Innovative Solutions to Animal Health Problems
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Innovative Solutions to Animal Health Problems |
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Reprinted from Veterinary Product News; September/October 1994; Vol.6, No.6 IMPRESSIVE RESULTS WITH RVI, SHOEING IN NAVICULAR SYNDROMEVPN Staff Report The use of Rubeola Virus Immunomodulator (RVI) combined with corrective shoeing yielded dramatic improvement in a group of performance horses disabled by navicular syndrome, a veterinarian has found. David Nichols, DVM, who treats numerous performance horses with lameness in his mixed animal practice in Marietta, OK says patients that display myofascial pain in the lumbar region often have concurrent lameness in the lower limbs. Lameness in the lower extremities often is accompanied by myofascial or bursal inflammation, directly or indirectly related to injuries of the tarsal-metatarsal region, he notes. RVI is a relatively new product for treatment of myositis in horses that appears to specifically target the musculo-skeletal system, reducing inflammation and pain. Dr. Nichols wanted to see if extended RVI treatment would benefit horses prone to tarsal-metatarsal injuries that also exhibited bursal inflammation and tendonitis, with or without myofascial pain in the lumbar region. Dr. Nichols used RVI in 20 horses with deep digital flexor tendon pain classified as having navicular syndrome. Some expressed lumbar muscle pain in addition to lower leg pain. All 20 had received corrective shoeing. RVI Regimen Two ml of RVI was administered subcutaneously for three consecutive days, followed by an injection every other day for the next three injections. Then, booster shots were given once weekly or as needed. The response was evaluated based on the ability of the horse to return to its performance event with maximal effort. Of the 20 horses, 19 responded to treatment and of these, the results were considered excellent in 18, Dr. Nichols found. Some horses in the study were regular patients and others were animals he had just started treating. As a result, Dr. Nichols was able to conclude that the addition of RVI yielded greater improvement and improvement came about faster than with corrective shoeing alone. He attributed the improvement among horses with navicular syndrome to a reduction of bursal inflammation due to deep digital flexor tendon disorder. In those that also had lumbar muscle pain, RVI appeared to yield dramatic improvement within the first three to six days, Dr. Nichols says. Dr. Nichols tried the same regimen of RVI on 11 additional horses exhibiting various lameness and lumbo-sacral, hock or stifle pain. Those with degenerative joint disease in the hock also received intra-articular anti-inflammatory drugs. Nine of these 11 horses responded, he says. Not A Cure Dr. Nichols warns that RVI is not a cure for horses with navicular syndrome or degenerative hock disease. If RVI is discontinued, unsound horses often will regress, and if they have muscle soreness, it may be even greater than it was previously. Administration of RVI as a booster every 14 to 30 days seemed effective, he says. There was one other interesting finding, Dr. Nichols notes. The horses demonstrated dramatic improvement in disposition with administration of RVI. Those that had been hard to handle or that easily go over-excited became more docile and responsive to training. Just how RVI works is not known for certain, but it is thought to enhance the immune system in a way that naturally reverses the inflammatory process (VPN, July/August 1991 p.1). RVI is made by Eudaemonic Corp. of Omaha Neb.
The use of Rubeola Virus Immunomodulator as a Practical Application For the Elimination of Musculo-Skeletal Pain in the Equine Athlete David Nichols, DVM, and Randall D. Robbins, Ph.D.
Introduction Rubeola Virus Immunomodulator (RVI) is a relatively new product available for the treatment of myositis in horses. The rubeola virus has been shown to influence many cells ofthe immune system including monocytes, B lymphocytes, T helper lymphocytes and T suppression lymphocytes. The mode of action of this product utilizes the theory that when a control mechanism of an animal’s immune system becomes unregulated, cellular damage can occur or be exaggerated from the same system attempting to protect it (Whitesides,et al. 1992). Developers of this product theorize that RVI functions by providing an appropriate molecule that can modify the immune system in a manner that allows the re-establishment of proper control mechanisms. Therefore, clinical myositis cases exhibit improvement of reduced lumbar myofascial inflammation not through the direct action of the drug, but by enhancing the animal’s immune system to naturally reverse the inflammatory process. The use of immunomodulators such as RVI to modulate the immune system, which in turn targets specific biological cells or systems that affect healing responses, creates many possibilities in the treatment of disease or injury. RVI specifically targets the musculo-skeletal system, effectively reducing inflammation and pain. Reports from field clinical investigations indicate that RVI has been effective in treating various problems of both horses and dogs. In field clinical investigations, RVI has produced positive results in dogs suffering from chronic intervertebral disc syndrome as well as spondylosis deformans (Polley, 1993). Horses subjected to the stresses of intense exercise programs and performance schedules are prone to muscle and skeletal injury. These horses respond rapidly to RVI treatment programs. Often, horses that display myofascial pain in the lumbar regions concurrently exhibit lameness in the lower limbs. Lameness in the lower extremities of often accompanies by myofascial or bursal inflammation directly or indirectly related to injuries of the tarsal-metatarsal regions. Therefore, the primary objective of this study was to determine the effects of extended RVI treatment programs on performance horses prone to tarsal-metatarsal injuries currently exhibiting bursal inflammation and tendonitis with or without accompanying myofascial pain in the lumbar region. MATERIALS AND METHODS The effects of extended RVI use were evaluated on active performance horses exhibiting lameness and/or musculo-skeletal pain. Horses used for this study were in the recent past or were currently being used to perform in western performance events that included barrel racing, calf roping, heading and heeling events, and cutting. Forty horses were initially selected to participate in this study. All horses selected were unable to compete or were severely inhibited in their ability to perform with maximum effort in their selected event. During the treatment period, horses were maintained by their owners and exercised or exhibited in performance events according to their ability to perform as evaluated by their owners. Individual horse owners were responsible for reporting the progress of their animals. Of the forty horses initially injected, nine owners failed to report the progress of their animals and were subsequently dropped from the study. The remaining 31 horses were grouped categorically based on pain responses exhibited by individual horses after palpation examinations. The sex, age, use of the horse, and presence of any concurrent lameness were recorded and are given in Tables 1 and 2. Horses were categorically grouped as follows:
Group 1 horses were also categorically classified as suffering from navicular syndrome disease. Each horse was injected subcutaneously with 2 ml of RVI for three consecutive days followed by injections every other day for the next three injections. Booster shots were administered once per week or as needed to reduce inflammation or pain. Responses were evaluated based on the th4e horses’ ability to return to their individual performance event with maximum effort. Responses were grouped into three categories:
RESULTS Individual animals’ responses to treatment are described in Tables 1 and 2. Responses of Group 1 horses are given in Table 3. Of the twenty horses treated from Group 1, nineteen horses responded to treatment. Eighteen (90%) were considered to have excellent results and were able to return to their performance event. One horse’s condition was considered improved and one horse did not respond. Similarly, nine of the eleven horses in Group 2 responded to the RVI treatments with two horses showing no response. These results are summarized in Table 4. Table 5 gives the combined results of both groups. Each vial of RVI contains 12 ml or six injections. The total RVI drug administered to individual horses varied from two to six vials. Responses reported for this investigation were primarily based on observations made after the animals completed the first six injections, or the first vial of medication. As the horses recovered and were returned to training and performance activities, additional booster treatments were administered to reduce muscle soreness and pain caused by the greater activity levels. DISCUSSION Rubeola Virus Immunomodulator was found to be a useful medication to reduce pain in horses suffering from flexor tendon pain, degenerative hock disease, and sacral-lumbar muscle pain. It is important to note that while RVI does not affect a cure for horses suffering from navicular syndrome or degenerative hock disease, muscle pain was dramatically reduced within the first three to six days. The resultant reduction in soreness enables these horses to return to high intensity activity much quicker and with a greater effort. However, because RVI does not cure the underlying skeletal problem, if the medication is not continued unsound horses often regress and exhibit an even greater degree of muscle soreness than they previously exhibited. Administration of RVI as a booster every 14 to 30 days effectively controlled muscle pain in these horses. Several Group 1 horses exhibited lumbar muscle pain in addition to lower leg pain while others only expressed pain in the lower extremities as a result of navicular syndrome. The reduction in pain of the navicular syndrome horses was attributed to a reduction of bursal inflammation caused by deep digital flexor tendon disorders. Horses exhibiting deep digital flexor tendon disorders were placed on a corrective shoeing program as part of their treatment program. Similarly, several Group 2 horses exhibited degenerative joint disease in the hock. These horses were given intra-articular anti-inflammatory drugs in addition to the RVI treatment. Several other investigations have produced similar responses. Vasko and McMichael (1988) reported a 78% response to RVI treatments in horses suffering for tendonitis, arthrosis, and back pain. Kannegieter (1993) also reported a 77% response rate in horses suffering hind limb lameness problems. These horses relapsed after two weeks, but improved again with a second series of RVI treatment. Vasko et al. (1988) reported improvement in 94% of horses treated with RVI compared to a 25% response from a placebo treated group. Treated horses also showed an increase in lymphocyte numbers and decreased alpha globulins when compared to placebo controls. In horses concurrently exhibiting myositis as a result of lower limb unsoundness, RVI eliminates the muscle pain; however, reoccurrence will be found if the underlying unsoundness problem is not addressed. The correct diagnosis of the lameness problem must be made and corrective procedures successfully administered for a complete recovery. Horses that are determined to be unsound will benefit from extended RVI treatments simply by controlling the muscular and bursal inflammation and relieving pain. Experience shows that RVI assists in the recovery process of horses with chronic tendonitis and bursitis associated with these lower limb disorders. An interesting side effect noted in this study was a dramatic improvement in the horses’ dispositions. Historically, animals that were hard to handle or exhibited tendencies of over-excitement became quieter and much more docile. Horses were easier to manage and became more responsive to training and performance practices. In summary, any horse exhibiting muscle tightness and soreness in the lumbar, sacral, or stifle region would be considered a candidate for RVI treatment. Experience from this study would suggest that a protocol of daily injections for the first three days, then injections every other day for the next three days would be sufficient to initiate a response. Booster injections will be required at two to four week intervals, or as needed, for horses exhibiting chronic back pain. The clinical successes that RVI has shown to date suggest that this product is beneficial to the treatment of horses with musculo-skeletal pain. With the limited knowledge of the role of the immune system in the healing process, more research should be conducted as to the mechanisms and effects of immunomodulators and their possible treatment applications. Table 1. Description and response of horses subjected to extended RVI treatment displaying deep digital flexor (DDF) tendon pain.
Table 2. Description and response of horses subjected to extended RVI treatment displaying various lameness and musculo-skeletal pain.
Table 3. Responses of Group 1 horses to extended treatment of RVI
Table 4. Responses of Group 2 horses to extended treatment of RVI
Table 5. Responses of all horses to extended treatment of RVI
REFERENCES Whitesides, J. F., W. McAlhaney, C. Kendall, V. Fricault, and K. E. Main. Preliminary studies on the immunomodulating effects of Rubeola Virus Immunomodulator (RVI) on peripheral blood leukocytes of horses with myositis or myofascial pain.
Polley, D. (1993). Rubeola virus immunomodulator: an experimental treatment for ossifying spondylitis. (Need publication references)
Vasko, K.A., and J. McMichael (1988). Anti-inflammatory effects of an immunomodulating agent. J Eq Vet Sci 8:77-79.
Vasko, K.A., et al (1998). Use of an immuno-modulating agent in the treatment of myofascial pain. J Eq Vet Sci 8:399.
Kannegieter, N.J. (1993). The use of Rubeola Virus Immunomodulator in the treatment of chronic back pain in horses. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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