Gastric squamous cell carcinoma in the horse: Seven cases (2009–2019)
Authors: Rocafort Ferrer G., Nolf M., Belluco S., Desjardins I.
Journal: Equine Veterinary Education
Summary
# Gastric Squamous Cell Carcinoma in Horses: A Retrospective Clinical Review Gastric squamous cell carcinoma remains a rare but challenging diagnosis in equine practice, prompting this retrospective analysis of seven cases presented between 2009 and 2019 to characterise clinical presentation, diagnostic approaches and outcomes. Clinical signs were largely non-specific—weight loss, anorexia, fever and tachycardia featured prominently—though recurrent choke, halitosis and hypersalivation emerged as more suggestive indicators, with chronic anaemia and hypoalbuminaemia commonly detected on blood work. Diagnostic confirmation proved difficult: whilst gastroscopy visualised a gastric mass in 57.1% of cases, oesophageal involvement precluded examination in three horses, and ante-mortem biopsy diagnosis was achieved in only 42.8% through either endoscopic or ultrasound-guided sampling; post-mortem examination confirmed metastatic spread to the liver and/or spleen in all four cases examined. For practitioners, this work underscores the importance of maintaining high clinical suspicion when confronted with chronic weight loss refractory to standard interventions, combined with those unusual signs of recurrent choke or excessive salivation. Most critically, the poor short-term prognosis—with euthanasia typically occurring within four weeks of diagnosis—highlights the value of early recognition and appropriate client counselling, given that a definitive diagnosis often necessitates multiple diagnostic modalities and may come too late for meaningful therapeutic intervention.
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Practical Takeaways
- •Gastric squamous cell carcinoma is rare but should be considered in horses with chronic weight loss, anorexia and recurrent choke unresponsive to standard treatment; a combination of gastroscopy, ultrasonography and biopsy may be needed for diagnosis
- •Early diagnosis is challenging as clinical signs are nonspecific and diagnostic sensitivity is low; suspect cases presenting with systemic signs and chronic anaemia warrant aggressive diagnostic investigation
- •Prognosis is poor even with treatment—most affected horses are euthanised within 4 weeks, so owner discussion should emphasise palliative rather than curative intent
Key Findings
- •Gastroscopy identified gastric masses in only 57.1% (4/7) of cases due to oesophageal obstruction limiting visualisation in 3 horses
- •Ante-mortem diagnosis was achieved in only 42.8% (3/7) of cases, with post-mortem examination confirming metastasis to liver and/or spleen in all 4 examined horses
- •Clinical signs were predominantly nonspecific (weight loss, anorexia, fever) but recurrent choke, halitosis and hypersalivation were more suggestive of gastric carcinoma
- •Most horses subjected to palliative therapy required euthanasia within 4 weeks, indicating poor short-term prognosis