THERAPEUTIC EFFECT OF AUTOHEMOTHERAPY IN HORSES RETROSPECTIVE STUDY IN VENEZUELA

THERAPEUTIC EFFECT OF AUTOHEMOTHERAPY IN HORSES RETROSPECTIVE STUDY IN VENEZUELA

Dr. M.V Carlos Federico Rodríguez,  Dr. M.V Eslam Ahmed Abdel Aziz  Dr. M.V Jairo Riera, Dr. M.V Abelardo Morales, EMV Hemerson Carballo
Caballosalud, Vargas State, Vargas State-Venezuela.

Caballosalud Egypt, Cairo

SUMMARY:
The objective was to describe the therapeutic effect of autohemotherapy in horses through a retrospective study in Venezuela. 97 horses were studied in Venezuela during the years 2014-2017, of the races: Quarter horse, Crusader, Criollo, PSC, Pinto, Arab and Palomino, 54 males and 43 females, between 2-17 years. All horses under clinical examination showed muscular atrophies mainly in the apaxial and rump muscles, only 45% presented muscle atrophies associated with chronic laminitis, 18% presented protozoal infestations and the rest 37% due to claudication, all were treated by autohemotherapy and were evaluated at 21, 45 and 60 days.

 The results obtained show to the clinical inspection an increase of the muscular mass where the treatment was applied (apaxial and rump muscles), and improvement in the physical condition with different times of evolution, the horses with slight muscular atrophy (27% ), presented an improvement in their condition after 20 days (average: 19.57), horses with moderate muscular atrophy (33%), showed a remarkable improvement after 42 days (average: 41.75) and finally in horses with severe muscular atrophy 40%, an improvement in condition was observed after 60 days (mean: 62.10) post-treatment.

In conclusion, the therapeutic effect of hemotherapy on muscle atrophies, parasitic infestations represents an important treatment strategy in horses, with a complete recovery of all the cases studied.


Keywords: atrophy, autohemotherapy, horses, immunomodulator.

INTRODUCTION
Disorders that affect skeletal muscle and peripheral nerves are common in horses; myopathies can adversely affect athletic ability. In a previous study, myopathies were identified in 18% of horses evaluated for poor performance (Valentine, 2008). Degenerative myopathy in equines can be fatal.

The causes of muscle disorders in adult horses: include nutritional myopathy, infectious disease, immune-mediated disorders, toxic myopathy, hereditary myopathies, endocrinopathies, rhabdomyolysis associated with grazing, malignant hyperthermia, and stress rhabdomyolysis (Valentine, 2008). When a muscle of a horse decreases in size, it apparently melts, it is known as muscle atrophy, when this occurs, the main concerns of a horse owner are whether the muscle will regenerate, returning to its normal size and shape, and how to treat to the horse to help him recover (Kentucky Equine Research Staff, 2011).

 In the tropics the impact of the hematozoa affects severely the working horses and high performance, this has increased in recent years with climate changes, in which there is a higher incidence of vectors. Clinical signs included weight loss (despite voracious appetite), lethargy, incoordination and instability of the hind limbs, atrophy of the large muscles of the hind limbs, muscle weakness and pallor of the mucous membranes (Rodrigues, et al., 2005).

 According to Stephanie Valberg, during her presentation at the conference of the 2011 Texas Equine Veterinary Association, obtaining a complete history and performing a physical, neurological and complete lameness exam are critical once muscle atrophy has been identified (Kentucky Equine Research Staff , 2011).

History should include injuries, falls, vaccines, medications, environmental problems, signs of illness, and birth records (Kentucky Equine Research Staff, 2011). The physical examination includes detailed palpation of the muscle masses, observation of the symmetry of the muscle mass and the presence of heat, pain, edema, inflammation or other abnormalities in a muscle. In terms of prognosis and treatment options, it is often useful to determine whether the atrophy is due to muscle cell wasting (myogenic atrophy) or to wasting due to the nerves that innervate the muscle (neurogenic atrophy), "said Valberg (Kentucky).

Equine Research Staff, 2011). Some of the therapeutic techniques commonly used for the treatment of muscle atrophies include physiotherapy, deep-wave ultrasound, electro-acupuncture, electric muscle stimulation, water resistance training, and hill work or run in the endless inclined band.

Autohemotherapy is a technique used in ancient times for human infections (Annals of the National Academy of Medicine, 1931), some references mention the treatment of some dermatoses by the application of immunotherapy by Ravaut in 1913, in 1938 this technique was described and used in humans by Gaston Lyon, however it was in 1984 when Niels K. Jërne described the specificity in the development and control of the immune systems and by the discovery of the active principle of the production of monoclonal antibodies.

 In 1986, an analysis of experimental and clinical data from different authors on the stimulating effect of autohemotherapy with respect to the immunological reactivity of humans and animals, as well as the in vitro experiments with lymphocytes (Klemparskaya, et al., 1986) is presented. In horses, this technique has been applied in equine daily practice;however, there are few reports in the literature.

In Venezuela in the 1950s, she was employed in horses for the first time by Dr. Bela Ujbary Mourakosi, followed by Dr. Carlos Germán Vilachá Mijares, Dr. Francisco Zurita Barrada and Dr. Carlos Federico Rodríguez. A technique used in the practice common in horses by the authors. Papilloma viruses are the cause of skin warts in cattle and horses. A described case of extensive cutaneous papillomatosis in a cow, treated by autohemotherapy was reported as resolved and successful (Hegde, 2011).

In the northeastern region of Brazil, due to financial and cultural difficulties, Castration of horse-drawn carriages are made by pilots, with high rates of mortality and suffering of animals. The autohemotherapy in acupuncture points was satisfactory in the postoperative period of Castration in horses (Barnabé Escodro, et al., 2012). A veterinary study veterinary in the Veracruz-Mexico tropical region, describes the treatment of dermal disorders by a paste of Aloe Vera and autohemotherapy, a technique also used for the treatment of tumors such as melanoma (Sánchez Cassanova, 2015).

By virtue of this important area of ​​study, we aim to describe the therapeutic effect of autohemotherapy in horses through a retrospective study in Venezuela.

MATERIALS AND METHODS

97 horses (Eqqus caballus) were studied, during the years 2014-2017, of the breeds: Cuarto de Milla (44/97), Cruzado (26/97), Criollo (17/97), PSC (6 / 97), Pinto (2/97), Arab (1/97) and Palomino (1/97), 54 of male sex and 43 females, between 2-17 years. In stables of the states of Aragua, Apure, Barinas, Bolívar, Carabobo, Capital District, Guárico, Miranda, Portuguesa and Vargas, Venezuela. All the horses under clinical examination showed muscular atrophies mainly in the apaxial and rump muscles, only 45% (44/97), presented muscle atrophies associated with chronic laminitis, 18% (17/97) presented hematozoa infestations and the rest 37% (36/97) for claudication.

 Muscle atrophies were classified according to the severity in mild, moderate and severe.

The procedure of autohemotherapy applied to each of the horses is described below: the jugular sulcus is disinfected with isopropyl alcohol.

A venipuncture of the left jugular vein is performed and approximately 120ml is extracted. Blood drawn into the syringe is applied to the contralateral atrophied muscles, usually pectoral, Apaxial and rump, by slow intramuscular puncture after disinfection of the area with isopropyl alcohol.

A small massage is done in the application area. The same procedure described above is performed, a venipuncture of the right jugular vein is performed and approximately 120ml is extracted. Blood drawn into the syringe is applied to the contralateral atrophied muscles, usually pectoral, Apaxial and rump, by slow intramuscular puncture after disinfection of the area with isopropyl alcohol.

 A small massage is done in the application area. Once the procedure is done, the horse should be kept at rest for a period of 24-48 hours. The procedure is repeated every 7 days for 30 days (approximately four weeks).

Once the treatment period had elapsed, a thorough clinical examination was carried out at 21, 45 and 60 days, considering the morphological aspects of the muscles and the physical condition of each one of the horses.

The results obtained and the evolution time were analyzed by descriptive statistics.

RESULTS
  

The results obtained show clinical  increase in muscle mass where the treatment was applied (Apaxial and rump muscles), and improvement in physical condition with different evolution times, horses with mild muscle atrophy (27%) ), presented an improvement in their condition after 20 days (average: 19.57), horses with moderate muscular atrophic (33%), showed a remarkable improvement after 42 days (average: 41.75) and finally in horses with severe muscular atrophy 40%, an improvement in condition was observed after 60 days (mean: 62.10) post-treatment.

 The highest incidence of cases was associated with laminitis 45%, followed by claudication 37% and hematozoa 18%. There were no complications associated with the applied therapy or secondary complications.

In the study period of 60 days, there was no recurrence of muscle atrophy, or re-infestation by hematozoa. No significant differences were observed between race, sex and age. The general results are presented in detail in the following table (Table 1).

1. - Classification table of the groups according to the degree of muscular atrophy of the horses, medication / autohemotherapy and time of evolution.

Classification table of the groups according to the degree of muscular atrophy		Number of horses (%)	Medication	Time of  Evolution
1	Mild  muscular atrophy Laminitis Claudications Hematozoa	26 (27%) 2/44 (5%) 11/36 (30%) 13/17 (76%)	Autohemotherapy 240 ml / 7days / 30days	21 days Mean: 19.57 SD: 3.06 V: 9.37
2	Moderate muscular atrophy. Laminitis Claudications Hematozoa	32 (33%) 5/44 (11%) 25/36 (70%) 2/17 (12%)		45 days Mean: 41.75 SD: 5.63 V: 31.80
3	Sever Muscular Atrophy Laminitis Claudications Hematozoa	39 (40%) 37/44 (84%) ----------- 2/17 (12%)		60 days Mean: 62.10 SD: 8.01 V: 64.30

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DISCUSSION
The horses treated with autohemotherapy showed a recovery in 100% of the cases, in a variable time of 20 days, 42 days and 62 days on average, although the cases were not compared with another treatment or control group, the evolution improved the initial prognosis in each case depending on the severity of muscle atrophy and the level of hematozoa infestation presented.

The therapeutic effect of autohemotherapy represents an important therapeutic alternative for the management of muscle atrophy of the horse at a low economic cost.

 The autohemotherapy in acupuncture points in the postoperative period of equine Castration has been shown to be effective, without any complication or signal of interference in the welfare of animals, although there is a need for more studies comparing the physiological response of horses subjected to autohemotherapy in points of acupuncture in relation to other horses subjected to conventional and anti-inflammatory antibiotics after the postsurgical procedure, to validate this protocol by veterinarians through a medical approach in equine postoperative routine in communities with limited economic resources (Barnabé Escodro, et al., 2012). Regarding its use for the treatment of papillomatosis, excellent results have been described in a period of approximately 2 months. In the treatment of papillomatosis after the third injection, the growing papilloma showed signs of regression; the animals were kept under observation for six weeks (Hegde, 2011).

 At the end of six weeks, the papilloma was completely reduced and only light black colored scars were seen in view of the growth. Other authors have used a combination of autogenous vaccine, hemotherapy and homeopathy to treat oral papilloma in dogs, as well as treated the bovine papilloma with a combination of autohemotherapy and autogenous vaccine within a period of 1.5-2 months, with a favorable response in all cases (Hegde, 2011). Experiences in the Veracruz-Mexico tropical region, of the use of autohemotherapy, in practice are favorable and represent a holistic and sustainable benefit for the region; however, it has been little documented in the literature (Sánchez Cassanova, 2015). The stimulating effect of autohemotherapy is manifested by an increase in resistance to infection (increase of LD50 in experimental infection), in addition to an increased production of antibodies against microbial and tissue antigens, as well as an activated functioning of defense mechanisms of immune mediated cells (Klemparskaya, et al., 1986).

This therapy may represent an immunomodulatory effect in horses immunosuppressed by parasitic infestation. Autohemotherapy does not cause side effects and is feasible in both internal and external patients (Klemparskaya, et al., 1986). This report coincides with the results observed in this study, where no secondary effect or complication in treated equids is described. In conclusion, the therapeutic effect of hemotherapy on muscle atrophies, parasitic infestations represents an important treatment strategy in horses, with a complete recovery of all the studied cases, with absence of complications, in a maximum time of 62 days, reducing the use of anabolic, steroidal and non-steroidal anti-inflammatories, which may affect the horse in competition in the toxicological examinations. Additionally, the use of immunomodulators may decrease, given their immunomodulatory effect. In the future, it is expected to document a greater number of horses treated by autohemotherapy, using other variables as indicators.

Caso Clínico de Colombia.

GRATITUDE

This study was funded by Inversions Caballosalud C.A. RIF J-40618319, Vargas State, Venezuela.

REFERENCES
1. Escodro PB. Et al. Autohemotherapy at acupuncture points post orchiectomy surgery in cart horses- Eight cases report. Vet. E Zootec. 2012. 19 (4): 502-506.

2. Hegde, Ganesh (2011). Cutaneous papillomatosis in a non-descript cow, Vet. Sci. Res. J., 2 (1 & 2): 37-38.

3. Klemparskaya NN, Shalnova GA, Ulanova AM, Kuzmina TD, Chuhrov AD.

4. Immunomodulating effect of autohaemotherapy (a literature review). J Hyg Epidemiol Microbiol Immunol. 1986; 30 (3): 331-6.

5. Memories: Annals of the National Academy of Medicine, second period, Volume II, Madrid 1931.

6. Muscle Atrophy in horses. Kentucky Equine Research Staff. September 16, 2011. Available at http://www.equinews.com/article/muscle-atrophy-horses

7. Rodrigues, Aline, Fighera, Rafael A, Souza, Tatiana M, Schild, Ana Lucia, Soares, Mauro P, Milano, Joaquim, & Barros, Claudio S.L.. (2005). Trypanosoma evansi suchas of trypanosoma em eqüinos not Rio Grande do Sul: epidemiological, clinical, hematological and pathological aspects. Pesquisa Veterinária Brasileira, 25 (4), 239-249.


8. Sánchez-Casanova R, Masri-Daba M, Alonso-Díaz M, Méndez-Bernal A, Hernández-Gil M, Fernando-Martinez J. 2015. Ethnoveterinary practices used by owners of working equids with dermal disorders from tropical regions of Veracruz , Mexico. IJTK Vol.14 (3). 344-350.

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