# Anyone had Experience of banding sarcoids on sheath/prepuce ?



## irishdraft (4 November 2010)

Hi Peeps

my 3 year has had 3 small sarcoids banded on his sheath/prepuce, site unsuitable for liverpool cream, imo only one was suitable for banding, the biggest one, but vet insisted on banding a very small nodule higher up the prepuce, of course the band was off by the next day and poor horse was left with an extremly swollen area, plus a small cut to the skin. Due to the site it was difficult too see daily but was obviously checking the whole area everyday. At the weekend I noticed weeping coming from this area, also the bigger sarcoid was nearly off. On monday sheath is huge, weeping and red hot, take horse straight to vet who says nothing to worry about but grudgingly gives me antibiotics for 4 days. Sheath has not improved at all and is also now red raw in folds of skin with all the crud that is running down, bigger sarcoid has come off but even that site is raw and cruddy, second banded sarcoid band has come off but not the sarcoid but does not look as though it is causing a problem. I was under the impression that this was a clean, dry way of removing sarcoids anyone elses experiences please


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## charmeroo (4 November 2010)

The only experience I've had with banding did leave a nasty 'wound' once the sarcoid actually came off.  It does look really nasty and all you can do is keep it clean as much as you can and we put purple spray (iodine) on it every day.  It took quite a while to heal up but it will in the end.  At least at this time of year you won't have the problem of flies!  Good luck - I'm sure that it will heal up gradually!


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## Ella19 (4 November 2010)

they do break down. Keep it clean if it's safe to do so with diluted hibi then blue spray. Is there another vet you could have for second oppinion just to give you more info if nothing else and help put your mind to rest. Has the whole sheath swelled?


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## ImogenBurrows (4 November 2010)

I have not had a problem such as this IME. I would recommend you ask the vet to come our a re-examine the sheath before the weekend as it sounds a bit concerning to be honest. 

It maybe he's reacted quite profoundly and just would benefit from some NSAIDs or more aggressive treatment, but I think either way he needs seeing. 

good luck
imogen


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## JanetGeorge (5 November 2010)

charmeroo said:



			The only experience I've had with banding did leave a nasty 'wound' once the sarcoid actually came off.  It does look really nasty
		
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That's not my experience of banding - but I know of a couple of other horses (treated by another vet!) who had very nasty wounds following banding.  I'd seen one of the sarcoids pre-banding and it definitely wasn't suitable for this type of treatment.  Banding is only suitable for nodular sarcoids on/above the skin - that have a clear 'neck' and no root!  It is often best used in conjunction with freezing to ensure a good result.

It sounds like OPs vet has cocked up - first in treating the sarcoids - and secondly, by dismissing the owner's concerns!  Personally, I'd be looking for a new vet!

A badly swollen sheath is not JUST very painful for the horse - it can lead to problems with urination.  Imogen is quite right - the poor chap needs anti-inflammatories to help reduce the swelling and make him more comfortable.

I have been treating a 5 year old ID stallion (under the direction of my vet and with advice from Prof. K) - who has 2 sarcoids on the sheath and one in the skin fold between his testicles - with Effudix cream (prescription only - used for some forms of skin cancer in humans.)  NOT as painful or severe as Liverpool cream - but still caused a lot of local inflammation and pain to the point that putting it on became quite dangerous (think twitch, AND front leg held up - and still dodging pretty determined kicks!)  And he was on Danilon throughout the treatment periods!  Too soon to know if it's worked properly yet.

Personally, my vet would NOT even start treatment on any but the most straightforward types of sarcoids without reference to Prof K - and he's a very experienced equine vet!!


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## millitiger (5 November 2010)

my 4yro had the sarcoid on his sheath banded and Liverpool cream applied.

it was slightly swollen (more from the cream i think) and a bit sore but nothing too bad.

his sarcoid was about the size of a pingpong ball and took around 6-8 weeks to fall off.
when it did, he had more of a dent than a hole which i put purple spray on and it healed very quickly.

now (about 1 year on) you can't even see where it was removed from as the scar is so faint.


i would see if there is a vet who can give you a second opinion as i wouldn't be happy with a very hot, swollen sheath.


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## ImogenBurrows (5 November 2010)

JanetGeorge said:



			Banding is only suitable for nodular sarcoids on/above the skin - that have a clear 'neck' and no root!  It is often best used in conjunction with freezing to ensure a good result.

It sounds like OPs vet has cocked up - first in treating the sarcoids - and secondly, by dismissing the owner's concerns!  Personally, I'd be looking for a new vet!
		
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Hang on, the OP doesn't state what type of sarcoid they are, but it does say they were three small ones - so the vet prob wouldn't have ringed them unles he did think that they we amenable.  I've personally ringed some very high into the groin and had no issues fortunately. 

Ringing IMO is best on those sarcoids where a clear neck and the area where you have  "free" skin to get right behind it IMO, but _not_ just for nodular lesions. 

I disagree about the freezing as well.  There are many different threatments available and not one is _right_ by itself.  Each case is different and personally I, like Janet states below, prefer to be guided by Prof K as I mostly use the AW4-LUDES cream from Liverpool.




			Personally, my vet would NOT even start treatment on any but the most straightforward types of sarcoids without reference to Prof K - and he's a very experienced equine vet!!
		
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However, that does *not* mean it's incorrect for a vet do treat sarcoids by other means such as banding/freezing etc using their own judgement.

Even when choosing what we think will be the quickest, most straight forward, most painless and most economical way for the horse and client, the sarcoid may not react as we had thought, leading to complications. 

I'm not a fan of cryo for example, but that doesn't mean in some peoples hands it doesn't work or that its wrong. 

I agree the OP has described the vets re-exam as not the most involved let's say, but think it's a bit harsh to just leap on the "_find a new vet_ wagon, without pushing the issue a bit first.  

Maybe the vet concerned didn't feel the swelling was unexpected in _their_ experience, but also didn't realise it was very worrying in yours? I think it does sound like the horse would need further attention before the weekend; I'd probably first approach the attending vet again, explaining your feelings - and you maybe surprised at the response. 

If you feel that you are still unsatisfied, ask for another vet, or second opinion; but personally I am always more aggrieved when client are not able / don't come back and explain.

We are human too and underestimate the situation sometimes!!! 

Hope that helps.
Imogen


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## irishdraft (5 November 2010)

Thanks for all your replies, in answer to some questions photos were sent to liverpool but because of the sites surgical removal was recommended. Apparently my vet discussed this with another equine vet who felt that this was not the best method and that banding would be, i also have the eufudix ? cream for one by his eye and a couple of tiny ones by his belly button which i have been doing. I think the main problem has arisen because vet tried to band a tiny nodule under the skin high up the prepuce and this came off next day (the band) but also cut the skin and has flared up badly. The larger sarcoid has come off but left a nasty wound this is at the end of the sheath so easy to see. The sheath is still very swollen, hot, I am now gently bathing what I can and putting vaseline inside to try to ease all the crud off, my vet stated to me it was only skin and so could not affect his urinary system, It has not really improved since monday despite having 4 days of antibiotics but I think all the crud is slightly drying up, I am so cheesed off because the is an ID gelding of 17.2 3 year old who could be really difficult with his size/age and he is so good about me doing all this, he really dosent deserve it, I was going to see how he goes over weekend and if no better take him back down to vet, but i do have bute and danilon here, do you think I should give him some Imogen ??


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## JanetGeorge (5 November 2010)

ImogenBurrows said:



			Ringing IMO is best on those sarcoids where a clear neck and the area where you have  "free" skin to get right behind it IMO, but _not_ just for nodular lesions.
		
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You disagree with Prof. K. then who says:

"Application of a strangulating band around the base of a nodular sarcoid may be effective if the lesion has no roots.

This is a common method employed by owners.  IT IS EXTREMELY DANGEROUS if there is a root structure.

It is most applicable to conveniently sized and situated nodular lesions and some small pedunculated fibroblastic lesions."





			I agree the OP has described the vets re-exam as not the most involved let's say, but think it's a bit harsh to just leap on the "_find a new vet_ wagon, without pushing the issue a bit first.  

Maybe the vet concerned didn't feel the swelling was unexpected in _their_ experience, but also didn't realise it was very worrying in yours?
		
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Maybe I've been spoilt - but my vet ALWAYS explains - in detail - any possible side effects or reactions to treatment BEFORE the treatment commences.  And if I am concerned he makes sure he takes my concerns seriously!  That's why he's been my vet for 22 years!




			I was going to see how he goes over weekend and if no better take him back down to vet, but i do have bute and danilon here, do you think I should give him some Imogen ??
		
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As a vet, Imogen cannot recommend drugs for a horse being treated by another vet - it wouldn't be ethical or professional!  I'm not a vet - just a very experienced horse breeder with a lot of horses and - unfortunately - too much experience with sarcoids!  If a horse has severe swelling (where I know the cause) and is in discomfort, I would always give bute or Danilon for a couple of days - why should the poor chap suffer unnecessarily??  Obviously if I didn't know the reason for the swelling/pain, I'd discuss it with my vet first!


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## irishdraft (5 November 2010)

JanetGeorge said:



			You disagree with Prof. K. then who says:

"Application of a strangulating band around the base of a nodular sarcoid may be effective if the lesion has no roots.

This is a common method employed by owners.  IT IS EXTREMELY DANGEROUS if there is a root structure.

It is most applicable to conveniently sized and situated nodular lesions and some small pedunculated fibroblastic lesions."




Maybe I've been spoilt - but my vet ALWAYS explains - in detail - any possible side effects or reactions to treatment BEFORE the treatment commences.  And if I am concerned he makes sure he takes my concerns seriously!  That's why he's been my vet for 22 years!



As a vet, Imogen cannot recommend drugs for a horse being treated by another vet - it wouldn't be ethical or professional!  I'm not a vet - just a very experienced horse breeder with a lot of horses and - unfortunately - too much experience with sarcoids!  If a horse has severe swelling (where I know the cause) and is in discomfort, I would always give bute or Danilon for a couple of days - why should the poor chap suffer unnecessarily??  Obviously if I didn't know the reason for the swelling/pain, I'd discuss it with my vet first!
		
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Point taken will be buteing first thing tomorrow if no improvement and phoning vet, Janet, is this a genetic thing with IDs this horse is a purebred by Beeston Lord Henry I have two other grey IDs with no such problems Yet !! this horse is Chestnut


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## JanetGeorge (6 November 2010)

irishdraft said:



			Point taken will be buteing first thing tomorrow if no improvement and phoning vet, Janet, is this a genetic thing with IDs this horse is a purebred by Beeston Lord Henry I have two other grey IDs with no such problems Yet !! this horse is Chestnut
		
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I am not aware of any _solid_ evidence that suggests genetic predisposition, breed-related or otherwise... although theories abound.

To quote Prof. K. again:

"The colour of the horse has no influence on the likelihood of sarcoid developing or on its severity."

I'd agree - of the 6 horses I have had that developed sarcoids, 5 were grey - but then - most of my horses are grey!

and

"There is no sex predilection although some studies have suggested that geldings are more liable.  Current consensus is however, that there is no obvious sex predisposition."

Of my 6, 5 were geldings - and one a stallion; although I own more geldings than mares, I also have more geldings and stallions STABLED than mares (and therefore in touch with others with sarcoids and concentrated populations of biting flies.)

and

"Although most breeds of horse are susceptible some appear to be highly resistant while others are reported to be more susceptible.  The Arabian horse is possibly more susceptible. The Lipizzaner for instance seems to be strongly resistant but crosses involving Lipizzaner horses are liable to the disease.  Susceptibility may relate to the genotype of the individual." 


Note 'appear to be', and 'possibly'.  4 out of my six horses that have had sarcoids ARE Irish Draughts - but then 90% of my horses are Irish Draughts! 

The only things I am personally SURE about with regard to sarcoids are that flies are heavily involved - and (therefore) sarcoids beget sarcoids!!!


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