B   Verrucose sarcoid

C   Verrucose sarcoid

D   Verrucose sarcoid

E    Fibroblastic sarcoid

F   Verrucose sarcoid

G   Verrucose sarcoid

H    Verrucose sarcoid

I    Nodular Sarcoid

J   Fibroblastic sarcoid

K   Fibroblastic sarcoid

L   Fibroblastic sarcoid

Sarcoids are best regarded as a benign form of skin cancer and are the most common skin tumours of the horse. They can appear singly or in clusters on any part of the skin.  Although some forms are very aggressive locally, the condition is strictly limited to the skin and the tissue directly under it. It does not spread to the internal organs. It can sometimes be difficult to differentiate them from true viral papillomas (warts). There is increasing evidence that the bovine papilloma virus (BPV) is responsible for sarcoids in horses.

Horses can develop sarcoids at any age although most cases are first noticed between 2 and 10 years of age. Appaloosas, Arabs and Quarterhorses are more at risk than Thoroughbreds and Standardbreds.

The most common sites for sarcoids are those areas with thin skin, limited or no hair cover and a tendency to sweat. These are also the areas where flies prefer to feed. Sarcoids are rare on the upper trunk, back and neck. At these sites they can be taken as having developed at sites of skin damage. The extent of damage to the skin can be slight - even injection sites on the buttock and the neck or tack rub marks on the face and girth can develop a sarcoid following even very minor damage.

There are 6 different types of sarcoids

Occult Sarcoid

These usually appear as grey hairless, often circular or roughly circular areas and look very similar to ringworm or tack rubs or lice infestation. Occasionally the only change may be a subtle change in the hair coat colour, thickness and density. They are commonest on the face, armpit, inside thigh and groin areas.

Verrucose (wart like) Sarcoid

These are grey, scabby or warty in appearance, and sometimes have small shot-like, solid nodules within them. There may be some ulceration of the surface exposing red, fleshy tissue underneath. They can be well defined or cover large, ill-defined areas. They are commonest in the face, groin, sheath, and armpit areas.

Nodular Sarcoid

Discreet solid nodules of variable size are common under the skin in the eyelid, armpit, inside thigh and groin regions. They can be single or multiple (often they can be present in hundreds). Many have no skin involvement (the skin can be moved freely over the surface) but some are firmly attached to the overlying skin (the skin cannot be moved over the surface of the nodule). Some ulcerate and form bleeding exudative masses.

Fibroblastic Sarcoid

Fibroblastic form presents particular problems in diagnosis in that it has a fleshy, ulcerated appearance which may be indistinguishable from exuberant granulation tissue (proud flesh). Fleshy masses, sometimes with a thin pedicle or with a wide flat base that commonly bleed easily. They may have a wet, haemorrhagic surface. They are common at almost every site and may develop quickly from a milder form following damage. The tumors may appear in wounds during the proliferative stages of wound healing, or, more often, at the wound site several months after obvious termination of original wound healing.  They also commonly develop at the site of skin injuries on the limbs.

Mixed Sarcoid

Variable mixtures of two or more of the other types. They can develop at any site but are commonest on the head, armpit and groin.

Malevolent Sarcoid

This is the most aggressive type in which the tumours spread extensively through the skin with cords of tumour tissue interspersed with nodules and ulcerating fibroblastic lesions. There are often some overlying verrucose and occult lesions. It is a rare form but is most commonly encountered in the elbow and face areas.

It is not known whether sarcoid tumours are transmissible between horses. There is no justification at present to worry about horses with sarcoids in contact with those without. Nevertheless, sensible fly control measures and hygienic wound management are always advisable for affected and unaffected horses. In particular horses with sarcoids that injure themselves (particularly on the limbs) should have extra attention to the wounds as soon as possible.

Treatment

Sarcoids are difficult to treat. Several treatments are commonly used - this suggests that no one is universally effective. Some can be very successful on some occasions and ineffective on others.

Surgical removal: Can be effective for very small lesions in safe areas but carries a relatively high failure rate due to difficulty to assess the borders of the tumor during surgery. Special surgical precautions can be taken to reduce (but not eliminate) the risk of recurrence. Nodules round the eye should not be treated surgically without careful consideration.

Cryosurgery (freezing): This is only effective for lesions with limited size and depth. There is a high rate of recurrence. To be effective freezing needs to be aggressive and it may cause extensive damage to surrounding structures and extensive scarring.

BCG Injection: This method works reasonably well for nodular and fibroblastic lesions around the eyes but is much less effective elsewhere. It should not be used on sarcoids on the limbs - they will often become much worse! The method has significant risks and so careful supportive medication is required.

Chemotherapy: Injection of cytotoxic drugs such as cisplatin into the centre of lesions is a useful method of treatment for some types but is restricted to certain types of sarcoid. The material is also very dangerous to the surgeon and special precautions must be taken.

Radiation: This is very expensive but it is near 100% effective. Usually it is preserved for small lesions at difficult sites such as around the eyes and over joints.  

Essential Oil Therapy: Topical application of diluted essential oils. Natural and safe treatment to stimulate the immune system, fight the bovine papilloma virus, eliminate toxins and to keep flies away. Can also be used  to promote healthy cell growth after surgical removal and cryosurgery. Excellent for wound care, preventing injuries  developing into sarcoids. Many essential oils have antiseptic, antibacterial, antiviral and antitumoral properties.  

 Essentilal Oils should only be administered under the supervision or the directions of a qualified aromatherapist.

Diagnosis

A diagnosis can be confirmed by biopsy (removing a small piece of tissue for examination under the microscope) of the lesions but may also be contraindicated  if a Sarcoid is suspected because of the risk of making the condition worse. Accidental or intentional (e.g. biopsy or surgical interference) damage to a Sarcoid may result in a more aggressive lesion with rapid re-growth.

Development of Sarcoids

Sarcoids are commonly reported to multiply on an individual horse over the summer and grow over winter. Most cases are first recognised in the spring following their initial development the summer before.  Flies are heavily implicated in the spread of sarcoid over the individual horse but whether sarcoids are transmissible between horses is very uncertain. Fly control measures on a horse with sarcoids through the summer months is important. Good fly control is likely to limit the development of new lesions. Many cases remain relatively static in growth over the summer months (although they remain liable to fly worry and consequent infection and inflammation and so may appear to be growing). Some sarcoids do not follow this rule! Some individual sarcoid lesions remain completely static for years (or even for the whole life of the horse). This is more common where there are few lesions of the occult or verrucose variety. There is nothing to indicate which cases will remain static and which will get worse. Static lesions tend however to be small, wide-based verrucose sarcoids. Some cases are very aggressive and grow persistently. Horses will often develop progressively more lesions over ensuing years but some will not.

A few cases heal spontaneously with complete disappearance of the lesions. These animals can then usually be regarded as being "immune" to the disease. It seems very unlikely that any new ones will develop in these cases.

Sarcoids and injuries

Horses with sarcoids that injure themselves can develop serious sarcoid lesions at the site of the injury. Injuries on the body and neck usually develop into verrucose sarcoids while wounds on the distal limb usually develop into aggressive fibroblastic sarcoids. Wound management is particularly important in horses with sarcoids and especially so over the summer months. If a wound (particularly on the limb of a horse with other sarcoids) fails to heal it should be tested for this possibility. Unaffected horses that injure themselves (over the summer/fly months in particular) and are in contact with sarcoid cases should be treated extra carefully. Prevention of fly contact with wounds seems to be a sensible preventive measure.

Prevention of sarcoids

An early diagnosis and prompt and effective treatment is the best overall policy. Do not wait for the condition to get better - it probably will not, it probably will only get worse ! Treatment becomes increasingly difficult with advancing time and clinical deterioration. To minimize the risk of development of sarcoids and/or exuberant granulation tissue in wounds, especially at the lower parts of extremities, prophylaxis, in the form of initially correct wound treatment, is essential. The use of prophylactic, systemic antibacterial therapy must always be considered.  Applicaton of diluted essential oils on wounds and injuries has proved to be very effective preventing sarcoids developing and repelling flies.  Essential oils should only be administered under the supervision or the directions of a qualified aromatherapist.

 Essential Oil Therapy and Sarcoids

The topical application of diluted essential oils is a natural and safe treatment to stimulate the immune system, fight the bovine papilloma virus, eliminate toxins and to keep flies away. Aromatherapy approaches ailments in a holistic way considering emotional and physical aspects, therefore a detailed case history which takes into account the animal's past history, temperament and personality is necessary to treat the animal individually. The oils contain ingredients that sick or injured animals would instinctively choose and eat in nature. It is a great advantage if the horse can choose its own oils (osmology test)  and so actively participate in the healing process. Up to 5 suitable oils are picked out, offered to the horse and then the reaction is assessed.

A customized blend of essential oils and herbal extracts is prepared and applied topically to the sarcoid.  

Nach seinen biologischen Eigenschaften ist das Equine Sarkoid ein semi-maligner Hauttumor die sich im Bindegewebe befindet. Es wächst lokal aggressiv und infiltrativ, eine Metastasierung wird nicht beobachtet.  Diese Tumoren gehören zu den epithelialen Tumoren wie die Melanome und einige Karzinome. Die Sarkoide treten bei 1-2% von der Pferdepopulation auf und stellen somit den häufigsten equinen Tumoren dar. Ca. 90 % aller Hauttumoren beim Pferd sind Equine Sarkoide. Grundsätzlich können Pferde aller Altersstufen an Sarkoiden erkranken.

Die Tumore können überall am Körper auftreten, sind aber meistens an den Geschlechtsteilen, zwischen den Vorderbeinen, an der Innenseite der Hinterbeine, in der Gurtlage oder am Kopf zu finden.

Sarkoide wachsen von kleiner Warzenform zu Tennisballgröße, häufig in Schüben, meist schnell, sind aber grund- sätzlich gutartig und bilden selten Metastasen.

Klinisch zeigen sie sich als trockene, schuppige Hautveränderungen, die ulcerieren und bluten können. Primäre Probleme dabei sind Infektionen der offenen Partien und mechanische Behinderung.

Ursache

An der Entstehung des equinen Sarkoide ist eine Infektion mit dem bovinen Papillomavirus Typ BPV1  oder dem nahe verwandten Typ BPV2 ursächlich beteiligt. Unter der Annahme, dass weit mehr Pferde der BPV Virus Infektion ausgesetzt sind, als sich equine Sarkoide entwickeln, kann man davon ausgehen, dass in Fällen, in denen es zur Ausbildung der equinen Sarkoide kommt, die Immunantwort der erkrankten Pferde unzureichend ist.

Verrucöse  Sarkoide

Typischerweise sind sie Golfball-große, trockene Gebilde unter der Haut. Sie befinden sich häufig am Kopf, Brust- und Schultergegend und peripher an den Gliedmassen. Die Haut darüber ist meist haarlos.

Fibroblastische Sarkoide

Wenn ein verrucöses Sarkoid zu groß wird und sich teilt oder mechanisch beschädigt wird, kann es sich in diese Form wandeln. Dabei kommt es zu massivem Größenwachstum, bis zu Fußballdurchmesser, die häufig zu Blutungen neigen. Die Folgen sind Ulceration, Irritation (z.B. durch Fliegen) und daraufhin lokale Infektionen. Die Fibro- blastenproliferation betrifft primär die Dermis, in seltenen Fällen kann auch die Subkutis beteiligt sein.

Occulte Sarkoide

Diese sind die abgeflachte Form der Sarkoide, die sich bei Beschädigung auch zu fibroblastischen wandeln können. Lokalisation ebenfalls am Kopf, seitliche Brustwand, Unterbauch und distale Extremitäten.  Sie können invasiv sein.

Behandlung

Inzwischen gibt es verschiedene Behandlungsmethode, zum Beispiel das Herausschneiden, Kältechirurgie, Injektion eines Impfstoffs, die Operation mit Laserstrahlen usw.
Sarkoide neigen leider nach chirurgischer Entfernung zur Rezidivierung und können an gleicher Stelle wieder erscheinen.

Für die Pflanzenheikunde spielt die genaue Bestimmung des Sarkoids keine Rolle. Die Abwehrkräfte des Körpers müssen unterstützt werden, damit das bovine Papilloma Virus erfolgreich bekämpf werden kann. Die Kombination von der Therapie mit ätherischen Oelen und der Zufütterung von bestimmten Heilpflanzen hat sich sehr erfolgreich erwiesen. Ziel einer Immuntherapie zur Behandlung equiner Sarkoide ist es daher, das Immunsystem betroffener Pferde gegen Tumorantigene zu stimulieren und auf diese Weise die Regression des Tumors auszulösen.

Die Wahrscheinlichkeit dass Sarkoide wieder erscheinen nach einer operativen Entfernung ist relativ groß. Es ist sehr ratsam andere Behandlungen zuerst auszuprobieren bevor man sich für das Wegschneiden entscheidet.
Eine Heilung/ Linderung ist durchaus möglich ohne OP.
Das Sarkoide Gel enthält ätherische Öle die anti-viral (Bovine Papilloma Virus), anti-tumoral, entzündungshemmend und stärkend auf die Immunabwehr wirken. Es eliminiert auch Toxine und hält Insekten fern. Die Moleküle von den ätherischen Ölen sind klein genug um effizient über die Haut in Gewebe, Lymph-, und Blutbahn zu gelangen. Die Selbstheilungskräfte des Organismus werden dadurch aktiviert um seelische sowie körperliche Vorgänge zu beeinflussen. Blockaden werden gelöst und die Energie kann wieder frei fließen. Das Sarkoide Gel basiert auf Aloe Vera Gel, dass lindernde und entzündungshemmende Eigenschaften aufweist.

Das Sarkoide Gel haben wir seit mehreren Jahren erfolgreich eingesetzt und viele Tierärzte in Europa verschreiben es. Wie mit allen anderen Methoden gibt es jedoch keine 100% Garantie auf Erfolg.  Je eher man mit der Behandlung anfängt umso größer ist die Chance dass das Sarkoid ganz verheilt. Ein Photo, damit Größe, Aussehen und Befindlichkeit des Sarkoid festgestellt werden kann, wäre für die Behandlung hilfreich, ist aber nicht zwingend.

Wichtig ist ein regelmäßiges Auftragen des Sarkoide Gel, zwei mal täglich, damit sich die Wirkung von den ätherischen Ölen voll entfalten kann.

Wenn Sie Fragen während der Behandlung haben, können Sie AROMANSI per Email kontaktieren. Wir beraten Sie gerne.

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