If you remember only one thing after reading this article, make it be that there are no West Nile miracle cures.
Genomed is actively soliciting owners to get their veterinarians involved in a protocol that uses ACE inhibitors or ARBs (angiotensin receptor blockers) as a remedy for West Nile Virus. This class of drugs is primarily used to treat hypertension in people.
Angiotensin has also shown some remarkable additional effects with insulin resistance, organ transplants and autoimmune reactions. It may even have indications for cancer, liver fibrosis and chronic viral infections. However, much of this research is in the early stages.
Genomed is targeting WNV horses after its reports of strong results in its trials with human WNV victims, including elderly patients. However, the human WNV survival rate is 90% overall anyway, although slightly less in the elderly who tend to be battling other disease states as well.
The company believes the drugs will fight WNV, since they can quiet excessive inflammatory responses that occur when the primitive immune system is activated. That may well be why it seems to help people, since human doctors don’t use corticosteroids and other anti-inflammatories the way veterinarians do. However, the ACE inhibitor and ARB drugs interfere with the body’s ability to mount a strong immune response, resulting in an imbalance of cell types that has been found in the brain of animals with severe, fatal West Nile encephalitis.
Drugs of this class are contraindicated in pregnancy and have possible side effects, including inflammation in the lung and possibly other organs, persistent cough, skin reactions, alterations of taste and bad taste in the mouth (which could throw a horse off feed), edema of the legs, lungs, abdomen or tongue. The number of people that experience these effects is relatively small. In horses it’s unknown. If you allow the use of one of these drugs in your horse, you should avoid giving NSAIDs like bute or Banamine at the same time.
Genomed isn’t the only group believing they can get better results against WNV. Last year, a Texas clinic claimed to cure West Nile by plasma transfusions. However, this clinic also treated the horses with large doses of corticosteroids, Banamine twice a day, DMSO and round-the-clock intravenous fluids for support.
They had no prior experience with West Nile and were astounded with their survival rate. However, the survival rate with West Nile encephalitis is considerably higher compared to other types of viral encephalitis cases and with that level of excellent symptomatic and general support many horses would survive without the plasma. Of course, the plasma may have helped, too. Our point is simply that the additional aggressive anti-inflammatory and fluid therapy has to be factored in.
There are also assorted and sundry isolated reports of horses recovering after being treated with nosodes, homeopathic remedies and aromatherapy. Nosodes are supposed to be prepared from tissues that contain the infectious organisms and are a crude form of vaccine. However, these nosodes are made from the blood of West Nile-positive horses, and it has been shown that by the time a horse shows symptoms the virus isn’t present in the blood stream, so these products don’t even conform to homeopathic principles used in preparing nosodes. Blood from infected horses may contain antibodies or other active immune factors that could be of help, but it’s unlikely this is occurring with the dosages and dilutions in nosodes. This approach to infectious disease is unproven, and a horse’s survival isn’t proof it works. It may be just as likely the horse survived despite it.
We’d pass on these drugs and therapies to treat West Nile in horses at this time because safety and dosing information in horses is unknown and because treatment protocols for horses already include aggressive anti-inflammatory therapy.
Survival with West Nile depends upon how effectively a horse’s immune system deals with the virus and how well the inflammation that results from the immune-system attack can be controlled. Once the horse is infected, it’s too late to make his immune system more effective, although treatment with the West- Nile-specific hyperimmune serum may help when administered in the early stages, while the horse is still attempting to get his own antibody production up to speed.
All conventional treatment strategies call for use of corticosteroids, NSAIDs and DMSO, given alone or in combination. Horses vary in their response to these treatments, from rapid, dramatic improvements to none. Overwhelming infections are always going to have a poor prognosis, since no available treatment can actually wipe out the virus.
There are always going to be treatment failures, but veterinarians are rapidly becoming experienced with West Nile and, all things considered, we feel that the conventional treatment approaches are as effective as anyone could reasonably expect them to be, with nothing to be gained by abandoning them in favor of unproven alternate approaches.