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Know What to Expect with Squamous Cell Carcinoma
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Know What to Expect with Squamous Cell Carcinoma

Just like you, I am a horse owner who tries to do things right to keep my horse healthy. I believe a healthy horse makes a happy owner and a happy owner can enjoy their happy horse.  However, as is life, there are some things that happen that until we experience them we do not know how life changing they will be. I experienced a life changing event last summer that did not end well for my horse.

In this article, I would like to discuss a topic that you may have heard about but may have not personally experienced. Equine squamous cell carcinoma (SCC) is the second most common equine skin tumor. If you own a horse with pink or non-pigmented skin, your horse has a higher predisposition for developing squamous cell carcinoma on the eyelid. If not treated with removal in the earliest stages, the chance that it could spread to the other eye, around the face, muzzle or genitalia is a high possibility.

This was recently my experience when my beautiful horse Rei was diagnosed with squamous cell carcinoma in August of 2014. Tumors had spread to both eyes and on the cornea of one eye. She lost her battle with this disease on September 19, 2014. I have written this post in her memory with the hope that I can inform other horse owners of what to expect once a diagnosis has been confirmed. I hope I can help prevent you from having to experience what I did. The information I gained during this tragedy may provide the tools you need to make informed decisions about the care, treatment and consequent aftercare that may occur if your horse is diagnosed with squamous cell carcinoma.

Some Facts

SCC is the second most common skin tumor in horses (Rassnick & Bradley, 2007). 72% of SCC tumors are located on the eyelids of horses who have pink or non-pigmented skin. If caught early, the chances of removing the tumor successfully from the eyelid with clear margins is fairly high. If noticed late, this form of cancer can spread to both eyes and other organs including genitalia, face, ears, and legs.

In 2007, Rassnick and Bradley conducted a study to identify the areas in which SCC was most prevalent. In the study, 157 horses were identified with SCC - 55% occurred on the eyelid, 25% occurred on the inner eyelid, 19% occurred on the cornea (Rassnick & Bradley, 2007). What was even more interesting is that out of the horses who were presented with eyelid tumors, 72% of these SCC tumors were located on horses with pink or non-pigmented skin on the eyelid. In another study, documented in the American Journal of Veterinarian Medicine, 50 horses who had tumors removed from their eyelid were monitored over an 11 year period.  In this study, the recurrence of tumors on the eyelid was significant when surgery was not combined with other measures (King, Priehs, Gunn, & Miller, 1991).

My advice, if you discover any odd growths around the eyelid of your horse, don’t hesitate in having your vet come out and look at them. If there is even the slight chance that the growth you discover is SCC, your vet will refer you to an ophthalmology department at a large animal hospital for a biopsy.

What to Expect

Here is what I want you to know before you arrive at the large animal hospital for further testing:

Create a budget and a limit on the amount of money that you can spend. I know that as horse owners, we want to do everything possible to save the eye and ultimately save the horse’s life. However, money is a factor in making decisions. Have your financial budget already in your head as you discuss treatment options with the ophthalmology team. Recognize that there are limits to what you can afford and that it is okay to have a limit. Be prepared for the guilt that this might make you feel but understand that you are not the only one who has had to make these same difficult choices.

Be prepared for the possibility that your horse could lose an eye. Removal of the eye is probably your best option in the overall picture rather than extensive surgery to try to save the eye. Additional surgery around the eye can develop into additional complications including the inability to blink, ulcers and infection.

Plan for at least a week or two of additional medical care in a layup facility designed for ophthalmology care and follow-up exams. This follow-up care may not be factored in to the initial estimate of the surgery by the hospital. These additional costs should factor in to your decision in how to proceed. Ask the veterinarian for contact information and discuss the daily charges and additional costs directly with the facility manager of the layup farm. There will be unexpected charges and you need to have a general idea of what these costs might be including transportation between the hospital and layup facility, additional medications, bandages or special diet considerations.

If you are given the go ahead to bring your horse home, the design of your stall is critical. A stall needs to have four smooth sides. As stitches begin to heal, they become extremely itchy. Boards with 90 degree angles are perfect for rubbing and this can actually damage the surgery area and create additional obstacles. A horse who has a smooth wall is less likely to damage the area further.

If you do opt to bring your horse home and care for him, prepare yourself for medicating 3 or more times a day and have the ability to change bandages 2-3 times a week or as needed. Having your local vet in on the care plan can help make the transition from layup facility or animal hospital smoother. Be with a trained medical professional the first time the bandage is changed after surgery as what you see under the wrap can be shocking and devastating to you emotionally. Be proactive. Apply protection. Prevent cancer.

My final message is to be proactive when examining brushing and loving on your horse. Apply protective measures to prevent excessive UV rays in penetrating the skin especially if your horse has pink skin around the face and eyes. Be informed when you do take him to the vet so that you are prepared for the cost, the aftercare and the possibility of eye loss with no guarantees that cancer will not appear somewhere else later on. Preventative care and early detection can help you avoid emotional and financial stress and most importantly can save your horse’s quality of life. Being proactive will help you keep your horse healthy and you happy.

References:

Christiane Kafarnik, C., Rawlings, M., Dubielzig, R.R. (2009). Corneal stromal invasive squamous cell carcinoma: a retrospective morphological description in 10 horses. Veterinary Ophthalmology. Vol 12. 1; 6-12.

King TC, Priehs DR, Gunn GG, Miller TR. (1991). Therapeutic management of ocular squamous cell carcinoma in the horse: 43 cases (1979-1989) J Am Vet Med Assoc.; 198:298-303.

Rassnick KM, Njaa BL: 2007, Cyclooxygenase-2 immunoreactivityin equine ocular squamous-cell carcinoma. J Vet Diagn.

Disclaimer: Of Horse! and sponsors do not endorse nor validate the accuracy of a blog post. Each article is the opinion of the blogger.

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