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Managing COPD and Allergies in the Horse with an Herbal Blend

An Observational Study of a Proprietary Herbal Formula in Controlling the Clinical Signs of COPD and Allergies in Equine Patients

Tom Schell, D.V.M, DABVP, CVCH

Skin allergies and Chronic Obstructive Pulmonary Disease are two common clinical problems affecting horses, especially in the eastern and southern portions of the United States.  These two clinical problems generally account for up to 40% of spring and summer veterinary visits in my practice and also lead to significant medical expenditures for their owners. In many cases, the increased humidity in these regions contributes significantly to the severity of clinical signs and disease manifestation.

COPD in the Horse with Cough
COPD in the Horse with Cough

The most common skin allergies in horses generally manifest secondarily to insect bite sensitivity or to inhalant allergens, resulting in skin irritation, pruritus, alopecia and secondary pyoderma. Allergies are also common in the respiratory tract of the horse, resulting in clinical signs ranging from recurrent sneezing, head shaking, inflammatory airway disease and COPD or RAO. In the latter of the conditions, the patients generally present with difficulty breathing (dyspnea), coughing and possible nasal discharge. The clinical signs of COPD generally tend to progress from year to year in terms of severity.

Current therapies for allergic skin type conditions in horses is limited from a western medicine perspective and include topical applications of medicated shampoos, fly sprays as preventatives, antibiotics for secondary infections and corticosteroid therapy.

Allergic type conditions are complex in nature and variable in terms of underlying etiology from patient to patient in most cases. Environmental influences are major players in allergy development, but overall, it has been shown that immune dysfunction as well as underlying chronic inflammation may have more critical roles and that antioxidant therapies could prove beneficial in cases such as COPD (1).

In horses, Recurrent Airway Obstruction (COPD) has been typically associated with a hypersensitivity reaction to dust or molds associated with hay or bedding material, which then triggers an immune component to the syndrome. The typical age range in horses diagnosed with the condition is 12+ years of age with no known breed predilection. Clinical signs of the typical patient include absence of fever, spontaneous cough, mucopurulent nasal discharge and exaggerated expiratory phase (8).

Current therapies are generally supportive in nature, helping to reduce clinical signs of the disease but rarely helping to address the underlying problem. Aside from environmental changes, antibiotics are used often to treat secondary infections that occur due to disruption of the natural skin barrier with skin allergies or due to bacterial accumulation secondary to poor air circulation in cases of COPD. Corticosteroids are often found to be beneficial in cases of allergies due to their effect on reducing immune over-response as well as modulating the inflammatory process, helping to reduce pruritus as well as airway irritation (8). The problem with long term corticosteroid use in horses is that there are potential side effects ranging from electrolyte disturbances, liver impairment, laminitis, immunocompromise and gastric ulceration (7).

Purpose of the Study:

In this study, we evaluated a proprietary blend (Cur-OST® EQ Total Support) of natural anti-inflammatory, nutritive, immune enhancing, liver supportive and digestive herbs on a small group of horses mainly affected with COPD.

From a traditional Chinese Medicine standpoint, many cases of allergies and COPD have a Damp Heat component to them, which is directly aggravated in most cases by humid and warm environments. Damp Heat accumulation can be secondary to a spleen or digestive origin but can also be associated with an overactive liver impairing digestive or spleen function. Our goal or area of investigation in this trial was to evaluate the approach of reducing inflammation, supporting immune function, supplying nutrition and aiding digestive support. In essence, we would be using herbs that target the liver to move Qi, detoxify the liver, support blood through nutrition, reduce inflammation by resolving stagnation, reducing liver fire or heat, resolving dampness and aiding overall digestion.

The trial formula (EQ Total Support) is a proprietary blend of herbs which include along with their mode of intended action:

  • BCM-95® (Curcumin 95% patented extract) -Anti-inflammatory; NF-kB inhibitor, Antioxidant
  • Boswellia 65% extract – Anti-inflammatory; 5-LOX inhibitor
  • Alfalfa Herb powder – Nutritive Herb; blood tonifying
  • Spirulina Blue Green Algae – Nutritive herb; blood tonifying
  • Vitamin C – Primary Antioxidant
  • Vitamin E – Primary Antioxidant
  • CoQ10 – Primary Antioxidant, Cofactor in ATP production; enhances mitochondrial function
  • E.I.S. (proprietary medicinal mushroom blend) – Nutritive herbs; blood tonifying
  • Dandelion 4:1 extract – Reduces inflammation, mild diuretic, liver supportive, detoxify
  • Marshmallow root powder – Supports digestion, moistens and soothes tissue
  • Parsley extract – Aids and supports digestion

Patient Selection and Criteria:

A total of 12 equine patients were enrolled into the trial with criteria requirements of:

  • Presence of COPD or Skin Allergies for > 12 months
  • Current or past therapy with Corticosteroids
  • Persistence of clinical disease despite medication
  • Ability of owner to provide supplements twice daily for 14 days minimum
  • Ability of owner to monitor and record progress of patient

The patients were enrolled from around the country and no physical exams were performed due to location distribution. Prior medical records were provided by the owners and were reviewed for adherence to study criteria.

Patients were originally graded on a scale of 1-10 with 1 being mild and 10 being very severe. The owners were asked to grade the patient at the beginning of the trial as well as at the end of the 14-30 day period. In most cases, the patients were graded at 14 days, but some were continued to the 30 day mark and evaluated. All results were non-biased in nature as the author did not examine patients but relied solely on reports back from owners as to progress and recovery.

All current medications were continued during the research trial, however, the owners were instructed to monitor the patient closely for steady improvement. If improvements were noted, then the owner was guided in reducing medication dosage to determine effectiveness of the supplement.

Product Administration:

Each patient was given 2 weeks supply of the Cur-OST® EQ Total Support product with designated dosing of 2 scoops (2 ounces) mixed with grain twice daily for the 14 days. In some cases, the product dose was increased to 3 scoops (3 ounces) twice daily due to body weight or severity of condition. The EQ Total Support product does have a dose range of 2-3 scoops ( 1 ounce per scoop) per 1000 lbs. twice daily for induction, then once daily thereafter if condition is controlled. The product formula appears to be very palatable to the patients and therefore readily accepted. If clinical improvement was noted at the 14 day mark, the patient was provided with another 2 week’s supply with continued monitoring.

Patient Outcomes:

Patient One:  22 y.o  gelding, initially grade 8/10 score, post treatment score of  2/10.  Chronic COPD and concurrent use of corticosteroids. No meds required by 30 day mark, minimal coughing, no discharge, returned to work as schooling horse

Patient Two:  7 y.o gelding, initial grade of 8/10, post treatment score of 3/10.  Recurrent and severe skin allergies associated fly bite sensitivity. Frequent corticosteroid use as well as topicals and antibiotics. At 30 days post patient had good hair regrowth, decreased pruritus, improved quality of life and no need for steroid therapy.

Patient Three:  10 y.o. gelding,  Initial grade 8/10, post treatment score of 3/10.  Chronic COPD with coughing. Intermittent need for corticosteroids and bronchodilators. At 30 days post, patient had no cough, no current medications, improved energy and performance and noted improved hair coat.

Patient Four:  16 y.o. mare, Initial grade of 9/10, post treatment score of 5/10. Chronic skin allergies with recurrent pyoderma and pruritus. Currently managed with corticosteroids as well as various topicals. Owner noted no change in reduction of medications or in skin lesions, but did report that she was more comfortable overall after 30 days.

Patient Five:  16 y.o gelding.  Initial score of 5/10, post treatment score of  2/10.  Chronic COPD type lesions with intermittent coughing, exercise intolerance as well as hives. Managed intermittently with corticosteroids. At 30 days post, owner reported no hives, no coughing noted, no medications being administered and hair coat was markedly improved.

Patient Six:  15 y.o gelding.  Initial grade of  7/10, post treatment score of 4/10.  Chronic COPD with coughing and discharge. Currently managed on corticosteroids, multiple supplements and antibiotics as needed. At 30 days, owner notes cough improved, decreased discharge, improved energy and quality of life, decreased need for medication frequency.

Patient Seven:  7 y.o. mare,  Initial grade of 5/10, post treatment score of 4/10. Chronic COPD with coughing and nasal discharge. Managed with anti-histamines and antibiotics as needed. Owner noted improvement with reduced coughing and discharge while on formula, but relapsed when humidity levels increased.

Patient Eight:  12 y.o gelding. Initial grade of 5/10, post treatment score of 4/10.  Chronic congenital COPD, managed poorly with corticosteroids, bronchodilators and other supplements. Owner reported no change overall while being supplemented. Appeared stable but did not attempt to reduce dosage of corticosteroids or other medications

Patient Nine:  21 y.o. gelding.  Initial grade of 9/10, post treatment score of 2/10. Chronic COPD, managed with high dose corticosteroids with flare ups. At 30 days post, owner noted marked reduction in cough, increased performance and endurance, corticosteroid dose reduced by half.

Patient Ten:  13 y.o gelding.  Initial grade of 8/10, post treatment score of 4/10. Chronic COPD being managed with corticosteroids and bronchodilators with frequent flare ups. At 14 days post, owner noted no cough, improved energy levels, reduced respiratory rate and effort, medications eliminated and overall improved quality of life.

Patient Eleven:  26 y.o gelding.  Initial grade of 7/10, post treatment of 3/10. Chronic COPD, most managed with corticosteroids, anti-histamines and bronchodilators with minimal response. At 30 days, more stable, no medications administered, increased energy and comfort. Noted that he relapsed quickly after formula discontinued but re-stabilized after 2 days of formula administration.

Patient Twelve:  21 y.o gelding.  Initial grade of 7/10, post treatment score of 2/10. Chronic COPD managed with corticosteroids and bronchodilators frequently. At 30 days, patient had no noted coughing, more relaxed, more comfortable and dramatic reduced need for medications.

Discussion:

The overall goal of the trial was to evaluate for a response in equine COPD and allergy cases, determining if there was the ability to improve clinical signs of disease and reduce the need for prescription medications. The overall trial results indicate a response in 100% (12/12) of the enrolled patients for improved quality of life and stabilization of the disease, while in 83% (10/12) there was not only an improved quality of life, but also a reduction in clinical signs and the ability to at least reduce the dose of prescription medications if not eliminate them.

The responsiveness of the patients to the formula raises the importance of inflammation modulation, immune modulation as well as liver/digestive support in these patients. The Cur-OST® EQ Total Support formula provides inflammation modulation through many synergistic herbs such as curcumin and boswellia, but also provides many herbs that modulate the immune response including mushroom derived beta-glucans. Liver and likewise digestive support are provided through the use of dandelion, parsley and marshmallow root extracts; helping to reduce heat or inflammation, support liver function, detoxify and reduce phlegm or perceived dampness. By reducing inflammation, supporting the immune response and decreasing phlegm accumulations, it is then possible to create positive impacts on overall health in these patients and reduce the need for various prescription medications.

Curcumin, one of the primary anti-inflammatory herbs used in the formula has been shown in multiple human studies to down-regulate pro-inflammatory proteins by NF-kB inhibition as well as providing potent secondary antioxidant properties which may aid in overall cellular mitochondrial health (10). Boswellia serrata is a secondary anti-inflammatory herb that has shown superior abilities to impact the 5-LOX pathway, which then down regulates the production of leukotrienes which may contribute to many allergic type of conditions (2). Dandelion root (Taraxacum officinale) has been traditionally used to strengthen and detoxify the liver, remove heat and relieve coughing, and also found to have antioxidant, anti-inflammatory and diuretic potential that may result in diverse biological effects (5,6). Parsley has been used in traditional treatment of many conditions including liver disorders, gastrointestinal and digestive complaints as well as in cases of edema or fluid accumulation. In one study, parsley oil was demonstrated to suppress both cellular and humoral immune responses as well as impact macrophage function (11). Marshmallow root has traditionally been used to relieve coughing, moisten tissues, and clear damp-heat or inflammation (6). In research studies, Marshmallow extracts have been shown to enhance tissue repair and cell viability likely through mucilaginous polysaccharides present (4). In another study, marshmallow root was demonstrated to exhibit dose dependent cough suppression which was not related to bronchodilation but attributed to rhamnogalacturonan, which acted at the 5-HT(2) receptor (9). The formula does utilize a proprietary blend of 6 whole mushroom extracts with the primary one being Cordyceps sinensis, which has demonstrated the ability to reduce inflammation, deposition of fibroblastic tissue, formation of reactive oxygen species and reduction of cytokines in a lung fibrosis model (3). The Cur-OST® EQ Total Support formula also provides multiple individual antioxidants as well as herbs which acts as secondary antioxidants, helping to improve overall cellular function and health.

Given the overall responsiveness of equine patients to the Cur-OST® EQ Total Support formula, it gives credence to the systemic approach of herbs to reduce inflammation, modulate the immune response and enhance liver/digestion function.

Acknowledgments/Disclosures:

Cur-OST® is a registered trademark of Nouvelle Veterinary Research, Inc. Contact by phone at
1-800-476-4702 or online at www.curost.com

Dr. Tom Schell is president and head of research and development for Nouvelle Research, Inc.

References:

  • Biswas, S. et al. Pharmacological and dietary antioxidant therapies for chronic obstructive pulmonary disease, Curr Med Chem. 2013;20(12):1496-530.
  • Boswellia serrata monograph, Alternative Medicine Review, vol. 13, no. 2, 2008.
  • Chen, M. et al. Protective roles of Cordyceps on lung fibrosis in cellular and rat models, J Ethnopharmacol. 2012 Sep 28;143(2):448-54
  • Deters, A. et al. Aqueous extracts and polysaccharides from Marshmallow roots (Althea officinalis L.): cellular internalisation and stimulation of cell physiology of human epithelial cells in vitro, J.Ethnopharmacol. 2010 Jan 8;127(1):62-9.
  • González-Castejón M, et al. Diverse Biological Activities of Dandelion, Nutr Rev. 2012 Sep;70(9): 534-47
  • Holmes, P. The Energetics of Western Herbs, Vol. II, Artemis Press , 1989, p. 469-470,580-581.
  • Plumb, D. 1995, Veterinary Drug Handbook,2nd Edition, Pharmavet Publishing, MN.
  • Reed, Stephen. et. al.,2010, Equine Internal Medicine, 3rd Edition, Saunders, MO, p. 340-346
  • Sutovská, M. et al. Possible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan in guinea pigs test system, Int J Biol Macromol. 2009 Jul 1;45(1):27-32.
  • Thangapazham RL, et al. Multiple Molecular Targets in Cancer Chemoprevention by Curcumin, AAPSJ, 2006, 8 (3).
  • Yousofi, A et al. Immunomodulatory effect of Parsley (Petroselinum crispum) essential oil on immune cells: mitogen-activated splenocytes and peritoneal macrophages, Immunopharmacol Immunotoxicol. 2012 Apr;34(2):303-8.

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