Partial Penile Amputation

[Jazzie]

Hi everyone, late last year I posted about my lovely boy. During a routine sheath cleaning we noticed unusual skin lesions on the tip of his penis. We had the lesions biopsied, and it was found to be pappilloma virus type 2 with the likelihood of it turning into sqamous cell cercinoma if left untreated.
The vets prescribed a treatment using human genital wart cream which they had to apply every other day for three weeks. It literally burnt a layer of skin off with each application. They were happy with the results, the skin had started to smooth out and they stopped treatment and wanted to see him in a month.
Last week was his monthly check up. They found that the virus had already returned, although they couldn't determine what was healing skin and what was the unhealthy skin. It just looked like a wrinkly mess to me. Vet said to give it another month and then start another round of cream treatment.
It was mentioned that, as I am currently doing an insurance claim for all this, would it be an option to go for a partial amputation and get it over with, as there is a huge likelihood that he will get squamous cell carcinoma on the area at some point in his future. Before I come to a decision I was hoping I could get some people's experiences of the surgery and mostly what the after care was like? He's also suffering from a low white blood cell count, which I'm so worried is linked to what's going on on his penis although the vet doesn't think it is. Thanks for reading and for anyone's input!

 

[Equi]

Cant give any advice as i have not heard of this before, but i do know of a horse who had a partial amputation and it healed quite fast and the horse was none the worse for it

 

[ester]

Sorry to read that was the case Jazzie, As you know I don't have any personal experience, I hope others have but in your position I agree I would give it some serious consideration.

 

[Elf On A Shelf]

I know of one who had a partial amputation due to a sarcoid. He was done under standing sedation and spent 3 days in horspital if I remember rightly. He healed really quickly, had no adverse effects. We just never told he had a really small willy after that!

To be honest I would be tempted to cut the loses (no pun intended!) and get the amputation done now before the flies are about and bothering him.

 

[Jazzie]

Thanks for the replies, I have heard stories about having to clean the area every day as the urine just goes everywhere rather than in a nice straight line when they pee, but this may be going back a few years when the procedure wasn't as common. Got a lot to think about, but the main question is will it be the end of it, and can he go back to being a normal horse, or will it mean ongoing vet visits and treatments still for the rest of his life. If it's the latter we may as well wait, enjoy competing etc until he needs the op, and just start saving now! If it's going to mean he has a good few years of normal horsing (a real term!) then it will hopefully be worth it now.

 

[Lanky Loll]

one of our old ponies had this due to the big C about 20 years ago, we actually bought him afterwards so not sure of the immediate aftercare, I don't remember having to do any specific things when we had him although we did keep an eye on what was left to make sure there were was no further occurrence but he continued to compete for a good few years afterwards

 

[ester]

I think part of the consideration has to be that he has had problems/infection with it as it stands? and if it does change to SCC even with monitoring is that change going to be recognise quick enough before the risk of any spread. I don't see any reason that he would require ongoing visits and treatment after the initial healing.

Different I know but one of our south african users older pony had a complete amputation and redirection and was certainly very fine and dandy just a few days afterwards.

 

[scats]

Mine had a partial phallectomy in 2013 after a diagnosis of squamous cell carcinoma.

The choices were to either go for the full en bloc resection and remove the whole penis and re direct urine out the back, so he would pee like a mare. This would have involved invasive surgery and a lengthy recovery that is similar to a colic recovery. Also I know of a pony who had it done and suffered initial complications, although he is fine now.

The other choice was a partial phallectomy. They would remove the majority of the penis and try to shave off the outer affected skin on the remaining part. This involves 48 hours box rest then life file return to normal.

I opted for partial for several reasons. It was summer and I didn't want him to miss out on summer grazing and being a horse by needing lengthy box rest.
He was in his mid teens, retired and was purely a pet.
I didn't wish him to have to suffer complications.

The partial phallectomy did not cure him, only the full operation would have done that. The partial left a remaining few lesions that we had frozen off, and the inevitable was always there that it would likely come back, but my choice was to short term quality of life rather than quantity.

Operation went well, horse returned home and lived a normal life for 2 years, he had 6 monthly checks and only had one lot of topical chemo afterwards.

Last year I noticed a few lesions came back and took him back to Leahurst to see if these could be treated or indeed how long we had. We knew we were reaching the end of the road and the lesions were not accessible for topical therapy. We took him home, on bute and he lived his normal life for the next few months. In June last year his sheath was very swollen and he started showing signs of stress laminitis quite out of the blue. I knew then that things had developed and it was time. The next day, I had him put to sleep.

I don't regret my decision at all to have the partial and Joe has a fantastic, stress free last few years out with his field companions.

I can send you pictures of the process if you are interested. Feel free to PM me.

 

[Jazzie]

Thank you all so much, have been very helpful, and making me feel better about what the op may mean. Scats, pics would be great please!

 

[Jazzie]

My vet rang me today, having spoken to the specialist at Rossdales, who has definitely recommended the amputation. He wants to book Bailey in for next week, and he wants to come out to visit Bailey the day before to examine him and discuss with us whether he needs a part or full amputation. That's me not sleeping for the forsee able future!! :-(

 

[ester]

At least if it is next week that won't be too many sleepless nights worrying which decision you are going to make. Do let us know how he gets on.

 

[Dusty1]

My vet rang me today, having spoken to the specialist at Rossdales, who has definitely recommended the amputation. He wants to book Bailey in for next week, and he wants to come out to visit Bailey the day before to examine him and discuss with us whether he needs a part or full amputation. That's me not sleeping for the forsee able future!! :-(

I know this was a while ago now but wondering how your horse got on after his op.?
Unfortunately my boy has developed a tumour and our vet wants to operate but we are yet to know how serious it is (taking him from a proper assessment on tuesday). I don't want him to go through the major surgery but a partial amputation doesn't seem so bad? Our only other option is to pts as the tumor will block his ability to wee sooner or later, but he is so healthy and full of life in every other way.

 

[racebuddy]

Will pm
U. Xx

 

[Getbackboys]

hi sorry to hear your horse is suffering this but you have caught it in time. i lost my dear 28 yo shetland to scc last March, it was diagnosed and he was gone in 2 weeks. i miss him terribly he was the sweetest cutest shetti ever. the vets i used would come and clean his sheath every w years under sedation cos he would not drop it, they pointed out the cauliflower nodules but never mentioned what they could turn into, they never suggested freezing or anything, in the end i lost him when it was to far gone for even surgery. i sadly was ignorant to what those cauliflower nodules could turn into, hindsight is a wonderful thing. if i can known then i would have done everything i could afford to stop him from getting scc. good luck fingers crossed for a good outcome.

 

[Dusty1]

thank you for your response. I'm so sorry to hear about your boy. It is such an awful disease :'(. Unfortunately we have had sheath problems for a while now, he had surgery to remove pre cancerous tissue back when he was around 12 years old, so there was always the risk that they would return. We have an appointment with the surgeon tomorrow to see if he can have a proper look as to what is going on further up as at the moment we can only see the tumour at the distal end. Its just so hard knowing what is the right thing to do for my boy as I don't want to put him through any unnecessary suffering. Trying to stay positive but can't help thinking the worse, just can't imagine him not being around anymore as he's been with me for 17 years. Even jumped him yesterday and he was loving life :'(

 

[nagblagger]

My horse had a partial amputation, found by chance when he went in for surgery to fix a broken leg! He went on to have many happy years and needed minimal aftercare. Even got back to riding him, so don't give up hope.