Ocular squamous cell carcinoma?--vet visit rescheduled

texsuze
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Ocular squamous cell carcinoma?--vet visit rescheduled

Postby texsuze » Tue Sep 25, 2018 8:58 pm

Yesterday, I noticed a tiny, gray "bleb" in the outside corner of my oldster's eye, on the sclera. DH sent photos to the equine vet at our local vet clinic and vet suspects squamous cell ca. A biopsy would be needed for a definitive diagnosis, and after that, there might be several treatment options.

My oldster (27 y.o. WB gelding, chestnut) has worn his fly mask nearly every day (including winter) for the past 10 years. Before that, when I boarded him, of course fly masks were always a management problem with multiple horses in each pasture, so were not allowed to be worn. I guess at this point it doesn't matter.

Complicating matters is my confidence in ophthalmic surgery at my small animal/large animal vet clinic. The folks are great and we've used them for years, but... having been to a different, equine-only clinic for my gelding's dentals last spring, I'd rather take my horse there for diagnosis and treatment, despite this initial 'curbside' consultation with our clinic.

Freaking out here that this is what we are dealing with. Any input with personal experience with this condition would help greatly.
Last edited by texsuze on Tue Oct 09, 2018 5:14 pm, edited 1 time in total.

heddylamar
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Re: Talk to me about ocular squamous cell carcinoma

Postby heddylamar » Tue Sep 25, 2018 10:33 pm

Mom's appy gelding who just passed away had an occular squamous cell carcinoma. On the advice of her vet, she hauled him to University of Missouri's vet school where their equine ophthalmologist, Elizabeth A. Giuliano, treated him. Part of G's eyelid was removed, but Dr. Giuliano stitched it back together in such a way what he didn't lose the eyelid (and thus the eye), and over two visits, G received chemo. On the advice of Dr. Giuliano, Mom put him in a fancy $$$ fly mask that blocked UV rays, etc. This is the fly mask: http://www.equinesunvisor.com/esvmaxx.aspx

The results were great -- his eye looked fantastic for the next 5 years, until he died. If I didn't know about the damage, and hadn't cared for his eye post-op, I wouldn't have been able to pin point the damage a year later.

I would recomend contacting Dr. Giuliano to see if she can recommend anyone in your area.

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Re: Talk to me about ocular squamous cell carcinoma

Postby Tsavo » Wed Sep 26, 2018 12:15 am

I have a thread that includes my horse's diagnosis and treatment of squamous cell carcinoma of the third eyelid. My regular vet did an expert job and got clean margins so we didn't need chemo. I added pictures of the surgery and the histopath report.

viewtopic.php?f=6&t=2817

That said, the sclera sounds like a lot more complex surgery than the third eyelid. I am surprised they did not just say they have to take the eye.

Good luck with this.

texsuze
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Re: Talk to me about ocular squamous cell carcinoma

Postby texsuze » Wed Sep 26, 2018 4:12 pm

Thanks for all the input so far. We are scheduled to see a veterinary ophthalmologist in two weeks' time. He works with the clinic I hoped to use, so fingers crossed. A fairly straightforward 2-hour drive away.

As best I can tell, this 'growth' on my horse's eye is limited to the eyeball and not involving the eyelid. He is asymptomatic re: discharge, tears, itching, etc. for now. According to the vet's office, the veterinary ophthalmologist will be able to undertake the diagnostics to confirm the extent of the lesion.

I'll be doing a follow-up post here after our appt. next month. Thanks for all the flymask and professional contact info.

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Re: Talk to me about ocular squamous cell carcinoma

Postby Ryeissa » Thu Sep 27, 2018 6:21 pm

jingles! my dog had a small growth removed from her lower eye, in the sclera. she ended up ok, it wasn't SCC

texsuze
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Re: Talk to me about ocular squamous cell carcinoma

Postby texsuze » Thu Sep 27, 2018 7:02 pm

Thanks; DH wonders if it might not be a pterygium, which humans get from not using sunglasses. Haven't researched to see if this occurs in equines. The vet also invoked a benign hyperplastic type of neoplasm, so that's what I hope this blob turns out to be. I should know in a couple weeks. Thanks for the jingles!

texsuze
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Re: Ocular squamous cell carcinoma?--vet visit rescheduled

Postby texsuze » Tue Oct 09, 2018 5:22 pm

Flash floods, a bit of hail, big 'ol storms... I decided to reschedule today's vet visit, seeing as how we'd be making most of the 2-hour trip to the vet entirely within this line of strong storms as it moves eastward. If my horse were symptomatic, and/or if his eyeball were showing changes, I certainly would've kept the appt. Nerve-wracking decision to make, but it's more about the other drivers on a particular stretch of highway (notorious for MVA deaths).

Now it will be a few more weeks before being able to see the veterinary ophthalmologist. Plan B would be to see my current equine vet here in town if anything changes WRT the eye bleb, vision, or other signs between now and then.

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Re: Ocular squamous cell carcinoma?--vet visit rescheduled

Postby ironbessflint » Wed Oct 17, 2018 3:36 pm

Hi! We've got Haflingers (who are a bit prone to SCC), and have been dealing with this in my mare. Back in 2015 I noticed a small blob in the corner of her eye. Had my regular vet take a look and she agreed it was probably SCC, and to try a topical chemo cream. One tube of the 5-f/u cream later and the blob was gone. We did a few more months of treatment to be safe and I kept her in a UV fly mask from then on, and all was well for quite some time.

This spring I noticed the blob had returned. Vet prescribed the 5-f/u cream again, but three weeks later when it continued to grow despite treatment, she referred us to Michigan State's Ophthalmology department. They did a full exam, agreed that with her breed and history it was likely SCC, but also agreed that different pathology wouldn't necessarily change our course of treatment. Since she had previously responded to the 5-f/u cream and the lesion was quite small, we opted to try a strong chemo before jumping into surgery. After one round (6 weeks, three cycles of week on/week off application) of the mitomycin the lesion was MUCH smaller, so they recommended one more round of the mitomycin, with the understanding that if it was not 100% cleared up after that she WAS going in for surgery. Unfortunately the lesion started growing again during that round.

She went in for surgery on Thursday, September 20, under general anesthesia, and came home on Friday afternoon. She was on stall rest and had to wear a blinder on that eye for about 2 weeks, and had a triple-antibiotic ointment applied during that time as well. She went back for a recheck at the two week mark, we opted to keep going with the abx for another week, but she was allowed to lose the blinder and return to turnout and progress back into work at that point.

Pathology came back confirming that it was SCC, but also confirming clear margins on what was removed. She'll live a UV fly mask for the rest of her life of course, but they feel chance of recurrence will be pretty darn low. She's got some sun damage on the other eye as well (redness and loss of pigmentation), so we'll also keep a close watch on that one.

The tubes of chemo cream ran about $75 each (for both types). The surgery and followup care and supplies totaled less than $3000. Her vision is 100% and I was riding her 2 and a half weeks post op. I'm quite pleased. I was terrified of the surgery (particularly the fact that they wanted to do it under GA and not standing), but all in all it was really NOT a big deal, and I wouldn't hesitate to go down the same road again if needed.

texsuze
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Re: Ocular squamous cell carcinoma?--vet visit rescheduled

Postby texsuze » Wed Oct 17, 2018 8:02 pm

Thanks, 'Flint, for your comprehensive run-down on your mare. Very glad that her prognosis is good, despite all the intervention and chemo. Interesting that the vets opted for treatment first to see if the lesion could be cleared. Our rescheduled appt is 3 weeks from now and I don't have a feel for how extensive the exam will be. My oldster will be seeing a vet ophthalmologist at an equine clinic, not a university center but I am within half a day's drive of Texas A&M University (my alma mater), so presume this vet would refer me to them if necessary. Fingers crossed.


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