Cimetidine Standstill

Goose started his cimetidine doses on February 28^th, so right on three weeks ago now. He’s been on 2mg 2x a day, the powder goes right in his feed morning and night. Dr. N had recommended we give it a shot while we waited on sourcing the vaccine so I shelled out the $60 to get him started.

When searching the forums and talking to friends in the industry (vets, techs, horse people in general) everyone seems to have a different opinion on cimetidine. Some people love it, other people have complained it’s a total waste of money. Recently while perusing a COTH forum, I came across several people convinced that cimetidine was absolutely never intended to treat anything other than ulcers and what kind of fool thinks that it would treat melanoma?! Surely no vet would have ever recommended such a ridiculous course of treatment.

Seriously, I can’t make this stuff up. Cimetidine is one of the MOST recommended treatments for melanoma because it’s one of the ONLY treatments available.

At this point, I’d like to take a moment to remind everyone that I am a blogger and a self-appointed crazy horse person, NOT a veterinarian. I’m sure there are people out there who have very different opinions of cimetidine or other melanoma treatments or have worked with vets with much more scientific and useful knowledge of the drug. Please keep in mind these are just my personal findings and experiences and are NOT to be referenced above the recommendations of your personal veterinarian.

Other reviews have praised the drug to the high heavens, saying that it saved their horse, regressed the melanoma, and caused their horse to start pooping fairy dust and farting rainbows. A more common answer has been that it worked for a little while and stopped new melanoma growth, until it stopped working. Others have added to that, saying that when it stopped working, the melanoma came back full-force and very quickly killed their horse. (Advice: Don’t fall into a COTH forum hole! Cue box of tissues next to my computer.) In my very un-scientific thought process following my un-scientific research, it seems that cimetidine sometimes works for some people, until it doesn’t, and ultimately many horses die of melanoma-related factors. Dosage has been all over the board as well, and if I had the mindset to check out studies and journals, I’m sure there’s a correlation between dosage and efficacy, but frankly I’m just not interested. I don’t trust that this is the right long-term solution for Goose.

I never had high hopes for the cimetidine, and being that it’s been three weeks with no noticeable changes, other than I’m pretty sure there are several more melanoma than before, I don’t see the point in continuing Goose on this medication path. His tub is almost gone, and I will not be reordering it. To be fair, it’s only been three weeks and if I were to keep him on it for longer I might very well see results. However, at $60 a container that will last me just over three weeks, I’m not too keen to continue with it when I’ve finally sourced the vaccine and am about to dump my entire life’s savings into paying for the loading doses. (Some of you might be thinking, WOW, this horse chick has savings? To which I would laugh and say OF COURSE NOT I’m still paying off his bloody vet bills from 2017 that continue to accrue interest on my credit card).  

But wait - did you catch what I said up there? No, before the "poor me I'm broke" tangent. Back on track - that’s right people, WE FOUND A VET! Well, I sincerely hope we found a vet. The reality of the situation is that we were referred to an equine oncologist by one of Caitlin’s vets who has confirmed they have the ability to get and administer the vaccine. Yesterday I passed on all my information as well as Goose’s and I’m waiting to hear back on a final quote for the loading doses and to hopefully schedule his first appointment. The oncologist is willing to either come out to the farm or we can trailer him in to the clinic which isn’t too far. In that case, they’ve said it would be a “poke and go” situation and he wouldn’t even have to get off the trailer. Except it’s Goose and the farm trailer is a slant load which he is NOT a fan of (seriously, I don’t recommend stuffing a big draft cross in a slant load. He has to physically scrunch himself in there). He would definitely get off the box to be poked.

Last night I had a lesson (and an awesome one at that, recap to come!) and made a point to check on Goose’s lump situation before turning him back out. I can’t say that I notice a heck of a lot of difference between what I saw on him last night and what I saw a few weeks ago, but I think there might be a few more little ones on his penis and when I checked up higher and in his sheath, I can feel a few that were certainly not there a few weeks ago. They’re still small, but they’ve been popping up quickly. Less than six months ago he had none under his tail and only one or two tiny ones above the big melanoma we removed in December. In my opinion, we can’t get this under control fast enough. I’m lucky I sounded the alarm while they’re small so we can get the vaccine underway before they become a bigger problem.

Here’s some melanoma pictures:

Pic from 3/21/18

Pic from 3/7/18

Pictures are pretty challenging to take in these areas of Goose's anatomy. The top picture above is from yesterday, the bottom from March 7th. If I had to be super picky, I'd say the ones from yesterday look slightly bigger or at least more pronounced. Honestly, they look mostly the same to me considering camera angles and lighting and all that.

Picture from 3/21/18

Picture from 3/7/18

Okay, both of these pictures are kind of blurry and not great references for comparison. However, the point stands that they both look pretty similar with the more recent pictures on the top maybe showing a tiny bit of growth from the past few weeks. 

I still need to break out the marker and start taking better notes and measurements, not to mention figure out how to better photograph the melanoma so I can use the pictures as easy reference points. I'm feeling hopeful that we'll get the vaccine in him soon and hopefully be seeing positive results soon after that.