What is CPL?

Chronic Progressive Lymphoedema (=CPL) is a condition of the legs of horses and is common in cold horses with fur and in Friesians.
Years ago, CPL was only seen in heavier horse breeds such as draft horses and Shires, but nowadays it is also seen in many Tinkers and Friesians, recently, unfortunately, CPL has also been observed in other breeds.
There are different manifestations of CPL and different stages at which a horse can have CPL. The abbreviation (CPL) stands for: Chronic Progressive Lymphoedema (Now that you know what this abbreviation stands for, you understand that we use the abbreviation CPL instead of the full name). These three fancy words mean that CPL never completely goes away, it gets progressively worse if you don't do anything (see tips below to take the Progressive off) and the condition manifests as an accumulation in the lymphatic system in the legs.
The lymphatic vessels of horses with CPL no longer work properly because there is too little elastin in the tissues. The exact cause of CPL is not yet clear. Malfunctioning lymphatic vessels and abnormal elastin levels in the skin play a role. There is also the firm suspicion that heredity plays a role, but there is no scientific evidence for this yet. Unfortunately, there is also no genetic test of CPL available yet that shows whether CPL is hereditary.

Symptoms of CPL

The symptoms of CPL are mainly under the socks. As a result, CPL is often difficult to recognise. The first spots are often seen in the pasterns and look like 'mug'. Flakes or a crack on the back front knee are also frequently seen.

Marks include:
Bumps, lumps, flakes, mug, wounds, wrinkles, folds, thickening, cracks or itching on the legs of a sock horse, coldblood or Friesian horse. Horses with CPL are also more susceptible to mites and therefore often have itchy legs. Sometimes one of these symptoms is visibly present, sometimes several.

CPL shows in different stages and it is important to recognise the condition as early as possible so that worse can be prevented.
Remarkably, mug and/or wounds are poor or unwilling to heal. With lymphatic drainage, free movement and proper nutrition, CPL wounds and skin tears do heal, read more about that below. If you do nothing, the skin and tissue will change over time. The skin on the legs becomes rigid and thus less mobile. Eventually, hard, thick lower legs can develop with deformities and yes, ... then a horse doesn't move finely either. Know that not every horse with CPL shows exactly these symptoms, nor does it have to lead to all stages.

Nutrition in CPL

Nutrition, health and the lymphatic system are inextricably linked. The right feed plays an important role in management for a horse with CPL. Clumsy feeding can make CPL worse. The same goes for stress and being stabled a lot, as exercise is crucial for a healthy lymphatic system. Any owner will unconsciously and out of ignorance give feed or roughage that is awkward for the lymphatic system and for a horse with CPL. Nobody does this on purpose, which is why it is important to gather a lot of knowledge about this.
Besides nutrition, other factors surrounding a horse also play an important role in CPL and his/her mental and physical health. I am referring to epigenetic factors, environmental factors, social, care, training and (stable) management factors. All these factors together determine the extent to which CPL has the opportunity to develop.
If I am asked to name one food product that is better not to feed to horses with CPL, my answer is: sugary hay and silage/pre-dry packed in plastic.

What can you do if your horse has CPL?

CPL is a multifactorial condition so there is no one thing or one remedy that will help. The important thing is to recognise CPL at an early stage and take action as soon as possible.
CPL never improves on its own! This condition is Progressive and if you don't take action, it will go from bad to worse with possible permanent tissue change. This causes pain and the leg becomes less mobile.
What can you do as an owner in case of (suspected) CPL: ✅ Check your horse's pasterns and legs for flaking, bumps, wounds, bumps, cracks or folds.
✅ Mite management; kill mites and make your horse unattractive to mites.
✅ Feed low in sugars and low in starch.
✅ Feed unpacked hay, which is low in sugars.
✅ Limit stress
✅ Give plenty of free exercise.
✅ Engage a qualified lymphatic drainage therapist.
✅ Shave the horse's legs.
✅ Good hoof care; Healthy hooves promote a well-functioning hoof mechanism and thus an active lymphatic system.
✅ Give physical contact with other horses.
✅ Get nutritional advice from a CPL expert.
✅ Proper leg care

How does CPL start and how does CPL stop

It usually starts with small wounds or lots of flakes on legs. In the early stages, the wounds look like mug. An owner spreads a mug ointment and the ointment does not help. Then you try the mug ointment your stablemate swears by ... it doesn't help either.... If your horse has ridges, bumps, itching or any of the other features I mentioned above, and you suspect CPL, please consult a CPL expert.

CPL is probably partly genetically transmitted. The extent of CPL and how it will develop is determined by multiple factors in and around the horse. My personal view: In my opinion, if we really want to prevent and stop CPL, it is important to stop at the beginning; do not breed a foal to a mare with CPL and choose a stallion without CPL traits. Unfortunately, there is no genetic test of CPL available yet that shows whether CPL is hereditary. Unfortunately, CPL is not a reason to reject a stallion within the studbook. Finding a stallion without any form of CPL requires quite a search and a lot of knowledge within the Netherlands. In addition, CPL is a taboo within certain breeds, which complicates understanding its severity in stallions and broodmares.

How do you know if your horse has CPL?

If you suspect CPL or your sock horse, coldblood or fries has itching, bumps or wounds on its legs, contact a lymph drainage therapist with experience of CPL or a vet. You can find qualified lymph drainage therapists in the mldregister.co.uk . Engaging a vet is always a good idea, unfortunately not all vets know how to recognise CPL at an early stage yet. Good to mention; Only a vet is allowed to make a diagnosis.

Mites

Mites and CPL unfortunately go hand in hand. If your horse has CPL, he/she is more susceptible and attractive to mites. Mites cannot be seen with the naked eye and live in and on the skin. Mostly the skin of the legs. Mites like heat, dirt and when the PH of the skin is upset, mites like to nest there. Mites cause itching in a horse. This itching causes the horse to rub, stamp and bite its legs. This biting of legs causes wounds, if the itching is permanent, these wounds will not recover and unfortunately, wounds attract flies. Not to scare you, but it regularly happens that flies lay eggs in the wounds and so maggots live in horses' legs. Obviously, you want to keep your horse free of mites; the mites have to die. You can ask your vet for a mite-killing product for this purpose. Realise that these chemical remedies again have a negative impact on the horse's overall resistance. But in serious cases, chemical treatment is necessary first. Always treat your horse again 8 days later with a chemical agent, because by then the eggs that were on the skin when the mites were removed will have hatched and you will also want to kill these new young mites. With mites, keep in mind the life cycle of eggs left behind, you need to treat several times. Note from experience; you have your horse mite-free if the horse no longer stamps, does not rub its legs or bite them. After this, you can use natural means to make your horse unattractive to mites. This can be done from the inside with the right feed and natural supplements, and a micro-organism-based skin spray also creates a natural environment on the skin thanks to the EM contained in the spray. Make sure your horse's resistance is as optimal as possible. A good resistance improves the horse's resilience against a mite outbreak. With CPL nutritional advice, you will learn how to optimise the resistance and, with the right feed, keep your horse unattractive to mites and prevent the CPL from spreading/worsening.

Manual Lymph Drainage

Manual Lymph Drainage (MLD for short) is a gentle 'massage' technique that activates the lymphatic system. It is a very subtle and relaxing technique that horses and ponies find pleasant.
Among other things, the lymphatic system takes care of the removal of waste products and germs in the body. Applying MLD increases the drainage capacity of the lymphatic system. It also improves recovery and overall immunity. The lymphatic system and immune system work closely together. The body's self-healing ability is activated with lymphatic drainage. Since CPL is a condition in the lymphatic system, Manual Lymph Drainage is a very suitable treatment method in CPL. You can find a qualified lymph drainage therapist in the MLDregister.co.uk

A qualified equine nutritionist like Marjan, helps your horse from within with advice and guidance on the right feed and proper management. This can be done online and throughout the Netherlands and Belgium. Because of years of experience and knowledge, photos and answering many questions are enough to guide your horse properly. A CPL dietary recommendation will not make your horse completely free of CPL, but the right feed will prevent CPL from worsening and ensure that the tissue remains as supple as possible.