This is Part 2 in our two-part series on lymphangitis in horses. Find Part 1 here.
Veterinarians will prescribe aggressive antibiotics and anti-inflammatories to combat the underlying infection causing lymphangitis while also administering medication such as phenylbutazone and flunixin meglumine for the pain and swelling. While most swelling is addressed with cold therapy and bandaging, these treatments are often ineffective or only work for a short time before the swelling returns.
The biggest tool for treating lymphangitis and the resultant lymphedema (build-up of fluid) is movement, which is difficult when the leg is so painful.
So, what can be done?
In humans, the only way to encourage drainage for the lymphatic system is by lymphatic drainage massage. This type of massage is a gentle massage that encourages the drainage of the lymph nodes and movement of the lymph fluids around the body. Humans can utilize lymphatic drainage massage, either manually or with a device, to move the fluid to be excreted from the arms and/or legs.
So how can veterinarians accomplish the same thing in horses?
History has seen veterinarians and owners use any type of treatment to battle lymphangitis.
“It's focused a lot on bandaging, regional limb perfusion with antibiotics, and we use the saltwater spa a lot (at NC State),” said Dr. Lauren Schnabel, professor of equine orthopedic surgery at North Carolina State University and co-founder/chief medical officer of Vetletics. “But we didn't have any sort of device to provide dynamic compression to push that fluid up and out of the limb when the horse's lymphatics aren't working properly.”
The challenge with this approach is the way the equine leg is built. Unlike humans, horses have very little musculature on their lower legs. They are totally reliant on the pressure on their frog from walking to propel limb fluid up the leg – which is something stall-bound horses aren't experiencing.
Luckily, the same tool that humans utilize for lymphatic massage has been reimagined for the horse. The EQ PressÔ, developed and sold by Vetletics Inc., is based on human systems through efforts led by Dr. Irina Perdew. This device involves full leg sleeves that cover the horse from the hoof to the top of the leg, with straps to keep the sleeves in place. Instead of cords attached to the main device that's typically sat beside the human, the device is battery-operated and settled in a pack on the horse's back. The pumps are quieter to lessen the chance of spooking the horse.
“The horses are incredibly receptive to it and have done very well,” said Schnabel. “Horses that have a severely painful lymphangitis leg may need sedation for the first time, but many of them don't. Honestly, they seem to really like it. Most of them will yawn, lick and chew, and some fall asleep.”
So far, there have been great results with the lymphatic compression device.
“We've had really good success with chronic lymphangitis cases getting their legs down to normal size,” said Schnabel.
Schnabel explains that research was done to see how using the device would change the lymphatic flow for relief and repair for the legs. This was accomplished by using a tracker that follows the lymphatic system. The tracker was injected under the skin just above the coronary band, and then followed up the leg using a special camera. When being treated with the EQ PressÔ, horses had significant accelerated lymphatic flow, meaning it reached the lymph node at the top of the leg much faster than when the same horses weren't being treated with the EQ PressÔ as a control. In these control horses, the tracker actually hardly ever reached the lymph node in the time that was studied.
Dr. Schnabel and her peers are hoping that using this kind of technology can help horses in three different ways:
- Treating horses with medical conditions like lymphangitis and cellulitis
- Assisting horses recovering on prolonged stall rest
- Athletic recovery
Veterinarians hope the device could also change the lives of horses who suffer from laminitis, especially contralateral limb laminitis.
“For horses, the lymphatic drainage system is the same for their blood pressure—if they're not moving, and that frog isn't getting pressure, the foot is not getting perfused with blood either,” said Schnabel. “Everything is dependent on pressure on that frog and moving to perfuse the foot properly. So, when they're stuck in a stall because they have a fracture of their left front leg for example, their right front leg is taking up all the weight and isn't moving, and the frog isn't mechanically stressed to encourage blood flow. [There have been] some great studies looking at different changes in blood flow. We'd love to see that if by having this device on, horses that cannot walk because of an injury perfuse their feet better as well as having the improved lymphatic drainage.”
The length of sessions, as well as the amount of pressure used, depends on the horse's condition. Most lymphangitis treatments last one hour at a higher pressure. Athletic recovery sessions are usually about 30 minutes at a lower pressure setting. Dr. Schnabel says that a lot of sport horses and eventers are using the lymphatic massage device for recovery from hard workouts or competitions because the massage helps accelerate the lymphatic flow, thus removing the toxic waste the tissues collect from the workouts. Clearance for its application on the track is in process with the Horseracing Integrity and Safety Authority, but some owners are utilizing the device for their horses' recovery at home—either from an injury or just as they take a break from training.
“The horses truly seem to enjoy the treatments and relax,” said Schnabel. “I'm excited to see how else we can apply this technique for the benefit of the horse. We're really excited about using [the device] to prevent laminitis. It could be a gamechanger.”
The post How Compression Technology Can Help Horses Battling Lymphangitis appeared first on Horse Racing News | Paulick Report.
