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  Discussion on Enlarged lymph glands
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Member:
kstud

Posted on Wednesday, Mar 7, 2007 - 5:39 pm:

Hi Dr O,
My 6yo gelding developed swelling of his mandibular lymph nodes about 5 weeks ago suddenly. The condition was noticed after he was brought in one evening from the field. He is stabled at night. The swellings were soft and non painful but restricted his vertical flexion when ridden. He has not been off his food and is in great body condition but these swellings fluctuate from not there to enlarged though never as large as the initial incidence. They only appear after he has been out in the field. If he is stabled for a few days then he is fine. He had a soft cough for 3 or 4 days a couple of weeks after they appeared and some yearlings in the yard had a slight cough. Though there is no sign of infection I gave him a single shot of penicillin when he was coughing. He is not at all lethargic or dull and there are no other clinical symptoms.
Initially I was worried about strangles though he had no contact with outside horses. The I thought it was viral but I would have expected it to have resolved by now. Blood tests are normal and a biopsy has not been done as there are no visible glands whenever my colleague calls out (I do not like poking at my own horses too much in case they resent me, silly I know).
The photo is not great but he is such a dark horse it is hard to get a contrast.
Have you any ideas what it may be?
Catherine
Moderator:
DrO

Posted on Wednesday, Mar 7, 2007 - 6:44 pm:

Hello Catherine,
These would be called the "retro-pharyngeal lymph nodes". I think you are right they were most likely swollen do to the result of a mild viral infection that has now passed. The reason they worsen when the horse is out is probably not do to contact with some antigenic substance but I believe most likely do to gravity.

Following being stimulated and enlarged the tissues have lost some of their elasticity or perhaps some mild unresolved inflammation that by itself does not cause noticeable swelling. When she spends all day out with her head down grazing all day, it markley increases the oncotic pressure in the head, resulting in fluid being pushing fluid out of the capillaries and not returning from the lymphatics efficiently.

This is likely to be a temporary issue that will resolve itself with time. Until it does you could limit the amount of time out at one time to reduce this effect. Or you could experiment with a little bute in case of mild inflammation but I am betting on the elasticity deal. Though this may sound odd this is really a pretty common problem.
DrO
Member:
amara

Posted on Wednesday, Mar 7, 2007 - 11:13 pm:

my pony has this problem occasionally... i never knew what it was, but as he never showed any other symptoms, and it always went away very quickly on its own, i never worried about it... while he doesnt flex his neck much under the best of circumstances (conformationally quite difficult for him), i never noticed anything under saddle...
Member:
brandi

Posted on Friday, Apr 6, 2007 - 1:16 pm:

Catherine,
This is something I have experienced myself recently. Last year my oldest horse, 26, had this problem in the spring (technically it was late Feb.) that persisted for about 4-6 weeks, it was more severe than yours and he got a significant amount of edema in addition to the swellings.

This year, however, 4 of my 5 horses were affected, beginning in late February, and I became very worried. They were all worse in the evening, coming out off the pasture, and it would be much better in the mornings. Some pastures affected them worse than others, but it would take several days to tell a difference. Two of the horses only swelled up on their left sides, but the two older ones were bilateral and quite uniform, my Friesian being affected the worst, even though his neck is quite thick, and small swellings would easily go unnoticed. I had blood drawn from my two healthiest horses, and both came up with very slightly elevated pyralizadine (sorry, I know that isn't spelled right), a liver enzyme, if I remember correctly, and slightly low white blood cell counts. Of course there was still no good answer from my vets as to why this was occuring. Otherwise, everyone was healthy, good appetites, bright and happy, no fever.

I had our county extension agent come walk my pastures to see if there was some substance or plant that might point to some mild toxin. All he found that caused him concern is that my pastures were overrun with clover, and I have been doing a very poor job of managing my pastures to allow the grass to compete. He is currently researching if any of my clovers might cause this kind of reaction.

I am very curious what Dr. O thinks of this information and I would love to hear if Catherine's field is rich with clover or legumes in general. It is now the first of April and my horses swellings have subsided almost completely. I still have plenty of clover, but in the past two weeks, I have been keeping the horses off of the areas have the high concentrations.

I had assumed that this was some sort of allergic reaction, and this year I put my oldest horse, the one who was affected alone last year, on APF from Auburn Labs for the month of March and even boosted him with Platinum Performance's Immunity Formula when things were the worst, and he didn't get nearly as affected this year as last. I feel this made a difference, because it would be expected that he be worse than last year, since the other horses were affected this year and not last. All of the horses that were affected were on the pastures last year during the same part of the year. None of the horses got the edema that my oldest did last year. The only unaffected horse was not on the pastures last year, as he came to us only in October, he is also the youngest horse we have, at 10, with no health issues.

Looking forward to your comments!

Brandi
Moderator:
DrO

Posted on Friday, Apr 6, 2007 - 6:52 pm:

The reason they were worse after a day on pasture Brandi, is that there heads were down. This increases the hyDrOstatic pressure in the head so lymph accumulates ventrally particularly around stimulated lymph nodes. With there head up in the stall all night the lymph drains.
DrO
Member:
brandi

Posted on Saturday, Apr 7, 2007 - 5:34 am:

DrO,

Thank you for your reply, and I understand that part about gravity making it harder for the swelling to clear,thus the overnight improvement. However, I wasn't very clear in stating what answers I'm looking for. I am hoping to uncover the possible causes and potential effects. Do you think the clover be a culprit? Other possibilities? With Catherine you mentioned a likely viral infection, but is that possible with my 4 horses being affected all at once, with no other symptoms whatsoever, and the one horse having it last year at the exact same time of year? I am worried that if I don't find out what's going on, next year things will be much worse, and I doubt my oldest horse will do well if the liver enzyme and white count levels are even further out of whack.

Thanks for your comments.
Moderator:
DrO

Posted on Sunday, Apr 8, 2007 - 8:27 am:

Brandi, I know it is frustrating but there is nothing in your post to diagnose the initiating cause. I am unaware of clover having such an effect but plants and their endophytic parasites, like fungi, are complicated affairs, it would be possible to postulate such a reaction. Then again it is just as likely that a rich clover fiel causes them to put their heads down and never pick them back up all day. The WBC count suggest mild viral infection.

Pyrrolizidine in a plant toxin and not a liver enzyme but can cause an elevation of liver enzymes but is not associated with enlarged lymph nodes of the head. Alsike clover contains this toxin but is not often planted. I don't know of a blood test for pyrrolizidine and mild elevations in liver enzymes are often of no significance as this happens in many healthy horses. For more on this see, Diseases of Horses » Colic, Diarrhea, GI Tract » Mouth, Esophagus, and Liver » Plant Poisoning and the Liver: Hepatotoxicty.

On the good side and concerning your long term fears, I do not know of any serious chronic recurring disease that presents this way early in its course and it sounds like it is getting better rather than worse in your older horse.
DrO
Member:
brandi

Posted on Sunday, Apr 8, 2007 - 6:32 pm:

Thank you DrO, I appreciate the clarifications, I know where I got confused with the vet, and I need to check in with them and get the name of the correct liver enzyme. But most importantly, your last statement does help me feel better about the situation. I am now more educated and informed about my pastures, and by next spring they will be balanced, healthy and no matter what is causing the current problem, it won't have a chance to affect them because there will be nothing but good, correct food for them. At least that's my plan!
Best Regards,
Brandi
Member:
kstud

Posted on Tuesday, Apr 10, 2007 - 5:46 pm:

Hi Brandi,
I basically took my horse off that pasture for 2 weeks then weaned him slowly back onto grass and it has only returned in a small way. Strangely enough we also have a lot of clover in our grass as we have been encouraging it for its Nitrogen fixing properties as we do not like to use artificial manure.
Dr O please close your ears here as I am going to say something very unscientific! Firstly I had a visitor here today in Ireland, a fellow HA member from Canada, Cheryl Anderson and boy did we get on like a house on fire. She is truly a wonderful person and I know we will remain great friends so thanks to HA for broadening my social life as well as my skills. Anyway a friend of mine, a vet and also an acupuncturist came over whilst Cheryl was here to check the horse pictured as he got cast a few weeks ago and was still a little stiff. I will post the photos when I can but when he ran his hand either side of the spine it was really amazing. Lots of little raised areas appeared in a perfect line each side of the spine like this . . . . . .,
All perfectly evenly spaced and equal size running each side from his wither right over his rump. Even my friend was amazed and had not seen anything like it before but said that they were actually the hair rising over the medians. I have always been sceptical that such things actually exist but these bumps appeared before our eyes, and they were just raised hair but did not flatten until after he had acupunctured (if that is how you say it)the horse.
Anyway, he also gave me a herbal tonic as he said my horse was affected in the liver (I think that is a chinese medicine thing), which also ties in with what your vet found Randi. I will keep you posted on what happens,
more tales of the unexpected to follow!!!
Member:
ajudson1

Posted on Tuesday, Apr 10, 2007 - 6:17 pm:

A few years ago I had the vet out to check similiar swellings in my Arab mare. The vet said my horse must have got her herself caught with her halter on and pulled back! Which was not the case, my horses never have their halters on unless they are being groomed and I know she didn't pull back.

Funny how I now have a possible answer to what that was about.

As for the clover thing, for the last few years I've only seeded clover in my pastures every spring and I don't think that was the problem. There are other grasses but the clover takes off really quick here and I've had good luck with frost seeding it.

Clover tea, taken by people, is considered a lymph system cleanser.

Love these tales of the unexpected...keep us posted. What is in the liver tonic, do you know?
Member:
canderso

Posted on Tuesday, Apr 10, 2007 - 6:28 pm:

Cheryl here to say that we did indeed get along extremely well. Thank-you for having me Catherine. Your family and your horses are lovely.

Thank-you Dr O for allowing me to make a very good friend.

Oh, and Catherine, please convey my apologies to your children once again that I am not an axe murderer.

As for that back thing. Yes I did see it. It was BIZARRE. Catherine's friend did nothing out of the ordinary but all of a sudden these bumps appeared. There was a single row of bumps the size of nickels on the left side of the spine, and a double row of bumps pin-prick size along the right side of the spine.

I noticed them just after Catherine lunged him to the left, and they did not subside for a good 1/2 hour, after the acupuncture needles were removed.

Any ideas?
Moderator:
DrO

Posted on Wednesday, Apr 11, 2007 - 8:44 am:

I put my hand over my ears Catherine but could still read the post I am afraid. Explaining mysteries by introducing mystical explanations really does not explain anything, does it? I have not seen such bumps and as I have never heard of horses becoming ill or dying in association with bilateral symmetrical bumps along the spine, I will assume whatever it was it was probably not serious.

Many people believe that the human meridian line and acupuncture points are well established determined by wizened Chinese medicine men many centuries ago. The truth is in Chinese medicine there is controversy over these meridians and acupoints and they have changed over the centuries and continued to be the subject of debate (David Ramey's review of aupuncture in equine Medicine). Interestingly whether you use traditional or transitional acupoint identification you get the same reported results.

Concerning the meridians of the horse these are extrapolated from human charts and there is little support for any of the claims that these points having special healing or pain relief characteristics. In studies on the use of acupuncture in horses where benefit was found and different methods compared it did not matter where you stuck the horse. There are no large well conducted studies are available that show a clear benefit to the use of acupuncture. Here is the most recent thorough review of the subject I can find and, though selected simply because it was the most recent published is a well referred journal, agrees with the current Horseadvice.com position on acupuncture.
DrO

J Vet Intern Med. 2006 May-Jun;20(3):480-8.
Effectiveness of acupuncture in veterinary medicine: systematic review.
Habacher G, Pittler MH, Ernst E.
University of Veterinary Medicine Vienna, Austria.

Acupuncture is a popular complementary treatment option in human medicine. Increasingly, owners also seek acupuncture for their animals. The aim of the systematic review reported here was to summarize and assess the clinical evidence for or against the effectiveness of acupuncture in veterinary medicine. Systematic searches were conducted on Medline, Embase, Amed, Cinahl, Japana Central Revuo Medicina and Chikusan Bunken Kensaku. Hand-searches included conference proceedings, bibliographies, and contact with experts and veterinary acupuncture associations. There were no restrictions regarding the language of publication. All controlled clinical trials testing acupuncture in any condition of domestic animals were included. Studies using laboratory animals were excluded. Titles and abstracts of identified articles were read, and hard copies were obtained. Inclusion and exclusion of studies, data extraction, and validation were performed independently by two reviewers. Methodological quality was evaluated by means of the Jadad score. Fourteen randomized controlled trials and 17 nonrandomized controlled trials met our criteria and were, therefore, included. The methodological quality of these trials was variable but, on average, was low. For cutaneous pain and diarrhea, encouraging evidence exists that warrants further investigation in rigorous trials. Single studies reported some positive intergroup differences for spinal cord injury, Cushing's synDrOme, lung function, hepatitis, and rumen acidosis. These trials require independent replication. On the basis of the findings of this systematic review, there is no compelling evidence to recommend or reject acupuncture for any condition in domestic animals. Some encouraging data do exist that warrant further investigation in independent rigorous trials.
Member:
kstud

Posted on Wednesday, Apr 11, 2007 - 4:39 pm:

Hi Dr O,
Sorry I was being rather facetious with the whole tales of the unexpected stuff but it was strange. Basically we did a straightforward lameness exam in case it was more than a muscular problem and then went out to the arena to lunge him. Anthony merely ran his hand along his back and neck to see if he was sore anywhere but it was by no means an exhaustive exam, just a cursory initial check. Then I lunged him to the left and right and when he was pulled up we noticed these circular areas of raised hair all along his back each side. Anthony said that he has never seen this outside of text books and even then not so clearly as on my horse. I do not have an explanation but it was very odd.
On the acupuncture, on the whole I have had a good success rate with it on horses where the problem has been a straightforward tightening of musculature, and certainly in this horse I had quite dramatic results. This is the first time he has ever had acupuncture and before yeaterday he was changing leads all the time at canter, not tracking up on the right rein and falling out through his left shoulder and being very cautious about going down slopes or hills. Anthony found him very tight and sore in the wither area and treated this and today I rode him in a dressage lesson. The horse was wonderful, very soft and round and even on both ereins, he also maintained canter perfectly on each rein. I am sure that a good massage may have the same effect but I am just lucky to have Anthony so near and am delighted with the results.
Moderator:
DrO

Posted on Wednesday, Apr 11, 2007 - 6:17 pm:

Catherine, I don't know of an text books that contain such a description and my equine medicine library is almost as large as some veterinary universities (at least the equine medicine sections) and updated monthly. What do his text books tell him about such bumps?
DrO
Member:
kstud

Posted on Wednesday, Apr 11, 2007 - 6:37 pm:

Here are the pictures, he says that they are due to the piloerector muscles raising the hair. I imagine the text books involved are the ones he studied in the course of his Veterinary Acupuncture studies, I will ask him tomorrow exactly which books they are. I am passing no comment but I have posted it purely as it was so unusual. The lumps arrived instantly and only disappeared after the acupuncture treatment.



Member:
hwood

Posted on Wednesday, Apr 11, 2007 - 10:10 pm:

Wow . . . definitely very dramatic. Glad you had a camera with you.
Member:
sonoita

Posted on Wednesday, Apr 11, 2007 - 11:49 pm:

Oh1 My goodness that is strange. Let us know if you figure this out.
Happy Trails
Moderator:
DrO

Posted on Thursday, Apr 12, 2007 - 6:47 am:

I think everyone must be hearing the Twilight Zone Music play. Fascinating Catherine, the appearance is one of a mild contact dermatitis or some other mild topical chemical reaction with a very unusual pattern.

Please let me know if you get a reference for a explanation of this or even better would be to post the information you find out here.
DrO
Member:
frances

Posted on Thursday, Apr 12, 2007 - 6:50 am:

Weird ..... and interesting ....
Member:
erika

Posted on Thursday, Apr 12, 2007 - 9:30 am:

Weird, all right! Question for you, Catherine: Does this horse regularly wear a blanket?
Member:
kstud

Posted on Thursday, Apr 12, 2007 - 7:18 pm:

Hi all,
The weather is unseasonably hot here at the moment...no complaints, but still cold at night so Kiff wears a rug at night only. The pictures were taken at roughly 5.30pm.
Dr O, The incident with the lumps was witnessed from start to finish by myself, Anthony and Cheryl, ie two vets and an experienced horse woman. There was no contact with any chemicals of any nature at all. The horses coat was normal, he was trotted up and down on concrete and then brought out to the arena to lunge. Anthony merely gently palpated his neck and back before lunging to see if there was any tightness or soreness. He ran his hands smoothly over the coat, he did not prod or tap in any way and only handled the horse for maybe a minute max. The horse was lunged and as he is very lazy he did not even break out of a slow trot. I would say he was lunged for probably three or four rounds each direction to ascertain that he was not actually lame and after being lunged the lumps literally just appeared. He was walked back to the yard (maybe 15/20 metres)and acupunctured outside his stable. At this stage the raised areas could not be flattened by hand. Anthony always carries a camera and he took the pictures. He put the needles in, we waited a couple of minutes and then he removed them. Within a few minutes of the needles having been removed the hair began to flatten of its own accord. This has never occured before or since with this horse. Anthony also handled my daughters pony but it had no reaction at all which if it was something chemical on his skin may have been expected as she is very fine skinned as opposed to my fat cob.
I am not making claims for what happened, but it really did defy any explanation we could think of. I am sure there is a scientific answer but I am certain it was not a contact dermatitis with anything chemical.
Actually I just thought, Anthony's hands were clean as he had tea and apple tart with us before he checked the horse.
Member:
brandi

Posted on Friday, Apr 13, 2007 - 4:50 pm:

I apologize to take things back to the boring old swollen throats & clover, but I wanted to thank Catherine and Angie for their comments on the clover. It doesn't answer any questions, but it gives me a direction for more research. It is ironic of your talk of seeding clover, because at this very moment, we are having broadleaf herbicide sprayed on our pastures (star- and bull-thistle is the main reason,but once my husband heard that our clover might be causing some problem-at the very least, too rich of a diet for our aging friends, he couldn't be stopped!). I will keep you posted of any further developments. Have a nice day.
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