Owner Reported Clinical Outcomes of a Homeopathic Proprietary Preparation for the Treatment of Upper Respiratory and Nasal Disorders in Companion Animals

Abbreviations

URTI: Upper Respiratory Tract Infection; URTD: Upper Respiratory Tract Disease.

Introduction

Upper Respiratory Tract Infection (URTI) was hardly considered in the list of common acute infective conditions of pets before 2007, when the subclinical infections of viral conditions were found responsible for the spread of cold-like disease [1]. Despite a few sporadic reports of respiratory infections [2], there was insufficient attention towards the condition and, thereby, its treatment. However, during the 2007 and 2016 outbreaks of avian flu, a large number of pets were infected with cold-like symptoms. The infectant had affected many pets, was tracked in the canine and feline upper respiratory tract [1]. This incident changed the perception, and upper respiratory tract infection evolved as a condition to be watched in pets. Later, this changed landscape was established even more strongly, with the addition of a viruses identified as the cause of URTI in pets.

As per a 2017 WHO report “Zoonotic influenza viruses: antigenic and genetic characteristics and development of candidate vaccine viruses for pandemic preparedness”, a significant number of influenza viruses (from H5 genetic clan) are affecting animals, especially pets, and of these several viruses were identified as infecting animals for the first time [3]. Other viruses, including Bordetella bronchiseptica, Chlamydophila Felis, Mycoplasma Felis, Feline Herpes viruses, and Feline Calicivirus, are among the leading causes of URTI or Upper Respiratory Tract Disease (URTD) in cats [4]. The pandemic of SARS-CoV-2 broke out, pets, especially cats, were also found to be infected with the novel virus, leading to COVID-19 [5]. It could be said that this leads to the misuse and potential misuse, improper use, and overuse of antimicrobials.

Antimicrobial therapies, which include antibacterial and antiviral drugs like Pheromone, Vedaprofen, Pradofloxacin, and Famciclovir, antibiotics like Doxycycline and steroids are among the popular therapies [6]. Therapy with passive antibodies is among the emerging options. However, there are many studies with either negative or unclear outcomes in various papers [7]. Many of these therapies also tend to produce certain side effects besides their cost and cause- specific short-term effects. Observed seasonality of infections appearing as outbreaks has been reported from various parts of the world.

This seasonality adds to the urgency of therapy to control the rapid spread. In an attempt to control the disease outbreaks, a vaccination program is under development.

However, the efficacy of the vaccine, or rather the vaccination program, in achieving the desired rate of immunization is our major challenge [8].

Two major concerns about the URTD8-11 of pets include the rapid spread of the URTD, which risks spreading to humans and a wide range of causative organisms, against which exact diagnosis and immunization are hard to achieve [8, 9, 10, 11]. There is an obvious relationship between the diagnostic methods available and used and the understanding of the real causative factors, so as to help the passive immunity therapy [9]. Hence, about seasonality, acuteness of the condition, unavailability of the definitive therapy, cost of diagnosis and treatment including immunization, appears to have led to alternate therapy becoming extremely popular for URTI / URTD [10, 11, 12, 13, 14].

Materials and Methods

This study was a survey-based study conducted with an internet-based questionnaire, facilitated through independent facilitators. The investigational product for this study was “Nose Relief,” a proprietary homeopathic combination medicine indicated for upper respiratory tract infection.

The Homeopathic medicines included in this formula are based upon the medicines indicated under the reportorial syndromes using symptoms watery nose discharge, Nose Sneezing, Eyes Discharge, Lacrimation, coryza, and Nose blocked in Robin Murphy’s Repertory.

Results

In all, 226 Respondents started the survey, of which 1 was dropped for not signing the Informed consent, and 92% of respondents continued. Of these, 14 (6.22%) respondents aborted the survey process before entering demographics details and 211 (93.77%) completed the demographics details, in which the details of 97 (45.97%) cats, 24 (34.12%) dogs, 1 (0.4%) mouse and 1 (0.4%) rabbit were captured. In all, 1 (0.4%) respondent started the survey, but aborted after entering demographics details. Thus, a total of 210 (92.92% of the initial group) respondents. This group of 210 evaluable animals consisted of 96 (45.71%) cats, 72 (34.29%) dogs, and 1 (1.06%) mouse and rabbit each. The 210 animals for which their owners added sufficient details were considered as the safety and efficacy evaluation population (Figure 1).

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Discussion

Acute URTI of companion pets has recently emerged as a concern after avian flu and COVID were observed to infect cats and dogs and facilitate spread. While various treatments, including drugs and antibodies, are used as therapy in the current landscape, there is a significant need for further research on URTI. Particularly, pertaining to the plethora of diverse pathogens that limit the specificity of targeted therapies, and hence, there are mixed observations from many studies. Chadwin et al. studied 5 cat holding rooms with 336 animals in a placebo-controlled trial of pheromone. In the study, no difference was observed between the placebo and pheromone 13. This indicates there is an ongoing search for therapies across many different approaches for this often-recurrent condition.

Lopez et al. studied 382 cats, of which 80 had febrile illness due to URTI. Vedaprofen produced rapid temperature and symptom control, pain relief, and control of inflammation [14]. However, the subset analysis of this study does not report the significance levels. Hartmann et al. studied Pradofloxacin for c Felis and Mycoplasma infection. However, the study reported that despite relief of symptoms, the infection might have continued. The two studies of Famciclovir where in which one was used as add-on therapy with doxycycline and in the second it was a single therapy, produced contradicting results. Reinhard et al. in a 22-cat placebo-controlled randomized study reported that Famciclovir was effective for the control of URTI [15]. However, Kopency, et al. did not find a difference between Famciclovir alone and Famciclovir given with Doxycycline in their 24-cat study with a similar follow-up [16]. In a 24-animal study by Friendl, et al., the use of passive antibody therapy has only a transient effect [17]. Most of these studies had a small sample or a subset analysis. Also, a majority of the population was in the cat shelters. The distribution of the study population was focused, if not biased, to cats. The current study was a real-world study that included all animals. Hence, it included 67 animals of which 49 (73.13%) were cats, 17 (25.37%) were dogs and 1 (1.49%) was a mouse. Hence, it is a good sample representative of a real-world population.

In brief, the URTI/URTD of pets has no definitive therapy and has a risk of spread and aggravation with misuse of antimicrobials. Hence, misuse, overuse, and improper use of antimicrobial agents have been common in this condition, leading to secondary bacterial infections [12]. On the contrary, alternative therapies have been extremely effective and focused [18, 19, 20]. Many research papers on the effectiveness of the Chinese medicines, Ma Huang Tang, Yinhuapinggan granules, FFYH, and Lonicera japonica Thunb, etc., have demonstrated significant effects on influenza 21 24. Herbal medicines also have efficacy and safety. Echinacea powder on URTI was among one of the additional pieces of evidence of alternative medicine use [21, 22, 23, 24, 25]. While there is no animal experience published for URTI / URTD for homeopathic medicines, several publications in homeopathic treatment of human URTI establish the effectiveness of homeopathic medicines therein 26 [16]. The current study was also able to establish the safety and effectiveness of homeopathic medicine “Nose Relief” (Homeopet LLC), based upon the owner-reported outcome survey. The sample was large enough to support a statistically and clinically significant outcome.

Limitations of the study

This was an owner-reported survey. Hence, the evidence level of the study is E2, similar to an observational study. The use of many clinical tools, such as the stress scale and other validated tools, was not possible in this study. However, the reported outcomes were based upon a comprehensible, transparent, and validated questionnaire.

Conclusion

Nose Relief, a proprietary homeopathic preparation by HomeoPet LLC, was found to be safe and effective for managing upper respiratory tract infections (URTIs) in companion animals. It can be administered orally—directly, in food, or water-with dosing 1 to 3 times daily generally sufficient. More frequent dosing was well tolerated and may be beneficial in acute or chronic nasal and upper respiratory conditions, offering a novel therapeutic option in veterinary care.

Ethical Conduct

The study was conducted in compliance with good clinical practice and ethical guidelines.

Acknowledgements

The Authors acknowledge the facilitators of the survey. The Authors also acknowledge and thank Dr. Ashish Indani for analysing the data and drafting this paper.