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  Discussion on Squamous Cell Carcinoma in the HOOF
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Posted on Thursday, Aug 22, 2002 - 5:52 am:

Jack is a 10 year QH gelding. Two weeks ago, my farrier discovered a yellowish mass on the bottom of his hoof at the outer angle of the sole. He believed it to be a corn and did minimal trimming on that hoof due to apparrent sensitivity. He recommended I soak it in betadine and water and call the vet in the AM to have a look/see. That night when I took Jack out of his stall, I discovered the outer wall of the same hoof, near his heel had broken away and granulated flesh was protruding from the site. The vet came the following morning, diagnosed the mass as Canker and cut away all affected hoof tissue taking nearly 1/5 of his hoof away, then it was cauterized. A egg bar shoe was applied so that Jack could bear weight. A sample of the tissue was sent to the state lab in Kississimme for dissection. His foot was bandaged (changed daily) with copper sulphate, then cotton, vetwrap, bandage tape, and finally duct tape. Betadine soaks daily to loosen old cotton from wound. 5 days later the path report came back-Malignant Squamous Cell Carcinoma.-not canker. Both the vet and the farrier were shocked. The lab was called to double check and the same result reported. I have searched for days for any type of documentation of this in the hoof and have found none...any ideas? thoughts? probability of recurrance? probability the tumor metastized before it was excised?
thankyou,
April

Posted on Thursday, Aug 22, 2002 - 8:36 am:

No this is a first for me. I am afraid I cannot answer any of your questions because I cannot see the extent of the lesion: Does your vet think the affected tissues be completely excised? If not there are other alternatives listed in the article associated with this forum. I think you may need a veterinary oncologist on this one but SCC generally has a good prognosis and is slow to metastasize.
DrO

Posted on Thursday, Aug 22, 2002 - 9:02 am:

Dear Dr. O,
My vet thinks he excised the entire lesion-
Could there be a possibility the pathologist is incorrect? Does squamous cell carcinoma look anything like canker tissue under gross observation? Also no fungal elements were noted in the specimen only bacilli colonies-is this typical of canker? I guess what I am getting at is how should we treat the horse given the available info? The vet does not fully accept the cancer d/x and wants to continue to treat the hoof as a canker-(By the way, I am going to talk to him today re:the use of caustic agents-the applications you recommend are the best I've seen on this topic-it just doesnt make sense to apply dressings that will only damage coveted new tissue) So if its cancer-is there really a need to follow the same regimen as canker? And one more question-I have read in the literature that canker is an anaerobic phenomena-would exposing the hoof to air for part of the day be beneficial-i.e. in a clean stall with absorbant bedding? Sorry I know this is wordy-I appreciate your help more than you know.
April

Posted on Friday, Aug 23, 2002 - 6:06 am:

It seems unlikely that malignant SCC would be confused with canker but this should be discussed with the pathologist who looked at the sample and if you continue not to feel confident have the sample forwarded to a pathologist at the Uni of FL Vet School. No it is not unusual not to find fungal elements, Canker is believed to be a bacterial disease.

I believe you can have your cake and eat it to: begin treating with noncaustic antibacterials but specific for canker, just like you would for a healing wound, in the mean time get to the bottom of the histopath sample and then you will know what to do next.
DrO

Posted on Friday, Aug 23, 2002 - 7:37 am:

Dear Doc-It is my vet and farrier that are having trouble swallowing the carcinoma d/x- I wouldnt know a squamous cell from a seashell! It just seemed important at the time to suggest that we send it off for i.d.-now I'm glad we did. This AM he was not bearing weight on that leg and the bulb of his heel on the side where the mass was removed looks puffy and irregular to me(lower than the right side also)-the sole and side of the hoof look sleek and clean though...hope that nasty bugger didnt go north.
Fingers crossed,
April
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