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Scary! Anaphylactic shock from Xylazine

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  • Scary! Anaphylactic shock from Xylazine

    Wow! Today the dentist was out to float the teeth of an OTTB rescue that is here. I have very little background on this horse and he has been here recovering nearly 3 weeks now.

    I administered 2 ml of Xylazine IV for the dentist - as I have dozens and dozens and dozens of times over the 3 decades. An WHAM! Anaphylactic shock!


    OMG Horrifying! When 1100 pounds of seizing TB goes down in an instant it is horrifying! Thank GOD the dentist was so calm and I pulled it together - knowing that it was too dangerous to do anything but stay clear!

    Luckily he was in a clean deeply bedded stall. I got the vet on the phone immediately. She had me give him 4ml of Dexamethasone under his tongue when he had stopped thrashing. That was the best I had on had. And she would have been over an hour getting here so I did what I could.

    It was touch and go for about half an hour. The dentist, his wife/assistant and thank goodness my adult Son was home! Stayed with the horse and I until he was clear.

    When it was "safe" I went and opened the back door of his stall to his paddock so he could get some air and sun because he needed to get up and not give up. We got him to raise a bit and wake up a little. He was still woozy from the meds. When he was ready he got up and was OK.

    His head hit the wall on his way down and then from the thrashing he is scraped up and his eye is swollen but OK. Suddenly he was "Ok" alert and interactive.

    The dentist felt he was OK of a mild hand float - the poor guy's mouth was a mess from LONG term neglect and he was having a difficult time eating since he has been here and is painfully under weight. The insides of his cheeks are raw and ulcerated from the hooks and ramps scrapping his cheeks inside.

    Lord how I wish I could permanently identify his allergy to this medication so it never happens too him again. His recovery is going to take several months due to his neglect but eventually he will go up for adoption. I will be sure to include this information in his paperwork - which I hope stays with him to prevent this from happening again.

    My Vet says that Anaphylactic shock from Xylazine is very very rare - But I thought i would give you all a heads up - this was SO totally unexpected!
    "If you don't know where you are going, any road will take you there"

  • #2
    What a scary experience that must have been! I'm so glad everyone is okay.
    Sarah K. Andrew | Twitter | Blog | Horses & Hope calendar | Flickr | Instagram

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    • #3
      My advice - get him a "broodmare collar" with his name and his allergy on it. A friend did that for one of her horses that was allergic to antihistamines (yeah, how do you treat THAT anaphylactic reaction???). It was on him 24/7 with the exception of when he was in the show ring. Last time I saw him (with his newest owner) he was still wearing it....
      Not all who wander are lost.

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      • #4
        This can happen when other medications are given if an artery is hit rather than a vein. Happened to my Callie when BO gave her a shot. BO freaked, but Callie got up 3x and was OK after beating her head against ground while I tried to keep it up. She'd had the same medication 2x a day for a year. it was not the medication, but the location of the shot (in artery) that caused the seizure. I've had friends and animals who had seizures, so i was calm.

        BTW Dex can cause founder in non-IR horses. Which is why Callie was on medication for a year.

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        • #5
          It's far more likely that you accidentally hit the carotid artery than the horse having an allergic reaction to xylazine. It happens (even to veterinarians, occasionally) - the carotid lies directly under the jugular vein, with a thin layer of muscle between them - so it's relatively easy to do. Fortunately, as long as the horse does not injure itself badly while thrashing, they generally recover just fine.
          ~Nancy~

          Adams Equine Wellness

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          • #6
            Originally posted by McVillesMom View Post
            It's far more likely that you accidentally hit the carotid artery than the horse having an allergic reaction to xylazine. It happens (even to veterinarians, occasionally) - the carotid lies directly under the jugular vein, with a thin layer of muscle between them - so it's relatively easy to do. Fortunately, as long as the horse does not injure itself badly while thrashing, they generally recover just fine.
            Yes. This is what happened to Callie. Grand mal seizure. Medication went to the heart and brain instead of circulating thru the veins first.

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            • #7
              Originally posted by McVillesMom View Post
              It's far more likely that you accidentally hit the carotid artery than the horse having an allergic reaction to xylazine. It happens (even to veterinarians, occasionally) - the carotid lies directly under the jugular vein, with a thin layer of muscle between them - so it's relatively easy to do. Fortunately, as long as the horse does not injure itself badly while thrashing, they generally recover just fine.
              Exactly.
              Originally posted by EquineImagined
              My subconscious is a wretched insufferable beotch.

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              • #8
                What a terrible thing to go through. I am curious as to where your injection site was?

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                • #9
                  And perhaps this is why Veterinarians are supposed to be on hand/on site if the dentist in question is not a Vet? I am glad horse survived, and can empathize with how scary this was.
                  Jeanie
                  RIP Sasha, best dog ever, pictured shortly before she died, Death either by euthanasia or natural causes is only the end of the animal inhabiting its body; I believe the spirit lives on.

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                  • #10
                    Originally posted by McVillesMom View Post
                    It's far more likely that you accidentally hit the carotid artery than the horse having an allergic reaction to xylazine. It happens (even to veterinarians, occasionally) - the carotid lies directly under the jugular vein, with a thin layer of muscle between them - so it's relatively easy to do. Fortunately, as long as the horse does not injure itself badly while thrashing, they generally recover just fine.
                    Yeah, especially if he has had xylazine in the past without problems (which most horses have, especially if they've been to the track)
                    Michael: Seems the people who burned me want me for a job.
                    Sam: A job? Does it pay?
                    Michael: Nah, it's more of a "we'll kill you if you don't do it" type of thing.
                    Sam: Oh. I've never liked those.

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                    • #11
                      As I'm understanding this article,

                      Link here:

                      http://www.thoroughbredtimes.com/hor...reactions.aspx

                      Anaphylactic shock can be caused by either immunoglobulin E-mediated (IgE-mediated) or non-immunoglobulin E-mediated (non-IgE-mediated) reactions.

                      Essentially, an incorrect route of administration for a drug (like hitting the artery), can trigger an episode of non-allergic anaphylaxis.

                      So it seems that even though an artery may possibly have been hit, it would still be anaphylactic shock....

                      So who knew? I learn something new every day...

                      Jingles for your horse OP.

                      Edited to add: I personally would probably still consider the horse allergic to Xylazine even if it was determined that an improper injection caused the reaction.
                      Last edited by alterhorse; Dec. 23, 2011, 04:25 PM.

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                      • #12
                        I am betting artery as well. Glad he is ok.
                        McDowell Racing Stables

                        Home Away From Home

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                        • #13
                          Having a seizing horse after an injection is almost certainly an injection into the carotid.

                          Just to recap, the needle should be OFF the syringe and placed into the vein all the way to the hub. You should then see a slow "drip drip drip" and that indicates you are in the jugular vein. If you see strong spurts of blood (some people have had the needle literally shoot out of the horse, as crazy as that sounds) then you are in the wrong spot, i.e. the carotid artery. If you are not a veterinarian and are giving your horse injections of any kind, please be directed on how to safely do this by your vet.

                          Some people will give intravenous injections without disconnecting the needle from the syringe. There may be a chance that you are in the carotid and do not know it.

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                          • #14
                            Originally posted by Merle View Post
                            Just to recap, the needle should be OFF the syringe and placed into the vein all the way to the hub. You should then see a slow "drip drip drip" and that indicates you are in the jugular vein. If you see strong spurts of blood (some people have had the needle literally shoot out of the horse, as crazy as that sounds) then you are in the wrong spot, i.e. the carotid artery. If you are not a veterinarian and are giving your horse injections of any kind, please be directed on how to safely do this by your vet.
                            This is how I learned how to give IV injections. One time I did get the needle in the artery and blood shot across the stall about 6 feet... VERY obvious if you're in the wrong place! Early on I was so worried about getting it wrong, but seriously, you can't mistake it doing it this way.

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                            • #15
                              Originally posted by Merle View Post
                              Having a seizing horse after an injection is almost certainly an injection into the carotid.

                              Just to recap, the needle should be OFF the syringe and placed into the vein all the way to the hub. You should then see a slow "drip drip drip" and that indicates you are in the jugular vein. If you see strong spurts of blood (some people have had the needle literally shoot out of the horse, as crazy as that sounds) then you are in the wrong spot, i.e. the carotid artery. If you are not a veterinarian and are giving your horse injections of any kind, please be directed on how to safely do this by your vet.

                              Some people will give intravenous injections without disconnecting the needle from the syringe. There may be a chance that you are in the carotid and do not know it.
                              Yup. Easy pleasy!
                              Originally posted by EquineImagined
                              My subconscious is a wretched insufferable beotch.

                              Comment


                              • #16
                                Originally posted by sdlbredfan View Post
                                And perhaps this is why Veterinarians are supposed to be on hand/on site if the dentist in question is not a Vet? I am glad horse survived, and can empathize with how scary this was.
                                Oh please oh please don't start with this again! Is the vet supposed to be on hand EVERY TIME an IV injection is given? If that was the case I'd have to have my vet move into the apartment at my farm.
                                Originally posted by EquineImagined
                                My subconscious is a wretched insufferable beotch.

                                Comment


                                • #17
                                  I hope the horse is no worse for wear today and that you aren't being too hard on yourself. I think it was a simple mistake plus a very large dose bordering on overdose. He should be ok.
                                  McDowell Racing Stables

                                  Home Away From Home

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                                  • #18
                                    Originally posted by Laurierace View Post
                                    a very large dose bordering on overdose.
                                    Really?
                                    Of course, I don't believe most owners ought to be playing with the stuff any road...
                                    "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

                                    ...just settin' on the Group W bench.

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                                    • #19
                                      Most likely IA injection.

                                      The dose was fine - prior to anesthesia some will give up to 5 mL of xylazine IV, so 2 mLs is not really a big deal.

                                      I'm going to chime in with the others - this was most likely an intracarotid injection. And while it can happen to anyone (including DVMs), if you're going to continue to administer IV medications, it might be worth a technique refresher with your DVM just to make sure you have the best chance of avoiding this.

                                      In a horse that is "painfully underweight" the muscle that lies between the jugular vein and the carotid artery would probably be as atrohpied as the rest as the rest of the other muscles and would make it more likely that you would hit the carotid.

                                      Glad to hear he recovered OK....

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                                      • #20
                                        Glad everyone is okay!
                                        Horse Show Names Free name website with over 6200 names. Want to add? PM me!

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