Lymphedema is an impairment of the lymph system (which is a major component of the immune system) in balancing the accumulation of lymph (mostly protein) fluid in the body.  The impairment results in chronic and often times severe inflammation.


The lymph system equates to a complex highway network that transports debris such as an accumulation of protein, cancer cells, red and white blood cells and other metabolic material. The lymph system is comprised of capillaries, vessels, nodes, ducts, and organs such as the spleen.


The lymph system acts like a sophisticated drainage process.  When the lymphatic system is impaired, the flow of lymph fluid is backed up causing edema or swelling resulting in inflammation.   The inflammation itself then inflicts additional damage to the surrounding tissues.  Lymph fluid consists of excess protein, water, red and white blood cells, lymphocytes (to fight infections), waste products and other foreign proteins and substances, bacteria, fat (intestinal lymph, chyle), and cancerous cells.


Equine Lymphedema isn't easy to live with...

Life is often a compromise...


The lymphatic system is superficial, meaning grooming, massaging, exercising will facilitate the movement of lymph. Respiration and exercise move lymph fluid. When your horse stocks up after a day or two in the stall, it is recommended you lunge or exercise them to move the lymph and reduce the swelling or edema.  Movement causes the lymph vessels to contract and move lymph.


The lymph system is also designed to protect the body from infections and disease by breaking down and destroying foreign material such as a virus, bacteria, and cancer cells.  When the lymphatic system is impaired, it weakens the immune system which long term can cause a host of other medical issues.  The lymph system has multiple functions and they are all interrelated and support each other.


Lymphedema generally affects the extremities such as front or hind quarters or the groin area of the horse.  It can be acute (rapid onset) caused by an insect bite, infection, surgery or a chronic condition (happens repeatedly).  Once the horse has it, they have it for life so it becomes a matter of effectively managing the disease to prevent its progression.


Most Americans know very little about the causes of lymphedema and how to manage this condition.  Unfortunately, it is more common than one might think.   Other terms referring to the disease include stocking up, lymphangitis, lymphedema, or chronic progressive lymphedema.


Many horses have been put down because the owner was at their wits end.  The treating veterinarian indicated there is no treatment while the deterioration continued to progress. What is the horse owner to do with no known treatment options available to them?


Fortunately, there is hope!  Education is the key in understanding the causes and developing the necessary management tools.  Also key is the passion and determination to assist the horse in leading a productive and fulfilling life.


Understanding the Causes of Lymphedema


The truth is that there is no definite cause for all cases of Lymphedema.  However, it is believed that it onset can be due to one or more of the following:

  • Congenital: often seen in larger breed of horses such as draft, warm bloods, and thoroughbreds
  • Trauma such as a kick, rope burn, wound etc.
  • Surgery
  • Infections stemming from insect bites, mud scratches, etc.
  • Medication

New Treatment Protocols


There are four protocols to be utilized to manage lymphedema.

  • Layman’s Grooming Technique

There is a specific grooming technique which helps stimulate the lymph system to move the lymph fluid in the body in a specific direction. This healthy technique can be used on all horses whether or not they have lymphedema. 

  • Manual Lymph Drainage Massage 

Specific massage strokes are designed to facilitate the movement of lymph. Since the lymphatic system is an intricate highway network, it has the capacity to absorb redirected fluid from areas that are flooded into areas that are not flooded thus reducing the edema or swelling. By redirecting the excess fluid to specific areas, the healthy parts of the lymphatic system continue to perform their normal function.  It is important to know in which direction to massage the lymph. Without that knowledge, greater congestion can result.   

  • Wrapping and Bandaging 

Wrapping is an art and skill acquired over time!  Although it looks easy, it is actually a bit more challenging.  Specific types of wrapping and bandaging materials are needed. Sometimes a horse may have to be wrapped 2 x a day depending on how fast the lymph moves through the system and is urinated out. As the fluid leaves the body, the wrapping gets loose so it must be managed closely.  The most effective tool to manage the lymphedema is wrapping and it can get expensive when you consider the legs may require bandaging 24 hours, 7 days per week.  Many horses function exceptionally well for many years competing and winning with this condition provided they have the appropriate care. As with any health related issue, early detection and education is the key. The earlier your horse gets diagnosed and given the proper care, the better the chances that you and your horse will enjoy many productive years together.   

  • Compression Garments

Compression garments can be a useful tool when wrapping and bandaging aren’t appropriate such as during an event or when trail riding. In addition, compression garments are effective in managing the early stages of lymphedema. The garments are designed to facilitate the movement of lymph fluid, although they are not a replacement for wrapping and bandaging!   They can be also used as a preventive measure when a horse must be stall bound. They are also helpful in the winter months when horses can’t be turned out due to icy footing or inclement weather. 


To learn more about compression garments, visit our wellness store to see the ones we use



About The Authors


Theresa and Paul Mueller of Gentle Touch Massage and Holistic Alternatives are a husband and wife team dedicated to health and wellness of both humans and equines.


Theresa is by profession is a human massage therapist, certified in manual lymph drainage and complete decongestive therapy (lymphedema therapist) and equine massage therapist. Theresa and Paul are also the first Americans to be certified as equine lymphedema therapists. 


The Muellers were accepted into the Hannover Medical School in Hannover, Germany and attended the Equine Manual Lymph Drainage course offered to vets, vet students, vet techs and equine physiotherapists in Europe.  Europe and specifically Germany are well advanced in the causes and treatment in human lymphedema as well as equine lymphedema.  The U.S. is rapidly catching up in the human field.  However, in the equine world it is a topic that is rapidly gaining interest but is lacking in education and treatment options.  


Gentle Touch Massage & Holistic Alternatives, LLC is developing the first course written for horse owners on how to manage equine lymphedema, which is scheduled for release in the fall 2011.   Contact us for more information.


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