diagnostic ability of vets

["Mike Hilyard" <PFmorabs@toast.net>]

I hate to say this, but I have to agree that if it ain't obvious, it ain't going to be diagnosed.  I have a gelding that last year had a chronic sheath infection.  As the vet said the first time he cleaned it "This is the ugliest penis I've ever seen."  High doses of a sulfa based antibiotic partially cleared it (enough so he wasn't laying down so he could reach back and scratch), but it never went away, despite 3 cleanings by the vet.  He won't drop for me - wonder why?  Well, after fly season we had the local vet clean it again ($40. farm call, $35. cleaning, $90 drugs), then packed him up and headed for Michigan State.  At the vet clinic they discovered raised plaques in his oral mucous membrane, as well as on his penis.  They did punch biopsies of both (my husband got a little green) and had a vet dermatologist look at him.  Apparently, large animal dermatologists are hard to find (I guess there wouldn't be much of a market), but this small animal guy said it looked exactly like the raised marks some dogs get in their mouths after pulling burrs out (note for you desert and Texas dwellers - in Michigan it is possible to pull burrs out and not draw blood).  Well, the biopsies showed it wasn't burrs and that it only involved the upper layer of the membrane - the epidermal layer, not even the dermis.  Also, there is no sign of these plaques in the anal area, so not all mucous membranes are affected.   They are calling the plaques "atypical" cells, not even pre-cancerous.  Meanwhile, after steroids and another round of high dose sulfa antibiotics, I still have a very nice gelding with a small amount of drainage that I'm sure will flare up in 4 weeks when the flies hatch in large quantities.  I still have no diagnosis or definitive treatment.  Chemotherapy was mentioned, but as an old oncology nurse, I know that systemic chemotherapy would have to be pretty high to reach epidermal skin layers, and 5FU is hard on the immune system.  We know it is not melanoma or sarcoids. 

 

So I guess the moral of my story is that a vet, trying to treat a dozen different species in every stage of life from new born to geriatric, is not going to know everything.  And apparently the specialist vets at large teaching facilities are just as lost where to start when presented with something unusual.  How about you ridecampers?  Anybody seen anything like this?  And no, I am not putting Schreiners on it!