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Discussion on Squamous Cell Carcinoma & ERU
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Posted on Wednesday, Jan 24, 2001 - 4:49 am:
DrO:
My 12 year old TWH has ERU in his left eye (not much damage yet) and now has been diagnosed with SCC in the same eye. It is below the sight line and still in early stages. The surgery is expensive and I'm wondering what to do considering the existing problem with his eye. He has two to three episodes a year of the ERU. Any insight would be greatly appreciated.
Paula
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Posted on Thursday, Jan 25, 2001 - 6:57 am:
Hello Paula,
It is not clear what your concerns (expense, loss of the eye, SCC spreading to the brain) are in your post. Since we do not know how long the eye may be useful, do to the ERU, it is impossible to know with certainty what the best course is. You must look at your goals and finances and from there decide what is the best course.
DrO
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Posted on Thursday, Jan 25, 2001 - 7:54 am:
Thank you DrO
This is a tough one. I want to do what is best for Tango, but there is not an easy answer and the time for decision making is so short!
DrO, can you tell me what the success rate for this type of surgery is, and in your opinion, is there a danger of it setting off the ERU? And if the whole eye is removed, the averages of the other eye developing ERU (or SCC). I know you don't have a crystal ball, but I would really appreciate any input. Thanks again
Paula
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Posted on Thursday, Jan 25, 2001 - 1:20 pm:
Hello Paula,
Taking them one at a time,
"can you tell me what the success rate for this type of surgery is":
good if caught early and the affected tissues easy to reach.
"is there a danger of it setting off the ERU?": Yes, but I do not see what this question has to do with the decision making, you do not let the fire rage just because you are worried that you might get the furniture wet putting it out.
"And if the whole eye is removed, the averages of the other eye developing ERU (or SCC)":
Whether removed or not there is a small to fair chance the other eye will develop ERU. If early I don't think there is an increased chance of developing SCC but you must remember that does not mean the chance is zero.
DrO
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Posted on Thursday, Jan 25, 2001 - 5:27 pm:
Thank you DrO, this helps alot.
Paula
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Posted on Monday, Feb 19, 2001 - 11:25 pm:
DrO
Believe it or not the biopsy came back "inconclusive". The ophthalmologist was so sure it was cancer...
On his advice I have used Dex. ointment 3xday for two weeks, and the 'spot' and edema have cleared up completely. I wish he would have suggested this treatment before the biopsy (and all of the emotional turmoil).
My question now is, do you prefer bute or Banamine as the NSAID of choice for ERU flair-ups? I have read the articles on both and am not sure. I have used bute in the past, along with Azaim when bute alone wasn't enough. Would Banamine work better on the inflammation, and can it be used with Aziam when necessary?
Thank you once again!
Paula
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Posted on Tuesday, Feb 20, 2001 - 7:28 am:
You almost sound disappointed that there was no cancer found. Inconclusive does not mean it is not cancer, just that this biopsy is inconclusive. Why was the result inconclusinve and not negative? What were the actual pathological findings?
Anyway, I think bute is just as good as banamine for ERU but there may be individual differences allowing run for experimentation.
DrO
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Posted on Tuesday, Feb 20, 2001 - 12:55 pm:
DrO
I was the happiest horse owner on the planet when the biopsy came back. I was trying to be professional and not gush all over your web site...I guess I did too good of a job! We are in a wait and see pattern for the SCC, and still dealing with the spring 'episode' of ERU.
I can't thank you enough for your advise and moral support!!
Paula
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Posted on Wednesday, Feb 21, 2001 - 8:24 am:
We like gushing..
DrO
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Posted on Wednesday, Feb 21, 2001 - 10:34 pm:
DrO
Tango's eye looks great after two weeks of the Dex. ointment. The spot is gone and the edema has almost cleared. I think the ERU flair is under control for now. Life Is Good!
The biopsy report states
Biopsy with microscopic (1 tissue)
SOURCE/HISTORY
Left cornea. Tissue is from a corneal mass.
*Microscopic Description:
A single section of the submitted specimen is examined in replicate. It is composed of moderately dense connective tissue that is diffusely and moderately infiltrated by a mixture of cells including lymphocytes, histiocytes and scattered neutrophils. There appears to be mild neovascularization. Very tiny fragments of surface epithelium are occasionally attached. The epithelial cells have round, uniformly basophilic nuclei and varying amounts of acidophilic cytoplasm.
*Diagnosis
Moderate pleocellular keratitis with neovascularization
*Comments
Findings in this tiny fragment are most consistent with inflamed granulation tissue. The overlying epithelium is present in very small amounts. It appears mildly dysplastic. This may be secondary to the inflammatory lesion present. A fungal stain will be performed. Results to follow
*GMS stained tissue is negative for fungal organisms
Dr. Scherlie said he considered the findings inconclusive because of how the blood vessals were acting around the growth. That's why the two weeks Dex. If it was in fact cancer, he didn't feel there would be any change. Since the eye looks so good I'm going to forget the "C" word for awhile and enjoy my horse!
Any thoughts on the biopsy?
Once again Thank you!
Paula
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Posted on Thursday, Feb 22, 2001 - 10:04 am:
He really is not making any sense: neovascualrization is a common response to any chronic inflammation and seen in both RU and SCC. Unless the primary lesion was missed a pretty good description of the changes seen in RU and the lack of cancer cells speaks for itself.
DrO
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