Active immunisation against GnRH as treatment for unilateral granulosa theca cell tumour in mares

Abstract

Background: Stallion-like or aggressive behaviour in mares affected by unilateral granulosa theca cell tumour (GTCT) is well-known, but use of a GnRH-vaccine as an alternative to surgical removal of the neoplastic ovary has not been investigated. Objectives: To determine the effect of immunisation against GnRH on ovarian size, testosterone concentration, Anti-Müllerian hormone (AMH) concentration, and owner-reported behaviour in four mares affected by unilateral GTCT. Study design: Retrospective case report. Methods: A presumptive diagnosis of GTCT was made in four mares based on clinical signs, behavioural changes, transrectal palpation, and ultrasonography. All mares were vaccinated twice with the GnRH-vaccine Improvac® on day 0 and on day 13-33. Further booster vaccinations were administered if aggressive behaviour recurred between days 15 and 498. Before and parallel to the vaccinations, serum levels of oestradiol, progesterone (P4), testosterone, and AMH were evaluated and transrectal ultrasonography was performed. Results: In all horses, analysis of serum levels of oestradiol, progesterone, testosterone, and AMH confirmed the clinical diagnosis of GTCT. Serum levels of testosterone dropped to baseline levels following the first two of three vaccination in all mares. In addition, AMH serum values decreased shortly after the second vaccination in three of four mares, and in one of the four mares returned to baseline levels. No further GTCT linked behaviour was reported by the owners and the affected ovaries diminished in size in all four cases. Main limitations: This report is a case series with a limited number of animals, no controls and no standardised immunisation protocol. Conclusions: Repeated vaccinations with the GnRH-vaccine Improvac® mitigated owner-reported behavioural abnormalities and stopped tumour growth in four mares affected by unilateral GTCT over the entire observation period which extends to 7 years in one mare.