Discuss Chronic Progressive Lymphedema In Draft Horses. at the Horse Health forum - Horse Forums. CPL is a very common, unsightly and deadly problem, which affects many and probably all, ...
Chronic Progressive Lymphedema In Draft Horses.
CPL is a very common, unsightly and deadly problem, which affects many and probably all, of the Draft breeds across the world.
UC Davis has done an indepth study of the problem. However, their funding for this has now run out.
CPL is a problem which all breeders of heavy horses must and probably will face, at some time or other. Sadly, little is still known about it and many breeders will not admit a horse they own, has it.
For the last five years I have been studying this problem and while a few have been willing to come forward and discuss it, many have not. Happily, in the last weeks, we have started an indepth discussion on our forum. We do not ask anyone to mention names of horses with the problem, only to give accounts what they have seen, what they know, when it started, how it started, what they have noted, what has maybe helped etc.
We breed Gypsy Horses and have noted many who have come into the country with the problem already well established. Sadly, some in the UK have said that it doesn't exist there. This is of course, absolutely untrue. A Vet friend of mine in England, told me years ago, that the problem is widespread in the UK. Unless and until, we admit the problem exists in all Draft breeds everywhere, we will not get anywhere in coming up with ideas, as to the cause etc.
We fully understand, that many Vets are not even aware of the problem and will put it down to a maybe, major case of scratches. Scratches and CPL are very different.
We must educate and be willing to share information between each other. We must educate any buyer of heavy horses we sell. We must all know how to spot the problem.
On our forum, as far as I know, this is the first time that CPL has been discussed openly. We seek only to share information, hopefully to come up with ideas and maybe share experiences. You do not have to own a Gypsy Horse, to take part. We only need your thoughts, ideas and maybe help, in discovering the real cause of this problem. We have all kept our heads in the sand long enough.
If you own or breed any of the Draft breeds, we invite you to join our forum and read and/or, take part in our CPL message thread. This is an incredibly devastating problem. We need to join together with information, ideas and thoughts.
Please do join us in this research.
What's Brewing Under Those Feathers?
by: Stephanie J. Corum, MS
February 01 2006, Article # 6570
It is quite probable that many people have never heard of chronic progressive lymphedema. However, if you have spent time with draft horses, chances are much more likely that you are familiar with the condition. This painful, debilitating disease has been identified in Shires, Clydesdales, and Belgians (especially those actually in Belgium). "Percherons, Suffolk Punches, Friesians, and other draft breeds without much feathering on the legs are not usually affected," says Gregory L. Ferraro, DVM, director of the Center for Equine Health at the University of California, Davis. Progressive swelling and thickening of the skin on the lower legs characterizes the condition. Encrusted lesions develop underneath the draft's beautiful feathers (long hairs at the fetlock), and clipping that hair is sometimes the only way to see them.
The clinical signs of lymphedema closely resemble chronic lymphedema or elephantiasis nostras verrucosa in humans. In these human conditions, the swelling is caused by a malfunctioning lymphatic system and a compromised immune system. It is believed that this might also be the cause of lymphedema in horses. However, to better understand the disease, it will be helpful to briefly review the lymphatic system.
The Lymphatic System
The lymphatic system is a one-way route for interstitial fluid (in the body's tissues) to get to the cardiovascular system. Lymphatic capillaries are present in almost all organs, and they have large, water-filled channels that are permeable to all interstitial fluid constituents, including protein.
The lymphatic system functions to transport body fluids and protect against disease. Lymph, a protein-rich liquid derived from the interstitial fluid, is transported through the lymphatic system to the major vein returning blood to the heart, the vena cava. This process also returns fluid that leaks from capillaries back into the circulatory system.
In addition, lymph vessels from the intestines transport absorbed fat to the vena cava. In the lymphatic system's protection role, foreign particles and lymphocytes (types of white blood cells that fight infection) are carried from infective tissue to the nearest lymph nodes, which are located at various points throughout this network. Accumulation of debris and lymphocytes in lymph nodes accounts for the "swollen glands" often noted in a sick person's throat.
In the circulatory system, the heart pumps blood through the arteries and veins. There is no such pump for the lymphatic system. Instead, skeletal muscle and respiratory pumps move the lymph. Valves increase the pressure and keep the flow going in one direction. Excess fluid also increases the pressure, and when that fluid accumulates, it is termed edema. This familiar "stocking up" condition is common when horses stand for long periods of time. Usually simply getting the horse moving will reduce the swelling.
A Painful Condition
The breakdown of the lymphatic system as it occurs in lymphedema in the horse leads to lymph leaking into lower leg tissue, which in turn causes fibrosis (fibrous scarring) of tissue under the skin. The thickening of the skin causes further blockage and decreased circulation. "This results in a phenomenon known as neovascularization: A process by which the body develops new blood vessels in a futile attempt to provide oxygen to its tissues," explains Ferraro.
Lymphedema often first occurs when the horse is young, and it eventually causes disfigurement, disability, and even premature death. For example, in affected Belgian stallions in Belgium, the horse's life expectancy declines from 20 years to six years because acute lymphedema is often accompanied by secondary infections as a result of the open wounds on the horse's legs. Dark- and white-colored legs are equally affected.
Lesions are similar to pastern dermatitis (also called scratches) that is common in other breeds, but lymphedema lesions do not respond well to treatment. Removing the scabs or even simple movement can cause bleeding, and according to Ferraro, the condition can be quite painful.
The small lesions progressively get larger, and while they often start on the rear of the pastern, they can spread as far up as the knees and hocks. The nodules can range in size from that of a golf ball to a baseball, and they interfere with the horse's natural movement. Thick skin folds form and as the condition worsens, the swelling becomes firm and permanent. This dermatitis is believed to be "a secondary result due to the body's inability to properly supply fluid circulation and oxygenate the skin of the lower leg," states Ferraro.
Searching for Answers
The exact cause of chronic progressive lymphedema is still unknown, but identifying the cause is the key to determining the pathogenesis. A deficiency of or abnormality in elastin (a component of tissue) might be the cause of lymph system degeneration. Since only certain breeds--and animals within that breed--are affected, there might be a genetic link. That link could define the long-term solution.
A study to determine the cause, treatment, and prevention of chronic progressive lymphedema is underway with a collaboration between UC Davis, the University of Ghent in Belgium, and human medical researchers. UC Davis will use Shires and Clydesdales, while the University of Ghent studies Belgians, to confirm that the cause is an abnormality of elastin. Then they will examine the cause and effect relationship between cellular abnormality and disease progression. Why does elastin deficiency lead to a breakdown of the lymphatic system, which in turn causes the progression of clinical signs? Once these questions are answered, there is a better chance of finding a treatment and cure.
Finally, they will examine the genetic profile of the draft horse and how it could be manipulated to avoid the problem. In humans, there are three different genes that cause the inherited form of the disease. For horses, the research is progressing. "We are working on the genetics of the condition and are continuing to study the cellular biology of the disease at this time," says Ferraro. "We hope to have some new scientific articles published this year."
No doubt draft horse owners will be glad to know that answers to this debilitating disease might be coming soon.
ejforrest- "A horse is the projection of peoples' dreams about themselves - strong, powerful, beautiful - and it has the capability of giving us escape from our mundane existence".
As you see EJ, that paper was written almost four years ago and now all funding has been stopped. We breeders have now been pretty much left to ouselves on the subject.
I originally wrote this five years ago and have been adding to it regularly and sometimes changing my thoughts as significant research comes to light.
You will find some more up to date info there. A friend of mine from England, who has also been investigating the possible causes, recently came to UCDavis and in their last paper, they did include some of her findings. There are also a couple of links there to the last findings of UCDavis and others. Also pictures from UCDavis.
Because it is such a devastating disease and mainly because nobody has wanted to talk about it in the past, that we have recently started a huge message thread about it on our forum. If you google Chronic Progressive Lymphedema, often the links go to the page I wrote above and for a disease such as this, it's just not good enough. Thankfully, it is now "out in the open" and little by little, people in many breeds are coming forward with their ideas, pictures etc. and admitting one or more of their horses has it. We have breeders with Shires, Clydesdale, Brabants and Gypsy Horses taking part. We would so welcome those with other heavy breeds to join us in the discussion, whether or not you've seen it in your breed. At the moment, we are all rather bent more on finding the "why" than a cure. Many interesting thoughts and ideas are being presented.
We have found, that breeders in the US are rather more forthcoming, than those in other countries where some have even declared that it doesn't exist!
Sounds like somebody needs GameReady to the rescue! (For treatment and pain relief of the affected horses.)
Im so Glad to finally find other people who recgonise this terrible condition. I found out last month my girl suffers from cpl.. even though it wasnt picked up when she was vet checked..as its not known in the uk Lame excuse for not doing your job right if you ask me !
The link on that page to their forum does not work.
Treatment of CPL
Suggest you look at website www.equinemld.com for up to date information on CPL and treatment.
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