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Discussion on Mestinon
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New Member:
Byron
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Posted on Monday, Dec 8, 2003 - 9:54 pm:
Our pony recently died of Acute Toxic Colitis. While in an equine hospital he was given Mestinon Tablets. I have tried to look into this but it appears Mestinon is for humans. I can not find any information about its use on horses. Can you help with any information. The pony originally broke out in allergy lumps and was given a penicillin, antihistamine and anti-inflammatory injection. Within days the pony was gravely ill with the blood work showing a count of 2 for white blood cells. In the hospital we was given fluids, plasma and antibiotics. But I was wondering about the Mestinon?
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Member:
Heidih
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Posted on Tuesday, Dec 9, 2003 - 10:49 am:
I have a friend that has a disease called Myasthenia Gravis. The only treatment for that disease is Mestinon. I've never heard of it being used for anything else. In fact I don't believe it's approved for anything else.
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Member:
Byron
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Posted on Tuesday, Dec 9, 2003 - 7:38 pm:
Thank you Heidi for replying. I live in Australia so I do not know the approval of its use here but I still cannot find any information about its use on horses. I am now really curious as to why it was given. The whole experience of this pony's death has really affected me, I feel traumatised and guilty. I still have many unanswered questions.
After being in the Hospital for about 5 days the pony shed his bowel lining, it was about 2 feet long and was green (this was very disturbing for me)I still cannot believe my little man went through this. I wanted to try and save him and he wanted to live but it was awful.
The vet said she had never seen a live horse pass its bowel lining like that. My question is should they have cultured this or kept it? They just threw it away and to this day I still do not know what sort of infection it was. They presumed clostridium or salmonella induced by the penicillin.
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Member:
Mrose
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Posted on Tuesday, Dec 9, 2003 - 8:04 pm:
Oh, Janet, my sympathy to you. This sound awful. I've never even heard of Mestinon so I'm no help, but I"m sorry you and your pony had to go through this. Please don't feel guilty. You did the best that you could. That's all that anyone, including your pony, could ask.
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Moderator:
DrO
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Posted on Wednesday, Dec 10, 2003 - 6:44 am:
My condolences Janet. Are you sure you have the name correct or perhaps this is a compounded name for another drug? I am wondering if perhaps your horse was given metronidazole, a common therapy for potential clostridial colitis.
As already stated this is a human drug used to treat MG and I have not heard of its use in horses and cannot understand why it might be given to a acute colitis case. To clear this up you need to ask the clinic about this: what was given and why was it given.
Laboratory examination of the passed intestinal cast may have helped with understanding what exactly caused this but I don't think it would have changed the outcome of the case.
DrO
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Member:
Byron
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Posted on Wednesday, Dec 10, 2003 - 8:03 am:
Thank you Dr. O for your reply.
The pony was definitely given Mestinon 10mg Tablets. They have even included this on the invoice and I remember seeing the container. He was also given Metronidazole Paste, Lignocaine, Flunix, Gentamicin, Procaine Penicillin, Vitamin injections, minject 4 in 1, Dextran 70 and 10 units of plasma.
I don't really understand all of this, I am only going by what I was invoiced. They did not give me a report of any kind and I do not feel comfortable talking with them. While the pony was being treated I feel the vet was frustrated with me and the questions I was asking at the time. She even snapped at me once when I asked about the culture and I only asked because my sister wanted to know what type of clostridium or salmonella they suspected it was.
I am still very emotional and hurt. I need to give myself some time, strength and knowledge before I can address this with them.
My sister is a scientist and has explained a few things to me, but she is also confused by all the different types of treatment. She explained that the feces culture may never grow due to the antibiotics and the changes to the cells. This all goes over my head.
The only reason why I became curious about the Mestinon is because when one of the other vets attended him I asked if he had given the Mestinon because I was worried after the last time and he said "no - the stuff is deadly". But from the invoice it appears that he was still given it at different times.
Any more information about this would be appreciated.
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Member:
Byron
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Posted on Wednesday, Dec 10, 2003 - 9:26 am:
Thank you Sara.
I don't understand why a perfectly happy and healthy pony that just came up in lumps - then dies.
We have two ponies and both came up in identical lumps or hives. Some were about the size of a 50 cent piece. They were soft and irregular shapes. They started down the back bone, on the flanks and shoulders. The pony that died also had some on his face. The front of his face the area between the eyes and down to the nostrils was swollen. I had the vet come out and he treated the pony that died and he was going to give the other pony a penicillin injection but I asked him not to because we wanted to do a show with him and the penicillin can swab. So the other pony was not treated and is alive. I know this is just the way it can work sometimes but I still feel that if he had not been treated he may be alive now.
I have also now become insecure about the other pony and have had my vet out 4 times within 2 weeks. I have had 3 blood tests and all are within normal ranges. My vets are a little concerned for me. They are wonderful. My own vet was not the one that originally came out to treat the ponies for lumps unfortunatley.
I could not contact them so rang and emergency call out for another vet.
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Member:
Paul303
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Posted on Wednesday, Dec 10, 2003 - 7:19 pm:
I, too, am sorry to read your story, Janet.
I also don't know why your pony was given Mestinon. My mother was diagnosed with Myasthenia Gravis in 1944, and lived with it until she died in 1996. I know the disease well. It is an autoimmune disease that attacks the body's receptor's for acetylcholine, a substance that enables the nervous system to transmit the impulse for movement to the muscle and translate it to actual movement. When the body's immune system mis-identifies the acetylcholine receptors and attacks and destroys them, the acetylcholine has no transport mechanism ( receptors ) to take it where it needs to go. Mestinon, allows the acetylcholine to remain longer, so that any receptors available will have an immediate supply of acetylcholine to hook up with quickly, and move the acetlycholine to it's destination.
In humans, Mestinon has some side effects. Increased secretions - some Myasthenics have a rough time coughing and clearing excess secretions. This is rough during an URI, and my mother had to watch carefully for pneumonia. Especially since many medications do not mix well with Mestinon.
Nausea and vomiting - My mother never took Mestinon without food. When she left the house, there was always food and mestinon in her purse.
Muscle weakness - usually due to improper amount of Mestinon in system....amazingly, too much has much the same effect as too little. There can be a delicate balance - especially in brittle myasthenics.
Abdominal cramps and diarrhea.
Not a pretty medication, but the alternative is the inability to move.
I don't know what went on with your pony, but your actions were exactly right. I don't know what more you could have done. Right now, stop torturing yourself with what went wrong and comfort yourself with all that went right over the time you owned your pony.
Keep a close watch out for whatever caused those hives in the first place.
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Member:
Byron
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Posted on Thursday, Dec 11, 2003 - 9:25 am:
Thank you Elizabeth for your reply.
Yes I am a bit puzzled.
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Member:
Heidih
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Posted on Thursday, Dec 11, 2003 - 11:12 am:
Hello again Janet,
I'm so sorry about what your pony went through. It sounds as if you did your best for your guy. You have my deepest sympathy.
I wish I could tell you what the Mestinon was for but I can't find any info on it's use in animals.
I've done a little bit of research on Mestinon. I work for a major pharmaceutical company, so I have access to some databases on drugs. I cannot find any list that shows Mestinon as being approved for use in animals. I have access to US and European databases but I don't have access to Australian information. If you want to search out answers, you might try contacting your country's Food and Drug agency. I know in the us it's the FDA and in Europe, each country has their own regulating body, so the Australian government most likely has an agency that could answer some of your questions.
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Member:
Byron
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Posted on Friday, Dec 12, 2003 - 7:46 am:
Thank you Heidi,
I contacted the Veterinary Board. Their response was that they do not provide veterinary advice but suggested I contact the manufacturer or the racing organisations. Following that, they suggest if I feel the wish to have the issue investigated by the Board I can obtain information about lodging a complaint on the Board's website.
I am actually starting to feel a bit guilty or that maybe I am over dramatizing this. Even a friend suggested that maybe they were just trying something as a last resort but I basically just want to find out if any other horse has ever been given this drug and why.
They might even be wandering!
I know I should probably just contact the equine hospital the pony was at but I think I would probably just end up crying on the phone.
I imagined I would just be able to find this information out to be quite simple - not.
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Member:
Byron
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Posted on Monday, Dec 22, 2003 - 10:15 am:
Just an update on the Mestinon.
I spoke to the manufacture and they have no knowledge/research about the use of the drug on animals and suggested I speak to the Australian Veterinary Association.
Maybe there are no regulations on drugs that can be given to horses!
Thank you Heidi and Elizabeth for your information.
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Member:
Paul303
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Posted on Monday, Dec 22, 2003 - 10:25 pm:
No thanks necessary, Janet, but if you ever do discover what the rational for the Mestinon was, I'd love to know.
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Member:
Byron
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Posted on Sunday, Jan 11, 2004 - 10:56 pm:
Dr. O.,
I finally built up enough nerve to ring the vet that attended the pony and ask politely why the penicillin was used. He said, it was used incase of any secondary infection. He also said he was shocked to here about the pony and that he showed no signs of colitis. (This confused me, because as far as I was made aware the penicillin given would have caused the toxic colitis.)
He also mentioned that you cannot look at every little pony with a few lumps and think colitis.
There was many other questions I wanted to ask but did not. I felt he was a little taken back when I asked about why the penicillin was given.
Anyway, I knew there would be some broad range of an answer.
After many phone calls to vets, vet associations, etc. I still have no answer on the mestinon. The only thing I can find out is that unregistered drugs are often used in horses or other non trade animals. This I can understand but I would still like to know if there has ever been any other horse given this drug before. It appears that mine may have been the only one.
I just get the feeling that no one wants to no about this one.
There seems to be no where to go from here but thank you for helping.
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Member:
Byron
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Posted on Friday, Apr 23, 2004 - 10:51 am:
Dr. O.,
I was wondering if you could give me any information that you know in the use of mestinon on horses or of someone that can answer my question.
A few months ago I wrote a letter to the clinic that treated our pony for colitis requesting why this drug was used and if it had ever been used on a horse before.
They wrote back saying the drug was used to relieve his bloat and that they dont have any research on the use of Mestinon in the treatment of horses suffering colitis. But it was used primarily on the clinical expertise and experience of the clinician involved.
They also mentioned that it is not registered for use in horses but nor are many other drugs which can be beneficial for treatment.
I cannot understand how they can use this drug.
1. Without my permission.
2. Without any known research.
Can you please help me find out information about the use of this drug on horses.
Thanks.
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Member:
Byron
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Posted on Monday, Apr 26, 2004 - 11:32 am:
Dr. O.,
Can you suggest a book or specialist in Equine Medicine that I can refer to regarding the Mestinon (pyridostigmine bromide).
Any help would be appreciated.
Thanks.
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Moderator:
DrO
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Posted on Tuesday, Apr 27, 2004 - 8:58 am:
Janet I can find no references to the use of this drug in horses, nor do I know anyone doing equine research with it. Many drugs we use in horses are not approved for the species, it is just too costly for the drug companies to do it so we learn through trial and error. I would speak with the veterinarian you actually administered the drug as to the logic in the decision.
DrO
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