Banamine IM injection

[skyy]

My vet just told me yesterday that Banamine should never be given IM because of a potential chlostridial infection. Has anyone ever heard this before?

[SLW]

Yes, had it happen to a mare of mine from a banamine shot I gave her. It was a mess to clear up.

[KnKShowmom]

If you do a search you will come up with some discussions on this, I believe one had some pictures which in and of themselves would keep me from ever risking it.

If you can't give IV, it works just great orally.

[Dazednconfused]

Someone posted a photo of an infected IM Banamine site here on COTH awhile back. It was hideous - looked like filletted fish filled with pus...yikes!

[JB]

If you search a little, you'll find disgusting pictures at The Horse, which is one of the articles and pictures referenced in that thread :)

ZERO reason to do IM Banamine. As mentioned, if you can't do it IV, it works as well orally as it does IM.

[Grataan]

This is why the IM label was removed several years ago. Just not worth it.

ETA: I just checked the flunixin on my truck. Apparently the IM label is back. I still won't do it IM, but I wanted to correct my above error.

[dwblover]

Not worth the risk, just give it orally.

[skyy]

I just got on the Banamine site and it still says iv or im for horses with a rare occurrence of chlostridial infections if im and a rare occurence of anaphylactic shock if iv. I guess you're taking a chance either way!

[cloudyandcallie]

I have given it IM without problems but quit that about 4 yrs ago.

I still give it IV but also give it orally.
You can squirt it into the mouth and it will work for horses who don't hold still for shots.

[tBHj]

Can it be given oral?

[TrueColours]

There's a Banamine paste you can buy if you are not comfortable doing IV shots isnt there? Ive never used it as I have no problem doing IV shots but Im sure Ive heard of it being available

And yeah - from everything I have heard, read and seen - Banamine IM is a huge no-no ... :no:

[Kellidahorse's elf]

No IM injections.

Orally was taught to me at the Univ of Fl years ago. They say it works well, and since I do it that way I can say it does.

Not worth the chance to do it IM. Ever.

[lovemyoldguy]

Oh wow. I used to give Banamine IM injections in an absolute pinch and never heard a word against it from my vets. I guess I got very lucky. Very scary.

[BuddyRoo]

The same dose you'd give IM can be given PO (orally)...just remove the needle after drawing from the bottle and give like you would a dewormer.

It's acts almost as quickly and with ZERO risk of the bacterial complications.

I will not give banamine in any other way than IV or PO. There is no good reason to take the IM risk.

[GatoGordo]

Here's a confirmatory blog entry (http://www.equidblog.com/2009/06/articles/another-category/other-diseases/intramuscular-injections-and-clostridial-myonecrosis/) (!) from U of Ontario/Guelph.

[skyy]

The part that I didn't understand was why it happened with Banamine and not with vaccines. After all, vaccines have to be given IM. The blog did mention that it can happen with vaccines. Maybe the Bananmine is just more irritating than things like Adequan?

[JB]

skyy, it's been discussed here many times :)

It's not about the injection. It's about *what* is being injected. The banamine chemical compound lends the situation more to a clostridial infection developing.

http://www.thehorse.com/ViewArticle.aspx?ID=6466

[skyy]

Sorry, I should have searched before asking. My bad.

[bugsynskeeter]

The part that I didn't understand was why it happened with Banamine and not with vaccines. After all, vaccines have to be given IM. The blog did mention that it can happen with vaccines. Maybe the Bananmine is just more irritating than things like Adequan?

I have seen a clostridium infection from vaccine. But its the only time I've ever seen it.

I have seen several clostridium infections from Banamine and they are UGLY! There is no reason what so ever to give Banamine IM. You can give the injectable form orally if you don't feel comfortable giving it IV.

Those infections are one of the worst things I've dealt with at the clinic. And the horses are normally in lots of pain.

[whbar158]

There are many people that have no idea about this, and I know many many people that have no problem giving it IM including vets. Personally not worth the risk for me when giving it orally works just as well in the same time frame.

[Grataan]

The problem with clostridial infections is that how the site is prepared seems to have no bearing on if there will be infection-as in, even IF you aseptically prep the area pre injection you can still get an infection.

There is research out there that shows the spores can actually live in the muscle tissue-and that it is not the act of injecting that carries bacteria into the tissue it is rather that the injection of the irritating substance sets off the reaction.

[murphyluv]

(in response to rodawn)
after seeing dozens of vets and other people perform injections, I have NEVER seen anyone cleanse an area prior to injection- unless going into joint. This includes vets doing IV banamine in a colic. If the horse is in pain, he needs the banamine NOW. I also remember a rumour that unless the area is clean AND dry, it's pointless to just rub some betadine on it, unless you do a full one scrub and scrub and scrub, and scrub some more, and so forth.

[katarine]

I don't ever see my vet prep an injection site...UNLESS it is a joint injection. Ever.

The horse is the problem, and Banamine should be given orally, or via IV. Period.

[Ghazzu]

most vets scrub the area to be injected with alcohol swabs/solution and then are careful to keep the area very clean before, during, and will cleanse the area again afterwards.

If you scrub for less than 5 minutes, you might as well spit on it for all the good it does.

Clostridial abscessation secondary to flunixin intramuscular injection has very little to do with skin preparation or lack thereof.

[Gry2Yng]

Clostridial abscessation secondary to flunixin intramuscular injection has very little to do with skin preparation or lack thereof.

Wow, try to say THAT 5 times fast.

[lovemyoldguy]

Ok, so a question - and this may be dumb, so forgive me: when we say "giving it orally works just as well", are we talking about the 10cc that would have been given IM or IV? OR are we talking about the paste? If giving the injectable orally, is there ever a problem with not getting all of the liquid into the horse's mouth? (My horse was 1) very tall and 2) a spitter, which is why I ask...)

I love COTH...I learn something every day.

[Laurierace]

If you scrub for less than 5 minutes, you might as well spit on it for all the good it does.

Clostridial abscessation secondary to flunixin intramuscular injection has very little to do with skin preparation or lack thereof.

Not only that but what dirt and such that your scrubbing did not remove is now suspended in whatever liquid you used to scrub making it easier for the needle to carry it in with it.

[akor]

I had given IM injections quite a few times. (different horses) No issues.

Then, I had an issue. A $2500+ issue and a horse that wasn't the same for a quite a bit. A horse now TOTALLY freaky about vet care. She has no mark at all from it, whch I guess is rare, but just a bad process all around. Her neck was slit open to look like fish gill and it tooks weeks of treatment to make it better.

I had some unusual circumstances, basically, I should NOT have trusted the source of what I used, but that's in the past and I believe it can happen with it no matter your precautons.

Now, I keep paste around. Same result, IMO.

To do IM again, I would have to know the horse would die in 3 hours - that's how Long it would take to get it to the nearest university.

[skyy]

I think I just read the report of a study that said that wiping the injection site with alcohol does no good. I can't remember where I saw it though.

I always thought that giving horses oral medication was a very stupid delivery system. How can you ever tell exactly how much they are ingesting? My horse is pretty good about it but I know that all of it never gets down his throat. Do the vets take this into consideration when giving you dosage? I am much more comfortable giving IM injections but now I guess I have to stop doing that and will have to finally learn how to do IV.

[whbar158]

I have found that as long as the horses mouth isn't too dirty the liquid goes in quite well. And works just as fast as IM. It is cheaper do buy the injectable and give PO than to buy the paste, plus I think it goes in better than the paste anyways.

[BuddyRoo]

Ok, so a question - and this may be dumb, so forgive me: when we say "giving it orally works just as well", are we talking about the 10cc that would have been given IM or IV? OR are we talking about the paste? If giving the injectable orally, is there ever a problem with not getting all of the liquid into the horse's mouth? (My horse was 1) very tall and 2) a spitter, which is why I ask...)

I love COTH...I learn something every day.


Yes, we're talking about giving the injectable form PO at the recommended injectable dose. So you'd draw the banamine from the bottle with the needle on (obviously), then you'd remove the needle, and squirt in the mouth.

The reason that giving it IV does not carry the same risks as giving IM is that it's not irritating the muscle tissues. The irritation is what is *thought* to trigger the response.

I'm not sure why this is not more common knowledge amongst veterinarians if they are doing CE. But I have been advised on more than one occasion to give IM. I give IV or PO, end of story. Not saying that I wouldn't give IM in some sort of whacko scenario that I can't quite dream up at this moment....but if I had other options, I would definitely avoid IM banamine.

[HotPinkHorse04]

I am currently fighting the infection with my new horse. So far it's a pain in the butt. And he is very uncomforatable...

[GatoGordo]

Warning: thread hijack ahead.


I always thought that giving horses oral medication was a very stupid delivery system. How can you ever tell exactly how much they are ingesting? My horse is pretty good about it but I know that all of it never gets down his throat. Do the vets take this into consideration when giving you dosage?

No, it is expected that all or most of the dose makes it into the horse. You would not want to overdose the horse who gets the entire oral dose, which is quite possible even for difficult horses if you are practiced. If you have trouble dosing your horse, I would suggest you practice with applesauce, maple syrup, or even just plain water until you feel comfortable enough to get the medication in when the horse really needs it. This has the bonus of making the horse think that getting stuff put in his mouth is OK or even tasty. Some random troubleshooting tips:

Their mouth needs to be empty when you start. If your horse likes to keep wadded up hay in his mouth and spit it out along with the medicine, you can take the syringe and just pass it through their mouth to make them start chewing and spitting out the hay. You can also rinse their mouth out with a different dose syringe and water if needed.

Being right-handed, I find it easiest to stand on the horse's RIGHT side and hold the halter with my left hand, using my right hand to work the syringe. I stand next the head, facing either straight ahead or angled towards the horse (never straight in front, facing them).

Lift the horse's head up so that their nose is up near your shoulder. You do NOT want their head so far up in the air that the liquid can run down into their trachea (I've actually seen a horse who had drugs in his lungs from this). If their nose is pointing to the ground it is easy for the meds to run out.

Put the syringe as far back on their tongue as you can, and give them a chance to swallow in between small doses (Banamine isn't a problem, but I don't like to do more than 15-20 cc at a time for an average-sized horse). If they are keeping their head reasonably still and not trying to open their mouth, you can just relax for a moment and let them swallow. If they do not want to swallow, you can wait them out or put some pressure on their throat to make them swallow. Sometimes, tickling/stimulating their tongue makes them swallow, but it can also make them slosh the meds back out, so you have to be careful.

If you have to mix pills with water, go for the smallest volume that will allow you to completely dissolve the pills into a liquid. The more watery it is, the more likely it is to run out the sides. However, if it is too chunky, the chunks will fall out of the horse's mouth when you let them go and they start making faces.

If they try to get away from you, put them against the wall with their butt in a corner. If they raise their head up too far for you to reach, put a nose or lip chain on as soon as you get in the stall and bring their head down just far enough for you to reach their mouth. You do not want their neck flexed unless it is a small amount of paste and they are good about swallowing -- gravity is against you when their neck is flexed. For most horses, I prefer to handle them myself when giving oral meds, but some horses are so bad that it helps to have someone to keep them from lifting you off the ground.

Wait to give the horse a treat until you know they've swallowed the drugs (same issue as the hay). If they are reluctant to eat afterward, wait 20 minutes and rinse their mouth out thoroughly with water.

I apologize if this is all old news to you, but I thought maybe it would help someone out there who is wondering how to make sure their horse is getting their meds. :)

Now, my cat, on the other hand, is the ninja of rejecting pills while making me bleed at the same time . . . :no:

P.S. No, if your vet tells you to dissolve a pound of Biosponge in water and syringe it in, it's just not all getting in there.

[Grataan]

P.S. No, if your vet tells you to dissolve a pound of Biosponge in water and syringe it in, it's just not all getting in there.OMG Gato, it's like you knew that I am currently waiting for the hot water to come up so I can wash off the mineral oil/electrolyte/biosponge spritzer I accidentally gave myself on my last call (Don't ask me how, but i managed to spray myself in the face)

[Meredith Clark]

I have found that as long as the horses mouth isn't too dirty the liquid goes in quite well. And works just as fast as IM. It is cheaper do buy the injectable and give PO than to buy the paste, plus I think it goes in better than the paste anyways.

The paste also expires faster than the injectable. I *knock on wood* never use the paste before it expires so now I just keep a bottle of the injectable.

[KnKShowmom]

Banamine has a pretty strong odor (and a nasty taste, ask me how I know :winkgrin:) so if after you have the dose drawn into the syringe, take off the needel and dip the end of the syringe into a cup of honey and draw a tiny bit in.

The honey on the end of the syringe will mask the smell and give them a bit of a sweet treat as well.

[fivehorses]

KnK, good tip.

This is why reading thehorse.com is a good idea. This has been well known not to give im banamine.

I ALWAYS KEEP 2 tubes on hand(I have big horses).
Paste works in about 20 minutes.
Also, I have been advised to never give more than a body weight in a 24 hour period. NEVER.

So, for a 1000 pound horse, I usually start with a 500 pound dose. If it is for something ongoing, I will dose 500 am and 500 pm. BUT, not 1000 am and 1000 pm unless instructed by a competent vet.
I had a newbie tell me to give the horse full dose am and pm, for an eye injury. No, I didn't do that. I listen to the hospital/clinic vets advice on things, and if different than my local vet, especially a newbie, I go with the clinician's opinion/advice.

Not knocking vets, but sometimes their lack of knowledge scares the heck out of me. Other times, I am also blown away at how much knowledge they do have.

Banamine is wonderful drug, but its not candy either. Its like taking one advil or 4...it really depends. Additionally, if you have ever needed to take 4 ongoing, you know what it can do to your gi tract.

[JoZ]

I almost didn't open this thread because I knew already that IM banamine was a no-no. But I'm glad I did!

I keep paste banamine on hand for my TB mare who has recurrent mild colics. She also has the weirdest reaction to any sort of paste (banamine or wormer) -- no matter how long and hard I work to ensure she has swallowed, she starts drooling big sloppy stringers about 10 minutes after paste administration. I don't think the substance is coming back out but I'm never 100% sure -- and it's messy and she's miserable!

I will ask my vet about letting me have the liquid to give her orally. It sounds like it would get to her tummy faster too. Thanks COTHers!

[GatoGordo]

OMG Gato, it's like you knew that I am currently waiting for the hot water to come up so I can wash off the mineral oil/electrolyte/biosponge spritzer I accidentally gave myself on my last call (Don't ask me how, but i managed to spray myself in the face)

Good luck with that! :lol: I call Bio-Sponge the edible Quikrete.

KnK, I submit the opinion that Bute paste is MUCH worse than Banamine paste (note to self: do not uncap Bute paste with mouth).

Fivehorses, I think it's a bit extreme to say not to give more than one dose by weight per day. As you said later in your post, go with what your vet says, but flunixin does not accumulate in the body and many horses receive full-dose (1.1 mg/kg) flunixin 2x/day for days or even weeks on end with no problems (although a lot of the ones I've known were put on Ulcergard in case of ulcers). While it's true that a horse who is dehydrated or renally compromised may need a lower dose and/or different dosing intervals, most reasonably medically stable horses do just fine with flunixin dosed twice a day.

[KnKShowmom]

KnK, I submit the opinion that Bute paste is MUCH worse than Banamine paste (note to self: do not uncap Bute paste with mouth).

:lol: :lol: :lol:

Yup, beentheredonethat with the Bute paste too - two hands are never enough.

With the Banamine, I have just had to learn to keep my mouth shut when dosing.....the dosing is probably the easier part of that task! :D