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Discussion on Penicillin toxicity
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Member:
walkingd
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Posted on Monday, Mar 23, 2009 - 8:59 am:
I have heard of several horses lately in our area that have been given Penicillin and died in just a matter of minutes. I talked with my vet yesterday and he said he had also spoken with 4-5 clients who had lost a horse minutes after giving Penicillin. He also said all of them pulled back on he syringe before injecting and they had said they seen no blood. I can't swear to what someone else did but here is my ordeal and I can swear by it. I had a broodmare have a colt Saturday. Saturday night I caught her up and as custom I gave her 20cc of Penicillin Procaine. I pulled back on the syringe and their was absolutely NO sign of blood. 2 minutes later she is dead. Now I have an orphan foal to try and raise. I do not understand all about Penn. but I know this was not in the blood. Also spoke to a couple of people who had tried giving it IV to a horse for euthanasia and said it had no effect even at 50cc IV. I was wondering if epenprine would have helped if I had had it to give?? No doubt it is a great antibiotic and I have probably given half a barrel of it over the years but I may try to be a little more cautious next time I reach for it.
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Member:
erika
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Posted on Monday, Mar 23, 2009 - 9:33 am:
Wow, Brian, what a shock. So sorry for your loss.
I can't help you with the penicillin issue, but I hope you have help or a nursemare to deal with the foal. Best of luck.
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Member:
hollyw
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Posted on Monday, Mar 23, 2009 - 9:59 am:
I wonder if the penicillin being used is all from the same company?
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Member:
pattyb
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Posted on Monday, Mar 23, 2009 - 10:12 am:
Dear Brian, I am so sorry for your loss, beyond words even.
Holly....that was my thought as well. Scary, very scary. I usually use Naxel here when I need an injectable antibiotic. My vet has seen less issues with Naxel and that is what he likes to prescribe.
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Member:
dres
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Posted on Monday, Mar 23, 2009 - 10:18 am:
https://www.doublelacres.com/milk_replacer.htm
here is a picture of a igloo feeder.. Best of luck to you and your little one..
On the first day God created horses, on the second day he painted them with spots..
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Member:
stek
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Posted on Monday, Mar 23, 2009 - 10:48 am:
Hi Brian, so sorry to hear about your mare. I would definitely contact the manufacturer and have them look into the possibility of a recall on the product.
I don't have the answer about epinephrine in this case .. will be interested to hear if it would be beneficial.
If you don't mind my asking what is the reason for giving penicillin after foaling? I haven't seen this as a standard practice before.
Good luck with the foal.
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Member:
3chip
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Posted on Monday, Mar 23, 2009 - 12:09 pm:
What you have described is sad but the only rational cause of your mare's death was the injection of penicillin into a vein. Even though you may have not had any return of blood when you pulled on the syringe, you are always a millimeter away from a vein or blood vessel and the slightest movement while injecting could send the material into a blood vessel. Outdated penicillin or "bad" penicillin would not cause such an instantaneous death. There have been cases where horses have died from and while the penicillin was being injected. Other cases have taken anywhere from 2 to 10 hours. Sorry to hear about your loss. I don't understand why you were giving her penicillin and in my opinion it should never be given as a cautionary treatment. Horses have foaled since the beginning of time without it.
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Member:
vickiann
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Posted on Monday, Mar 23, 2009 - 4:21 pm:
Brian,
I am sorry about your loss. What a horrible experience.
Recently I was instructed to give Penicillin G injections three times daily (for a case of cellulitis) into a catheter in my horse's neck, placed there by my Veterinarian.
He showed me how I had to do the injecting very, very, very slowly, just a little, tiny bit at a time, due to the danger of bad reaction, including death.
This was not procaine penicillin but a powder that I had to mix up with water out of a bag that he supplied.
If I recall correctly though, rapid injection could potentially cause aneurysm or heart attack, among other things.
I am thinking that sudden uptake can cause extreme electrolyte imbalance?
With a death as rapid as your mare experienced, I have to believe Epenephrine would have made no difference whatsoever, but Dr. O will have to be the authority supplying the answer.
I too have to question the "one shot" idea of using procaine penicillin, as all that I have read about this states that giving it less than a full, recommended course at an amount properly based upon the horse's weight will do more harm than good with regard to stopping any infection.
In any case, it will be interesting to have Dr. O's input.
Again, I am sorry about what happened to your mare, which I am sure was very surprising and unexpected.
I have given a lot of IM Procaine Penicillin shots over the years without any reaction, but can tell you that every time I have found blood in the syringe after pulling back on the plunger, it almost caused me to panic.
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Member:
mitch316
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Posted on Monday, Mar 23, 2009 - 5:20 pm:
Brian, I have literally given thousands of Penicillin shots, and have never had this bad of a reaction. The quick decline and death makes me think shock due to an allergic reaction, but I am not sure. Hitting a vein is definitively dangerous, but from what I can read about it, it is not this sudden. I am in agreement with 3chip on how easy it is to hit a vessel, even with no blood return. Given the fact that other horses have done the same, I think the vet needs to do some investigation on this and notify the proper authorities if he/she suspects bad medicine. Epinephrine is effective in allergic reactions that lead to shock, but it sounds like you would not have had time any way, and as an aside, their are usually several symptoms that rapidly progress during shock, so you would have noticed. Eclampsia (sp?) has symptoms similar to shock, but you definitely would have noticed if she had that before giving her the shot. Hope at least a little of this helps you put the pieces together. I am very interested n what Dr. O says about this. Again, I am sorry for your loss.
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Member:
vickiann
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Posted on Monday, Mar 23, 2009 - 6:05 pm:
I am thinking that rather than an allergic reaction to penicillin, the mare's death was perhaps a reaction to the procaine.
Dr. O's article about reactions mentions toxicity to the central nervous system.
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Moderator:
DrO
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Posted on Tuesday, Mar 24, 2009 - 8:22 am:
Hello brina,
Yes this sounds like procaine toxicity rather than a allergic reaction to the penicillin but we need a description of the symptoms to know for sure. The article explains the difference and when epinephrine is indicated.
Please everyone note, we do not recommend a routine (read that as preventive) penicillin or any antibiotic for anything.
DrO
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Member:
walkingd
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Posted on Tuesday, Mar 24, 2009 - 9:07 am:
Thanks Dr. O, Years ago our vet use to come out after foaling and he would give the mare a tetanus shot and a shot of penicillin, I guess for good measure and I always thought it seemed like a good idea so we have continued that practice even though we no longer have a vet to attend after every foaling. As for the symptoms, this mare was extremely protective of her foal to the point of she would hurt you if she could, we had her in a pen taking off the foalert transmitter and giving the foal an enama. The last thing we did was give her the shot of Pen. at which point she became even more excited. Took nose twitch off and turned her loose as I first thought she was just getting crazier about her foal. She went off about 50 feet and hit the ground into convulsions. In a few seconds she was dead. Colt is doing fine drinking out of a bucket. No problems with him yet. Guess I will be a little more hesitant to reach for pen. bottle next time. I think I will have a shot of epinephrine on stand by when I do as I can't see how it would hurt if something like this ever happened again. Thanks for all others who offered their comments and concern. Brian Anderton
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Moderator:
DrO
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Posted on Tuesday, Mar 24, 2009 - 10:37 am:
Unfortunately the epinephrine will not stop this reaction. It will be useful in the case of anaphylaxis however.
DrO
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Member:
pattyb
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Posted on Tuesday, Mar 24, 2009 - 11:12 am:
Good morning Brian...I am so glad to see that your colt is doing well. I was very sad yesterday about your mare and was hoping the baby would be alright.
Last night, I was thinking back to when my buckskin gelding had a reaction to his third procaine penicillin injection and the vet told me it sounded like a procaine reaction. His injections were post surgery and we stopped after his reaction. His symptoms started as I was getting ready to inject the second half of his dose on the opposite side. First, he stopped eating...then got real wide eyed. My first concern was to get my mother out of the area as she was standing in the door way (rope across) when this all started. I sooo hated yelling at my mother but she had no clue how dangerous this can get.
Within a few seconds, he started kicking out as I lead him out of the stall. From there, I just tried to keep him calm and walking, during which time he continued to kick out. Being very mindful that he wouldn't hurt anyone on purpose, I did everything I could to stay at his head. At about the "when do I bail out" point, he started to calm down, probably 10 minutes in total.
Jeeze Louise, my knees were shaking when I called the vet because like you, I knew I had pulled back on the syringe prior to injection. That horse never got another penicillin shot again. We went to SMZ tablets to finish out his course of treatment. Many years later when he needed antibiotic injections (high fever and not eating), he received several days of Naxel. It's more expensive ($80.00 for 4 days) but for what it's worth, my vet feels that it is much safer in terms of reactions.
Brian, I wish you the best of luck with the new baby, please post updates when you can.
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Member:
mrose
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Posted on Tuesday, Mar 24, 2009 - 9:37 pm:
I am sorry to hear about your mare, Brain. Good luck with the foal. I suspect he'll do fine.
I have had a great respect for antibiotics in general and Pen in particular as years ago I knew a doctor (!) that died from an allergic reaction to it. He had taken it several times with no problems. He had a speaking engagement, was getting a sore throat, took some Penicillin and was dead 5 mins. later. Brian's mare's death is a good reminder that ALL drugsw are potent and need to be taken very seriously. I think most of us have too great a tendency to dole them out.
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