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Anaphylactic shock from a 6-way shot

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  • Anaphylactic shock from a 6-way shot

    This week has been horrific for us. Tuesday, our two quarter horses (both about 20 yrs old) got their annual check-ups, 6-way shots, and rabies shots. The vet (who's well-respected in the area) declared them both to be in perfect health. She hung around for maybe 10 minutes, then left.

    90 minutes later, our gelding banged into something in his stall, stumbled around the corral, fell over and had a seizure. He went into anaphylactic shock, and died a few minutes later. Fortunately, we were outside and were able to be there. By the time the vet got back 30 minutes later, it was far too late.

    We've had that gelding for 18 months, and he got the exact same 6-way last year, with no ill effects. The rabies vaccine is a different brand than last year. Our mare had no problems with either. The vet reported the incident to the drug company, and they immediately recalled that batch. No word yet on whether we're the only case that's been reported. I'm not sure which brand either of these drugs was, but I'll try to find out & post here.

    How common is this? The vet (who's maybe in her 30's) said it's unbelievably rare. Our neighbor (who's about 50 and owns horses) said it used to be more common, to the point where some horse owners used to keep epinephrine on hand, and the vet used to stay for 30 minutes after every shot, just in case. Not that it makes any difference now, but would a human-sized epi pen have done any good for a horse? We remembered the following day that we have one for our son, who (ironically) is allergic to horses.

    Another thing I noticed: the following morning, there was blood dripping from the spot on his neck where the shot had been administered. There was also a little bit of swelling around that area. There was no bleeding there the night before, even an hour after he died. Does that mean anything?

    Needless to say, we're all heartbroken. This was my 17-yr-old daughter's first horse--the one she'd longed for her entire life, and for whom we'd spent all summer searching. This horse was like spouse to my daughter. If our mare (who kind of fell into our lap a few months later) had died, it wouldn't have been quite as hard.

    Our mare is also very lonely. She isn't eating as much these last two days. She stands out by the road all day, waiting for that yellow truck (the renderer) to bring her friend back home. I'm already exploring options to bring her another companion, but it's tough to balance that against my daughter's broken heart for her gelding.

    We're fairly new to horses, and I've learned a lot of stuff along the way as we've encountered it. If there's something we should have done differently here, this is NOT how I wanted to learn it, but I definitely don't want to make the same mistake again. Should we have done something differently? Should the vet have done something differently? Should we try to take some sort of recourse with the drug company?

  • #2
    So sorry for your loss. That is exceedingly rare. I've been in horses for well over 30 years, and never seen it happen or heard of it happening to a friend. I did witness an anaphylactic shock after a penicillin shot once and it was horrifying. 90 minutes is quite a long time after the shot to see such a reaction. Did your vet have any thoughts on why?

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    • #3
      How terrible, hugs to your family.

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      • #4
        How shocking and terrible. So sorry for your loss, what an awful way to lose a horse.

        I'd expect the vaccine company to reimburse you for any veterinary expenses related to this, and also for disposal.

        No, the bleeding and swelling the next day is probably not related or indicative of anything particularly telling. It's probably just tied to the death and decomp process (I'm sorry, that's an icky thing to hear )

        Such a drastic vaccine reaction is very, very rare. Betting most vets, even, only see one in their career, if any.

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        • #5
          First, I am SO very sorry. I can't imagine how horrifying that was to go through

          I'm curious - can anaphylaxis from a vaccination happen that late?

          When you say the vet reported this, and "the batch" was recalled, are you talking about the 6-way, or the rabies, or both?

          I'm also hope you will be able to get the brand and name of the rabies vac, because it's interesting there's another thread right now about 2 horses have a big reaction to a rabies shot.
          ______________________________
          The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

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          • Original Poster

            #6
            Originally posted by joiedevie99 View Post
            90 minutes is quite a long time after the shot to see such a reaction. Did your vet have any thoughts on why?
            The vet's first thought was that maybe it was caused by some sort of tumor that went undetected, but suddenly caused the problem. The timing of it happening right after his shots was a little too coincidental, though. She later (same visit) suggested that it was more likely a reaction to the shot, which is why she reported it to the drug company.

            Most of what I've read today suggests that anaphylactic reactions typically happen within 15 minutes, but an hour or more isn't unheard of.

            We weren't monitoring the gelding closely during that 90 minutes, so we can't say for sure how long it took for symptoms to set in. He appeared fine (he's pretty laid back anyway) when the vet left. Later, my wife saw him (from a distance) grazing out in the pasture with our mare. Later still, she heard a banging commotion in his stall, and saw him stagger out into the corral. That's when everything fell apart. My point is that 30-60 minutes after his shot, he was apparently feeling well enough to walk a couple hundred yards to the far end of the pasture to eat. We don't know what caused him to return to the barn.

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            • #7
              So very sorry for your loss, and having to experience what you did.

              I have owned horses for about 40 years, and have always heard about the possibility of anaphylactic shock as a reaction to vaccines. I do think it was more common years ago, as you don’t seem to hear about it as much now.

              I have had friends, who do their own vaccines, who kept epinephrine on hand in case of a reaction. The big “but” here is that even an extremely experienced veterinarian would have a difficult time saving a horse from anaphylactic shock, even if they were right there with epinephrine in hand. This comment was made to me by a vet I had used for many years.

              I doubt using an epi-pen would have made any difference, as they are a dosage based on human size, and your average horse will be about four times that of a large human.



              "You can't fix stupid"- Ron White

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              • #8
                Originally posted by cutter99 View Post
                So very sorry for your loss, and having to experience what you did.The big “but” here is that even an extremely experienced veterinarian would have a difficult time saving a horse from anaphylactic shock, even if they were right there with epinephrine in hand. This comment was made to me by a vet I had used for many years.
                I just wanted to second this. In the case I was present for, the vet was there and we couldn't do a thing. The reaction happened in less than 10 minutes - and we were only a few stalls down with another horse when it started. By the time the vet went out to the truck for drugs and came back, the horse was thrashing too violently to enter the stall safely.

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                • #9
                  Sorry to hear of the loss of your horse. I have a horse that’s sensitive to vaccines. Everything gets split up and spaced a few weeks apart. The one time we tried to do a 4way combo vaccine he came in a few hours later trembling, clacking teeth, staggering walk and a temp of 106.7 (Which he normally temps at 98.7) Luckily for him he was a young, healthy horse and we were able to help him but it was ugly. I wonder if your horse had a similar reaction but being slightly older did not fare as well. Especially if there was something underlying that would not be caught in a typical annual check up that was aggravated by say a sudden spiked temperature. I know my guy we have to watch as every year his reactions get stronger to the vaccines- I just wonder if everything sadly compounded on your horse.

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                  • #10
                    Originally posted by Obi-Wan View Post

                    Another thing I noticed: the following morning, there was blood dripping from the spot on his neck where the shot had been administered. There was also a little bit of swelling around that area. There was no bleeding there the night before, even an hour after he died. Does that mean anything?
                    ​​​​​​so sorry for your loss

                    I'd be very interested to know what your vet says about this. To me, it seems very weird.
                    Ahhhh, spring is here. The birds are singing, the trees are budding and the paddocks are making their annual transformation from cake mix to cookie dough.

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                    • #11
                      In humans anaphylactic reactions can happen in seconds or over a much longer period. Depends on just how the person is responding to the insult.

                      In horses it looks like it can happen within a few minutes to as along a s few days, with most occurring under 48 hours.

                      Here is a scholarly article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1776115/

                      Here is a more general article. https://thehorse.com/152315/allergic...and-treatment/

                      This is a very sad situation. Even more sadly, it's pretty much unpredictable, particularly with a relatively new horse. I'm very sorry for the OP's loss and hope they don't have another.

                      G.
                      Mangalarga Marchador: Uma Raa, Uma Paixo

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                      • #12
                        I am so sorry for your loss.

                        I was present for a similar situation (not my horse). The reaction happened within 10 minutes. The vet was still there and administered care. It did not save the horse. Chances are, if the vet were still at your property, it would not have made a difference. I hope that can bring you some solace.

                        We try not to use "combo" immunizations, and we spread them out. That way, if there is a reaction, we know which one caused it.

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                        • #13
                          Truly sorry to read of your loss and for your young daughter's grief.

                          We had one horse that had a reaction to WNV. The reaction was nothing like what your horse went through. If you sent the horse's remains to the renderer - you're not going to be able to have an autopsy done. Over the years, we have had several horses die from what the vet surmised as a tumor on the spine or stroke. None of them thrashed. They went down and couldn't get up. Each had to be euthanized - they did not die on their own. I share that information with you as to how we've experienced a tumor/stroke. It does sound like your horse died from a different cause.

                          If you want to do something - you might explore if there are other horses experiencing the same reaction. A poster here mentioned another thread on the same subject. It was very good that your vet reported the reaction. If you can post the name of the company and batch number that was recalled - you might help some other folks.

                          Again, I hope your daughter feels the warm thoughts coming your way to you and your family.

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                          • #14
                            I'm so sorry for your loss. In my years doing running a barn (and administering a lot of medications and vaccinations), I have come across several horses that have had allergic reactions to medications. In one case, a horse had a reaction to a vaccination and broke out and hives and began to act violent and colicky about 30 minutes after the injection. Had we not intervened and treated the horse with dexamethasone and banamine (and the vet may have given additional medication), the horse easily could have injured himself thrashing around. The area where the injection did swell up significantly. We did not inform the drug company as there's no way we could hold them responsible for a random allergic reaction to a vaccine.

                            I had another situation where a horse experienced an anaphylactic reaction immediately after an IV injection, but thankfully the the vet was at the farm next door and was able to intervene immediately with medication. In this instance, we did inform the drug company as it was a newer medication.

                            In both instances, safely restraining the horses to treat them was a major issue, the horses were in violent distress and had we not been present they almost certainly would have injured themselves. Both horses made full recoveries, but both were also very healthy young animals who had their reactions at a layup barn with medication, multiple handlers, and veterinarians close at hand.

                            Different vaccines are formulated differently. I personally do not notice more swelling or reactions with the combined products. I give vaccinations at a time when I am working in the barn and able to observe the animal/s afterwards. Aside from being impractical, there is no evidence that combination vaccinations or spreading vaccinations out is safer or better in any way.

                            As far as closure, I don't know what to tell you except that it sounds to me like you gave your horse good, proper care, and that he lived a long and well-loved life until something rare and un-preventable occurred.

                            Regarding your other questions, blood dripping from an injection site means nothing. If your horse did indeed have an anaphylactic reaction, the swelling at the injection site could be consistent with that. Also, a human sized eli-pen would not have saved your horse.

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                            • #15
                              Originally posted by BeeHoney View Post
                              We did not inform the drug company as there's no way we could hold them responsible for a random allergic reaction to a vaccine.
                              This is all kind of vague in my memory, but I think I did recently read about a similar situation but I think the horse survived, although there were considerable vet bills. For some reason the company paid the vet bills, although the circumstances were such that I wouldn't have expected them to. (Routine vac, or something like that.) So it might be worth asking?

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                              • #16
                                Originally posted by kande04 View Post

                                This is all kind of vague in my memory, but I think I did recently read about a similar situation but I think the horse survived, although there were considerable vet bills. For some reason the company paid the vet bills, although the circumstances were such that I wouldn't have expected them to. (Routine vac, or something like that.) So it might be worth asking?
                                kande04, I guess I disagree. I think it is fine to inform the drug company regarding what happened in case there is some kind of a pattern or issue that is appearing. However, the expectation of some kind of re-imbursement for an anaphylactic reaction--which no one, including the drug company has any control over--strikes me as inappropriate. In this case, I'm not even sure what the company could reimburse for. The value of a retired, 20 year old horse? The cost of a routine vet visit? I think that would provide cold comfort to the OP in this instance who plainly dearly cared about this horse.

                                The horse received two vaccines, likely from two different companies--which company is "responsible"? Since the horse has been rendered and no autopsy was done, no one knows for sure what happened. Yes, anaphylaxis is likely, but there are other possibilities, including some underlying illness.

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                                • #17
                                  I am so terribly sorry to hear about your traumatic loss, Obi-Wan.

                                  I do believe that anaphylactic reactions can occur more than an hour after a vaccination. My horse hasn't, thank heavens, experienced anaphylactic shock, but she has had very serious immunologic reactions to vaccines (hives all over, sweating, rapid respiration, tremors) and those have typically started an hour or more after vaccine administration. Delayed anaphylaxis is well documented in humans. I wouldn't doubt for a second that the terrible loss described here could be an allergic response in an otherwise healthy horse.

                                  I recently had a chat with a pharma rep (from Merck, I think?) who was very curious about my horse's vaccine reaction experiences and suggested that even if not done immediately reporting is useful for a) the company's internal scrutiny of their products and monitoring of adverse effects, and b) the potential to receive support from the company for treatment costs. It sounds like the latter is usually initiated by the vet who administered the vaccine. I hope your vet is advocating for you financially in her reporting to the vaccine manufacturer, and that she's also reported to USDA Center for Veterinary Biologics (the agency that regulates things like vaccines). It might be possible to get reimbursed for any emergency call that resulted from the reaction, and wouldn't hurt to ask about support for any expenses related to the horse's passing (e.g. disposal of remains). I suspect you're unlikely to get any compensation for the loss of the horse himself, since anaphylaxis is a known risk of vaccination. He sounds like he's irreplaceable anyway.

                                  I hope your daughter can mourn and heal in time. And that your mare starts to cope better. All my best to your family.

                                  Comment

                                  • Original Poster

                                    #18
                                    OK, I just got off the phone with the vet again.

                                    The rabies shot was Merial Imrab 3. This is different shot than we got last year. This version contains only the killed virus plus a preservative.

                                    The 6-way shot was Merck Prestige 5 + WNV. It treats eastern & western encephalomeylitis (EEE & WEE), influenza (EIV), herpesvirus types 1 & 4 (EHV-1 & EHV-4), tetanus, and west nile virus. I count seven diseases there, not six, but oh well.

                                    The doc didn't know the batch numbers for either off the top of her head. She reported the incident to both companies as standard procedure, and both companies automatically recalled that batch. Both companies said that no other serious side effects had been reported, although Merck did report a few instances of minor swelling around the injection site. Our vet is still in contact with the companies, so she'll know if any other instances get reported.

                                    I told the vet about the swelling & bleeding from the 6-way injection site the morning after his death. She said she'd report that, but she suspected (like previous posters here) that it was likely caused by insufficient time to coagulate and the unnatural position in which his neck lay all night.

                                    I asked the vet about keeping some epinephrine on hand, and she said that'd be a good idea for peace of mind, given what we've gone through. Odds are nobody would ever need it, though. She'd be happy to teach me how to administer it. I've read that it needs to be stored at a consistent temperature, so I can't just throw it into the tack room cabinet--I'll need to either store it in the house (100' from the barn) or get a mini-fridge for the tack room.

                                    This is one of the larger clinics in the area, so I'm sure they're on top of notifying all the agencies that should be notified about this.

                                    Neither the vet nor I broached the subject of our vet bill from Tuesday. That's probably a discussion to be had with their office staff. She seems like the type that would be happy to lobby the drug company for me if needed. It would be great if they'd pay to replace the horse, too. This is just an older trail horse, but we're still talking about $1000-2000, plus a prepurchase exam for every horse we seriously consider.

                                    Three days later, our mare still spends all day & night standing by the road watching for that yellow truck to bring her friend back. In the interest of her emotional health, I've already started looking for a replacement. We have a friend who's moving out of state and needs a new home for his 22-yo Appy gelding. He's a little sway-backed (the horse, not our friend), but is awesome with beginners & has a beautiful lope, and my daughter already knows the horse. We'll see...

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                                    • #19
                                      Obi-Wan could you possibly get a "loaner" horse from a friend or acquaintance until you get things figured out? Someone to keep your mare company in the interim?

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                                      • #20
                                        Originally posted by kande04 View Post

                                        This is all kind of vague in my memory, but I think I did recently read about a similar situation but I think the horse survived, although there were considerable vet bills. For some reason the company paid the vet bills, although the circumstances were such that I wouldn't have expected them to. (Routine vac, or something like that.) So it might be worth asking?
                                        When one of my horses had a vaccine rxn a few years ago (pretty sure it was Fort Dodge), the company covered all the expenses related to the reaction. It was just the cost of the vaccine plus the cost of the vet coming out for a few days afterwards to monitor (and some banamine maybe). It wasn’t something I had anything to do with, vet reported it and company reimbursed him.

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