accidental injection into nuchal ligament...?

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ugh. my guy has been laid up for a couple months now regrowing hoof from an injury, and then the other day he colicked. He's fine now, but as a part of the care I gave him an IM banamine injection in his neck- no biggie, done this a million times before. Except this time I must not have been paying attention and got him too high- initially the site swelled a bit and then went down, I figured I bruised him with the needle, but now a week later he's still got some general swelling in the area and he's verrrry ginger when he spreads his front legs to take his neck down to graze.

I'm afraid I got him good in a bad spot. Barn owner said she did this once and the horse took 6 months to recover!!! what have I done?! Anybody have any experience with this? I feel awful...

[FairWeather]

You aren't supposed to inject Banamine in the muscle--it can cause lots of problems, including what you are seeing.

[JB]

Call. Your. Vet.

A clostridial infection from IM banamine is nothing you ever want to have to deal with.

After as many times as you've done this without any problems, your luck is bound to run out.

http://www.chronicleforums.com/Forum/showthread.php?t=211452&highlight=banamine+IM

[Percheron X]

http://www.anokaequine.com/wellnessprogram.html/horse-health-topics/medications/intramuscular-banamine-injections-should-you
Intramuscular Banamine Injections, Should You be Concerned?


Have you ever given an intramuscular Banamine injection to your horse? Although it has been common practice, we have seen some significant abscess formation following these injections and therefore no longer recommend it. The intramuscular route for injectable Banamine does, however, remain a labeled use of the drug.
An intramuscular Banamine injection reaction often first shows signs of swelling at the injection site, and is warm and sensitive to the touch. After 1-2 weeks the area of swelling can develop into an abscess. The biggest concern for this abscess formation is an infection with bacteria known as Clostridium . Other related bacteria include those that cause tetanus and botulism. When a Clostridial infection is established in an environment without the presence of oxygen, such as deep in a muscle, toxins and gas are produced that destroy normal cell defense mechanisms and cause tissue death. As a result the muscle swelling can become very painful and gas can be felt underneath the skin. The skin on top of the infection may progress to cool, firm and insensitive.
Once the infection has progressed to this point a veterinary visit is needed, although it would be best to have it attended to much earlier. During this visit a thorough physical exam is followed by an ultrasonic evaluation. Ultrasound is used to search for pockets of fluid within the abscess so that these pockets can be opened and drained to allow the body to heal and clear the infection. A large needle is first passed into the fluid pocket to locate any drainage. Then a scalpel blade is used to open up the abscess which is then debrided to allow for adequate drainage. This procedure is important to introduce oxygen into the area of the abscess since the bacteria grow in the absence of oxygen. These abscesses require diligent at-home care for proper healing which includes 10 to 15 minutes of flushing daily for 2 - 3 weeks. Vaseline is applied below the openings of the abscesses to prevent scalding as they continue to drain. In addition antibiotics are prescribed for approximately one week.
In the future, to prevent potential severe reactions to an intramuscular Banamine injection we recommend that you use oral Banamine paste as instructed by a veterinarian.

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thanks for the links. I had no idea injecting banamine into muscle was so controversial, my vet told me to do it. just called the vet. She said if it were the life-threatening infection he'd be very sick, it would be very swollen and painful to the touch, and fortunately he is none of these things- he's bright eyed eating and drinking and pooping normally (except when he tries to go down to graze).

She thinks it's likely that he's just got some secondary swelling from the injection site. This is a vet who was on faculty at NC state for many years, so I trust her judgement. She advised treating it by massage and even a bit of heat.

[Pancakes]

I will never get out of my mind the two horses with enormous abscesses from IM banamine shots:

1. abscess hole cleaned out of its neck left a basketball-sized hole that you could put your entire fist up and into, out of sight.

2. 3 yo Colt had injections on both sides of the neck-- needing big slashes to open up the pockets of pus and drain them. It looked like a horror movie scene, with all the massive wounds on his neck. He ended up getting septic and euthanized shortly.

Like JB said. You might get lucky, but it's not worth it when (and yes, it's a matter of time) it happens. If you do not feel comfortable giving banamine IV you can get paste compounded, or even squirt it orally in a syringe (though not recommended).

Here are some nice testamonials: (warning: GRAPHIC!!!)
http://www.baywindfarm.com/forum/showthread.php?t=8911 scroll down
http://www.thehorse.com/images/content/reactions/reactions.htm

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percheron x, i posted before I saw your response. Thanks- sounds like what my guy has could very well be on the way to what you're describing, as it's only been a week. Presumably there's nothing to do at this point but keep an eye on it and see if it worsens, and then if it does get the vet out ASAP?

[mvp]

Yup, call your vet.

But treating the abscess isn't that bad... after you puke while you watch your vet cut into the neck and a horror-movie amount of pus come out in a horror-movie way.

Back in the last century (around the time we tube wormed), horses sometimes got IM abscesses from vaccinations. It was my job as a kid to clean out a lanced one everyday. Puss became no big deal. If you clean the wound out and treat the edges as the above post mentions, it heals from the inside out pretty quickly, leaving a very, very small scar. You do want to swipe some vaseline on the hair below the hole as the pussy skank will scald the area.

Don't freak out, but definitely have your vet out sooner rather than later.

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wow pancakes, that is some horrorshow stuff. percheron said it could fester in there for 1-2 weeks, but it seems like many of these cases appeared one to two days after the initial injection... I'm hoping hard that the 1-2 week cases are the exception, not the rule....

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thanks mvp- I did call the vet and she said that since he's behaving normally and the only evidence that he's in any discomfort is mild swelling that isn't hot or painful to the touch, and, of course, that he's uncomfortable lowering his neck to graze, that she doubts at this point that it's a big cause for alarm. I hope she's right. I could really use a break. and so could my credit cards.

[mvp]

Great your horse is doing ok. Abscesses, depending on their size and depth, can show up on our radar at any point in their construction. You can wait to call your vet. But in the meantime, you might try some hot compresses on the area....if you have more time than money and want to speed things up-- either the healing of a deep bruise or an abscess that was gonna blow anyway.

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great, that is consistent with her advice. I have little of either time or money, but if I had to pick, I'd pick time! I just sent my other horse to the vet school to the tune of thousands and thousands of dollars- and this one, as the first post mentioned, has been on stall rest recovering from tearing half his hoof off, plus the ding dang colic that caused this whole debacle to begin with! I'll put a hot compress on it tomorrow and keep monitoring it. thanks!

[Tiffani B]

Ice and DMSO will help the pain and swelling.

[mvp]

Geez. It seems to me that this horse should be bringing you a hot compress or a hot cocoa. No one can say you haven't put in more than your share of time, effort and money to horse doctoring.

He owes you, dammit, so the least he could do is make this problem no big deal.

I have recently had this conversation *out loud* with my normally no muss-no fuss horse who suddenly decided to get all high-maintenance in February and has not let up yet. WTF, dude?1?

[Roan]

. . .If you do not feel comfortable giving banamine IV you can get paste compounded, or even squirt it orally in a syringe (though not recommended).

Why not recommended? My mare is currently on 7ccs banamine 2x a day. Considering the cost of paste versus IV given orally -- about $13 for one dose of paste versus $4 for one dose of IV for me at the moment -- it makes no economic sense to buy the paste. I would just not be able to afford it. It works just as well for my mare given orally and she will take it with little fuss. So long as she gets a few cookies immediately thereafter, that is.

I can attest that it tastes HORRIBLE, though. It was accidental, you can be sure of that, but UGH! Burning, numbing, stinging. . . ugh.

Eileen

[Ghazzu]

. If you do not feel comfortable giving banamine IV you can get paste compounded, or even squirt it orally in a syringe (though not recommended).



No need for compounding.
There is a paste formulation made by Schering-Plough.

[TrueColours]

Add me to the list that would never ever given Banamine IM

IV or paste. Never anything else

Hope that he recovers okay from this. I also saw a horse that had to be cut open and drained a few years back from an IM banamine shot. It looked like a mini bomb exploded in there. Poor guy - I have NO idea why any vet would ever tell a client to give this IM ... :( ... when there is so much evidence as to how many problems it can cause by doing so

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Ok so, my guy's fine- he's been getting slightly more comfortable each day, swelling is mild enough that you wouldn't notice it unless you were looking for it, and he's not reactive when you push/massage it.

So now that I know (probably) that there's nothing terrible brewing in there, I return to my original question:

Anyone just simply gotten the needle in the wrong place and made them sore like this? How long did it take before they recovered?

[FLeckenAwesome]

I have done the same thing, only with Rabies shot. (And...sad to admit it.. I am a vet!! Small animal, but...still).... so I gave the rabies shot too high and he has a lump... STILL... and it's been oh.... 10 months!!

He was sore for the first day or two but then has been fine since. If he'll let you cold hose/pack it, I'd try that. Fleck's lump has gotten smaller but is still evident..

Apparently I'm not qualified to give IM injections... IV sure... no sweat!! But.. Poor Fleck not only has that lump, but he also has a area of denervation atrophy where I hit a nerve... I was trying to hit an acupuncture point, but.. it didn't go well. And then the baby... the IM ace.. accidently went a bit SQ and now he's had a lump for 2 weeks too. Doh!!!

Seriously?!?! I do have letters after my name and all... Oh well!!

Hope your pony feels better and the banamine doesn't cause any issues!

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Thanks FA, you make me feel much better! :)

[FLeckenAwesome]

Glad to help ;)

Yeah... it's soooo embarassing, but...ah well... I'm a MUCH better small animal vet :)