What is Chronic Progressive Lymphedema (CPL)?
Chronic Progressive Lymphedema (CPL) is a debilitating disease affecting the lymphatic system. One of the main roles of the horse’s lymphatic system is to drain excess fluids and remove waste products from the cells within the body. In cases of CPL there is a dysfunction or malformation of the lymphatic vessels, leading to impaired lymphatic function.
What are the symptoms of CPL?
- Firm swellings accompanied by thickened skin and wrinkles on the lower legs
- Crusty or scabby lesions on the skin
- Poor hoof growth
- Intense itching and discomfort
- Limb deformities are commonly seen as the condition progresses
In severe cases, horses may develop open sores which can lead to secondary bacterial infections. If bacterial infection is suspected it is important to contact your vet as soon as possible as a course of antibiotics may be required.
Unfortunately there is no cure for CPL, however with careful management affected horses can live quite comfortably. Unfortunately due to the nature of the condition, many affected horses will have shorter life expectancies. Management focuses on controlling swelling and preventing the development of further complications as a result of the diagnosis
What causes CPL?
The precise cause of CPL is unknown however it is believed that genetics play a role in the development of the condition as it tends to more commonly affect specific breeds, primarily heavy horses including Cobs, Clydesdales, Shires and Drafts. As a progressive condition, CPL and its symptoms will become worse as horses age.
What to do if you think your horse has CPL
If you suspect that your horse has CPL it is important to contact your vet as soon as possible. A diagnosis is usually made on clinical signs and presentation, however some vets may carry out further tests if they believe your horse’s symptoms may be related to a different issue.
Management of CPL
- It is important to ensure that the lower legs remain clean and dry, particularly if there are open wounds present. If cleaning the legs to remove dirt it is important that they are dried thoroughly afterwards, as moisture creates an ideal environment for the growth of bacteria.
- Minimise exposure to dirt, mud and wet ground, which can be difficult during the winter months when rain is more frequent. Where possible turn your horse out on an all weather surface and stay clear from poached or water logged paddocks. Ensure that your horse’s bed is mucked out regularly and do not allow them to spend long periods of time standing in soiled bedding.
- Gentle daily exercise can be used to promote healthy lymph fluid distribution, which may ease some of the swelling associated with the condition. Prolonged periods of stabling and inactivity can contribute to fluid accumulation on the legs. If possible, horses affected with CPL should be given increased access to turnout as this allows for greater freedom of movement. Feeding a combination of marigold and clivers can also help promote healthy fluid distribution and may minimise the occurrence of leg fill.
- The over production of keratin as a result of CPL makes favourable conditions for parasitic feather lice who feed on the skin crust which forms as a result of this. Clipping the legs can help prevent lice, however extra care must be taken when clipping horses with CPL as the thickened skin and lesions can make the procedure more difficult and painful. If you suspect your horse has developed lice, contact a vet as soon as possible who will be able to advise on an appropriate course of treatment.
- Bandaging the lower legs is a technique commonly used to manage fluid accumulation in the lower limbs. However, this may not be possible in cases of CPL depending of the severity of deformity. Before attempting to bandage a horse with CPL, owners should always consult with a vet as this may not be in your horse’s best interest. A vet may advise on alternative treatments that can be used to promote fluid circulation instead.
- Regular farriery care is extremely important for horses affected with CPL as poor hoof quality is common among horses with the condition. Depending on how the condition presents, some horses may benefit from remedial shoeing to better support the limbs and help maintain soundness. Horses with poor hoof quality may also benefit from biotin supplementation to help strengthen their hooves.
Whilst it may seem like a worrying diagnosis, if still sound, many horses with the condition can still be ridden and exercised. As the condition begins to progress you may have to adapt your horse’s work load to cope with this. The life expectancy of horse’s with CPL can be shorter, however with a correct management plan in place, affected horses can live relatively normal and healthy lives.