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  Discussion on Growth inside mouth of 30 Y.O. gelding
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Posted on Tuesday, Apr 9, 2002 - 2:50 pm:

Hello Dr.,

My wife has had General, a 30+ year old American Draft palamino gelding, longer than she has had me - 25+ years, he is in good condition for a horse his age. Two weeks ago he developed what was found to be a Squamous Cell Carcinoma ("High-grade, undifferent malignancy, oral mucous membrane") inside his mouth on the back lower jaw gum-line. The vet that came out specializes in dentistry, and after sedating the horse, he manually pulled the top off of the tumor (the material sluffed of quite easily) and sent it in for biopsy that confirmed SCC. For the last year or so he has been eating moistened sweet grain/complete horse feed pellets with some free feed alfalfa and fescue hay (of which we have seen that he has been balling the hay/alfalfa up sometimes and spitting it out). Last week he stopped eating the grain mixture, so it's a good thing that it is Spring because he only wants to eat the young grass.

My questions are:
1) what is the prognosis for SCC found in the mouth ?
2) is there any other treatment that we should consider, taking into account General's age (30+) ?
3) how may this disease progress and how rapidly ?
and lastly
4) for General's quality of life, what are the questions to consider in choosing when to have him put down ?

Posted on Wednesday, Apr 10, 2002 - 5:14 am:

Hello Mat,
I am very sorry to hear about your wifes gelding. I don't think simply pulling off the top is likely to be curative. There are not enough oral cases to know what the prognosis is but I see no reason that the same treatment and prognosis principles applying to skin and eye SCC would not apply here (see article for details).

The most important difference would be that in this location it may have been there for a while making metastasis more likely. SCC can be both locally destructive and metastasize so I would expect the tumor to enlarge and affect the surrounding tissues of the mouth, creating a large sore area prone to swelling and infection. It can also metastasize to the local lymph nodes causing them to enlarge. Other organ involvement is rare. The time frame is variable from months to several years.

The fourth question is certainly the hardest to answer. I would say there are two main considerations:
1) Overall body condition and the ability to maintain it.
2) How much pain is General in. Generally chronic pain of this time is exhibited by inappetance and depression.
Hope this helps Mat and if after reviewing the article you have any more questions let me know.
DrO
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