Combined decongestive therapy including equine manual lymph drainage to assist management of chronic progressive lymphoedema in draught horses
Identifieur interne : 003566 ( Istex/Corpus ); précédent : 003565; suivant : 003567Combined decongestive therapy including equine manual lymph drainage to assist management of chronic progressive lymphoedema in draught horses
Auteurs : H. Powell ; V. K. AffolterSource :
- Equine Veterinary Education [ 0957-7734 ] ; 2012-02.
Abstract
Equine chronic progressive lymphoedema (CPL) is a disabling disorder of draught horse breeds. Combined decongestive therapy (CDT) is the treatment of choice for lymphoedema in man and has been adapted for use in horses. Equine CDT, which includes manual lymph drainage (MLD) and subsequent bandaging with short stretch bandages, was expected to improve the signs of CPL in draught horses because CPL resembles primary lymphoedema in man. Five affected horses ‐ Gypsy cob (n = 1), Clydesdale (n = 1), Shires (n = 3) ‐ were included. Lesions were documented pre‐ and post treatment. Percentage volume loss of the distal legs was calculated using the disc model. Initial plans for daily CDT had to be adapted; intermittent treatment of Chorioptes infections required alternating between CDT and MLD in 4/5 horses. Concurrent pyoderma (1/5 horses) was treated throughout the study. Development of unrelated lameness (hoof abscess) allowed limited CDT treatment only in one horse. Marked softening of previously firm tissue indicated the change from ‘brawny’ to pitting oedema in 2/5 horses. Fibrotic nodules and folds in the pasterns became markedly softened and smaller in 2/5 horses. Skin surface notably improved in all horses: hyperkeratosis decreased, erosions and ulcerations healed completely and crusts disappeared. After 2 weeks, a mean volume reduction of 11.25% was seen, ranging from 4.75–21.74% and quality of movement improved. This pilot study documents evidence that CDT assists management of CPL. Current CPL management is limited to palliative treatments of secondary infections. Whilst not a permanent treatment, CDT offers a promising tool to manage horses with CPL, improving their quality of life and potential usefulness. More extensive and prolonged studies with a larger number of horses are warranted to evaluate the full potential of CDT.
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DOI: 10.1111/j.2042-3292.2011.00311.x
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Affolter</name><affiliation><mods:affiliation>Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, UC Davis, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: vkaffolter@ucdavis.edu</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Equine Veterinary Education</title><title level="j" type="alt">EQUINE VETERINARY EDUCATION</title><idno type="ISSN">0957-7734</idno><idno type="eISSN">2042-3292</idno><imprint><biblScope unit="vol">24</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="81">81</biblScope><biblScope unit="page" to="89">89</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2012-02">2012-02</date></imprint><idno type="ISSN">0957-7734</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0957-7734</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Equine chronic progressive lymphoedema (CPL) is a disabling disorder of draught horse breeds. Combined decongestive therapy (CDT) is the treatment of choice for lymphoedema in man and has been adapted for use in horses. Equine CDT, which includes manual lymph drainage (MLD) and subsequent bandaging with short stretch bandages, was expected to improve the signs of CPL in draught horses because CPL resembles primary lymphoedema in man. Five affected horses ‐ Gypsy cob (n = 1), Clydesdale (n = 1), Shires (n = 3) ‐ were included. Lesions were documented pre‐ and post treatment. Percentage volume loss of the distal legs was calculated using the disc model. Initial plans for daily CDT had to be adapted; intermittent treatment of Chorioptes infections required alternating between CDT and MLD in 4/5 horses. Concurrent pyoderma (1/5 horses) was treated throughout the study. Development of unrelated lameness (hoof abscess) allowed limited CDT treatment only in one horse. Marked softening of previously firm tissue indicated the change from ‘brawny’ to pitting oedema in 2/5 horses. Fibrotic nodules and folds in the pasterns became markedly softened and smaller in 2/5 horses. Skin surface notably improved in all horses: hyperkeratosis decreased, erosions and ulcerations healed completely and crusts disappeared. After 2 weeks, a mean volume reduction of 11.25% was seen, ranging from 4.75–21.74% and quality of movement improved. This pilot study documents evidence that CDT assists management of CPL. Current CPL management is limited to palliative treatments of secondary infections. Whilst not a permanent treatment, CDT offers a promising tool to manage horses with CPL, improving their quality of life and potential usefulness. More extensive and prolonged studies with a larger number of horses are warranted to evaluate the full potential of CDT.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>nodule</json:string><json:string>lymphoedema</json:string><json:string>oedema</json:string><json:string>fibrotic</json:string><json:string>equine</json:string><json:string>affolter</json:string><json:string>decongestive</json:string><json:string>rautenfeld</json:string><json:string>lymphedema</json:string><json:string>plantar</json:string><json:string>decongestive therapy</json:string><json:string>fedele</json:string><json:string>hind legs</json:string><json:string>fibrotic nodules</json:string><json:string>lymphatic</json:string><json:string>dermatitis</json:string><json:string>skin surface</json:string><json:string>elastin</json:string><json:string>shire</json:string><json:string>fetlock</json:string><json:string>manual lymph drainage</json:string><json:string>ulceration</json:string><json:string>draught</json:string><json:string>pilot study</json:string><json:string>hoof abscess</json:string><json:string>short stretch bandages</json:string><json:string>distal limbs</json:string><json:string>draught horses</json:string><json:string>bandaging</json:string><json:string>progressive lymphoedema</json:string><json:string>oedema reduction</json:string><json:string>compression bandaging</json:string><json:string>distal legs</json:string><json:string>disc model</json:string><json:string>bacterial infections</json:string><json:string>skin care</json:string><json:string>lymph</json:string><json:string>mite</json:string><json:string>ferraro</json:string><json:string>pastern dermatitis</json:string><json:string>skin scrapings</json:string><json:string>lymphatic system</json:string><json:string>draft horses</json:string><json:string>lymphatic vessels</json:string><json:string>front legs</json:string><json:string>heavy draught horses</json:string><json:string>better definition</json:string><json:string>belgian draught horses</json:string><json:string>chronic pastern dermatitis</json:string><json:string>fold</json:string><json:string>pilot study documents evidence</json:string><json:string>elastin peptides</json:string><json:string>chronic lymphoedema</json:string><json:string>equine health</json:string><json:string>mammary gland</json:string><json:string>volume reduction</json:string><json:string>plantar pastern</json:string><json:string>verrucous pastern dermatitis syndrome</json:string><json:string>distal limb</json:string><json:string>fibrous folds</json:string><json:string>multiple erosions</json:string><json:string>miliary crusts</json:string><json:string>mite infections</json:string><json:string>heavy feathering</json:string><json:string>lower extremities</json:string><json:string>many nodules</json:string><json:string>natural profile</json:string><json:string>topical treatment</json:string><json:string>international society</json:string><json:string>numerous nodules</json:string><json:string>plantar area</json:string><json:string>clinical observations</json:string><json:string>post treatment</json:string><json:string>less firm</json:string><json:string>skin folds</json:string><json:string>skin condition</json:string><json:string>firm folds</json:string><json:string>plantar aspect</json:string><json:string>percent volume reduction</json:string><json:string>larger number</json:string><json:string>primary lymphoedema</json:string><json:string>promising tool</json:string><json:string>more definition</json:string><json:string>lymph drainage</json:string><json:string>secondary infections</json:string><json:string>palliative treatments</json:string><json:string>german draft horses</json:string><json:string>belgian draft horses</json:string><json:string>initial volume</json:string><json:string>chorioptic mange</json:string><json:string>pastern</json:string></teeft></keywords><author><json:item><name>H. 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Combined decongestive therapy (CDT) is the treatment of choice for lymphoedema in man and has been adapted for use in horses. Equine CDT, which includes manual lymph drainage (MLD) and subsequent bandaging with short stretch bandages, was expected to improve the signs of CPL in draught horses because CPL resembles primary lymphoedema in man. Five affected horses ‐ Gypsy cob (n = 1), Clydesdale (n = 1), Shires (n = 3) ‐ were included. Lesions were documented pre‐ and post treatment. Percentage volume loss of the distal legs was calculated using the disc model. Initial plans for daily CDT had to be adapted; intermittent treatment of Chorioptes infections required alternating between CDT and MLD in 4/5 horses. Concurrent pyoderma (1/5 horses) was treated throughout the study. Development of unrelated lameness (hoof abscess) allowed limited CDT treatment only in one horse. Marked softening of previously firm tissue indicated the change from ‘brawny’ to pitting oedema in 2/5 horses. Fibrotic nodules and folds in the pasterns became markedly softened and smaller in 2/5 horses. Skin surface notably improved in all horses: hyperkeratosis decreased, erosions and ulcerations healed completely and crusts disappeared. After 2 weeks, a mean volume reduction of 11.25% was seen, ranging from 4.75–21.74% and quality of movement improved. This pilot study documents evidence that CDT assists management of CPL. Current CPL management is limited to palliative treatments of secondary infections. Whilst not a permanent treatment, CDT offers a promising tool to manage horses with CPL, improving their quality of life and potential usefulness. 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K.</forename><surname>Affolter</surname></persName><affiliation>Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, UC Davis, California, USA<address><country key="US"></country></address></affiliation><affiliation>email: vkaffolter@ucdavis.edu</affiliation></author><idno type="istex">72B3B184C3B2E751B22A523983A7EEA12A99E003</idno><idno type="DOI">10.1111/j.2042-3292.2011.00311.x</idno><idno type="unit">EVE311</idno><idno type="toTypesetVersion">file:EVE.EVE311.pdf</idno></analytic><monogr><title level="j" type="main">Equine Veterinary Education</title><title level="j" type="alt">EQUINE VETERINARY EDUCATION</title><idno type="pISSN">0957-7734</idno><idno type="eISSN">2042-3292</idno><idno type="book-DOI">10.1001/(ISSN)2042-3292</idno><idno type="book-part-DOI">10.1111/eve.2012.24.issue-2</idno><idno type="product">EVE</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">24</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="81">81</biblScope><biblScope unit="page" to="89">89</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2012-02"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Summary</head><p>Equine chronic progressive lymphoedema (CPL) is a disabling disorder of draught horse breeds. Combined decongestive therapy (CDT) is the treatment of choice for lymphoedema in man and has been adapted for use in horses. Equine CDT, which includes manual lymph drainage (MLD) and subsequent bandaging with short stretch bandages, was expected to improve the signs of CPL in draught horses because CPL resembles primary lymphoedema in man. Five affected horses ‐ Gypsy cob (n = 1), Clydesdale (n = 1), Shires (n = 3) ‐ were included. Lesions were documented pre‐ and post treatment. Percentage volume loss of the distal legs was calculated using the disc model. Initial plans for daily CDT had to be adapted; intermittent treatment of Chorioptes infections required alternating between CDT and MLD in 4/5 horses. Concurrent pyoderma (1/5 horses) was treated throughout the study. Development of unrelated lameness (hoof abscess) allowed limited CDT treatment only in one horse. Marked softening of previously firm tissue indicated the change from ‘brawny’ to pitting oedema in 2/5 horses. Fibrotic nodules and folds in the pasterns became markedly softened and smaller in 2/5 horses. Skin surface notably improved in all horses: hyperkeratosis decreased, erosions and ulcerations healed completely and crusts disappeared. After 2 weeks, a mean volume reduction of 11.25% was seen, ranging from 4.75–21.74% and quality of movement improved. This pilot study documents evidence that CDT assists management of CPL. Current CPL management is limited to palliative treatments of secondary infections. Whilst not a permanent treatment, CDT offers a promising tool to manage horses with CPL, improving their quality of life and potential usefulness. More extensive and prolonged studies with a larger number of horses are warranted to evaluate the full potential of CDT.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">horse</term><term xml:id="k2">chronic progressive lymphoedema</term><term xml:id="k3">combined decongestive therapy (CDT)</term><term xml:id="k4">manual lymph drainage (MLD)</term><term xml:id="k5">equine CDT</term><term xml:id="k6">equine MLD</term></keywords><classCode scheme="tocHeading1">ORIGINAL ARTICLES</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/72B3B184C3B2E751B22A523983A7EEA12A99E003/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1001/(ISSN)2042-3292</doi><issn type="print">0957-7734</issn><issn type="electronic">2042-3292</issn><idGroup><id type="product" value="EVE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="EQUINE VETERINARY EDUCATION">Equine Veterinary Education</title></titleGroup></publicationMeta><publicationMeta level="part" position="02102"><doi origin="wiley">10.1111/eve.2012.24.issue-2</doi><numberingGroup><numbering type="journalVolume" number="24">24</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2012-02">February 2012</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="7" status="forIssue"><doi origin="wiley">10.1111/j.2042-3292.2011.00311.x</doi><idGroup><id type="unit" value="EVE311"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title></titleGroup><copyright>© 2011 EVJ Ltd</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:3.1.2.1 standalone mode:FullText" date="2012-02-15"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-10-09"></event><event type="publishedOnlineFinalForm" date="2012-01-04"></event><event type="firstOnline" date="2011-10-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-25"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.3.4 mode:FullText" date="2015-02-24"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="81">81</numbering><numbering type="pageLast" number="89">89</numbering></numberingGroup><correspondenceTo>
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Affolter</title><title type="short">Management of equine chronic progressive lymphoedema</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>H.</givenNames><familyName>Powell</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2" corresponding="yes"><personName><givenNames>V. K.</givenNames><familyName>Affolter</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Equine MLD, Worcestershire, UK; and</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="US"><unparsedAffiliation>Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, UC Davis, California, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">horse</keyword><keyword xml:id="k2">chronic progressive lymphoedema</keyword><keyword xml:id="k3">combined decongestive therapy (CDT)</keyword><keyword xml:id="k4">manual lymph drainage (MLD)</keyword><keyword xml:id="k5">equine CDT</keyword><keyword xml:id="k6">equine MLD</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Summary</title><p>Equine chronic progressive lymphoedema (CPL) is a disabling disorder of draught horse breeds. Combined decongestive therapy (CDT) is the treatment of choice for lymphoedema in man and has been adapted for use in horses. Equine CDT, which includes manual lymph drainage (MLD) and subsequent bandaging with short stretch bandages, was expected to improve the signs of CPL in draught horses because CPL resembles primary lymphoedema in man. Five affected horses ‐ Gypsy cob (n = 1), Clydesdale (n = 1), Shires (n = 3) ‐ were included. Lesions were documented pre‐ and post treatment. Percentage volume loss of the distal legs was calculated using the disc model. Initial plans for daily CDT had to be adapted; intermittent treatment of Chorioptes infections required alternating between CDT and MLD in 4/5 horses. Concurrent pyoderma (1/5 horses) was treated throughout the study. Development of unrelated lameness (hoof abscess) allowed limited CDT treatment only in one horse. Marked softening of previously firm tissue indicated the change from ‘brawny’ to pitting oedema in 2/5 horses. Fibrotic nodules and folds in the pasterns became markedly softened and smaller in 2/5 horses. Skin surface notably improved in all horses: hyperkeratosis decreased, erosions and ulcerations healed completely and crusts disappeared. After 2 weeks, a mean volume reduction of 11.25% was seen, ranging from 4.75–21.74% and quality of movement improved. This pilot study documents evidence that CDT assists management of CPL. Current CPL management is limited to palliative treatments of secondary infections. Whilst not a permanent treatment, CDT offers a promising tool to manage horses with CPL, improving their quality of life and potential usefulness. More extensive and prolonged studies with a larger number of horses are warranted to evaluate the full potential of CDT.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Combined decongestive therapy including equine manual lymph drainage to assist management of chronic progressive lymphoedema in draught horses</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Management of equine chronic progressive lymphoedema</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Combined decongestive therapy including equine manual lymph drainage to assist management of chronic progressive lymphoedema in draught horses</title></titleInfo><name type="personal"><namePart type="given">H.</namePart><namePart type="family">Powell</namePart><affiliation>Equine MLD, Worcestershire, UK; and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">V. K.</namePart><namePart type="family">Affolter</namePart><affiliation>Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, UC Davis, California, USA</affiliation><affiliation>E-mail: vkaffolter@ucdavis.edu</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2012-02</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">8</extent><extent unit="tables">2</extent><extent unit="references">42</extent><extent unit="words">5814</extent></physicalDescription><abstract lang="en">Equine chronic progressive lymphoedema (CPL) is a disabling disorder of draught horse breeds. Combined decongestive therapy (CDT) is the treatment of choice for lymphoedema in man and has been adapted for use in horses. Equine CDT, which includes manual lymph drainage (MLD) and subsequent bandaging with short stretch bandages, was expected to improve the signs of CPL in draught horses because CPL resembles primary lymphoedema in man. Five affected horses ‐ Gypsy cob (n = 1), Clydesdale (n = 1), Shires (n = 3) ‐ were included. Lesions were documented pre‐ and post treatment. Percentage volume loss of the distal legs was calculated using the disc model. Initial plans for daily CDT had to be adapted; intermittent treatment of Chorioptes infections required alternating between CDT and MLD in 4/5 horses. Concurrent pyoderma (1/5 horses) was treated throughout the study. Development of unrelated lameness (hoof abscess) allowed limited CDT treatment only in one horse. Marked softening of previously firm tissue indicated the change from ‘brawny’ to pitting oedema in 2/5 horses. Fibrotic nodules and folds in the pasterns became markedly softened and smaller in 2/5 horses. Skin surface notably improved in all horses: hyperkeratosis decreased, erosions and ulcerations healed completely and crusts disappeared. After 2 weeks, a mean volume reduction of 11.25% was seen, ranging from 4.75–21.74% and quality of movement improved. This pilot study documents evidence that CDT assists management of CPL. Current CPL management is limited to palliative treatments of secondary infections. Whilst not a permanent treatment, CDT offers a promising tool to manage horses with CPL, improving their quality of life and potential usefulness. More extensive and prolonged studies with a larger number of horses are warranted to evaluate the full potential of CDT.</abstract><subject lang="en"><genre>keywords</genre><topic>horse</topic><topic>chronic progressive lymphoedema</topic><topic>combined decongestive therapy (CDT)</topic><topic>manual lymph drainage (MLD)</topic><topic>equine CDT</topic><topic>equine MLD</topic></subject><relatedItem type="host"><titleInfo><title>Equine Veterinary Education</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0957-7734</identifier><identifier type="eISSN">2042-3292</identifier><identifier type="DOI">10.1001/(ISSN)2042-3292</identifier><identifier type="PublisherID">EVE</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>24</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>81</start><end>89</end><total>9</total></extent></part></relatedItem><identifier type="istex">72B3B184C3B2E751B22A523983A7EEA12A99E003</identifier><identifier type="DOI">10.1111/j.2042-3292.2011.00311.x</identifier><identifier type="ArticleID">EVE311</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2011 EVJ Ltd</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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