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  Discussion on MELANOMAS IN THE THROAT LATCH AREA
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Member:
infiniti

Posted on Thursday, Apr 9, 2009 - 12:04 pm:

Ok guys...I think I'm posting in the right area (hopefully)! I've read through the Drs. info on melanomas and the numerous questions and answers. But most pertain to the backside of the horse. My question is: Does anyone own a grey horse that has been diagnosed with melanomas in the throat latch area and what has been the outcome? It appears this is a very difficult area to treat.
Member:
mitch316

Posted on Thursday, Apr 9, 2009 - 11:55 pm:

Pam, I have not had a gray horse with melanoma, but have helped treat quiet a few horses with either injury or some other problems there. The problems we had were not that it was necessarily difficult, but it was very easy for them to scratch the fire out of themselves, causing a secondary problem. Being that the skin is so tender and thin, it does seem that every scratch, cut, or even melanoma's are harder to heal and sometimes fester up with some really awful looking drainage. Someone correct me if I am wrong, but I think it is more the location that the actual melanoma that makes this area difficult to treat.
Moderator:
DrO

Posted on Friday, Apr 10, 2009 - 6:33 am:

Hello Pam,
When you say throat latch can you tell us what specific anatomical structures are involved with your melanomas? For instance melanomas of the skin of the throat latch would not be any more difficult to treat than on the skin anywhere. You do see melanomas in this area that can involve deeper structures, including large veins, arteries, nerves, lymph nodes and salivary glands. So the specifics of your case will depend on the specifics of the location and involvement of these structures.
DrO
Member:
infiniti

Posted on Friday, Apr 10, 2009 - 11:28 am:

The area in question would be his lymph nodes and salivary glands. I've just recently noticed some pea sized melanomas closer to the base of his ears that weren't there at the time of his laser treatment a few weeks ago. I was told at the time (by my vet) that the slight swelling of his lymph nodes was probably due to the filtering of melanomas through his system.

I've read through all your excellent articles, but was at a loss when it came to any specific treatment of melanomas in these areas.
Moderator:
DrO

Posted on Friday, Apr 10, 2009 - 7:18 pm:

Pam, when you say the area do you mean it is in that area or that there are organs tied up intimately in the melanoma. If it is uncertain this is your first step determine the extent and involvement of the melanomas. A good ultrasound and experienced ultrasoundographer should help clear this up. If they are not intimately involved then surgical removal or some of the other typical methods used. If they are, the images or horse needs referral to a soft tissue surgeon for a treatment plan and prognosis. Even knowing they are the devil will be in the details and decisions made whether to completely remove the organ or whether partial removal may be OK.
DrO
Member:
infiniti

Posted on Friday, Apr 10, 2009 - 8:06 pm:

Do these melanomas typically attach themselves to these glands? I just got back from the barn and I felt some melanomas (pea size) above the area of the lymph nodes closer to the base of his ear. They seem to be lining up in that grove between his jaw bone and neck and quite close to the surface. I think I will have to go and look at a picture of a horses head and jaw line to give you a more detail description.

I truly appreciate all your input. If you have any recomendations for an ultrasoundographer and surgeon I live in Los Angeles, CA.
Member:
mitch316

Posted on Saturday, Apr 11, 2009 - 7:59 am:

Pam, not to play a devil's advocate or anything, are you sure these are melanomas? Seems like you got quiet a few bumps there and I am not trying to insult your intelligence, just trying to cover all bases. There are some pretty good anatomical pictures on here under references that you could copy/paste over here to point us in the right direction. When you said throat latch area, I was thinking the soft area running up the middle, growing larger as it becomes closer to the neck. Horrible description, so I hope I do not confuse anyone like I think I did myself, ha.
Moderator:
DrO

Posted on Saturday, Apr 11, 2009 - 8:28 am:

I have seen rather large melanomas that involve the deeper structures of the throatlatch, so it happens. Has the horse been examined by a veterinarian, if these are superficial an exam might be all it might take to rule out deeper involvement. As to local imaging I am not familiar with who is out there but your veterinarian should have an idea. When all else fails the closest veterinary school is a good bet.
DrO
Member:
infiniti

Posted on Saturday, Apr 11, 2009 - 10:48 am:

First of all, thank you Dr. for your timely input. I believe the area in question is the parotid salivary gland, this is where I can feel a couple of small nodules within some swelling of this area. If you recall in my last post, he had several small melanomas (vet said benign) lasered from under his tail and perianal area. I've had him on cimetidine at your recommended dosage since March 18th.

I will now hunt down a competent surgeon and vet hospital. I understand you don't have enough info for a prognosis and since he just turned 10, I'm going to do everything possible for him. It seems this situation can take many turns for better or worse...wish me and my horse luck and I'll keep you update.

And Jesse, I wish you were insulting my intelligence and these were just bug bites. If you google equine parotid gland you'll see several sites with pictures.
Member:
infiniti

Posted on Saturday, Apr 11, 2009 - 12:40 pm:

Dr. one more question...should I wait a couple of more months and to see it if the cimetidine will have an effect or, schedule an appointment with a vet?
Member:
mitch316

Posted on Sunday, Apr 12, 2009 - 1:07 am:

Pam, just trying to cover all bases. I would have to say that the treatment options depend on whether the melanomas are still localized at the skin, or have metastasized into the surrounding tissues and organs.

You can do a search to find the closest equine hospital equipped to handle this condition. I am not familiar with your area so do not know if any schools are close (is anything close in a city as large as Los Angeles?), but I do know that there are equine vets around, especially down in the valley where all the horse farms and ranches are located.
Moderator:
DrO

Posted on Sunday, Apr 12, 2009 - 9:25 am:

If there is a possibility of organ involvement I would not wait as early assessment might catch it before it becomes impossible to treat.
DrO
Member:
infiniti

Posted on Sunday, Apr 12, 2009 - 11:53 am:

I've located a surgeon and hospital near my home and now will make the necessary calls. Do you need a referral from your vet? I've lost faith in the one I've known for years, especially in the pre purchase of this horse...small subdermal bumps under tail, nothing to worry about. No mention of grays and melanomas, etc. Sorry, just had to vent.

I will keep you posted.
Member:
vickiann

Posted on Sunday, Apr 12, 2009 - 4:06 pm:

Good luck Pam and it is good to hear that you are pursuing this promptly.

I don't blame you for being frustrated as I have also been on the receiving end of "Nothing to worry about" when there was plenty to worry about.
Moderator:
DrO

Posted on Monday, Apr 13, 2009 - 8:59 am:

Pam it will depend on the policy of the hospital, call and ask.
DrO
New Member:
lwmilne

Posted on Saturday, Apr 18, 2009 - 4:53 pm:

sorry to butt in here. I was told by a friend that Virginia Tech in Blacksburg is using grapeseed extract as an anti-inflammatory to decrease the size of the melanoma lesions. I do not see any reference to that in your article, dr. O. It sounds a bit "voodoo" but was wondering if you had heard of it.
Moderator:
DrO

Posted on Sunday, Apr 19, 2009 - 10:13 am:

hello Leslie,
We have had grapeseed recommended bug repellent, ulcer treatment, treatment for infections and now melanomas. The fact is none of this studied so we don't know what use there might be in these conditions. Quite frankly I would have little hope for help in the genetic disorder we know as equine melanomas.

Grapeseed extract is rich in flavonoids that have antioxidant properties in biological systems but there is a long way to go to see what might be the benefits of their use and what might be appropriated dosages to achieve this result but their are suggestions this might be helpful in preventing cardiovascular disease in humans.
DrO
Member:
infiniti

Posted on Wednesday, Apr 22, 2009 - 2:04 pm:

DrO, my horse is responding to the cimetidine; there's a decrease in the swelling and some of the small nodules in the area of his salivary glands. I'm keeping a WATCHFUL EYE on this area. Now, my question is my barn is having a vaccination clinic and will be giving the Flu/Rhino, Pinnacle(?), and West Nile. All these are mandatory. Will these vaccinations decrease the effectiveness of cimetidine? He's been on it for exactly a month today.
Member:
vickiann

Posted on Wednesday, Apr 22, 2009 - 4:58 pm:

That is great news, Pam and it will be interesting to see what Dr. O has to say about the vaccinations.
Moderator:
DrO

Posted on Thursday, Apr 23, 2009 - 7:22 am:

Pam there is no research on this subject but I am unaware of any such reports.
DrO
Member:
infiniti

Posted on Thursday, Apr 23, 2009 - 11:29 am:

What would be your "gut feeling" on this? He's had these vaccinations before. A year ago or so I had my vet run a titre(sp?) on both my horses to see what level of immunity they had for Strangles, etc.; at the time, I was more interested in not over vaccinating my older gelding. My vet suggested we run tests on both horses and found that Silverado's levels were quite low and needed yearly vaccinations.
Moderator:
DrO

Posted on Friday, Apr 24, 2009 - 7:50 am:

The lack of such reports in what is a fairly commonly instituted treatments suggest it will not effect the outcome.
DrO
Member:
infiniti

Posted on Friday, Apr 24, 2009 - 10:34 am:

Thank you DrO. As always, your timely responses are greatly appreciated.
New Member:
lwmilne

Posted on Friday, Apr 24, 2009 - 11:51 am:

I have been interested in starting cimetidine on my horse with melanoma in the throat latch area. I am a people doctor and am curious about the horse dosing. If my horse weighs 912 lbs=414 kg, the dosing is about 1035 mg. (2.5 mg/kg) Human pills come in 50 mg tabs over-the-counter. Do I just give him lots of these or do I need a prescription for a more concentrated formula for horses?
Member:
infiniti

Posted on Friday, Apr 24, 2009 - 12:27 pm:

Leslie, I get my cimetidine from FarmVet.com. I use the 800mg (500 ct.) tablets which I've been giving my horse 3x a day for a month now and have seen some improvement so I'll continue for another month.

My horse weighs 1365lbs., I wonder if he's receiving the correct dosage...DrO?
Moderator:
DrO

Posted on Monday, Apr 27, 2009 - 7:29 am:

Pam the article gives our recommendations on dosage.
DrO
Member:
infiniti

Posted on Friday, May 29, 2009 - 4:01 pm:

DrO,

Here's an update on the above referenced horse. I took Silverado to West Coast Equine hospital and the surgeon there implanted 6 cisplatin beads in the area around the parotid gland area near the base of his ear. He did some debulking first before the implantation. He also had a smalll melanoma removed on the other side of his head which he said he could remove surgically without any undue problems since it was closer to the skin surface. I believe he was only able to get maybe 50% of it because he nicked a vein and had to quickly clamp it off. I was watching this whole procedure and was wondering at the time how much blood a horse could loose before being compromised! Anyway, I asked him if this would cause rapid regrowth of the tumor and he just shrugged and said he would implant some cisplatin beads in the area if it does. Your thoughts on this?

The area that was treated with the beads went much more smoothly. He did "some" debulking of the area and then proceeded with the implants. There is swelling in both area's and I guess that's to be expected.

I read that these beads desolve slowly over 30 days. Is this correct? With so much swelling it would be difficult to see any improvement. Have you heard from anyone on this site who's done this procedure? I would be curious to know. One more question, my horse has been on cimetidine 3x's a day for exactly 2 months. Should I continue?

Thanks in advance,
Pam
Moderator:
DrO

Posted on Friday, May 29, 2009 - 4:52 pm:

They can loose about a gallon acutely before swooning. No I don't think anyone on the site has used the beads and I have not yet either however the experimental work has shown consistently good results. The desolution rate sounds about right and yes the plan for the side next to a big vein reasonable from the information provided.

I would discontinue the cimetidine myself, I believe active metabolism of the tumor increases the sensitivity of the tumors to the cisplatin and cimetidine may slow this down...but I am out on a limb with two conjectures here.
DrO
Member:
infiniti

Posted on Friday, May 29, 2009 - 6:09 pm:

What are the two conjectures? Could you possibly lead me to some more research or is this area of discussion still too new? I have read about the good results in regards to the beads and melanomas.
Moderator:
DrO

Posted on Saturday, May 30, 2009 - 8:25 am:

1) Cimetidine works by slowing down the tumors metabolism.
2) Cisplatin works best on metabolically active tumors.

We have an article on cisplatin at Treatments and Medications for Horses » Miscellaneous Drugs » Cisplatin.
Member:
infiniti

Posted on Saturday, May 30, 2009 - 10:31 am:

Thank you DrO for taking the time to explain your response. I didn't quite understand what you meant by "I am out on a limb with two conjectures here".
Member:
infiniti

Posted on Monday, Jun 1, 2009 - 11:53 am:

Would immunostimulants work in a case like this? I just stopped giving my horse the cimetidine per your advice and I feel very nervous since I believe it may have been controlling (to a degree) the spread of these disgusting melanomas.
Moderator:
DrO

Posted on Tuesday, Jun 2, 2009 - 7:54 am:

Pam I do not give instructions and the decision to medicate or not medicate always should be made as a decision between the horses owner and veterinarian. The information I provide is for your consideration as I cannot examine the horse. From the information you have provided, if I was presented with such a case, it is what I would do and for the reasons provided.

I don't think a immune stimulant is indicated here.
DrO
New Member:
cbauer

Posted on Monday, Jul 6, 2009 - 8:50 pm:

https://www.horseadvice.com/horse/messages/4/311774.html
I have 7 yr old grey with possible melanoma in the throat latch area. How is the recovery coming. I'm at the ultra sound stage. In the process of making arrangements. I'm in San Juan Capistrano. Who did you go to & where are they? When I put West Coast Vetrinary hospital I get vets all over the state of CA. Appreciate your help
Member:
infiniti

Posted on Tuesday, Jul 7, 2009 - 2:33 am:

I'm sorry to hear about your horse. Silverado is recovering nicely. I'm about to call the vet out for a recheck,since the swelling has gone down quite a bit. I took my horse to West Coast Equine out in Somis, and the surgeon by the name of Dr. Kent Sullivan did the implantation of the beads. My gut feeling tells me he may have to go back for another round (not unusual). I was pleased that there were no outward signs of discomfort from the cisplatin. Please keep us posted when you get the ultra sound done.
New Member:
cbauer

Posted on Tuesday, Jul 7, 2009 - 9:17 am:

That must be where I took my mare for stone removal. She was 32.5 yrs. They didn't want to operate but I went ahead & had the surgery. She lived 2.5 yrs after. It's a wonderful hospital Dr. Mike did the operation. They are wonderful. My first instinct was to send her there. They are by far my favorite. What's not to like, they saved my old mare. What kind of price tag if I can be so crass?
Member:
rg77

Posted on Tuesday, Jul 7, 2009 - 12:12 pm:

Hi Pam, DrO, I thought this would be a good time to share my experiences with you guys about veterinarians that use Ozone Therapy as part of their practice.
The knowledge about Ozone comes from decades of use in human medicine in Europe (most of the research is published in german). It is very effective against bacterias, viruses, cancers, tumors, which is why it is a major part of the protocol in several cancer clinics around the world (outside the US) It is very safe to use, and I have also had it done (IV) on myself by a MD in New Jersey (for preventative health purposes). It is used by a few veterinarians around the country as its uses can be beneficial in several areas. It can be administered IV, intra-articular, sub dermal, bagging of a wound, intra-vaginal, ozonated water can be used as a potent disinfectant during surgeries etc.
DrO, a couple of weeks ago there was a thread by Lisa Danforth about her 4 month old colt with a severe hock infection. That would be an example of how if that vet had access to ozone therapy, then while he took some of that joint fluid for testing, he could have injected some ozone into the joint...and by the time the results came back, the infection would have been history.

I thought at the very least, Pam, if you can't find a vet in LA that did ozone, then you could consult with a vet that had experience in it, and see what they had to say. You can visit the link below as an example of one of the vets you could call. You can read some of the articles on the site as well.

https://www.fullcircleequine.com/services.htm
Member:
infiniti

Posted on Tuesday, Jul 7, 2009 - 6:30 pm:

Cyndi it sounds like you took your horse to Alamo Pintado. Somis was a lot closer to where I live. Cost of treatment was $750.00. By the way, I just left a message for Dr. Sullivan to contact me.
Moderator:
DrO

Posted on Thursday, Jul 9, 2009 - 7:46 am:

A comment on ozone therapy. First we should note that the science on ozone therapy in medicine is growing and from the early research there seems to some indication for its use. However it should not be currently looked at as a cure all as you intimate in the hock case. There is still much work to be done with what is a fairly toxic oxidative molecule and it's use carefully considered based on the scientific work available.
DrO
Member:
infiniti

Posted on Thursday, Jul 9, 2009 - 5:19 pm:

Good Afternoon Dr.O and Cyndi,
Just had a recheck done yesterday and my vet said the cisplatin beads are working; the tumor is smaller and he will recheck again in 6 weeks. These beads (6), were implanted 6 weeks ago and I was very happy with the implantation procedure (no anesthesia). Cyndi, there are a few equine hospitals in your area...I would take your horse to a hospital and they might be able to use these beads in the treatment of your horse. The tumor that is being treated on my horse, is in an area that would be very difficult to operate on without causing nerve damage, etc. I too, had my horse on cimetadine but have since discontinued it per Dr.O's recommendation. It seems the jury is out on it's effectiveness. However, the cisplatin beads have a very high success rate.
Member:
vickiann

Posted on Friday, Jul 10, 2009 - 4:04 pm:

Great news, Pam!

Thanks for the update.
Moderator:
DrO

Posted on Saturday, Jul 11, 2009 - 2:42 pm:

Great to hear the progress report Pam.

Cyndi, I want you to start by carefully studying the article associated with this discussion Diseases of Horses » Skin Diseases, Wounds, and Swellings » Bumps / Nodules / Warts / Tumors » Melanomas. It should answer your very general question or at least give you many ideas about what is available. If when you get done you still have some questions post them in a new discussion. By keeping specific cases separate it makes reading the discussions easier.
DrO
Member:
infiniti

Posted on Friday, Jul 17, 2009 - 7:15 pm:

Cyndi,

I saw your post from this site, but inadvertently deleted it. You were talking about your horse's upcoming surgery. Would it be possible for you to let DrO and myself know the findings even if you have to start a new discussion. The medical field is finally acknowledging the fact that "grey horse melanomas" need to be addressed in a more agressive manner.
Member:
cbauer

Posted on Thursday, Jul 23, 2009 - 9:35 pm:

SILVERADO 6/30/09
POSTING FOR PAM LEVY - HORSE IN THIS DISCUSSION THREADSILVERADO
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