CPL in draft horses


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CPL in draft horses

  1. 1. CHRONIC PROGRESSIVE LYMPHEDEMA IN DRAFT HORSES Prof. Dr. H. De Cock University of Antwerp
  2. 2. CPL IN DRAFT HORSES <ul><ul><li>Lymphatics of the skin </li></ul></ul><ul><ul><li>What is lymphedema? </li></ul></ul><ul><ul><li>Causes of lymhedema </li></ul></ul><ul><ul><li>CPL in draft horses </li></ul></ul><ul><ul><ul><li>Clinical signs - histology </li></ul></ul></ul><ul><ul><ul><li>Diagnosis </li></ul></ul></ul><ul><ul><ul><li>Treatment </li></ul></ul></ul>
  3. 3. 1.The lymphatic system of the skin
  4. 6. 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)
  5. 7. 3. Causes <ul><ul><li>Primary lymphedema: congenital malformation or malfunctioning of lymphatics (CPL most likely) </li></ul></ul><ul><ul><li>Secondary lymphedema: after trauma or infection skin </li></ul></ul>
  6. 8. 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
  7. 9. CPL mild lesions Scratches or pastern dermatitis looks similar in initial stages
  8. 10. 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
  9. 20. Lymphangiography
  10. 21. Histology Extremely dilated and degenerated lymphatics, proliferation of blood vessels (hypoxia), edema, inflammation and degenerated elastin surrounding the lymphatics in CPL
  11. 22. Normal lymphatic In CPL
  12. 23. Normal lymphatic In CPL
  13. 24. Elastin difference between normal (left) and CPL (right)
  14. 25. Diagnosis <ul><ul><li>Most importantant are clinical signs </li></ul></ul><ul><ul><li>Lymphoscintigraphy possible but not routinely performed </li></ul></ul><ul><ul><li>Anti-elastin antibodies rise in serum (ELISA test performed at University of Antwerp) </li></ul></ul>
  15. 26. Treatment in humans <ul><ul><li>Good skin care </li></ul></ul><ul><ul><li>Elastic bandages </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Manual lymph drainage </li></ul></ul>
  16. 27. Treatment in horses <ul><ul><li>Good skin care -> prevention trauma and irritation </li></ul></ul><ul><ul><ul><li>Chorioptes mites prevention </li></ul></ul></ul><ul><ul><ul><li>Wound care </li></ul></ul></ul><ul><ul><ul><li>Dry skin </li></ul></ul></ul>Reason: irritation and inflammation increases lymph stasis in legs
  17. 28. treatment 2. Supportive elastic bandages, life long and as much as possible Reason: pushes accumulated fluid out of the skin
  18. 29. treatment 3. Lots of exercise Reason: muscle movement pushes fluid out of the tissues
  19. 30. treatment <ul><ul><li>Manual lymph drainage </li></ul></ul><ul><ul><li>Few people know how to do this in the horse ≠ regular massage </li></ul></ul>Reason: pushes accumulated fluid out of the skin
  20. 31. Results of treatment: lesions before and after treatment
  21. 32. Met dank aan iedereen die meewerkte aan het project: Eigenaars Dierenartsen Leen Van Brantegem (UA) Verena Affolter & Greg Ferraro (UCDavis) Prof. Ducatelle (UGent) Technisch personeel UA, UGent & UCDavis