Recognising and Supporting Chronic Progressive Lymphedema (CPL) in Horses

Written by Astrid | January 19, 2026

Thick legs, scabs or skin changes on a horse’s lower limbs are often dismissed as something harmless or as mud fever. However, in some cases there may be more going on. CPL is a condition that develops slowly and can be difficult to recognise in its early stages. This is precisely why it is important to know what to look out for and which steps you can take if you have doubts.

The condition mainly occurs in horses with heavy feathering, such as draft horses and cold-blooded breeds, but it can also occur in other breeds. CPL usually develops gradually, which means that the first signs are not always recognised immediately. By gaining more insight into the characteristics and progression of the condition, it becomes easier to notice changes in time and apply appropriate care.

Appropriate support

What is CPL in horses?

CPL stands for Chronic Progressive Lymphedema. It is a progressive condition in which the lymphatic drainage in the legs does not function properly. As a result, fluid can accumulate, leading to thickening of the skin, swelling and changes in the lower limbs. CPL is a chronic condition that can gradually worsen and is not curable, but with the right care it can often be managed effectively.

How does CPL develop?

CPL develops due to a malfunction of the lymphatic system. Lymph fluid is not adequately drained and accumulates in the tissues. There is often a hereditary predisposition, particularly in hardy breeds with heavy feathering, such as draft horses and cold-blooded breeds. In addition, environmental factors, skin problems and infections can exacerbate the symptoms, but they are usually not the original cause.

How can CPL be recognised (even at an early stage)?

In the early stages, CPL can be difficult to recognise. Early signs are often very subtle and may resemble mud fever, but they are important to take seriously. These may include:

Thickened lower legs, especially around the fetlock
Stiff or folded skin
Recurring scabs or cracks
Flaking of the skin on the legs
Reduced skin elasticity
Sometimes itching or sensitivity

At a later stage, the legs may become noticeably thicker and skin changes become increasingly visible. In addition, there is an increased risk of so-called entrapment, where fluid and waste products are, as it were, trapped in the tissue. These complaints can be very painful for the horse and make movement noticeably uncomfortable.

Is CPL fatal?

CPL is not directly fatal, but as mentioned earlier, it is a progressive condition that can have a major impact on a horse’s welfare. When the condition is recognised early and managed consistently, a stable situation can often be achieved for a longer period of time. However, there are often periods during the year when the symptoms may temporarily worsen, making increased vigilance and adjustment of care important. In severe cases, quality of life may be compromised.

Support and treatment for CPL

CPL cannot be cured, but it can be managed. The lymphatic system is overloaded, and the focus is on keeping the horse as comfortable as possible, supporting skin health and stimulating lymphatic drainage.

Important pillars include:

Nutrition: a frugal, fibre-rich base with sufficient high-quality hay, and limitation of sugars, starch, grains, molasses and sugar-rich mashes. In addition, fatty acids from linseed and vitamin E can provide extra support for skin elasticity.
Exercise: stimulates circulation and lymphatic drainage.
Clipping or keeping feathering short: makes inspection much easier and allows cracks, folds and flaking to be detected and treated more quickly. The cordless and compact Sectolin Clipper Pro SE-210 can be a useful tool for keeping the fetlock areas neatly trimmed.
Keeping the skin supple: for example with Pet’s Relief Derm-10, helps prevent cracks and scar tissue.
Treating infections promptly: to prevent worsening.
Proper care of wounds and cracks: helps prevent scar formation.
Lymphatic drainage: may have a supportive effect in some horses.
Timely treatment of mite infestations: to prevent more severe skin damage.
Weight management: keep your horse’s weight under control.

In cases of severe CPL, additional veterinary treatment focuses mainly on managing complications and improving comfort. This may include the use of antibiotics or antifungal agents for infections, anti-inflammatory medication or pain relief for marked swelling and sensitivity, and targeted treatment against mites when they play a role.

CPL or mud fever: what is the difference?

Mud fever and CPL are often confused with each other. Mud fever is a skin inflammation, usually caused by moisture, bacteria or fungi. CPL, on the other hand, is a chronic disorder of the lymphatic system. Although mud fever–like symptoms may occur with CPL, the underlying cause is different. Therefore, the approach to treatment is also different and often more long-term. Always have your veterinarian determine what you are dealing with so that the correct treatment can be initiated.

The influence of mites

In horses with CPL, mites often play a role. Itching and skin damage can worsen symptoms and make infections more likely to occur. Good monitoring and, if necessary, targeted treatment against mites are therefore an important part of caring for horses with CPL. After treatment, it is especially important to support and strengthen the skin barrier of the legs so that the skin becomes more resistant to external influences. Especially during wet seasons, when the skin is exposed to moisture and dirt for prolonged periods, protecting and caring for the skin can help prevent new problems.

Practical tips and support

In addition to daily care and good management, supplementary support can help support the skin and underlying tissue in horses with CPL. This may include herbal-based supplements that can contribute to fluid drainage, immune support and circulation, and are often used over longer periods of time.

External care is also important. A nourishing cream or spray can help keep the skin supple and protect it from drying out, especially in the case of cracks or thickened skin. Natural products such as coconut oil are sometimes used, provided the skin is clean and dry.

In addition, some horse owners choose dried herbs, such as nettle or a lymphatic blend, as a supplement to the ration. Which support is most appropriate varies per horse and per stage of the condition. A combination of care, appropriate nutrition and supplementary support helps to maintain comfort as well as possible.

Do you have doubts about your horse’s legs?

If in doubt, it is always advisable to have your horse’s legs examined by a veterinarian. An early diagnosis can contribute to appropriate treatment options and help keep the situation stable for as long as possible.

Do you still have questions after reading this blog about CPL, its care or supportive products? Please feel free to contact our veterinary team via veterinarian@vetsend.co.uk.

About the author

Astrid, veterinary nurse at Vetsend

Astrid is a veterinary nurse and works at Medpets as a content specialist, where she uses her many years of hands-on experience to provide pet owners with clear and reliable information. She specializes in rabbit behaviour and enjoys contributing ideas for innovative products and blog posts that meet the needs of both pets and their owners.