Cutaneous Horn

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What is a Cutaneous Horn?

A cutaneous horn is a general term used to describe a cylindrical mass of a-cellular keratin which extends from a red base on the skin. The height is greater than the diameter, and the size and shape of the growth can very considerably.  Cutaneous horns are rare in dogs and cats and causes are speculative, although it is believed that exposure to radiation can trigger the condition.

Aetiology comes from an evaluation of the skin at the base or beneath it. Some cutaneous horns may derive from viral papillomas, actinic kerotoses, bowenoid in situ carcinoma, dilated pores or invasive squamous cell carcinomas.

Hal's Story

In early 2016 I found what looked like a claw in Hal's tail.  My initial thoughts were that he and his brother had had a fight and a claw had got caught in the tail, but on further investigation I discovered that this claw-like object was actually growing from a hair follicle in the tail.  I did some research and discovered that the horny excrescence is often referred to as a cutaneous horn.

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I showed the horn to one of Hal's vets, and she confirmed that nothing should be done at this stage - if it were to be removed then it would just grow back again.  I was told to keep an eye on Hal and only get concerned if it becomes infected or Hal starts to be annoyed by it.

The horn continued to grow, as more keratin was excreted and flowed down the existing horn:

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As Hal also had a few other little issues I made an appointment with a holistic vet to see if I could get advice on all of them, and hopefully stop the horn from growing.

In April 2016 we had our appointment, and following the consultation Hal was put on two different homeopathic remedies to hopefully resolve his issues.  During the time Hal has been on the homeopathic remedies, his diet has remained exactly the same and nothing topical has been applied to the horn - all the changes are coming from within him.

Within three days I noticed that the outside of the horn was drying out and the surface of the horn was going a greyer colour.  The very outside then started to crumble, and underneath the horn was turning black in places:

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Day 3
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Day 4
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Day 5
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Day 5

On Day 6 the end of the horn broke off, leaving the horn about half the length it was previously.  The center of the shortened horn was darker in colour - was this some sort of core or because the center hadn't yet dried out?

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The center looking darker
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The bits that broke off from the tip

By day 7, the center of the remaining horn had become the same colour as the rest of the horn.  This remaining excrescence is very hard and still firmly attached:

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Day 7
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Day 7
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Day 7
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Day 8
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Day 8

By day 16 there had been no further changes to the horn - the remaining portion was still dry and hard and no crumbling.  I phoned Hal's holistic vet with a full update (he was being treated for other things as well) and it was decided to stop one of his remedies and add two new ones.  These remedies arrived on day 21.

Three days later, on day 24, I was inspecting Hal's horn and it appeared to have become greasier, and the end looked as though it was going to start crumbling again.  And then I noticed that one side of the horn was starting to come away from his tail:

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Day 24
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Day 24
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Day 24
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Day 24

A little playing with the horn and it then came out totally:

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Day 24
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Day 24
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Day 24
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Day 25

One week on and the hair follicle itself is less swollen, but the hole is still the same size. There has been no bleeding or weeping from the hole, but the inside is all crusty - could this be the surface of the hole breaking down?

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Day 31
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Day 31

The crusty/waxy substance continued to increase, and started to protrude from the end of the hole.

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Day 37
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Day 44

Hal then got a swelling right next to where the horn had been - it started off soft and squidgy as though it had fluid inside, but soon became quite firm.  With a little encouragement it burst and released its contents:

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Day 45
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Day 46
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Day 46

On day 47 we stopped Hal's remedies as over the last couple of days he had started to scratch more than normal - since stopping the remedies, his scratching has also stopped.

On day 49 the new waxy plug came out of the hole where the horn had been, leaving a smaller hole than last time:

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Day 49
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Day 49
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Day 49 - waxy plug next to Hal's paw for size comparison

The second lot of remedies were restarted on day 83 as one plug had been in place for a month with no sign of it wanting to come out.  This plug then came out 4 days after the remedies were restarted, and then we got back into a cycle of plug being produced and coming out within a couple of weeks,

Day 83 - plug has been in place for a month
Day 108 - new plug getting ready to come out

On day 109, the hole bled considerably when the latest plug came out - this was the first time this had occurred.  I was advised to stop the second lot of remedies and return to the original remedy.

Day 109 - hole bled when plug came out
Day 125 - plug contains more blood than previous ones
Day 129 - further bleeding when the latest plug came out
Day 133 - hole looking slightly better

Since we reverted to the original remedy, the hole size has continued to get smaller.  Keratin is still being produced, but it either forms a little swelling next to the plug hole and then comes out this way, or it forms a new small horn that can easily be removed.

Day 178 - Hole getting smaller and flatter

Remedies Used

I have been asked several times what remedies were used to effect this change in the horn.  I have not stated the remedies as with homeopathy the remedies must relate to the cause of the problem and the dog as a whole - what works for Hal will probably not work for another dog.  This is where homeopathy is different to more conventional veterinary treatment - it treats the cause, not the symptom.

If you use a headache as an example, if you get a headache then you will probably take a pill of some description (possibly Aspirin).  This will fix the current headache, but will not address why you got the headache in the first case, and will not stop you getting future headaches.  The headache itself could have been caused by a number of issues - alcohol-induced, migraine, not enough water being drunk, bad eyesight, sunstroke - all of these will need a different approach to cure the underlying problem, and will need an understanding of the patient.  In the same way, homeopathy will need this understanding to invoke an underlying change that fixes the real issue.