• Regimen:
○ ○ Successive injections are given at 1, 2 and
3 week intervals with each subsequent
injection being given a further week apart, up
to a maximum of 4 week intervals, until an
effect is observed. Three to 9 doses are usually
required (~5).
○ ○ Commonly some swelling at site and even
abscess formation with sinus tract formation.
○ ○ Monitor horse for 12-14 h post-injection due
to risk of anaphylaxis.
• Freeze-dried attenuated BCG is cheaper, but more
dangerous to operator and more liable to cause
anaphylaxis.
Hyperthermia
• Requires repeated application over several weeks
- impractical.
delay the application of proper methods often to
the point where conventional medicine has no
chance.
Before embarking on this, a proper analysis of
clinically derived trials must be studied. Usually →
failure of declaration of any results at all.
Monitoring
• Resolution of lesions.
• Non-recurrence of lesions in same or distant site.
• Good cosmetic and functional results should be
achieved - some caveats at difficult sites such as
the eyelid.
Subsequent management
Treatment
Intralesional therapy
• Cisplatin (emulsion of 1 mg cisplatin/ml in sesame
oil to have prolonged effect from injection - good
for nodular lesions, not for occult lesions) or AW5-
LUDES.
• Lesions around eye and mouth where BCG
unsuccessful.
• Nodular lesions (AW5-LUDES).
• Some treatments may need to be repeated.
• Care must be taken not to traumatize lesions.
Monitoring
• Non-recurrence of lesions.
Prevention
Autogenous vaccination Control
• Illogical, no evidence that they are of any benefit
and may increase severity of condition. • Ensure horses have minimum lesions over summer.
• Ensure good fly control.
• Lesions multiply over summer and grow over
winter.
• Wound management is critical where the horse
has sarcoid or where other in contact horses have
sarcoids.
Homeopathy
• Homeopathic remedies are often used but as
might be expected are universally disappointing
and can → serious exacerbation.
• The main problem with these methods is that they
• Volume 21 Issue 3 | September 2019 •
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