International Association of Animal Therapists
Case Study


Treating lymphangitis of the hind limb

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Case study

Treating lymphangitis of the hind limb

Date: 23/02/16

Acknowledgements: Rebecca Crawford


Lymphangitis, a swelling of the lymphatic vessels, generally in the hind limbs, has little scientific 

research surrounding it and therefore can be difficult to pinpoint and treat. Also, due to the delicate 

structures of the horse’s distal limbs, a fat leg is a common thing to most equestrians, with there 

being several different causes; infection, trauma or foot issues being some of the many causes.

Lymphangitis has a tendency, as with most causes of chronic swelling in the distal limb, to reoccur, 

which makes it a tricky condition to treat.

The lymphatic system is designed to gather liquid from the body through a series of tubes that act 

like capillaries and return it to the cardiovascular system.  Conversely the vessels also act as drains, 

mopping up water and macromolecules from the blood system. (Sellnow. L, 2000)

When the flow of lymph through the skin is blocked, for whatever reason, the system ‘backs up’ and 

the interstitial space becomes flooded causing swelling and pain response. 

"Lymphangitis is a condition that results in swelling of the leg and is thought to be due to a 

restriction in lymphatic flow, possibly due to a bacterial infection," Rose and Hodgson write in their 

Manual of Equine Practice. They go on to say that, "Corynebacterium pseudotuberculosis has been 

cultured from affected horses, but in many cases bacterial culture will be negative. Lymphangitis 

sometimes occurs in outbreak form, and we have seen up to 20 horses affected in a mounted police 

stable. The mode of transmission and the etiologic agent could not be established." (Rose & 

Hodgson, 1999)

Within the research, it was found near impossible procure adequate samples for bacteriology, 

making it difficult to find the causative agent. 

As with all cases of swelling, cryotherapy and compression help in management of the condition. 

When the condition progresses to ulcerative lymphangitis, where the lesions happen in the affected 

area, which often ooze and leak lymph. This is believed to be caused by bacteria entering the skin, so 

good stable management is very important.

Expediency is also crucial. The vet will usually prescribe anti-inflammatories, steroids and antibiotics. 

Gentle exercise is also important to increase drainage within the limb. This will often be very painful 

for the patient, but is necessary.

Laser therapy

Laser or red light therapy has long been used on humans to treat pain and swelling. It is effective to 

treat equine lymphangitis for many reasons, it can modify the viscosity of the lymph making it easier 

to ‘flow’, it also reduces the oedema, meaning less pain for the patient and enabling more 

movement in the effected limb.  The blue light therapy is an effect antibacterial modularity, proving 

to be very useful specifically in the ulcerative lymphangitis, due to the large amounts of open 

wounds on the effected limb.

Case study 1

‘Ocean’s Fury’ a 12 year old TB gelding. Has been semi-retired through arthritis of the facet joints of 

the back. Has history of skin conditions. No lesions found on leg.

Owner found patient with a very filled and swollen leg out of the box in the morning. 5/5 lame on 

effected limb. Vet attended patient and diagnosed ulcerated lymphangitis. Antibiotics and pain relief 

were prescribed. Owner advised to walk patient for 5 minutes twice a day.

I attended patient the day after the veterinary diagnosis. Owner had cleaned and massaged limb, 

removing any dead skin and excess hair. Red light therapy was applied over the entire limb, then 

specific attention given around the periphery of the ulcerated wounds. Treatment time was 15 

minutes in total. 

Blue light therapy was also applied over the ulcers to inhibit bacterial proliferation.

The patient then received 15 minutes of red light therapy and 5 minutes of blue light every day for 5 

days, alongside his veterinary treatment.

Treatment outcome

After 5 sessions of red light therapy, the hair and infected skin started to slough away, revealing 

healthy pink skin underneath. After veterinary inspection, it was declared the horse was healing 

exceptionally well. The lymph was draining through the skin and the oedema had lessened. The 

horse was visibly less lame. 

10 days post diagnosis, horse is now being turned out on hard standing daily and is 2/5 lame, with 

minimal swelling in the affected limb. The skin has healed beautifully and the vet and owner are 

delighted with the outcome.


The limb, although ‘clean’ with good hair regrowth, suffered a set-back with the oedema returning. I 

revisited and increased the length of treatment. Patient is now being ridden to assist in in drainage 

of the limb, which works well. I have also suggested compression bandages on the effected limb at 



Equine lymphangitis is a pervasive and reoccurring condition, for reasons that are still to be fully 

researched. However, this small study, and other peer-reviewed papers confirm the use of red light 

therapy to assist in the healing of all skin conditions.  

I have experienced excellent result using this modality for this condition. The treated skin 

regenerated far faster than untreated skin I’ve witnessed previously and the vet was impressed with 

how quickly the infected skin sloughed away and healthy skin showed underneath. Upon treatment 

conclusion, there was new hair growth coming through the worst affected areas.

Most importantly in treating lymphangitis, the red light therapy increases the viscosity of the lymph, 

making it easier to flow through the lymph vessels, assisting in the clearance of oedema and 

ultimately recovery from the condition.

I would like to see more research specifically on the condition and how the red light effects the skin 

at a cellular level.  I would have also liked to compare several cases alongside one another to test 

different treatment times and longevities.

I will be recommending and using this modality in the future for any cases of lymphangitis or 

cellulitis in equine limbs.  

Reference list

1. Sellnow. L, (2000), ‘Lymphangitis in horses,, Feb 2016

2. Reuben J. Rose DVSc PhD DipVet An FRCVS MACVSc, David R. Hodgson BVSc PhD 

FACSM (1999), Manual of Equine Practice, 2nd Edition, Saunders Books, UK

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