Equine Melanocytic Tumors: A Retrospective Study of 53 Horses (1988 to 1991)

A study of 57 cutaneous melanocytic tumors from 53 horses revealed 4 distinct clinical syndromes: melanocytic nevus, dermal melanoma, dermal melanomatosis, and anaplastic malignant melanoma. Melanocytic nevus and anaplastic melanoma each had histopathologic features that distinguished them from dermal melanoma and dermal melanomatosis. Dermal melanoma and dermal melanomatosis were histologically similar but could be differentiated by their clinical features. Melanocytic nevi were diagnosed in 29 horses with an average age of 5 years; they were solitary, superficial masses that occurred in both grey and nongrey horses, and in which surgical excision was generally curative. Dermal melanomas were diagnosed in 20 horses with an average age of 13 years; all horses of known coat color were grey. Eight horses with an average age of 7 years had 1 or 2 discrete dermal melanomas. Follow-up information was available for 6 horses; metastases occurred in 2 horses, and surgical excision was apparently curative in 4 horses. Dermal melanomatosis was diagnosed in 12 grey horses with an average age of 17 years; all 6 of these horses evaluated had internal metastases. In 2 aged nongrey horses with anaplastic malignant melanoma, the tumors metastasized within 1 year of diagnosis. Two tumors with features of both melanocytic nevus and dermal melanoma remained unclassified.     

Congenital and acquired melanocytomas (benign melanomas) in eighteen young horses.

In a retrospective study, cutaneous melanocytic tumors from 18 horses, less than 2 years old, were examined histopathologically and clinical follow-up requested. Melanocytomas (benign melanomas) occurred in a variety of breeds and in horses of varied coat color. The age of the horses at the time of biopsy ranged from 3 weeks old to 2 years old. Four melanocytomas were congenital, 11 melanocytomas were acquired by 1 year of age, and three were acquired prior to 2 years of age. Of the 18 horses, five were male, and 13 were female. All tumors were solitary and located on the legs or trunk; none were in the perineal region. Ulceration of the overlying epidermis was common. Tumors were generally localized and were not encapsulated. The tumors had a variety of cell patterns ranging from sheets, to streams, or nests of melanocytes. Cellular morphologic findings also ranged from epithelioid, to a mixture of epithelioid and spindle cells or to a spindle pattern. The nuclei were large and euchromatic, especially in the epithelioid cells. Several tumors had moderate cellular pleomorphism and binucleate cells. Mitotic activity was generally low (less than 1/high-powered field), but was readily detected (1-2/high-powered field) in bleached sections of four cases. Melanin pigmentation varied from mild to heavy. Melanophages were admixed with the tumor cells or in the adjacent tissue. Follow-up information was obtained on 15/18 horses and revealed that 14/15 horses were free of recurrence following excision. One neoplasm, that was poorly demarcated and had a spindle cell pattern, was not completely resected and continued to grow. These melanocytic tumors in young horses are distinct from melanomas in aged horses in their location, epithelial involvement, and age of horses affected. The majority of these tumors appear to be benign and share features of melanocytic nevi of human beings.     

Equine giant cell tumor of soft parts: a series of 21 cases (2000-2007).

In horses, giant-cell tumors of soft parts are rare neoplasms, with the majority of reported cases occurring within the hind limb muscles and soft tissues in older horses. The following article documents 21 cases of equine giant-cell tumors of soft parts clinically examined within the state of Colorado from 2000 to 2007. The majority of cases occurred in male horses aged 10 years or older. Nine (43%) arose within the hind limbs. Key histologic features included numerous multinucleated giant cells and hemosiderin-laden macrophages admixed with a spindle-cell proliferation. The majority demonstrated liposarcomatous change, variable areas of necrosis and hemorrhage, and an intermediate number of mitotic figures. Immunohistochemical results demonstrated 2 distinct cell populations: vimentin-expressing neoplastic mesenchymal cells and CD18 (histiocytic marker) expressing multinucleated giant cells. These results suggest a mesenchymal origin of the neoplasm with possible recruitment of the secondary histiocytic population. Surgical excision was attempted in the majority of horses and was considered clinically complete. A recurrence of the neoplasm was documented in 1 horse and 1 mule. In 18 horses, surgical excision, regardless of margin integrity, appeared successful with no recurrence of disease documented. Unfortunately, 10 of 21 horses were lost to follow-up within approximately 3 months of surgery. Of the 11 remaining horses that were available for follow-up evaluation, there has been no evidence of metastasis. A larger case series with more controlled follow-up is necessary to evaluate malignant potential and the importance of complete surgical excision.     

Equine Sarcoids. A Clinical and Epidemiological Study in Relation to Equine Leucocyte Antigens (ELA)

Associations between clinical parameters of sarcoids and the equine leucocyte antigen system (ELA) were analysed for 120 Swedish horses. Median age of affected horses was 5.2 years, and the majority presented with solitary tumors between 2 and 5 cm in diameter and ventral abdomen was a predilection site. Clinical signs first appeared at a median age of 3.5 years, and sarcoids at different locations first appeared at different ages. Lesions at different sites differed in size, and multiple tumors, early onset, long duration, and older age all had an association with large size. Clinical manifestations of sarcoids and the association between certain ELA-specificities and early onset (A5) and increased recurrence rates after surgery (W13), in addition to increased prevalence (A3W13), strengthen further that some horses are inherently predisposed to sarcoid growth. Unassociated with any clinical parameters, one third of the untreated horses became free of sarcoids due to “spontaneous” regression, perhaps as a result of immune responses against the tumors. Seventy percent of the horses were treated (mostly by excision), and large size was the main parameter promoting treatment. Excision had no significant effect on possibly remaining sarcoids. Recurrence rate after first treatment was about 35%, with the majority of tumors recurring within 4 months. Early onset, long duration, large size, and localization to distal limbs all appeared to increase risk of recurrence. Early treatment, performed under general anesthesia in recumbency which permits wide excision and measures to avoid autoinoculation, significantly reduced recurrence rates.     

Progressive ethmoidal haematoma in horses

Progressive ethmoidal haematoma was diagnosed in 12 Thoroughbreds, 1 part- Arab and 1 stock horse. Ages ranged from 3 to 18 years and both males and females were affected. Diagnosis was based on history, clinical signs, endoscopic and radiographic findings, and was confirmed histologically in 10 cases. Eleven (78%) of the lesions were unilateral and 3 (22%) were bilateral. Two horses were euthanased on diagnosis, 4 were treated conservatively. Of the latter, 3 were euthanased 6 to 24 months after diagnosis, due to progression of the lesions, while 1 case resolved completely within 13 months. Eight horses were treated by surgical excision of the lesion. Three died in the post-operative period, 3 were euthanased within 48 months after recurrence of the condition, and 2 had no recurrence within 60 and 72 months, respectively.     

Equine basal cell tumors

Basal cell tumors from 11 horses were examined histologically. Distinct patterns identified in the order of frequency are adenoid (six), solid (three), and medusoid (two). A minor component of most of these neoplasms was a ribbon pattern and cystic spaces. Hyalinized connective tissue and clear cells reminiscent of hair follicle glassy membranes and outer root sheath were present in a solid and the medusoid tumors. Heavy melanin pigmentation was present in one solid basal cell tumor. In eight cases for which information was available, the tumors had not recurred 3 to 8 years after excision.     

Analysis of risk factors for recurrent airway obstruction in North American horses: 1,444 cases (1990-1999)

OBJECTIVE: To identify risk factors for recurrent airway obstruction (RAO) among horses examined at veterinary teaching hospitals in North America. DESIGN: Retrospective case-control study. ANIMALS: 1,444 horses with RAO and 1,444 control horses examined for other reasons. PROCEDURE: The Veterinary Medical Database was searched for records of horses in which RAO was diagnosed. A control group was identified by randomly selecting a horse with a diagnosis other than RAO that matched the institution and year of admission for each of the horses with RAO. Information obtained included hospital, admission year and month, age, sex, breed, and discharge status. The association between risk factors and diagnosis of RAO was estimated with logistic regression models. RESULTS: The risk of RAO increased significantly with age, with horses > or = 7 years old being 6 to 7 times as likely to have RAO as were horses < or = 4 years old. Thoroughbreds were 3 times as likely to have RAO as were ponies. Horses were 1.6 and 1.5 times as likely to be examined because of RAO during winter and spring, respectively, than they were during summer. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that RAO was more likely to be diagnosed in females, horses > or = 4 years old, and Thoroughbreds and that RAO has a seasonal distribution.     

Use of cisplatin-containing biodegradable beads for treatment of cutaneous neoplasia in equidae: 59 cases (2000-2004)

OBJECTIVE: To determine outcome for equids with cutaneous neoplasms treated with cisplatin-containing biodegradable beads, alone or in conjunction with debulking. DESIGN: Retrospective case series. ANIMALS: 56 horses, 1 zebra, 1 donkey, and 1 mule. PROCEDURES: Medical records were reviewed. Follow-up information was obtained through telephone conversations with owners and trainers of the animals. RESULTS: 22 tumors were sarcoids, 6 were fibrosarcomas, 1 was a fibroma, 2 were peripheral nerve sheath tumors, 11 were squamous cell carcinomas, 14 were melanomas (13 gray horses and 1 bay horse), 1 was a lymphosarcoma, 1 was an adenocarcinoma, and 1 was a basal cell tumor. Forty-five (76%) animals underwent conventional or laser debulking of the tumor prior to bead implantation. Forty of 48 (83%) animals for which long-term follow-up information was available were relapse free 2 years after treatment. This included 20 of 22 animals with spindle cell tumors (including 11/13 horses with sarcoids), 6 of 10 animals with squamous cell carcinomas, 13 of 14 animals with melanomas, and 2 of 3 animals with other tumor types. Adverse effects were minimal. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that implantation of cisplatin-containing biodegradable beads, with or without tumor debulking, may be an effective treatment for equidae with various cutaneous neoplasms.     

Clinical, laboratory, and histopathologic features of equine lymphoma

Clinical, laboratory and tissue findings from 37 horses with lymphoma were investigated. Horses ranged in age from 0.3 to 20.5 years (median 5.0 years) and included 18 females and 19 males. Weight loss (n = 25) and ventral edema (n = 21) were the most common historical and physical abnormalities. The most common laboratory abnormalities were hyperfibrinogenemia (n = 26), hypoalbuminemia (n = 19), anemia (n = 19), leukemia (n = 14), hyperglobulinemia (n = 13), and thrombocytopenia (n = 13). Thirty-four tumors involved multiple lymphoid tissues and abdominal or thoracic organs, and 3 tumors were restricted to cutaneous and subcutaneous sites. Histopathologically, all tumors diffusely effaced normal lymph node architecture. Tumor cell morphology was heterogeneous in 17 tumors, and 8 tumors had marked histiocytic and multinucleated giant cell infiltrates. Extensive necrosis or focal fibrosis was present in 22 and 4 lymphomas, respectively. Staining of tumor sections with antibodies against CD3 and CD79alpha molecules resulted in classification of T-cell (n = 26) or B-cell (n = 7) origin. Four tumors could not be classified. Most T-cell tumors comprised small to medium CD3(+) lymphocytes, whereas 5 of 7 B-cell tumors were infiltrated by numerous small T lymphocytes and classified as T-cell-rich B-cell lymphoma. Neither estrogen nor progesterone receptor expression was consistently identified by immunochemical assessment of tumor tissues. Fresh tumor cells from 6 horses bound antibodies reactive with equine CD4, CD5, CD8, CD21, or major histocompatibility class II molecules, confirming T-cell (n = 5) or B-cell origin (n = 1). These findings suggest that T-cell lymphoma is more common than B-cell lymphoma in horses and that inflammation, possibly from tumor cytokine production, is frequent.     

West Nile virus encephalomyelitis in horses in Ontario: 28 cases

West Nile virus encephalomyelitis was diagnosed in 28 horses presented to the Ontario Veterinary College Veterinary Teaching Hospital between August 20 and October 15, 2002. The age range of affected horses was 5 months to 20 years (mean 6.9 years, median 6 years). Clinical signs were highly variable. Duration of hospitalization ranged from < 1 to 12 days (mean 5 days, median 5.4 days). Overall, 16 of the 28 (57%) horses were discharged and, of the 14 from which follow-up information was available, 13 (93%) were reported to be clinically normal 4 to 6 weeks following discharge, while the other horse had markedly improved. This pathogen is emerging as an important cause of neurological disease in Canada.     

Evaluation of Locally Injected Mycobacterium Cell Wall Fraction in Horses with Sarcoids

A reformulation of Mycobacterium cell wall fraction immunotherapeutic can be used to successfully treat sarcoids in horses. Sarcoids are reported to be the most common equine skin tumors with tumor type and location influencing the choice of treatment. Wide surgical excision is curative for many tumors, but may not always be feasible. Previous studies have reported sarcoid regression after injection with mycobacterial cell wall immunotherapeutics. A new formulation of the Mycobacterium phlei cell wall fraction immunostimulant (Immunocidin Equine) was used to treat cutaneous tumors in horses. Equids with skin tumors diagnosed as sarcoids were enrolled in the study. Sarcoids were injected at the initial visit with Immunocidin Equine and subsequently at approximately 2-week intervals. Of 17 cases, nine cases were completely resolved at the end of the study period evaluation or at the time of final follow-up (52.9%). Three cases were reported as improved (smaller), but not resolved (17.6%). Three cases were discontinued from the study as the respective masses were growing larger or not resolving (17.6%). One case (5.8%) with two masses had resolution of one mass, whereas the other tumor had a small regrowth 5 months after the last treatment. One case (5.8%) was lost to follow-up. All cases had mild to moderate swelling of the injection site, and some cases had discharge after the second, third, or fourth injections. No serious systemic side effects or complications were encountered during the study.     

The Incidence of Australian Stringhalt in Horses in New Zealand

Seventeen horses diagnosed as having navicular syndrome on the basis of history, clinical findings, regional local anaesthesia and radiography were subjected to bilateral navicular suspensory desmotomy. Before surgery, the duration of navicular lameness ranged from 6 weeks to 4 years. Previous unsuccessful treatments prior to surgery included nonsteroidal anti-inflammatories, corrective shoeing, rest and isoxsuprine. For the seventeen horses subject to surgery, twelve horses were sound, one horse was improved and four horses were lame at a minimum of 6 months after surgery.     

Partial orbital rim resection, mesh skin expansion, and second intention healing combined with enucleation or exenteration for extensive periocular tumors in horses

Ocular and periorbital sarcoids and squamous cell carcinoma are common in equine practice. Extensive involvement of periorbital tissues often necessitates removal of the globe if the function of the eyelids can not be maintained with tumor removal alone. This report describes a modification of the standard enucleation or exenteration technique for cases in which there is insufficient skin to achieve primary closure following complete surgical excision. The caudal portion of the dorsal orbital rim is protuberant; partial excision with an osteotome facilitates skin closure by decreasing the size of the wound. Mesh expansion of skin via multiple rows or parallel stab incisions can also be used as an adjunct to facilitate closure. Four horses underwent enucleation or exenteration using the orbital rim resection and mesh skin expansion techniques for extensive periocular tumors that were unresponsive to prior treatments. Follow-up intervals ranged from 6 to 42 months and no horses had tumor regrowth.     

Surgical treatment of navicular syndrome in the horse using navicular suspensory desmotomy

Seventeen horses diagnosed as having navicular syndrome on the basis of history, clinical findings, regional local anaesthesia and radiography were subjected to bilateral navicular suspensory desmotomy. Before surgery, the duration of navicular lameness ranged from 6 weeks to 4 years. Previous unsuccessful treatments prior to surgery included nonsteroidal anti-inflammatories, corrective shoeing, rest and isoxsuprine. For the seventeen horses subject to surgery, twelve horses were sound, one horse was improved and four horses were lame at a minimum of 6 months after surgery.     

Arthroscopic treatment of meniscal cysts in the horse

Reasons for performing study: To describe the clinical symptoms, treatment, and outcome of meniscal cysts in horses. These structures have not been previously described in the literature as a potential cause of lameness in the horse. Hypothesis: Meniscal cysts are an uncommon condition of the femorotibial joint but can be a significant cause of lameness. Symptoms can be resolved by arthroscopic excision. Methods: Records of horses diagnosed with meniscal cysts and treated by cyst excision and meniscal debridement at 2 surgical practices were reviewed. Clinical outcome was determined by repeat veterinary examination and contact with owner. Results: Seven cases of meniscal cyst were treated with arthroscopic cyst excision and meniscal debridement. Five of 7 horses had lameness attributable to femorotibial joint pathology, while the remaining 2 horses had meniscal cysts found incidentally during diagnostic arthroscopy for the treatment of osteochondritis dissecans of the lateral trochlear ridge of the femur. Five of 6 horses with long‐term follow‐up were sound and a 7th horse was improved 11 months after surgery. Conclusions and potential relevance: Meniscal cysts, while uncommon, can be associated with progressive lameness in the horse. Surgical excision of the cysts results in resolution or improvement of symptoms, without evidence of recurrence on follow‐up examination.     

Intramuscular desmoid tumor (musculoaponeurotic fibromatosis) in two horses.

Intramuscular desmoid tumors (musculoaponeurotic fibromatosis) were discovered in two young adult horses. The tumor in one horse was in the lateral cervical musculature, and that in the second horse occurred in the pectoral musculature. Histopathologic features were similar in both horses and included proliferation of fibroblasts and cells expressing muscle actin (myofibroblasts), with extensive dissecting fibrosis within muscle. These features are similar to those of desmoid tumors in humans, particularly those also known as musculoaponeurotic fibromatosis. Dissection of these lesions revealed a single central (horse No. 1) or multiple central (horse No. 2) fluid-filled cavities with associated sterile inflammation. The presence of these cavities supports the hypothesis that equine desmoid tumors are traumatic in origin, possibly occurring at sites of injections or bursal rupture. Surgical excision of the tumor in horse No. 1 was apparently curative, but the extent of the tumor in horse No. 2 precluded surgical excision.     

Anaplastic malignant melanoma of the tail in non‐grey horses

Information regarding signalment, clinical findings, treatment and outcome of 5 previously reported cases of anaplastic malignant melanoma of the tail in non‐grey horses and of 5 additional cases are summarised. Age was recorded for 9 horses and mean age was 16 years, range 8–23 years. Gender was recorded for 8 horses and 6 of these 8 horses were male horses over 14 years of age. The most common coat colour was bay (6 horses). Other coat colours were palomino (one horse), chestnut (one horse) and black (one horse); coat colour of one non‐grey horse was not specified. Follow‐up information was available for 9 horses and only one horse, a palomino, survived more than 10 months following diagnosis and tail amputation. Surgical excision, including tail amputation and medical therapy with oral cimetidine, was not effective in non‐grey, non‐palomino horses. Tumour recurred on tail tissue remaining after amputation in 2 horses, widespread metastases were documented in 4 cases and metastasis was suspected at the time of death or euthanasia in 3 cases, including one case with amputation site regrowth. No subjective histopathological differences were detected in the palomino horse that survived as compared to horses of other coat colours. Findings suggest that anaplastic malignant melanoma of the tail in non‐grey horses is most often a very aggressive neoplasm, but that there are rare exceptions.     

Ectopic cilium in seven horses

Ectopic cilium was diagnosed by slit-lamp biomicroscopy and treated surgically by transconjunctival excision in seven adult horses. All cases presented with a common history of blepharospasm, ocular discharge and keratitis. Ophthalmic examination revealed a single translucent cilium in the upper eyelid palpebral conjunctiva, emerging approximately 5 mm from the eyelid margin. Corneal ulceration was not observed in any horse. Most horses responded well to transconjunctival surgical excision. There was recurrence of ectopic cilium 6 weeks postoperatively in one horse. Histopathologic examination was performed in two cases and confirmed the diagnosis of ectopic cilium in one horse. This is the first publication of ectopic cilia in horses and emphasizes their importance as etiology for epiphora, blepharospasm and keratitis.     

Confirmed and presumptive cervical vertebral compressive myelopathy in older horses: a retrospective study (1992-2004)

BACKGROUND: Cervical vertebral compressive myelopathy (CVCM) is a common cause of myelopathy in horses aged 6 months to 4 years. Little information is available regarding the types of lesions, treatment, and outcomes in horses with CVCM that are > or =4 years old. ANIMALS: Twenty-two affected horses (10 with a confirmed diagnosis of CVCM and 12 presumptive cases) and 210 contemporaneous control horses. METHODS: Horses > or =4 years old that were diagnosed with CVCM between January 1992 and January 2004 were identified from medical records at Texas A&M University and the University of Florida. Data analyzed included history, signalment, neurologic examination findings, lesion location, treatment, and outcome. Signalment was also recorded in a population of contemporaneous controls. RESULTS: Horses identified had a median age of 8.4 years, and there was a greater percentage of male horses among the cases than among the controls. The most common breeds represented were warmblood (n=6) and quarter horse (n=5) types; warmbloods were significantly (P < .05) overrepresented relative to control horses. The caudal cervical vertebral column was the most common site of CVCM lesions, and the C5-C6 (4/9) and C6-C7 (3/9) articulations were most often identified as abnormal via myelography. The most common lesions seen with radiography and myelography were articular process osteophytes. Of the 22 affected horses, 8 were euthanized and a diagnosis of CVCM was confirmed by necropsy for all; 5 of 8 of these horses had spinal cord compression caused, entirely or in part, by articular process osteophytes. Medical management was the therapy chosen in all horses, and administration of corticosteroids and nonsteroidal anti-inflammatory drugs resulted in improvement in the greatest number of horses. CONCLUSIONS AND CLINICAL IMPORTANCE: CVCM should be a differential diagnosis in older horses with cervical myelopathy. Articular process osteophytes are the most frequently identified cause of spinal cord compression in this group. Male horses and horses of warmblood or Tennessee Walking Horse breeds may be predisposed to this condition.     

Evaluation of peroral transendoscopic contact neodymium:yttrium aluminum garnet laser and snare excision of subepiglottic cysts in horses

Three basic techniques (and one modified technique) were developed, allowing successful excision of subepiglottic cysts in 10 horses (5 Standardbreds, 4 Thoroughbreds, and 1 Quarter Horse; mean age, 3.5 years) via peroral approach. This approach eliminated the need for laryngotomy or pharyngotomy and reduced postoperative care. None of the cysts redeveloped. Clinical signs of disease before surgery included respiratory noise, exercise intolerance, coughing, and dysphagia and were eliminated in all horses except one that raced successfully, but in which some respiratory noise was detected. Peroral subepiglottic cyst excision was performed on anesthetized horses that were positioned in lateral recumbency and intubated via the nares and trachea. General anesthesia allowed careful intraoral palpation and endoscopic visualization of the oropharynx on a television monitor. Custom-designed instruments, including a guide tube, cyst snare, and long grasping forceps, facilitated either laser or snare, or laser and snare cyst excision. Hemorrhage was negligible in all horses. Initial attempts to develop a technique to submucosally excise subepiglottic cysts through a transnasal transendoscopic approach in conscious horses, using a contact neodymium:yttrium aluminum garnet laser, were unsuccessful. In each of 3 horses, the cyst was inadvertently penetrated before it could be excised, causing it to collapse and disappear beneath the soft palate. Postoperative complications were excessive subepiglottic swelling after laser excision (n = 1 horse), which resolved completely in response to anti-inflammatory treatment, and subepiglottic cicatrix formation after snare excision (n = 1 horse), which required surgical excision of the cicatrix.