Penis problems

[Jazzie]

Hi all, sorry for the gross post, I am not much of a poster on here but I always find myself coming onto hho forums to read advice and support from you lovely lot. I am currently experiencing a problem with my 10 year old gelding and thought I'd come on here to see if anyone else could give me there experiences.
I have owned my boy for 4 months, having lost my old tb to arthritis earlier in the summer. He is a 10 year old, 15.3hh ISH gelding. A few weeks into ownership I noticed that he was very dirty 'down under' and attempted to give it a bit of a clean up, but he was very 'shy' about it all and certainly did not want me to touch it! Leaving it alone, I noticed that he had started to kick his back legs in discomfort and at his sheath, and the discharge was building up. So I decided to call my vet to come out to sedate him, so that we could give him a really good clean. The vet said that it was slightly infected and so put him on a course of antibiotics and said he should be fine. A month later I rang the vet to come back out, as he seemed to have a large build up of smegma again already and was finding it difficult to retract after urinating. The vet gave him more sedation this time, and took swabs to send to the lab. While he was down there, the vet discovered some unusual skin lesions and spots on the very tip of the penis, underneath the smegma build up. He took pictures, and suggested we try to get rid of all the infection before re-examining, and that it may require a biopsy!! He is worried that it might be penile squamous cell carcinoma.
This was three weeks ago, we have given him 20 days of antibiotics and had the swab results back. Here was a large amount of bacteria found, and no signs of any fungal infection. I have the vet booked to come out again on Thursday to see if the infection has cleared up, and to decide whether to take a biopsy. I am terrified. I have no idea what to do or what to expect. I have researched as much as I can, but I just wodered if anyone could advise me:
What is the biopsy procedure like?
Is it worth it at this stage? (I know no one can make that decision for me though)
What happens if the results are inconclusive or they say it's pre cancerous and to re test again in a few months/years? Do I carry on competing/working as usual when it's always at the back of my mind that it might be turning into cancer and he could be sore/suffering?
These skin lesions do not look ulcerative, just abnormal, I have the pics if anyone wants to see what I mean, I have shown almost everyone on the yard and none of then have ever seen anything like it!

My vet has been wonderful, and I have given him plenty of questions to answer, I'm just hoping I can get some advice from people who have been through this, or not and what would they do? Thanks so much for reading.

 

[ester]

So my lad had a suspected squamous cell carcinoma nearly May 2013, no recurrence. It was an roughened area of skin that had started to produce a lot more dead skin than normal. It wasn't worth biopsying so after pics were sent to liverpool it was treated with chemotherapy cream (one of the bits of liverpool cream for sarcoids) and liquid nitrogen, it took 2 goes to get rid of completely partly as the vet was a bit too gentle to start as he was concerned about causing strictures as near the urethra. He had to stay at the vets overnight as the regime required cream on day one, and day 2 then freezing I think. I would strongly suggest your vet sends pictures to Dr Knottenbelt

The main issue if it is is it spreading elsewhere, my vet had done a partial amputation on his own horse but lost him a year or so down the line as it had already spread elsewhere in the body. I would therefore absolutely work it up at this stage as time is of the essence.

I did however get very good at taking willy pics! Even the vet said I looked like I had a good grip!
This is what it looked like, this was actually after the first treatment failed but gives you an idea, looking back at the pics we seem to have treated two areas, I think the other was successful on first treatment

under the dead skin

After the first treatment, you can see not quite there.

it went on to look like the first picture and was re treated, and other than a bit pinker than before no issues.

I hope that helps as a total success story.

 

[stencilface]

Sorry no help op, but just wanted to chuckle at ester for having those pics on her phone

 

[Jazzie]

Thank you so much ester! That was very helpful. What made the vets decide that a biopsy wasn't worth doing? My boy has similar looking ridges on his skin.
How can I get photos on here?

 

[ester]

They're on my facebook!
in a hidden folder though I did show lots of people at the time of treatment, they didn't seem as interested as me though :eek3:.

They occasionally come in useful, particularly along the lines of I understand if you don't want to clean your gelding but please get familiar with his bits, it might mean you spot something early. My vet had a student with him on the first visit who said err how did you spot that, well .

I will say I didn't get the vet out on first spot, I picked the skin off and monitored, when it came back quickly I thought briefly I might pretend it was nothing but sent a photo to vet to get opinion hoping he might say nah nothing, no point in coming out but he didn't he said it looked well dodge, in vet speak.

 

[ester]

Thank you so much ester! That was very helpful. What made the vets decide that a biopsy wasn't worth doing? My boy has similar looking ridges on his skin.
How can I get photos on here?

It is easiest to upload pictures to a third party site, so facebook/photobucket etc. Then paste the .jpg codes here and put

at the end of the code.

I think because of it's size to biopsy meant you would be taking most of it out anyway, but also potentially upsetting it and I think the conclusion was from him and prof K. that given the high % of lesions which turn out to be cancerous down there it was highly likely it was a problem, essentially they were convinced enough. Essentially penis+ lesions = likely enough cancerous that worth treating as such.
At which point I was just like well lop it off now quick then :eek3: vet was less keen and said my pony didn't need a GA when he was 19 unless we really had to (even though he did his horse at 18 ) . They do have someone that comes in and does laser surgery in their op room and that was discussed as a possible under standing sedation but thought unnecessary in the first instance and probably high risk of causing other issues (strictures again iirc).

 

[racebuddy]

Will pm you xx

 

[Jazzie]

Did this work?

 

[ester]

Did this work?

not quite,

right click on the img and click copy image address and post that here

 

[Jazzie]

It won't work, I'm useless!!

 

[ester]

do you want to email them to me?

 

[scats]

Sadly I had my 18 year old Welsh cross put to sleep in June this year due to two issues- but stemming from squamous cell carcinoma of his penis and sheath.

He was diagnosed in 2013, underwent surgery to have a partial phallectomy (I opted against the full en bloc resection), then had the remaining lesions frozen off.

All was well for 12 months, then the lesions started to reappear and we were unable to freeze them off due to their positioning and an inability to keep his penis out despite sedation (he didn't have much left after the partial phallectomy so keeping hold of it was a nightmare!)

We opted for bute and regular cleaning and basically just see how we went day by day. I noticed it starting to get very swollen and him kicking at it quite a bit. He then came down with mild lami, which he had never had in 18 years, and vet and farrier agreed it may well have been a stress response.
I had already decided that we were reaching the end of the road and this was the tipping point for me. It was very difficult because he looked absolutely fantastic, honestly the shine on his coat and his appearance, you just wouldn't have known anything was wrong, but it was time.

He went very peacefully at the beginning of June.

I have no regrets about the way in which I dealt with it. Yes, if we had gone for the full en bloc resection in 2013, we potentially could have cured him there and then, but I felt it was an invasive procedure and would have meant a lot of box rest and potentially a painful recovery. Horse had been retired since 6 after a field injury, so I wasn't trying to save him for a ridden career, just to continue his very cushy life of being spoilt rotten!

I can email you images of our journey- the pre-op photos might make you bring your breakfast back up mind!

Good luck xx

 

[Jazzie]

Thank you scats for sharing your story, I'm so sorry about your boy, sounds like you made every decision with his needs first. If you don't mind I would love to see the pics, firstly to compare what you had against what I have, and secondly to see what I might be up against?

 

[ester]

So here are the OPs pics,

Jazzie that does look very similar, I would certainly discuss treatment options with your vet asap and get them to talk to the prof as a skin lesion expert and there seem like quite a few

scats sorry to read that, I think I would have only done a partial on him if we had to, despite my initial reaction just to lop the whole thing off. It wasn't long after the poster from South Africa with the little palo pony had had a complete amputation and reroute done and he seemed to recover remarkably well.

 

[Jazzie]

Thanks ester for posting my pics for me! I am considering sending the pics straight to Newmarket or Cambridge, which is where he would be referred anyway.

 

[Naturalhorse]

I've heard just shove a hose up there to clean. LOL

 

[ester]

How does that help detect and treat a potential cancer?
I don't see anything to lol about in this thread.

 

[Naturalhorse]

I am very very sorry about that I did not mean that was in any way funny. I meant that to clean a sheath you should do that.

 

[scats]

Thank you scats for sharing your story, I'm so sorry about your boy, sounds like you made every decision with his needs first. If you don't mind I would love to see the pics, firstly to compare what you had against what I have, and secondly to see what I might be up against?

This was the willy pre-surgery- it was badly infected as a result of the cancerous lesions.

**Warning- yucky pictures alert, weak stomachs should avoid**










His willy a week post surgery-


Two weeks post surgery-






April 2014 (9 months post surgery)



The bobbly bits that you can see were a build up of scar tissue-


The red tissue here isn't blood, it was basically the inner tissue which now sat on the outside-




The new lesions that started to form earlier this year, 2016. We took him back into Leahurst to see a specialist about having these removed topically but unfortunately it was just too close to his urethra. Vet sent him home with bute and told us to keep an close eye on him and monitor it daily. He was still an extremely lively and happy chap with no problems at this point, but I knew we were only headed one way. I just decided to make his last months as perfect as I could.



He never got to the stage where he struggled to pee at all but I felt that we were probably only months away from that. In June this year it was very swollen on a daily basis and I had seen him kicking at it. This, combined with a sudden and very unusual (for him) bout of what looked like mild lami was the final straw. We buted him up, let him have one last lovely night out in the field with his pals, and then put him to sleep the next day.

I'd had him since he was an unbroken 4 year old and as sad as it was, I totally believe it was the right thing to do and at the right time.