He says, “The wart has been there for a long time and sometimes it changes shape; then the wart becomes more bumpy, and then it can become smoother again. The owner has already tried a number of ointments but without result. Such a spot can have many causes. She examined the mare and the wart She suspected the bump might be sarcoidosis.
Sarcoidosis is the most common skin tumor in the horse and it can appear in various forms. It is usually not contagious but can be spread to a horse. They can be found anywhere on the skin, but are most commonly found on the moist areas, the head, legs and the underside of the abdomen. The exact cause of the development of sarcoidosis is not yet known, but research is ongoing. In addition to genetic causes, infection with human papillomavirus (BPV) appears to play a role.
Any horse can develop sarcoidosis and there is no specific predisposition for age, breed or sex. Sarcoidosis is divided into six different forms, each with its own characteristics: a type of wart (warty form), a round nodule (nodular form), a fungal spot (fuzzy form), a fleshy wart that bleeds easily (virubian form), or a combination of these forms. To get certainty about the diagnosis, a piece of tissue was sent to the lab for histological examination, says Van Wart. With sarcoidosis, this carries risks because sarcoidosis is somewhat damaged when the tissue is removed. Infected sarcoidosis can come back worse. In addition, the damage can also cause sarcoidosis to spread to other parts of the horse. When presenting tissue, the choice is made to remove sarcoidosis as completely as possible. An alternative is to take a swab of tissue and test it for BPV. The advantage of this is that it is non-damaging and less invasive. The disadvantage is that a negative result does not provide certainty about the absence of sarcoidosis.”
There are several ways for your vet to remove sarcoidosis. The most appropriate treatment may vary depending on the site and type of sarcoidosis. With cryotherapy, the tissues are frozen and then die. It is possible to apply immunotherapy. The horse is being treated with Bacillus Calmette-Guérin, a human vaccine that can be used to combat sarcoidosis in horses. In addition, topical treatment with special ointments is possible, and there are many options for this. Sarcoidosis can also be removed surgically. Surgical removal usually involves excision of the sarcoidosis with a relatively large area to avoid leaving parts of the sarcoidosis behind. In some cases, this can cause very large surgical wounds.
A relatively new treatment method is the surgical excision of sarcoidosis using surgical fibers of a high-energy laser. With this technique, work can be done relatively quickly with little blood loss. It is not suitable for all forms of sarcoidosis, but it is a better alternative than regular surgery for many common types. Thus, in literature She described a marked difference in the recurrence of sarcoidosis after surgery. After regular surgery, a significant proportion (up to 70%) of the sarcoidosis recurred in one spot on the horse, while 83% of the sarcoidosis remained absent when removed with surgical laser and 72% of the horses remained on the rest of the body, and his body remained clear of Sarcoidosis.
to work accurately
‘The mare’s owner preferred to have the bump removed using a surgical laser,’ Van Waart continues. The nature and shape of the bump lends itself to laser surgical removal. With these small warts it is usually possible to remove the bump under both permanent and local anesthesia. Thanks to the laser, there is generally relatively little blood in the surgical wound and the tissues generally recover quickly. Working with a surgical laser is a bit more time consuming, but it gives the opportunity to work very accurately.
Click here for a video of laser removal of sarcoidosis by Matthijs van Waart
The wound has been repaired
After the operation, the removed bump was sent to a laboratory for examination. The remaining wound was treated as a normal wound. After a period of treatment, the wound recovered well. Finally, the message came back from the histological examination of the submitted piece of tissue. It turned out to be sarcoid.
The practical story of Dr. Matthys van Wart appears in Friso Dec