Equine Manual Lymphatic Drainage works with the body's own processes to promote healing, and should be used as soon as possible after conditions arise. With time tissue changes can take place, which are less influenced by EMLD.
Inflammation:
Inflammation is the body's response to damage or irritation, however inflammation can sometimes become excessive, or continue beyond the healing stage and become chronic.
When inflammation is caused by bacteria, viruses, poisons or allergens EMLD is contraindicated because of the risk of moving these into the blood stream, but when your vet has confirmed that these have responded to treatment, or for inflammation from other causes, e.g. injury, tendonitis, EMLD will quickly remove the products of inflammation, ease symptoms, limit damage and speed up healing, encouraging tissues to return to their normal state.
Idiopathic Synovitis, Tendosynovitis:
Where there is no underlying cause of injury, these conditions (windgalls, bog spavin) are classed as blemishes not requiring treatment. However, if they become very large they may cause a mechanical lameness and owners may also find them unsightly. In these situations EMLD combined with the use of specialised compression stockings can reduce swelling and soften hardened fibrous tissue without the need for drugs or box rest.
Tendonitis:
EMLD can be used as an auxiliary treatment for tendon injuries. Because bleeding and oedema are reduced, and the transportation of toxic waste products increased, further damage to the tendon tissues is reduced. The treatment also encourages longitudinal orientation of the new collagen fibres and recovery times are significantly shortened. It is important however to start EMLD immediately after injury to take advantage of the body's own processes.
Laminitis:
Unfortunately the pathological changes taking place during this condition are initially ‘silent’ and by the time the distressing symptoms appear, the damage has started and the highly constricted space within the hoof is inflamed and congested. Because EMLD can speed the removal of toxic inflammatory products from the hoof capsule it can alleviate the pressure and the injury to tissues caused by these, reducing damage and speeding up recovery times, and is therefore a useful adjunct to veterinary treatment. However, to be effective it needs to be used at the acute/sub acute stages of laminitis.
Tying up:
‘Tying-up’ is one of many names for a collection of clinical signs or symptoms that used to be thought of as one condition but are now known to have several causes, although the symptoms, most strikingly muscle cramping, are similar in each.
EMLD increases the elimination of metabolic products from the muscles and is an effective auxiliary treatment for these conditions, resulting in reduced symptoms and quicker recovery. It also has a prophylactic use with high performance horses and research indicates it may be useful in the treatment of horses that repeatedly tie up.
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Equine Purpura Haemorrhagica:Although EMLD is normally contraindicated for acute allergic reactions, it can be safely used with EPH because this condition is systemic from the start. It produces a faster and greater reduction of the massive oedema, which also affects an improvement in the horse’s general health and the clinical picture of the disease. EMLD treatment should begin at the first indication of oedema formation, to control its potential development.
Swollen legs (Stocking up):
This condition (‘idiopathic primary lymphoedema’) develops in some horses when their movement is restricted for any length of time, typically after being kept in overnight, with the swelling disappearing once the horse is exercised again. To perform adequately, the lymphatic vessels of the horse’s legs are especially dependent on additional factors such as movement to stimulate their activity and the flow of lymph, and if for any reason the lymphatics are damaged or not formed properly they will not be able to cope with the loss of this support, forcing the tissues to swell.
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Over time without treatment the condition can worsen and the legs become increasingly vulnerable to trauma and risk of infections such as lymphangitis, leading to serious oedema and chronic secondary lymphoedema. Horses with this condition should not be kept in unless absolutely necessary, and then only for the shortest possible time.
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Recent research has shown that the use of stable bandages stops the movement of lymph in the standing horse, preventing the provision of nutrients to the tissues and the removal of toxic waste products. The apparent lack of swelling is an optical illusion as fluid disperses above the bandage. Again this can result in further tissue damage and may be a cause of 'filled legs' in previously unaffected horses on box rest. As it is not possible to test for the effect on lymph flow when bandaging moving horses, it is recommended that these be avoided (especially perhaps those which include the fetlock joint) and for protection suitable boots be used for the shortest time possible.
A course of EMLD, followed if required by the use of specialised compression stockings, is an effective means of controlling this condition.
It is a common misunderstanding that high protein feed causes 'filled legs'. Oedema is caused by a very low protein diet, as seen in victims of famine.
Cellulitis:
This is an acute infection with inflammation of the tissues under the skin, which causes oedema. It can occur anywhere but in horses often affects the legs. It must be treated with antibiotics which should resolve an attack. However, it often harms the superficial lymphatic vessels and may develop into lymphangitis which can lead to obstruction and permanent damage to the lymphatic system, predisposing the horse to recurrent attacks. EMLD treatment of cellulitis can begin as soon as antibiotics have cleared the infection, quickly reducing oedema and further potential damage.
Lymphangitis:
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This is a painful condition caused by an infection to the lymphatic system, usually in the horse’s leg. Lymph nodes close to contain the infection to prevent it spreading through the body, inflammation causes more fluid to enter the tissues, and the leg swells. Lymphangitis must be treated promptly by a vet with antibiotics. Unfortunately, damage to the lymphatics often causes some swelling to remain which over time becomes fibrotic, and the legs become vulnerable to further infection – a secondary lymphoedema. EMLD or CDT should start as soon as the infection has been treated, to resolve any swelling, prevent fibrosis and limit the possibility of further infections.
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Pastern Dermatitis:
Pastern dermatitis is a general term for a number of conditions which affect the skin of the horse’s lower legs, including for example mud fever, mite infestation, contact allergic reactions and photosensitivity. Conditions may appear similar but have a quite different cause, it is important therefore that your vet identifies this so that appropriate treatment can be started.
Oedema is frequently present suggesting a lymphatic involvement or reaction, but this has not been researched for most diseases. Repeated attacks trigger further inflammation which causes recurring damage to tissues including lymphatic vessels, limiting the local immune system’s ability to respond and increasing the horse's susceptibility to chronic inflammation and a secondary lymphoedema.
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EMLD to reduce inflammation and stimulate the immune system can begin as soon as any infection or allergic reaction has been treated, or if an active bacterial cause is present, systemic antibiotics used under veterinary monitoring during treatment are required to prevent the spread of infection.
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Treating pastern dermatitis can be frustrating, time consuming and expensive which may encourage owners to 'diagnose' and treat conditions themselves. Unfortunately this sometimes does more harm than good. The skin on horses' legs is sensitive and made more so by many conditions, and can be further damaged by some home remedies. Keeping legs clean and dry, clipping feather and applying soothing bland creams (e.g. aqueous, Sudocrem) to prevent skin drying out and cracking is good basic practice, but accurate veterinary diagnosis so that causes can be removed, management adjusted if necessary and correct treatment applied is very important.
Post traumatic and post operative oedema:
EMLD can be used to reduce oedema and scarring and help speed recovery following injury, burns and after surgical procedures including castration, and for conditions such as mastitis to reduce swelling and enable the use of local instead of systemic antibiotic treatment. EMLD is also effective for eliminating oedema caused by box rest, for example when recovering from laminitis.
My own experience suggests that EMLD may be effectively used to reduce the symptoms caused by Equine Metabolic Syndrome in horses with laminitis.
Lymphoedema:
Please see under 'Equine Lymphoedema Complex', 'Chronic Progressive Lymphoedema' and 'Swollen legs'.