Sarcoids - treatment with Liverpool Cream

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Bojingles

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When clipping the comedy cob I found some sarcoids in her armpit - both nodular and occult. I was shocked to say the least as I clip her legs at least every 6-8 weeks and they weren't there last time. I got the vet out immediately and he sent photos off to Professor Sarcoids at Leahurst who recommended treatment with Liverpool Cream and sent a protocol. For those who aren't familiar with it, it's a highly cytotoxic cream which induces inflammation and - hopefully - tissue death. The plan is that the sarcoids over a number of weeks die and fall off. I knew nothing about this cream before and - obviously - have scared myself half to death googling it ;). So I thought it might be useful for anyone else in a similar situation or about to embark on treatment to get an idea of what to expect. After two treatments the sarcoids have swollen to about 3 times their original size and have started to crack and weep. I'm cheering myself up with the thought that this means the cream is working. The vet thought he'd have to sedate her to apply the third dose but she's either being extremely stoic or is not in any pain as she didn't even flinch. Here are the pics so far: the first is before treatment and the second is after two applications of the cream.

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Thank you for posting. My mare has a similar sarcoid in her armpit and like you I have scared myself reading about them! The vet has seen it and has said that we can leave it for now but monitor closely for any changes. If there are any changes we will send pics to Liverpool.
Please keep us up to date with your progress.
 
For anyone interested I have many pictures of my horses treatments with Liverpool cream for extensive sarcoids over the last 18 months. If I hadn't taken action he would have been pts over them. Awful treatment. That's all I can say.
 
I've just treated my gelding with Liverpool cream (well the vet has) for sarcoids between his armpits mainly. He had a huge swelling when we banded one before so I was a bit worried. Can safely say I was really impressed and we had no adverse reaction. It's had the desired result just waiting for last one to fall off and all others have healed wonderfully.
If you're worried talk to your vet, every horse reacts differently and it's hard to tell what will happen. They have to tell you the horror stories to cover their backs but also the cream may not work at all. There are other options of treatment but if you've already been approved for Liverpool cream Id give it a go.
 
Thanks for replies everyone. I've just been to see Bella, with a view to putting on a bit of Sudocrem and giving her some bute if necessary. The nodular sarcoids are hugely swollen now; I'd say one is about the size of an apple. She let me have a good look and didn't move away and in the end I applied the Sudocrem without her even wearing a headcollar so I really don't think she's in any pain at all, which is a big relief :). She always lets me know her feelings and opinions in no uncertain terms! So far so good and thanks for the good news stories!
 
The cream worked well on my horse's nodular one but the occult one on his armpit has sort of risen from the dead. I'm currently feeding turmeric and applying it on the sarcoid, half turmeric to sudocreme. Lots of success stories on the Turmeric User group on Facebook. Might be a handy preventative of they go with the cream.
 
Thanks for posting this. I'm about to embark on the Liverpool cream treatment for my gelding who has a sarcoid on his sheath. I'm dreading it, especially as it's in such a sensitive place, but I daren't leave it as it's grown considerably since the vet first looked at it in May. (I left it over the summer as the flies would have been a nightmare)
 
Well, Bella had her fourth treatment today and, stoic as she is, it's starting to take its toll now. Although she'd seemed fine over the weekend, the nodular sarcoids have swelled quite considerably and she's looking miserable :(. She hobbled down the lane to the yard but didn't flinch when the cream was applied. She had some bute this am and pm which perked her up considerably so I'll keep her on that for as long as necessary. Here's her beautiful armpit today - the whit bits are Sudocrem.


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Poor girl, it's for the best but it looks such a horrid treatment. I'm dreading starting it with my boy. Are you giving yours bute before the application of the cream, or after it, or keeping her on it all the time for the duration? Any advice on how I can make the whole process more bearable for my lad would be gratefully received! :(
 
I think it varies a lot from horse to horse. The vet said he usually has to sedate them by the third or fourth application but Bella was fine. I think they like to hold off the bute for as long as possible as the inflammation is needed to kill off the cells. As soon as I knew she was feeling it we put her on bute, 2 sachets a day. Good luck with your lad - let us know how he gets on.
 
Liverpool cream worked fantastically on my mare's rapidly expanding nodular sarcoid. Had the treatment back in Jan/Feb this year, initially it looked angry and more swollen, now there is a little scar tissue to indicate where is was but unless you stick your head under her leg you don't see it. No other sarcoid growth since and she always had a couple, one would grow and the others would be dormant, then they would fall off and a dormant one would grow... 10 months of being sarcoid free now :-)
 
Well here we are about 3 weeks after the last treatment, and it's looking really gruesome. To give you an idea of scale the wound's at least an inch deep. The vet warned me how gory it would be but I'm going to get him out next week for a check-up. Poor Bella's still being incredibly brave; she's not overly keen on having sudocrem put on but who can blame her. She's down to one bute a day and seems well in herself.


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A sedation and clean-up later, this is where we are today. An enormous chunk of flesh is half hanging off but fortunately the flesh underneath is good and healthy. The vet was surprised and said the roots of the sarcoid must have been really deep. Poor Bella, she's being very stoic but expecting to clean that up without sedation was a step too far! She's still on bute and now anti-bs just in case. Hope I haven't spoiled anyone's dinner ;)

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Gosh, that's going to be a big hole when that flesh sloughs off. It will be worth it in the end to be rid of the sarcoids though and it certainly looks like they are going to be gone.
 
I'm soooo having second thoughts about putting my lad through this seeing these photos, Bojingles. How big was the sarcoid when you started the treatment? The one on my gelding has grown, but it isn't bothering him at the moment - I just hate the thought of putting him through the pain of this. (he's 22 and retired due to COPD) Would you do it again, knowing what you know now?
 
Grumpy Herbert said:
I'm soooo having second thoughts about putting my lad through this seeing these photos, Bojingles. How big was the sarcoid when you started the treatment? The one on my gelding has grown, but it isn't bothering him at the moment - I just hate the thought of putting him through the pain of this. (he's 22 and retired due to COPD) Would you do it again, knowing what you know now?
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The three times I have seen this cream used (on livery horses), it really put me off and I decided against using it on my gelding, especially as he was retired in any case. The two horses that it was used on (one twice), reacted very badly to the pain and had to have the vet to sedate each time. One was positively dangerous and really violently kicking out, even when sedated. The treatment was abandoned. The second horse had the treatment twice because the first time the sarcoid came back (treatment was not continued for long enough and didn't get the root). The second time the treatment was horrendous, but successful. However, the wound continued to open up painfully over the next year (blood and gaping wound - was where the hind leg meets the belly so was always moving). Sadly the horse was lost through colic a year after treatment due to internal melanomas.
 
Thank you for the updates, they are very interesting. I hope Bella feels better soon. We are still leaving Saffy's sarcoid and seeing whether it develops, I hope we don't have to give her any treatment.
 
Gloi said:
Gosh, that's going to be a big hole when that flesh sloughs off. It will be worth it in the end to be rid of the sarcoids though and it certainly looks like they are going to be gone.
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It's going to be huge isn't it?!

Grumpy Herbert said:
I'm soooo having second thoughts about putting my lad through this seeing these photos, Bojingles. How big was the sarcoid when you started the treatment? The one on my gelding has grown, but it isn't bothering him at the moment - I just hate the thought of putting him through the pain of this. (he's 22 and retired due to COPD) Would you do it again, knowing what you know now?
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She had several, mostly occult but one nodular. It was about the size of a grape when treatment started and it rapidly swelled to about the size of a large apple and then started cracking. I think I would do it again to be honest, as I genuinely think that, to her, it doesn't feel as bad as it looks. The most painful part was towards the end of the treatment and even then she was fine on her 2 butes. She now lets me put sudocrem on it in the field without a headcollar. She was hooning round her field bucking today - she seems to be feeling well. I don't know if I'd put a 22-year old through it, but I think it varies a lot from horse to horse.

katherine1975 said:
Thank you for the updates, they are very interesting. I hope Bella feels better soon. We are still leaving Saffy's sarcoid and seeing whether it develops, I hope we don't have to give her any treatment.
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Thanks :)
 
Thank you for answering, Bojingles. It's good to hear that it seems almost worse for us as owners than for them!!! My boy is 22, but is in fantastic shape and if it wasn't for exercise intolerance due to his COPD would still be in work - if he was on his last legs, I wouldn't even consider it. Will talk it over with my YO who will be supervising any treatment, and decide from there.
 
ester said:
I think that although it looks horrid it should be possible to keep the horse comfortable enough on bute etc.
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I agree - she allowed me to give it quite a decent clean today, including syringing right into the wound, with hardly any fuss at all.

fornema said:
Out of interest how much has the treatment overall cost you? And has it been possible to claim on insurance?
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I've submitted a claim and hopefully it should be covered. So far we're at about £550 but that does include numerous call-outs. I started off by taking her to the vet's for treatment but she gets so sweaty on the lorry that she was sweating the cream off. Without the call-outs it'd be half that.
 
My boy has one on his willy and some on his belly, the vets coming out next month to take photos to send to Proffesor Sarcoid at liverpool but on our yard we have one that reacted really badly to the LP cream and has since got in excess of 70 sarcoids, and due to the liverpool cream has become really badly behaved, she had the vet up and he said the best thing they can do is PTS due to the sheer amount of sarcoids... hence Im really reluctant to use LP cream! Especially on a really sensitive area! However I have heard that lasering them off has a really good success rate (I think 80% - don’t quote me on that though) so going to try and persuade the vet to go down that route – we don’t live far from a practise that can do the laser operation, it’s just hell have to go under for it!
 
Our cob years ago had a large sarcoid in his chest that our vet treated with Liverpool Cream. It swelled up and look awful at first but eventually the sarcoid dropped out and left a hole the size of an apple that then healed. The sarcoid never came back and we used the cream again on another gelding with a flat sarcoid on his sheath. Yet again very successful. Hope this helps.
 
Carrots&Mints said:
My boy has one on his willy and some on his belly, the vets coming out next month to take photos to send to Proffesor Sarcoid at liverpool but on our yard we have one that reacted really badly to the LP cream and has since got in excess of 70 sarcoids, and due to the liverpool cream has become really badly behaved, she had the vet up and he said the best thing they can do is PTS due to the sheer amount of sarcoids... hence Im really reluctant to use LP cream! Especially on a really sensitive area! However I have heard that lasering them off has a really good success rate (I think 80% - don’t quote me on that though) so going to try and persuade the vet to go down that route – we don’t live far from a practise that can do the laser operation, it’s just hell have to go under for it!
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some are, some aren't suitable for lasering, my vet thought we would laser but didn't in the end. Frank had a squamous cell carcinoma that had 2 treatments over 2 days using a liverpool-like cream and liquid nitrogen (2 treatments as the vet was too nice the first time! He was actually remarkably not sore just had a few days bute. The belly ones probably wont be laserable, not sure it is doable on bellies.
 
Just on the subject of lasering, I have had 2 horses done with the cream and 1with laser. I would now go with laser every time, it looks awful but heals very well and I think is nicer for the horse. Mine had 5 lasered off, one big one on his face, one on his girth line, one on elbow and two quite big ones on his belly. They can laser most areas I believe, also much cheaper than the cream.
 
That's interesting, did they think they wouldn't be able to get deep enough? I'm not at all anti the cream, just that, having had both methods, I'd go for the laser if it was possible :-)
 
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