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The Horse and Hound publish letter from Rebecka Blenntoft, in response to the news that King Solomon III has retired due to a bout of Lymphangitis

According to Equine Manual Lymphatic Drainage specialist Rebecka Blenntoft, retirement was not necessarily the answer...

Sad News:

 

"King Solomon III, Mary King's Olympic partner, who went on to star in the dressage arena with Paula Lee, has been retired from affiliated competition aged 23. The Athens medal-winner suffered a bout of lymphangitis this summer- thought to have been triggered by a serious barn fire at Paula's yard in Nutwell, Devon - which left him with a severely swollen hindleg. "He is actually sound on his leg, but it is still huge and he is unlikely to be able to return to normal work," said Paula, who will partner "Solly" in his own special retirement ceremony at the South West Equine Fair on 3-4 December"

Ellie Hughes, 4 November, 2011

 

The response of Rebecka Blenntoft


"Sir - I was saddened to hear that King Solomon III had been retired following a bout of lymphangitis (news, 4 November).

As one of three therapists in the UK trained at the University of Veterinary Medicine Hannover to be able to use manual lymph drainage (MLD) therapy on horses, and as one of 250 qualified therapists able to treat lymphoedema on the NHS, I can attest that limb volume can be reduced and maintained at normal or near-normal levels. We use special massage movements to encourage the lymph to move out of the limb, while specialised bandaging further aids decongestion, without compromising vulnerable lymph drainage vessels below the knee and hock. Compression garments then maintain the limb at the correct volume and areas of hardening can be softened using specialist under-bandaging or DEEP OSCILLATION® treatment.

Horses are ideal candidates to receive MLD, but the structure of their lymphatic system means that they are significantly compromised by standing for long periods. Elasticated bandaging also compromises their deep collectors by compressing and restricting lymph flow.  Equine MLD is a popular therapy in Germany, where over 450 therapists regularly treat horses for a wide variety of conditions. I am in the process of copying the German model and setting up a school in the UK to train therapists in equine MLD.

Unfortunately, the term manual lymph drainage is not protected in this country, so therapists with the correct level of training can be found via the MLD UK or British Lymphology Society websites"

Rebecka Blenntoft, Deddington, Oxon 17 November 2011

 

Terminology simply explained:


Massage: Manual Lymph Drainage (MLD) is a hands-on therapy. The therapist uses their hands to stretch the skin in 2 directions and then a release phase. This has to be done very specifically, at the right pressure, speed and direction. This makes the small, initial lymphatic vessels under the skin fill and empty much faster. As it is a one-way system, we can increase the speed of lymph flow from 8-10 beats a minute to 35-40 beats per minute by this hands on technique.

Short stretch bandaging: There are two types of bandage - ones with high resting pressure (long-stretch, or elastic) and ones with a low resting pressure (short stretch or inelastic). When you put an elastic bandage on a horse below the knee and the hock the elastic ones compress the deep lymphatic vessels and stop the flow of lymph up the leg. We use short stretch bandages as when the horse is standing, they do not compress the leg, but when the horse moves the short stretch bandage gently contracts in a pumping action to help the lymph move up the vessels. The most important thing is that these bandages do not constrict!
 
Deep collector vessels: lymphatic fluid moves along channels or vessels, rather like the blood does through veins. The deep collectors in the lower leg drain the lymph from the tissues and the tendon sheaths rather like straws going up the leg. In a human, you can't access deep collector vessels as they are covered in muscle and subcutaneous fat. In a horse, there is no muscle or much fat under the knee or hock. They are vulernable because any compression on the lower legs contricts the flow of lymph up these deep collectors in the legs (think of them as looking like veins but moving lymph!)
 
Fibrosis- When a horse has multiple attacks of lymphangitis or cellulitis, the swelling gets harder and harder and eventually feels very hard and tough instead of nice and soft. This is because there is damage to the lymph vessels because of the infection. So not all the lymph comes out of the area affected, and protein molecules are left behind, which turn hard over time as the body starts to attack them. The swelling also goes hard and fibrotic becuase the collagen changes in the skin as well - instead of nice and flexible, they go hard and fibrotic. Its really hard to get rid of fibrosis once it is there.