Q: “I have just noticed a sarcoid on my horse on his sheath I am now deciding what to do to treat it. Do supplements really work and is there a preferred veterinary treatment method? I would be grateful of any advice.”

A: Sarcoids are one of those subjects everyone has an opinion on and, no doubt, someone on your yard has advised you of a lotion / potion which, in their eyes, cures sarcoids.

I take sarcoids very seriously for one reason alone; they are a type of skin tumour/cancer. I frequently come across clients who have been told in the past to either leave a sarcoid, or try a treatment often purchased off the internet. At this point, I usually ask the client how they would approach treatment of skin cancer if they had been diagnosed with the condition by their doctor… leave it to see how it grows, ignore it, go online and buy a cream which claims to cure a multitude of aliments, or go to their doctor and speak to an oncologist (a doctor that specialises in cancer therapy) and treat accordingly?

No matter how small a sarcoid is, once found contact your vet and treat it immediately. Trust me, it will not only save your horse but save you time, money and heartache in the long run. It is my personal opinion that a sarcoid should never be ignored or left.

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So what is a sarcoid and what types are there, before suggesting what treatments are available?

In essence, a sarcoid is a skin cancer/tumour that is seen in all horses, ponies, donkeys and mules. Sarcoids usually infiltrate into local tissues and do not spread into internal organs however, once an animal has had sarcoids, they will always be prone to growing further tumours. There are six different types, including “mixed” sarcoids of multiple types.

Occult sarcoids — these are the stage that is often missed as they can just appear as small circular areas of hair loss and are frequently mistaken for conditions such as ringworm. There is never an ideal sarcoid, however I would personally recommended treating all occult sarcoids, before they develop any further.

Verrucous sarcoids — these often look like warts and tend to be a little more prominent. The surrounding skin is often flaky/scaly.

Nodular sarcoids — as the name suggests, these look much more like a distinct nodule which can have a pedicle (neck). Quite often, as these grow they tend to become ulcerated.

Fibroblastic sarcoids — this type of sarcoid can grow very quickly and looks similar to granulation tissue, but often bleeds as it rapidly grows. This type can vary in size from some as small as a golf ball to some the size of a gala melon!

Malevolent sarcoids — this is probably the worst type of sarcoid to have, as they grow very quickly and are incredibly invasive and difficult to treat.

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With regards to treatment of sarcoids there is no one rule for all. Every sarcoid should be evaluated and treated individually. Most treatments involve the use of topical creams, which are what we usually term ‘cytotoxic’ or ‘cell-killing’.

If topical creams are not appropriate (quite often due to the sarcoid type and location) other treatments available include cryotherapy, intra-lesional injection of cytotoxic/chemotherapy agents, surgical de-bulking prior to topical treatments, dioide laser therapy, BCG injections, brachytherapy (use of radioactive isotopes such as iridium), to even radiotherapy (using equipment such as linear accelerators).

Treatment of some types of sarcoids in certain locations (especially around the head/ears) can be difficult and invariably expensive, therefore early diagnosis and treatment is essential.

Never leave a sarcoid. Contact your vet if you are ever suspicious of one.