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CHRONIC PROGRESSIVELYMPHEDEMA IN DRAFT
HORSESProf. Dr. H. De Cock
University of Antwerp
CPL IN DRAFT HORSES
1.Lymphatics of the skin2.What is lymphedema?3.Causes of lymhedema4.CPL in draft horses
o Clinical signs - histologyo Diagnosis o Treatment
1.The lymphatic system of the skin
2. What is lymphedema?
Lymph vessels are abnormal in structure (congenital malformation or secondary to trauma) → accumulation of fluids in tissue → tissue swelling → hypoxia of tissue → skin fibrosis (hardening), hyperkeratosis and secondary bacterial infections (not proper functioning of immune system)
3. Causes
• Primary lymphedema: congenital malformation or malfunctioning of lymphatics (CPL most likely)
• Secondary lymphedema: after trauma or infection skin
4. CPL in draft horses
Clinical signs: Starts with mild enlargement distal limbs → skin folds in pastern region → hyperkeratosis and ulceration skin → swelling becomes hard and nodular → secondary skin infections → lymphangitis
CPL mild lesions Scratches or pastern dermatitis lookssimilar in initial stages
Lymphedema ≠ Scratches
Cause is poor function of lymph vessels
Many possible causes
Slowly progressive Usually does not progress
No or minimal improvement with regular treatment
Cure with good treatment
All 4 limbs affected 1 or 4 limbs affected
Lymphangiography
Histology
Extremely dilated and degenerated lymphatics, proliferation of blood vessels (hypoxia), edema, inflammation and degenerated elastin surrounding the lymphatics in CPL
Normal lymphatic
In CPL
Normal lymphatic
In CPL
Elastin difference between normal (left) and CPL (right)
Diagnosis
• Most importantant are clinical signs• Lymphoscintigraphy possible but not
routinely performed• Anti-elastin antibodies rise in serum
(ELISA test performed at University of Antwerp)
Treatment in humans
1.Good skin care2.Elastic bandages3.Exercise4.Manual lymph drainage
Treatment in horses
1.Good skin care → prevention trauma and irritation oChorioptes mites preventionoWound careoDry skin
Reason: irritation and inflammation increases lymph stasis in legs
treatment
2. Supportive elastic bandages, life long and as much as possible
Reason: pushes accumulated fluid out of the skin
treatment
3. Lots of exercise
Reason: muscle movement pushes fluid out of the tissues
treatment
1.Manual lymph drainage • Few people know how to do this in the
horse ≠ regular massage
Reason: pushes accumulated fluid out of the skin
Results of treatment: lesions before and after treatment
Met dank aan iedereen die meewerkte aan het project:Eigenaars
DierenartsenLeen Van Brantegem (UA)
Verena Affolter & Greg Ferraro (UCDavis) Prof. Ducatelle (UGent)
Technisch personeel UA, UGent & UCDavis