Injectable Banamine given orally?

[avezan]

Is it safe/effective to give injectable banamine orally? Not the paste, or the granules, but the flunixin solution that is given IV or IM. I've googled a bit and couldn't find anything conclusive.

[risingstarfarm]

Absolutely.

Actually, it's not advised to administer I.M.

I use it orally if I don't have time or inclination to find a vein. It's effective and safe.

[kypeep]

Yes, my vet highly recommends dosing orally unless horse is in need of immediate pain relief that can be achieved only via vein.

[Laurierace]

But OMG the taste!!!! Even mixed in some orange juice its the most vile thing you could imagine. I haven't tasted the paste but I hope they have taken that awful taste into consideration for the poor beasties and made it somewhat palatable. There is no one around that is competent at IV injections?

[dwblover]

I gave it orally, and my horse could care less about the taste. He simply swallowed it and went back to eating. I don't like giving it IM.

[avezan]

Thank you! I did find in my googling that it was safer IV than IM, but didnt' see anything about oral. Yep, it smells stong, I can imagine it tastes bad! Thanks again.

[Freebird!]

But OMG the taste!!!! Even mixed in some orange juice its the most vile thing you could imagine.


And we know this, how?....:winkgrin:

[SeeHowSheRuns]

But OMG the taste!!!! Even mixed in some orange juice its the most vile thing you could imagine. I haven't tasted the paste but I hope they have taken that awful taste into consideration for the poor beasties and made it somewhat palatable. There is no one around that is competent at IV injections?

Someone else here has taken the Banamine and OJ shot as a hangover cure...
Sure does work though!

[SLW]

And we know this, how?....:winkgrin:


Sure, it taste bad but it does not sting when you get it in your eyes. :)

[Simkie]

My horse is the QUEEN of objecting to foul tasting things (and things that are not foul, that she just doesn't like :rolleyes:) and she has no problem with injectable banamine given orally. Since she doesn't care, I have a hard time believing that horses think it's icky.

[westernrider]

You can give it orally? How much do you give--either for mature 1100# horse, or by 100# of horse?

[Simkie]

You give the same dose as you would if you were giving it IV.

[KateUCET101]

I beg to differ! - It sure does sting the eyes! ...The other day I had a syringe explode in my face and thought I was going to be blind! Luckily, I was fine, but it sure stung for awhile!

[ESG]

Is it safe/effective to give injectable banamine orally? Not the paste, or the granules, but the flunixin solution that is given IV or IM. I've googled a bit and couldn't find anything conclusive.

Yes. My vet says to squirt it in their mouths, if you can't do anything else. Perfectly safe.

Also, IM Banamine is quite safe, as well.

[tarragon]

Someone else here has taken the Banamine and OJ shot as a hangover cure...
Sure does work though!

It sure does! The all-time best hang-over cure ever :D

But um, uh... I, of course, wouldn't know that from personal experience or anything :winkgrin:

[Laurierace]

I have never tried it for a hangover as I am usually already barfing and that stuff wouldn't stand a chance of staying down. I used it for incredible back pain before I could get into the chiropractor.

[Acertainsmile]

I took a little liquid Banamine myself for a horrible tooth ache.... I was at the barn, and wasnt scheduled for a trip to the dentist untill later in the day...

The Banamine was nasty... but it was effective... I could have had that tooth pulled without novacaine that afternoon!

[Sobriska]

OK, what is the human dose?

[Jumphigh83]

IF you can keep down banamine with a hangover you are not sick enough! The polyethylene glycol precipitates out in orange juice (WHITE orange juice??? gack!!!) I took a cc and a half for a really nasty back issue and it DID work BUT I would NEVER do it again! I can still taste the nasty bitterness!! (where is the throw up icon!!???)

[Ghazzu]

Also, IM Banamine is quite safe, as well.

Not.

[merrygoround]

Not.

I assume you are referring to the abscess possibility if good technique is not observed, and sometimes despite good technique.

[EqTrainer]

I don't think the IM concern is about technique at all, but that there is a predisposition towards.. oh crap, what is it? Ghazzu?!!

BTW, for those of you who have taken Banamine, please try out Adequan next! I really think I could benefit from a round of that stuff :lol: Ok, I am kidding but only just, as my neck is killing me today.

[JB]

Also, IM Banamine is quite safe, as well.

until you get a clostridium infection.

[Laurierace]

I assume you are referring to the abscess possibility if good technique is not observed, and sometimes despite good technique.

No it has nothing to do with the technique or lack thereof. You would have to do a search or wait for Ghazzu to give the details, but there is an inherient risk specific to banamine. Something about it causing the tissue to die and the necrotic tissue gets walled off if I remember correctly.

[Ghazzu]

I assume you are referring to the abscess possibility if good technique is not observed, and sometimes despite good technique.

I am.
You only need to have one experience with irrigating the resulting mess by placing a garden hose inside the abscess cavity to conclude that it is an unacceptable risk.

Speaking of unacceptable risk, the preceding posts concerning flunixin use in humans are enough to put me off ever leaving a bottle of it with a client.

Has it occurred to anyone, that if the stuff were safe in humans, the pharmaceutical industry would be advertising it on prime time?

There's a reason the FDA takes flunixin residues in food animals very seriously.

[BeastieSlave]

I have no problem when I put it on/in the beastie's feed. It may taste bad, but it's not so bad that it keeps them from their food!

[Ghazzu]

I don't think the IM concern is about technique at all, but that there is a predisposition towards.. oh crap, what is it? Ghazzu?!!



Clostridial myositis with necrotizing abscessation.

[hedmbl]

Not.


:lol::yes:

[Firefilly]

So then, why does it say that the Banamine can be given IM right on the packaging?

Would it be better to give it orally than to give it IM then? That is, if no one is around to give it IV?

[fernie fox]

How much would you squirt in a horses mouth?

I have always been told 10cc for colic,would the same amount be correct if giving orally?

[Sport]

Sure, it taste bad but it does not sting when you get it in your eyes. :)

I got it in my eyes and it stung a lot. Spent quite awhile flushing it out. :lol:
After getting it in the eyes, I almost injected myself with it when the mare suddenly moved. Wasn't a good day for giving needles.

[Ghazzu]

So then, why does it say that the Banamine can be given IM right on the packaging?

Would it be better to give it orally than to give it IM then? That is, if no one is around to give it IV?

Because it can be.

Like Clint says, "you've got to ask yourself a question: Do I feel lucky?"

Many times it causes no problem. The drug was approved for IM use before the problem with clostridial abscesses came to light.
I saw 3 of these when I was a student, and the drug company denied it had anything to do with the drug.
Now, the possibility is listed on the package insert. So they apparently believe there's an association.
What puzzles me is why anyone would want to take a chance on a nasty side effect when the same drug can be administered safely by oral dosing.

[Just Wondering]

So then, why does it say that the Banamine can be given IM right on the packaging?

Would it be better to give it orally than to give it IM then? That is, if no one is around to give it IV?


Can and should are hugely different!

[avezan]

What puzzles me is why anyone would want to take a chance on a nasty side effect when the same drug can be administered safely by oral dosing.

Probably because they don't know! I did not realize the side effects of the IM administration (until my google search yesterday), and just learned of the oral dosing recently.

Quick question for Ghazzu or other vets - do you know the amount of time it takes to take effect orally vs IM? Clearly IV is the fastest, but for faster effects, would IM be faster than oral dosing?

[Ghazzu]

IM--peak concentrations in 30-90 minutes.

PO--peak concentrations in 60 minutes for the granular form,
45-60 minutes for the injectable used orally. Detectable levels within 15 minutes of administration.

I'd call them comparable.

[Tiramit]

I always give banamine via IV because of the above stated reasons. A giant hole in horse neck just doesn't sound pleasant. :no:

Ghazzu, what is the "official" peak time for IV? I know it's quick, but HOW quick?

[avezan]

IM--peak concentrations in 30-90 minutes.

PO--peak concentrations in 60 minutes for the granular form,
45-60 minutes for the injectable used orally. Detectable levels within 15 minutes of administration.

I'd call them comparable.

That's very good to know. Thanks!

[Ghazzu]

I always give banamine via IV because of the above stated reasons. A giant hole in horse neck just doesn't sound pleasant. :no:

Ghazzu, what is the "official" peak time for IV? I know it's quick, but HOW quick?

Essentially instantaneous--it's being delivered into the plasma. Just needs to distribute into the volume.

[Tiramit]

Essentially instantaneous--it's being delivered into the plasma. Just needs to distribute into the volume.'

Guess that's quick. :winkgrin: And all the more reason to give it IV!

[pintopiaffe]

I have never before been told the dangers of it IM. And my vet leaves me with a bottle as I'm in the middle of nowhere, best case scenario +1hr for a vet to get here. I will give it orally from now on, as I don't do IV shots yet. I've been taught... but with no one to hold the horse... and since I don't banamine unless absolutely necessary (i.e. thrashy colic)... I will use it orally from now on. Especially since the timeline is the same.

Thanks for the info.

[Sparky Boy]

So how many CC's would be given orally to a 1000 lb horse with colic symptoms?

How is banamine stored? I have two syringes filled by the vet. Should they go in the fridge?

[Oldenburg Mom]

Well, one night I had a horse with a tummy ache. Clearly uncomfortable...and the person that does our IV was not around.

With much trepidation, I gave it to him orally.

You would have thought I had stuck hot pokers in his mouth!!! He actually kicked at his belly, curled his lip, shook... I was waiting for him to keel over with all four legs straight up in the air!!!

About 15 minutes later he was fine. *sigh* I was a puddle on the floor, however.

[asanders]

Not.

OK, so an article to do with banamine shots and gas gangrene circulated with a horrific picture, and freaked everyone out. This condition has to do with IM injections in general (and is very rare). Banamine was the third most common injection linked to the condition, but this was not adjusted for frequency of use (banamine being one of the most common injectables in horses)

IV -safe, fast response, not all feel comfortable doing (although I think if you own a horse, you should learn)

IM - small risk, as with any IM of gas gangrene, slower response, easy

ORAL - don't use if history of ulcers, slower response, very easy
BTW, horses don't taste 'bitter' the way we do, which is why they are not bothered by this extremely vile tasting stuff...

Best advice, make a decision with your veterinarian...

...so when the banamine came out in the little packets, folks on the backside thought it was like the best BC powder for hangovers --trouble is it is HELL on human kidneys. I had a lameness issue to treat; I was warned that it was bitter, but to just put 1-2cc in a sip of OJ... so I thought, well, if I put it in a whole glass of OJ it will be OK. I don't think a whole tanker of OJ could hide that taste. It was the most vile thing I have ever consumed, but an hour later I could walk again!

[Bensmom]

Ghazzu is correct about the reasons it is not approved for human usage -- in people, you can end up with almost instant bleeding gastric ulcers. Ugh.

Now, I can say that for certain things, it is the best NSAID ever, but it is NOT advised for people, and when I do use it in horses, I give in concurrently with a 1/4 tube of GG, espeically in my sensitive tummy horses.

It not only tastes vile, but has a sort of numbing effect on mucus membranes -- if your horses don't object to it (and lots don't) then they just are less sensitive types.

I had two that would have conniption fits when it was given IM, back before I knew not to do that, and we finally determined that it was due to the little bit of the drug stinging in the muscle -- I have a couple in my barn that wouldn't even lift their heads from eating when you gave it and then the two that would all but thrash on the ground.

On my little TB, if you give it to him orally, he will flehmen like he is in great pain, drool for half an hour or more and refuse to touch any other food.

But, he's a drama queen. :lol:

The little fat pony that was on it orally never even paused in eating her dinner. :)

So, like anything to do with horses, YMMV.

Libby (that stuff is NASTY!)

[horsepoor]

I have in the past given it orally, mixing it with a bit of peppermint oil to try to mask the taste. My horse hated it but he can't have bute, and when you need to use it over a period of several days, it is cheaper than the paste, as I recall. Someone mentioned getting it in their eye, and I did that too -- it hurt like heck! But glad to know I'm not the only one that managed to do that...!

[wlrottge]

We were told the "human" dosing for over indulging is 1/2 cc in a glass of OJ... A friend of ours was giving 1/2 cc's out in syringes for christmass one year at their party....

We were taught by our vet to give IV shots the other day. It's a bit weird when you first learn but not nearly as scary or hard as I thought it would be. We discussed banamine b/c we keep some at home (boonies). She told us the same thing, do NOT give it IM. She had a client that did and horse lost like half it's neck. Said it was terribly nasty!

[Ghazzu]

OK, so an article to do with banamine shots and gas gangrene circulated with a horrific picture, and freaked everyone out.

I've been warning people about the stuff for years.
Not because I was "freaked out" by a picture in an article, but because I've personally seen 3 cases.
Pictures don't do it justice.

Statistics are all well and good when it's not your one horse who is the one in a million...

[Sparky Boy]

So how many CC's would be given orally to a 1000 lb horse with colic symptoms?

How is banamine stored? I have two syringes filled by the vet. Should they go in the fridge?


Anyone?

[wlrottge]

***Disclaimer*** I'm NOT a DVM!!

From our colic experiences, ~10cc for a 1k lb horse. Ours are larger but 10cc seems to be the starting does. Most vets prefer that drugs NOT be administered until they can see the horse first. In more sever cases they might advise drugs before they get there but always consult with a DVM FIRST.

Depending on your storage location options, the fridge is a good place to keep it.

[Sparky Boy]

Makes sense then that the syringes are both filled to 10cc's. Thanks.

[asanders]

I've been warning people about the stuff for years.
Not because I was "freaked out" by a picture in an article, but because I've personally seen 3 cases.
Pictures don't do it justice.

Statistics are all well and good when it's not your one horse who is the one in a million...


My point was not that it should be ignored (if you read, I'm in favor of IV). The point was that the picture happened to be after banamine, but the problem can occur after any IM injection. By freaked out, I mean the response of people like you giving out blanket issue rules for people without any further explanation, that they are then free to misinterpret (e.g. Banamine causes horrid abcesses).

BTW for those of you thinking, well what about all the vaccines I've given --I've never seen that, so it must be the banamine. Consider: vaccines typically not from multidose vial stored long term; dose is much smaller (less tissue damage).

[Ghazzu]

My point was not that it should be ignored (if you read, I'm in favor of IV). The point was that the picture happened to be after banamine, but the problem can occur after any IM injection. By freaked out, I mean the response of people like you giving out blanket issue rules for people without any further explanation, that they are then free to misinterpret (e.g. Banamine causes horrid abcesses).


If *you* read, you'll see that I readily admit that it isn't a *common* occurrence, but to me, it is a completely avoidable risk. And I have repeatedly gone into rather detailed explanations. Just didn't bother repeating them on this thread.

BTW for those of you thinking, well what about all the vaccines I've given --I've never seen that, so it must be the banamine. Consider: vaccines typically not from multidose vial stored long term; dose is much smaller (less tissue damage).Consider, doses of fluinixin from a new unopened bottle, cultured after the incident, have revealed that it wasn't contamination of the medication.

[JenRose]

So how many CC's would be given orally to a 1000 lb horse with colic symptoms?

My old man decided to colic yesterday afternoon. I called the vet and he told me to give him 12cc banamine IV, which I did. Horse promptly got up, farted, and started back grazing. This is a 15.2 hand "easy keeper". I would definitely think that he is less that 1000 lbs though. Not sure if 12cc is considered a high dose, but I did what I was told.

[Simkie]

12 ccs is what I've been told to give as well. 16 hand TB, though, who's probably at least 1200 lbs.

[asanders]

Consider, doses of fluinixin from a new unopened bottle, cultured after the incident, have revealed that it wasn't contamination of the medication.

...Never suggested that this was THE pathology.
And again, I absolutely agree that there is a choice here and IV > oral > IM, but I'm not going to slam people who've given there horse IM banamine like its the most horrid thing you can do.

Good rule: avoid unecessary IM injections, especially if dose is large.

Since I don't have time to go searching for your detailed explanations elsewhere, can you point to anything that links banamine, specifically with gas gangrene?

[Bitsymongomery]

I had such an abcess in my mare. Had it punctured surgically and a rubber tube was placed through the abcess and tied outside. I chose to gently flush both sides with warm epsom salts while also compressing with very warm epsom salts three times a day. I gave an antibiotic which was administered rectally. My question is: would you have agreed with the flushing with the warm epsom salts....and if you would have, how effective do you consider this therapy?? The abcess did heal very slowly with no disfigurement.

[Ghazzu]

I'm not going to slam people who've given there horse IM banamine like its the most horrid thing you can do.

Not slamming anyone for doing it--merely advisong them it carries risks.

Good rule: avoid unecessary IM injections, especially if dose is large.

True enough.
FWIW, one of the cases I saw was from the antiendotoxic dose (<3 ml)


Since I don't have time to go searching for your detailed explanations elsewhere, can you point to anything that links banamine, specifically with gas gangrene?
Try the package insert.

[Leather]

Banamine Product Disclosure:

http://www.banamine.com/disclosure/index.html

In rare instances in horses, fatal or nonfatal clostridial infections or other infections have been reported in association with intramuscular use of BANAMINE Injectable Solution.

[asanders]

On reading drug inserts...
The FDA has about a gazillion rules about what gets added, why, and how it is worded. If, for instance Banamine had caused a statistically significant increase in the risk of clostridial infections of the type described in the clinical trials this would have gone in the precautions or safety heading (and probably it would not be labeled for IM use at all --which it is).

This is also on the Banamine insert:
flunixin meglumine injection, when used under the proposed conditions of use, is safe and effective for the alleviation of inflammation and pain associated with musculoskeletal disorders when administered intramuscularly or intravenously at 0.5 mg/lb daily for up to 5 days and for the alleviation of visceral pain associated with colic when administered intravenously at 0.5 mg/lb as needed.

In deciding what goes in the adverse reaction section FDA provides the following guideline:
Because it is very difficult to establish that very low frequency adverse events are caused by a drug, events included should be limited to those that are serious, that are typical of drug-induced reactions (e.g., liver necrosis, agranulocytosis, Stevens-Johnson syndrome), that have a relatively strong causal relationship, such as a positive re-challenge, or that are particularly plausible in light of the drug_s pharmacology. In general, events that would be expected to occur in the observed or studied population at a similar frequency absent drug therapy (e.g., acute infarctions in the elderly, palpitations, upper respiratory infections, minor symptomatic complaints such as headaches, diarrhea, nausea, and dry mouth) should be omitted. In contrast, events that are serious but very unusual in the absence of drug therapy (e.g., liver failure, agranulocytosis, significant hemolytic anemia, thrombocytopenia, rhabdomyolysis, idiopathic thrombocytopenic purpura, intussusception, acute renal failure) should be included, even if there are only one or two reports.

The entire AR section of the banamine label looks like this:
In horses, isolated reports of local reactions following intramuscular injection, particularly in the neck, have been received. These include localized swelling, sweating, induration, and stiffness. In rare instances in horses, fatal or nonfatal clostridial infections or other infections have been reported in association with intramuscular use of Flunixin Meglumine Injection. In horses and cattle, rare instances of anaphylactic-like reactions, some of which have been fatal, have been reported primarily following intravenous use.

Sentence one describes general IM reactions. 2nd is the rare instances one we've already seen. The 3rd is worded the same -rare instances, some fatal, but relates to anaphylaxis following IV use

--so which should I avoid?

This product is labeled for IV or IM use. If your vet has told you to either, they are not wrong. If you choose to avoid one method or the other due to the AR label, fine.

But Ghazzu, the whole reason I posted here in the first place was because of your completely non-"advising them of the risks" post which I can quote here in its entirety (much more brevity than the FDA) "Not."

People SHOULD know about the drugs they are using, and what the possible risks are, and they should read the package inserts, and be aware of risks, but as much as the FDA keeps trying to make them easier to read, it is NOT always that simple to interpret what the label says or why. Worst case scenerio: Owner with horse having gastric ulcers does not give banamine to colicing horse because they can't do IV and are scared to give IM or oral dose.

[Leather]

All you asked for was something that specifically linked Banamine to gas gangrene, you didn't ask for stats. :winkgrin:

[criss]

So...didn't I read on here a while back that IV carries a small risk also, insofar as the needle can leave a little banamine in the tissues as you withdraw it? Clearly you could avoid any possibility as you put the needle in by sticking a clean needle in the vein and then attaching the pre-filled syringe, but then what? Could you effectively flush the needle by drawing a little blood out of the vein before withdrawing the needle?

I can give IV injections, though I've only done three of them--well, two blood draws and an IV injection--so I'm not a pro at it by any means, but as long as the horse is quiet they're quite easy to do, in my limited experience. I just think maybe I don't know all the finer points, so to speak.

[Ghazzu]

asanders, I've been around here a lot longer than you and therefore have posted more detail on the subject prior to your registration. I expect there are plenty of people here who are damn tired of hearing me discuss the matter.

The fact that you don't want to bother looking for the information in more detail doesn't obligate me to post a thesis on the subject every time it is raised.
This is an internet bb, not anything remotely comprising a V-C-P relationship.

And FWIW, the original packaging for flunixin did not mention the clostridial abscess issue.
It was added after the accumulation of reports on the matter.

I'm not stopping anyone here from administering the stuff in any manner they want.
But noway nohow am I using it IM, and noway nohow will I reccommend it's use in that manner.

[Bravo]

Asanders,
You DO realize that Ghazzu is a vet, right??? I'm a certified vet tech and have been for almost 20 years. I've also seen several cases of the gas gangrene infection. NOT PLEASANT!! Why are you arguing the point so much. Banamine is just one of those drugs that you don't take a risk with giving it IM. Besides that, it stings like hell, especially when given intramammory. (Needle cap came off when I was sticking a loaded syringe in my scrub top pocket. Only got what was on the needle, but is stung badly)
I give banamine several times on a daily basis. I work for a mostly equine dentistry veterinarian and we give it to all our patients (unless they have problems with it, of course). What little, tiny amount that MAY leak out of the vein doesn't present a problem that we've ever seen.
My advice to anyone who doesn't use banamine IV is ALWAYS use it PO then. NEVER, EVER, give it IM.

[asanders]

I DO realize Ghazzu is a vet. Maybe that is why her posts irk me so much. That and the fact that she is an educator too.

This thread started with a question about giving banamine packaged for injection orally. A reasonable question, but obviously not from someone with in depth veterinary knowledge on the subject, or they would not have asked
...so what could be the point of posting "Not." in response to the post that it is OK to give IM? Do you think all of the folks that read these threads know that Ghazzu is a vet? I'm sure it is not in the signature because this IS a BB and NOT a V-C-P relationship. So sometimes its "please don't read this like it's coming from a vet", but other times "just accept what I say, I'm a vet"

Who's forgeting this is a BB?

Ghazzu, I've seen your other posts. I don't want to pick a fight with you. Usually your answers are direct post of facts in answer to a question --helpful to have your knowledge, but some of the posts are very much your personal opinions --maybe you need a veterinary alter. Maybe it is because it is exam week.

After the "Not." post, you added that you have seen 3 cases of it yourself. Not so weird since your a vet, but if I thought every average poster had seen 3 cases of something recently, I'd believe it to be common (which this reaction is not).

FWIW, I too am an RVT (registered vet tech), with nearly 20 yrs exp, and have a graduate degree in Animal Science, research is my job, so I am usually about providing facts, not judgements.

I will not post about Banamine again, although after all this I may need some.

[S A McKee]

I Do you think all of the folks that read these threads know that Ghazzu is a vet?

I'm sure a lot of readers do know that.

What's a 'dairy scientist' ? Is that a vet tech for cows?
Just askin cause that's what you have in your profile.

[asanders]

I'm sure a lot of readers do know that.

What's a 'dairy scientist' ? Is that a vet tech for cows?
Just askin cause that's what you have in your profile.

:lol::lol::no:Not exactly.

A dairy scientist is a research scientist in the dairy field.

[Ghazzu]

Speaking of cows and flunixin, this came across a veterinary list I'm on recently:
"A USDA veterinary meat inspector has told me in the past that banamine IM leaves an unmistakable injection site in the muscle in cattle (he sees a lot of dairy culls). Anytime they see an inflamed/necrotic muscle site they test for bute and banamine, and I had the impression that banamine left as much or more muscle damage than bute."

[asanders]

SAMc, I assume you are asking about dairy scientists not because you couldn't figure that out but because it does not say RVT?

I worked as a vet tech for equine and small animal practices. I sat for the board exam and got certified because I could, and because I think it is the right thing to do. After grad school (in dairy science) I went to work for USDA as a dairy scientist in a research lab -teching got me through school and was its own school, but no, it is not what I do now.