Combined treatment with valacyclovir and heparin reduced the incidence of equine herpesvirus myeloencephalopathy and improved survival in naturally occurring equine herpesvirus-1 outbreaks.

Valacyclovir and heparin combination reduces EHM incidence and improves EHV-1 survival.

This multicenter retrospective study evaluated the efficacy of valacyclovir and heparin in managing equine herpesvirus-1 (EHV-1) infection across 111 naturally exposed horses from August 2017 to March 2018. Of 22 confirmed EHV-1-positive horses, 9 developed equine herpesvirus myeloencephalopathy (EHM). Treatment groups included: 14 horses receiving metaphylactic valacyclovir and heparin (5 developed EHM), 5 horses receiving prophylactic valacyclovir with metaphylactic heparin (1 developed EHM), and 4 untreated horses (all developed grade 5/5 ataxia and were euthanized). All treated horses survived, while untreated horses had 100% mortality. The combination therapy significantly reduced EHM incidence and improved survival outcomes. Prophylactic valacyclovir administration prior to clinical signs, combined with metaphylactic heparin after symptom onset, demonstrates therapeutic promise in outbreak settings.

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