Researchers from North Carolina State University have taken technology aimed at helping humans suffering from lymphedema and developed a medical device to aid horses suffering from the same condition.
There is a fine balance between fluid leaving the blood vessels and being taken up by the lymphatic system, which transports it from the tissues back to the bloodstream. Lymphedema occurs when that balance is disturbed and there is an accumulation of lymphatic fluid in the tissues of the limb.
In a pilot study, Drew Koch and colleagues, found that the device, called the EQ Press, was successful in moving fluid up the limbs and into the lymph nodes. Its developers suggest it could lead to relief for horses with chronic conditions, as well as with temporary swelling due to injury or inactivity.
“Across the board, horses are predisposed to lower limb swelling,” says Lauren Schnabel, associate professor of equine orthopaedic surgery at NC State and co-author of the study. “Lymphatic flow is driven by muscle contractions that circulate lymph fluid through the lymphatic system – horses are prone to lymphatic issues because they have very little musculature in the lower limbs.”
The severity of the condition can vary widely – from temporary swelling due to restricted mobility, to lymphangitis caused by infections that can scar the lymphatic system. Treatment is often frustrating, but may include cold water, ice, bandaging and encouraging exercise.
“Humans suffer from the exact same type of lymphedema horses do, but the difference is that human medicine has a very effective treatment option – pneumatic compression devices,” Schnabel says. “So, we wanted to create a horse-specific version of those devices and see if it would be similarly effective.”
Working closely with a company that manufactures human pneumatic compression devices, Schnabel developed the EQ Press in collaboration with former NC State veterinary student Irina Perdew.
In the study, six healthy thoroughbreds were injected with a tracer isotope – a Tc-99m labelled sulfur colloid - at the coronary band in the front legs. The colloid is taken up and excreted through the lymphatic system. A specialised camera followed the movement of the isotope up the lymphatic system and into a lymph node in the upper limb, a process known as lymphoscintigraphy.
Each horse underwent lymphoscintigraphy twice – once with treatment by the compression device on the front limbs and once without – randomized between treatment and control.
In all EQ Press treated horses, the camera showed the tracer isotope moving from the lower limb to the lymph node in the upper limb within a 60-minute window. Of the control horses, only one showed that the tracer isotope was able to reach the lymph node in the same time.
Overall, EQ Press treated horses had significantly accelerated lymphatic flow compared to untreated horses, recorded as both time for the marker to move out of the lower limb and time for it to reach the lymph node in the upper limb.
Schnabel and the research team found the results encouraging and want to determine whether pneumatic compression treatment will be as helpful for horses as it is for humans.
“Now we have compelling evidence that pneumatic compression treatments can accelerate lymphatic flow in healthy horses,” Schnabel says. “Our next step is to study the effectiveness of the EQ Press for treatment of horses with medical conditions such as lymphedema.”
The open-access study is published in the American Journal of Veterinary Research.
Schnabel is co-founder and chief medical officer of Vetletics, Inc., the company that manufactures the EQ Press.
For more details, see:
Pneumatic compression therapy using the EQ Press accelerates lymphatic flow in healthy equine forelimbs as determined by lymphoscintigraphy
Drew Koch, Lauren Schnabel, Justin Reynolds, Clifford Berry.
American Journal of Veterinary Research (2023)
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