Effects of the multi-compound complex in Immunal® U on horses with chronic and recurrent urticaria – a prospective observational study of 8 cases

Abstract

Chronic and recurrent urticaria are common skin reaction patterns in horses based on hypersensitivity reactions. Although not necessarily impacting the horse`s general health, the intended use of the horse might be negatively affected. The diagnosis is usually made based on clinical appearance, but additional diagnostic tests, including histopathological examinations of skin biopsies, are required to exclude other differential diagnoses, like erythema multiforme. Long term management of these patients can be frustrating, both for owners and veterinarians as finding the causing agent and avoiding it is an extremely difficult task. Corticosteroids are the first choice treatment for urticaria, however the use of antihistaminic drugs is also described in horses. Unfortunately, both drug groups are doping relevant. Modulation of the immunological response (i.e. allergen immunotherapy) is also widely used with varying results. The aim of this case study was to evaluate the effects of the multi-compound complex GHA®-CMC in the nutraceutical Immunal® U in horses with chronic or recurrent urticaria. A total of eight cases, three with chronic, three with recurrent and two with chronic as well as recurrent episodes of urticaria, received the nutraceutical in combination with Lactal®, which contains lactulose, to try and stabilise the normal microbiome. The horses were clinically examined by their veterinarian and the veterinarians and owners filled in questionnaires at the beginning and the end of treatment and reported the progress every second week including pictures of the horses with urticaria. In all eight horses receiving the nutraceutical, the urticaria lesions initially improved within the first four weeks of treatment. Complete clinical remission was achieved in four out of six horses receiving the nutraceutical alone and in two horses receiving prednisolon at the same time. In these two horses prednisolone could be discontinued, while the horses still received the nutraceutical and no recurrent urticaria was observed. Mild urticaria lesions remained in one horse and in another horse the lesions worsened again and then did not respond to further application of the nutraceutical. No recurrence was noted in the six successfully treated horses for two to seven months. No problems with acceptance or major adverse effects were noted. Results of this case series indicate that the nutraceutical Immunal® U in combination with Lactal® can help to control chronic and recurrent urticaria in some cases, probably due to its mast cell-stabilising effect. Depending on the course of disease and severity it can be administered on its own or in combination with corticosteroids/antihistamines as well as prophylactically in phases of an increased risk of urticaria in predisposed horses.