Saturday, January 23, 2010

Take Two Aspirin and Call me in the Morning: How to Administer Medications to your Horse

By: Darlene M. Cox (

Many who have had a sick or injured horse know that the fun really begins after the vet leaves, because then it is up to you to administer the prescribed medications to your horse. Giving the meds looked quite easy when the vet did it, you muse to yourself, surely I can do it without all those years of extra training. What may seem a daunting task can be accomplished with little to no fuss, once you learn how to properly administer the drugs.

Medications come in many forms: powders, pastes, pills, liquids, injections, etc., and their applications may be varied. Before your vet leaves the barn, make sure you have specific instructions and an understanding of dosage amounts, time between doses, duration of medication therapy, drug storage requirements, etc. If the medication is in the form of pills or capsules, ask if the pills can be ground up or removed from the capsule and mixed with water and placed in a syringe or sprinkled over food. Some pills or capsules may require being administered whole, specifically if they work on a time-release which means they are designed to dissolve in a certain part of the body (stomach, intestines) or at a particular rate of absorption. Crushing the pill or removing the powdered drug from the capsule may prevent the medication from working as it was designed. Also, adding acidic agents (e.g., applesauce) may affect the efficacy of the medication. Therefore, it is always best to ask the vet if such methods can be employed. Some medications may require refrigeration or be kept out of direct light to maintain their healing properties.

Oral Dosing

Oral dosing of medications can be accomplished in varied ways. Resourcefulness does pay out at times when you have a horse that is finicky about taking his meds.

The first and foremost basic method of administering pills to a horse is to dose by hand; however, this will require a willing horse. If your horse is having none of it, all you will end up with is a horse-slobbered hand and a mushy pill that bears no resemblance to what it looked like when it came out of the bottle. Make sure you are in a space with ample room to allow for movement should your horse thrash his head a bit or you need to make a safe exit.

Provided your horse is a good patient, utilize the following steps to hand-administer pills:

· Attach a lead rope to your horse (cross ties work well, too) and stand beside him, facing him.
· Insert your fingers at the bars of his mouth and coax his mouth open.
· After he opens his mouth, grab his tongue with one hand and hold it securely while gently pulling it out the side of his mouth. Gentle pressure will allow the movement of his tongue outside of his mouth, which will also cause him to open his mouth wide.
· With the pill in your opposite hand, place it as far back on his tongue as you can, but do not place it in his throat.
· After pill placement, quickly release his tongue and raise his head parallel to the ground. The release of his tongue will trigger him to swallow, while the raising of his head will prevent him from spitting the pill out.

A balling gun, which is an instrument specifically designed to administer pills to large animals (cattle, mostly) can also be used to dose pills. A balling gun is a simply designed tube that is fitted with a plunger. Simply place the pill on the end of the tube and follow the above method to open your horse’s mouth (you don’t necessarily need to pull the tongue out, but I think it better aids swallowing), inserting the tube to the base of the tongue (do not place tube in the throat, as injury may result), depress the plunger and dispense the pill on the back of the tongue. Simultaneously, remove the balling gun while lifting the horse’s head parallel to the ground.

Sometimes, dosing requirements involve quite a number of pills to be given, and you may find your horse’s patience wearing thin when you have to give him 12 or 14 pills two or three times a day. If this is the case and the medication is one (upon your vet’s approval) that can be ground into a powder, dosing can be accomplished by mixing the powdered drug into his feed. For finicky eaters, who can discern the taste of the new addition, you can mix the meds in applesauce, yogurt, wet beet pulp, maple syrup, or just about any kind of “treat” your horse has a taste for.

Some horses may refuse medicinally-laced treats, which would require you to resort to one last option of dosing with a syringe. Providing the pills can be powdered, grind them into a fine powder, place the powder in a bowl/cup, and add a small amount of warm water to dissolve the drug into a soupy (not watery) solution, which can then be transferred into a large syringe. Use the largest size syringe that you can adequately hold and control with one hand. You can add a bit of cherry or strawberry Jell-O powder to this for flavoring if needed. Ready your syringe, by removing the plunger from the barrel. Cover the barrel tip with a thumb or finger, and carefully, pour the dissolved medication into the barrel (minus the needle), making sure that all of the medicine is out of the bowl/cup.

Just as you would hand dose your horse with a paste wormer, do the following:

· Stand beside your horse, and in front of him
· Open his mouth, by placing the fingers of one hand against the bars of his mouth
· Once his mouth is open, carefully insert the syringe with the barrel point angled down and back, dispensing the medication on the back of the tongue (do not insert the syringe into the throat)
· Once the syringe is empty, simultaneously remove the syringe while lifting the horse’s head parallel to the ground
· Wash the cup/bowl and syringe with warm, soapy water prior to their next use

Injectable Medications

Some forms of medications must be injected into the horse’s body. Of these drugs, some require different injection types. These types are:

· Intravenous – injections into a vein
· Subcutaneous – injections under the skin
· Intradermal – injections into the skin
· Intramuscular (IM) – injections into large muscles

The most widely used method of injectable medications are administered IM, into the large muscle masses located near the base of a horse’s neck, the pectoral (chest) muscle, or the buttocks. I defer to the professional training of my veterinarian to administer any injections that must be given into a vein.

A word of precaution is warranted about possible risks when administering injections. Some horses are “needle shy” and may defensively react when they see and/or smell the syringe and medication. Always be aware of your horse’s demeanor and reaction to needles and make sure that you are in an area that allows for free movement and provides you an escape route to move away from your horse if he has a fearful response. If you are unsure of how your horse may react, do not tie him as he may panic further and increase the chances of injuring himself or you. It may be ideal if you have someone to assist you, but this is not always possible. If you have to perform this injection alone, place a lead rope on your horse. In the event of a fearful reaction, move with your horse until he calms down and then continue with the injection. If your horse tries to kick, pull his head to you, as this will move his hindquarters away from you. Some horses (and I have had one or two) are so terrified of needles that they must be “neck rolled” or have a twitch placed on their lip to give them something else to think about, which will allow you the time to administer the injection.

Just as there are needle shy horses, there are “needle shy” owners, who aren’t quite comfortable piercing their horse’s skin with a needle. If you fit within this category, practice the injection procedure first on a piece of citrus fruit (orange or grapefruit). The thickness and feel of the needle piercing the rind of the fruit is somewhat similar to the feel of the needle being placed into the horse’s muscle. It is no treat to the horse to have repeated preemptive hesitancy “sticks” of the needle, as his owner builds the courage to correctly place the needle. If, after practicing needle sticks on the fruit, you remain uncomfortable with giving the injection, please find a competent horse friend who can do this.

Always confer with your vet to make sure you have the right type of syringe and needles for the medications prescribed. Ideally, thick meds like penicillin are more easily injected through an 18-gauge needle, while a 20-to-21 gauge needle can be used for watery medications, such as gentamicin.

Regardless of the muscle group into which the medication is being injected, always clean the injection site of visible dirt and scrub it with an antiseptic soap, which works much better than alcohol or betadine. If the area is particularly hairy, you may want to shave the area first. Any needle passing from the skin surface into the muscle can carry harmful bacteria into the body. When choosing your injection site, it is best to inject the drug low into the muscle. There is always some risk for the development of an injection site abscess. If an abscess does occur, it will drain much better from a lower point as opposed to a higher point.

Once the injection site has been prepped, follow the basic steps below to administer the injection:

· Uncap the needle and place needle in bottle, pulling back on the syringe plunger to dispense the prescribed dose of medication into the barrel. Retain the cap in a place that it can be easily retrieved.
· Remove needle from bottle and gently depress plunger to remove air from the barrel.
· Grasp the needle at the hub and remove it from the syringe barrel.
· Positioning yourself appropriately near the horse and the selected injection site, insert the needle, with a quick and decisive movement, straight into the skin (perpendicularly) until you reach the hub. (Note: inserting the needle while it is detached from the syringe will protect you from accidental needle sticks and injection of the medication into your body.) Other methods include pinching the skin up and then inserting the needle, but I feel this doesn’t position the needle as deep into the muscle as it needs to go.
· Attach the needle to the hub (syringe).
· Gently pull back on the plunger to check for any aspirated blood return into the barrel. (Warning: Blood return indicates the needle is positioned in a vein and not the muscle. Do not inject! Some meds, such as penicillin, will kill a horse if it is injected straight into a vein.)
· If blood return is noted, gently pull up on the needle, while it remains in the muscle and move it over a small bit, and push down to reposition in the muscle. Pull back again on the plunger and check for blood return). If no blood return is noted, slowly dispense the medication into the muscle.
· After all meds are injected, remove the needle with one continuous motion, pulling the needle and syringe from the muscle and skin.
· Carefully recap the needle. Set syringe safely aside.
· Gently knead the injection site area to assist with breaking up the medication within the muscle for quicker absorption.
· Properly dispose of the needle and syringe.

If multiple injections must be given over the course of several days, alternate injection sites and sides to prevent soreness. Inspect injection sites repeatedly for signs of abscess for 48-hours post injection. If an abscess (heat, swelling, redness, pain) results from injection, consult your vet for proper treatment (antibiotic pills, salves, etc.)

If more than one injectable medicine is prescribed, use different syringes for each injection. Do not use the same syringe, because mixing the medications may cause a bad reaction.

After all is said and done, offer your horse a pat and a hug of encouragement and thank him for being a good patient. And, as you head to the house congratulate yourself on being a good horse doctor!

Happy trails!

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