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Fluid THINKING

THE HORSE HAS A UNIQUE FLUID TRANSPORT SYSTEM WHICH CAN BE AFFECTED BY STABLE MANAGEMENT REGIMES, INJURY OR ILLNESS. IRENE DE BEST DVM, MRCVS LOOKS AT CONDITIONS OF THE LYMPHATIC SYSTEM AND THE AVAILABLE TREATMENTS.

The lymphatic system in horses consists of an extensive network of vessels and nodes, superficial and deeper in the body. It transports all the nutrients the cells need to function anywhere in the body. It does that in a watery substance called interstitial uid. In return the cells get rid of all their waste products and pathogens.

Horses have evolved from small ight animals designed to move around almost constantly, to the horses we have today. Although the external appearance has changed a lot, the physiology remains similar to that of millions of years ago.

Because horses were meant to move a lot, the design of the lymph vessels is different to humans. Horses have less smooth muscle in the walls of the vessels and its ability to contract is mostly dependent on the function of elastic fibres. There are no muscles in the lower leg to help with contraction of the vessels. The horse’s skin is its own compressive bandage and helps with the upward pump function as it tightens when horses move.

This means that a horse needs physical movement to activate the lymphatic system and encourage the transport of lymph uid.

Modern methods of husbandry (stabling, limited exercise, short sessions of training/exercise) increases the risk of malfunction of the lymphatic system, with added complications of infection and forming of scar tissue.

Due to either injury or recovery from disease or surgery, horses often need box rest. This will reduce the normal function of circulation and with that, compromise the lymphatic system.

CONDITIONS OF THE LYMPHATIC SYSTEM

• Primary lymphoedema occurs in horses born with a compromised lymphatic system and is usually seen in heavy breeds. • Secondary lymphoedema can be caused by wounds, burns, wire cuts etc. or through infections (cellulitis or lymphangitis). • Lymphangitis is dramatically different from lymphoedema as it presents with an acute onset very painful hugely swollen leg. The horse will be depressed, have a high temperature caused by bacterial infection and in ammation. The bacteria gain access through cuts, puncture wounds or even abrasions. It needs to be treated aggressively with antibiotics and anti in ammatories and other medication to minimise the damage to tissue and lymph vessels to try and avoid developing chronic progressive lymphoedema (CPL).

FILLED LEGS

Stable fill’ is well accepted in the horse world and this usually disappears after exercise. However this is an early stage of secondary lymphoedema. actors which will affect the condition long term are age of the horse, medical condition, amount of exercise and the damage already done.

Over time, microscopic changes will compromise the cellular immunity and increase the chance of recurrent infection. Each infection will cause more damage and the disease will be more di cult to manage.

There are no treatments or surgical procedures for the repair of the lymphatic system and lymphoedema is considered to be a degenerative condition that will get worse over time.

Damage limitation is of the essence. In the early stages of secondary lymphoedema it is very important to try to help lymph drainage to help prevent irreversible damage.

METHODS OF TREATMENT FOR FILLED LEGS ARE LIMITED.

Bandaging is still being used to remove oedema from the lower leg, but research has proven this to be contra-indicated. Pressure of bandaging on the vessels and surrounding tissue will compromise lymph drainage and damage the vessels even more.

Specialised compression wraps create a pressure gradient up the leg and might help keep the swelling down between attacks.

Cycloidmassage therapy is a unique three-dimensional massage system which has scientifically been proven to increase local circulation, relaxation and joint mobility. It can be used to treat certain problem areas as it delivers deep circulatory massage to the whole leg which increases circulation and lymphatic circulation and thereby improves lymph drainage.

Equine manual lymph drainage (EMLD) has been used with IRENE DE BEST is consultant veterinary surgeon to success but is labour intensive and niagaraequissage.com Visit the website for more information on not always easy when the leg is Niagara Equissage Pulse. still painful. Deep oscillation electrostatic lymphatic therapy has been used in limited cases and proved to be effective even when there is scarring and fibrosis. ow light laser therapy (LLLT) has been successfully used to reduce oedema. However, the equipment for these two techniques is

CYCLOIDMASSAGE THERAPY HAS BEEN SCIENTIFICALLY PROVEN TO INCREASE LOCAL CIRCULATION, RELAXATION AND JOINT MOBILITY. ABOVE AND OPPOSITE: TREATMENTS FOR LYMPHATIC CONDITIONS

ARE LIMITED, BUT CYCLOID-MASSAGE THERAPY CAN BE USEFUL. expensive and should only be used by trained professionals. It is important to remember that lymphatic disease is a dynamic condition and requires immediate treatment in the acute stage and maintenance for a better long term prognosis.