Currently there is no diagnosis or cure for lymphedema, but therapies such as manual lymphatic drainage with support bandaging can help manage the condition as long as no infection is present. Prognosis is poor due to the chronic & progressive nature of the disease. Prevention is unknown due to the limited research available as this is a recently recognized condition in horses.
Chronic Progressive Lymphedema (CPL)
This is the specific name given to primary lymphedema. It is a congenital and thought to be genetic.
CPL appears to be caused by defective
, a protein very important to the structure
& function of lymphatic vessels.
Predisposition is draft horses/ponies with heavy feathering including Frisians and Gypsy horses. It also tends to appear in closed breeding programs. The severity of CPL varies from mild to severe. CPL starts with a soft pitting edema, which can easily be overlooked especially on heavily feathered legs. Fibrosis occurs, commonly starting as firm folds, crusting & lichenification below the fetlock and in the back of the pastern. As increasing amounts of fibrosis develop, the lower leg circumference grows, and the leg is disfigured by ‘bone hard’ fibrosclerotic nodules which may interfere with movement. Because the lymphoedema damages skin immunity, it is very vulnerable to infections from bacteria, viruses and fungi, and to infestation by , causing mange, and the heavy feather helps create a perfect environment for these.
Diagnosis is biopsy showing
. Pastern dermatitis needs to be ruled out.
Currently there is no cure for primary lymphedema, but decongestive therapies such as manual lymphatic drainage can help manage the condition as long as no infection is present. Other management procedures include clipping of the feathers, treating skin lesions appropriately, regular exercise, support bandaging & use of stockings. Genetic testing is being developed to help identify CPL in foals. Prognosis is poor as life expectancy is only 6 years of age due to pain associated with the condition.
Malignant Lymphoma (Lymphosarcoma)
Malignant Lymphoma is a neoplastic disease of the lymphatic system or any lymphoid tissue. Equine lymphosarcoma is the most common internal cancer affecting horses, but the cause of lymphosarcoma is rarely identified, but certain bacteria and viruses have been implicated in its development. Transmission is unknown.
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