Manual Lymph Drainage to aid in Laminitis Treatment?

Manual Lymph Drainage to aid in Laminitis Treatment?

Powell described the lymphatic system (depicted here) as "essential for fluid homeostasis and immune surveillance, intimately involved in inflammatory diseases, and having functional roles in fat metabolism and metabolic syndrome."

Photo: Heather Powell, Vodder, MLD, DLT/Schlütersche Verlagsgesellschaft

Danish doctors pioneered manual lymph drainage (MLD), a noninvasive therapy resembling massage, in humans in the 1930s. European practitioners have since performed the technique when managing human conditions such as lymphedema and cancer, yet little research exists on its efficacy in horses. Because anecdotal reports support the use of MLD in horses with laminitis, Heather Powell, Vodder, MLD, DLT, EMLD practitioner and founder of Equine MLD, in Worcestershire, United Kingdom, conducted a study to examine the therapy's efficacy in laminitis cases. She presented her results at the 2013 International Equine Conference on Laminitis and Diseases of the Foot, held Nov. 1-3 in West Palm Beach, Fla.

First, let's review a few of the lymphatic system's functions. The system's primary purpose is to transport proteins and plasma that have left the blood circulatory system, carrying oxygen and nutrients, back to the blood circulation via a network of conduits called lymphatic vessels. These vessels also serve an immune purpose: If any of the cells they transport are bacteria or viruses, the lymph nodes (with which they connect along the way) will recognize them as such and initiate a defensive response. Additionally, the lymphatic system carries certain essential fatty acids into the body.

Powell described the lymphatic system as "essential for fluid homeostasis and immune surveillance, intimately involved in inflammatory diseases, and having functional roles in fat metabolism and metabolic syndrome."

The purpose of MLD, therefore, is to encourage natural "lymph" drainage from the body's tissues using a specific amount of pressure in rhythmic, circular motions—starting from the point where the lymphatic system connects with the bloodstream (in horses, just in front of the shoulder blade) and working toward the affected area of the body. Because MLD has the potential to relieve inflammation and edema (fluid swelling) and drain toxins and fluid from the hoof, Powell suggested veterinarians should integrate it into acute laminitis treatment.

"The aim of this preliminary study was to document the use of MLD in the treatment of recurrent laminitis in horses with equine Cushing's disease or equine metabolic syndrome (EMS) and those with acute laminitis," she said.

In Powell's study she looked at the case histories of seven horses—three with acute laminitis (when the laminae attaching the coffin bone to the hoof first become inflamed); two with subacute laminitis (when the horse is recovering from the acute stage); and two with acute laminitis due to Cushing's disease or EMS. Each horse had received, on average, seven consecutive days of 45-minute MLD treatments by a qualified MLD practitioner as an adjunct to traditional laminitis treatment. Powell observed that:

  • The acute cases experienced a quick and uneventful recovery;
  • The subacute cases displayed improved comfort and mobility;
  • The Cushing's and EMS cases recovered from laminitis; and
  • All horses' recovery was unexpectedly fast, as noted by the treating veterinarians.

Based on these results Powell suggested that prompt MLD might help speed recovery and reduce internal hoof damage in affected horses.

"When used in horses with acute laminitis, MLD limits the inflammatory response; drains edema and tissue debris (e.g., damaged cells), reducing pressure within the hoof; and limits processes damaging the laminae, leading to better recovery," Powell concluded. "Further effects promote activity of the parasympathetic nervous system, tissue glucose absorption, pain relief, and reduced hypertension (high blood pressure)."

She added, however, that more research into this therapy is needed, and practitioners must become properly certified before performing MLD on horses.

The study, "A preliminary study into the use of manual lymphatic drainage to support recovery from laminitis," was published in the October 2013 issue of the Journal of Equine Veterinary Science

About the Author

Alexandra Beckstett, The Horse Managing Editor

Alexandra Beckstett, Managing Editor of The Horse and a native of Houston, Texas, is a lifelong horse owner who has shown successfully on the national hunter/jumper circuit and dabbled in hunter breeding. After graduating from Duke University, she joined Blood-Horse Publications as Assistant Editor of its book division, Eclipse Press, before joining The Horse.

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