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Mary H. Schultz
Member
Username: Chip
Post Number: 42
Registered: 11-2000
| | Posted on Wednesday, Sep 22, 2004 - 5:17 pm: |   |
Dear Dr. O,
I have started giving my horse Adequan injections. The vet showed me initially and I read your article – good info. I have just a few questions – more out of curiosity than anything else so this isn’t an urgent issue.
The article mentions using multiple sites to limit the volume injected at any one site to 10 – 15 ml. At 5 ml (Adequan), that’s no problem. However, I had wondered if there is any benefit (or detriment?) to gently pulling the need out as the plunger is pushed in to avoid putting an X ml size ‘pocket’ in the muscle. Or, is it better to deliver the entire volume to the deepest site the needle can reach?
When I take the needle out of the horse, I bend the metal needle, jam on the original plastic cover and then trash it. I guess I don’t like the idea of the needle being “in the trash” for kids to find or as a hazard to the trashmen. Anyway, I pricked myself the last time I did that. Nothing extremely deep, but enough so that a drop of blood was visible. Now, I guess if I was in the medical profession treating humans, that sort of thing might be alarming – depending on patient history. I’m wondering what, if any, are the issues concerning accidental needle pricks when dealing with a different species.
Thanks,
MaryS
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Robert N. Oglesby DVM
Moderator
Username: Dro
Post Number: 11235
Registered: 1-1997
| | Posted on Thursday, Sep 23, 2004 - 8:47 am: | |
Hello Mary,
Boy I can tell your mind is working overtime on this one.  Pulling the needle is contraindicated: this is a IM injection that you check by pulling back before injecting. To get to this place you most certainly passed through a small vessel or two. As you withdraw you cannot control whether the medication enters a vessel.
This is a excellent question. It is unlikely enough medication would be injected to cause a problem but if uncertainty exists this should always be confirmed with a doctor.
We call a disease that is transferred from animals to humans a zoonosis. Which potential diseases you are exposed to depends on the specie so let's confine ourselves to horses. Risk also depends on the health of the individual pricked: a immunocompromised individual would be far more susceptible to pathogens so would need to be evaluated by his doctor whenever such an event occurs.
Next, lets differentiate the healthy horse from the sick horse. Off the top of my head I cannot think of a zoonosis that a healthy horse is likely to transmit through such a exposure. Of course there are the pathogens (streps and staphs mostly) on the horse's skin and your skin that may contaminate the needle and wound. On the other hand a sick, particularly febrile, horse may in a tiny number of cases represent a real threat:
Lancet. 1997 Jan 11;349(9045):93-5.
Fatal encephalitis due to novel paramyxovirus transmitted from horses.
O'Sullivan JD, Allworth AM, Paterson DL, Snow TM, Boots R, Gleeson LJ, Gould AR, Hyatt AD, Bradfield J.
Department of Neurology, Royal Brisbane Hospital, Herston, Queensland, Australia.
BACKGROUND: In September, 1994, an outbreak of severe respiratory disease affected 18 horses, their trainer, and a stablehand in Queensland, Australia. Fourteen horses and one human being died. A novel virus was isolated from those affected and named equine morbillivirus (EMV). We report a case of encephalitis caused by this virus. FINDINGS: A 35-year-old man from Queensland had a brief aseptic meningitic illness in August, 1994, shortly after caring for two horses that died from EMV infection and then assisting at their necropsies. He then suffered severe encephalitis 13 months later, characterised by uncontrolled focal and generalised epileptic activity. Rising titres of neutralising antibodies to EMV in the patient's serum at the time of the second illness suggested an anamnestic response. Distinctive cortical changes were shown on magnetic resonance neuroimaging and histopathological examination of the brain at necropsy. Immunohistochemistry and electronmicroscopy of brain tissue revealed pathology characteristic of the earlier cases of EMV infection. PCR on cerebrospinal fluid taken during the second illness, brain tissue, and serum retained from the original illness resulted in an amplified product identical to that previously described from EMV. INTERPRETATION: The results of serology, PCR, electronmicroscopy, and immunohistochemistry strongly suggest that EMV was the cause of this patient's encephalitis, and that exposure to the virus occurred 3 months before the fatal illness.
The great majority of infectious diseases of horses are not known zoonosis. I did run a search and came up with these possibilities I list below. I have not reviewed these for current accuracy. Other than the case I present above I don't see any other cases of serious human disease caused by direct contact with horses and the most common report of direct transmission is ring worm (various species).
Venezuelan Equine Encephalitis
Salmonellosis
Tetanus
Larva Migrans Nematosa
Q Fever
Vesicular Stomatitis Virus
Anthrax
Dermatophytoses (Ring Worm)
Pseudomonas Species
Chlamydiasis
Onchocerca
Dermatophilosis
Echinococcus Granulosus
Streptococci
Toxoplasma Gondii
Rickettsia Conori And Coxiella Burnetii
Anthrax
Leptospirae
Fasciola Hepatica
Streptococcus
Trichinellosis
Equine Morbillivirus
Giardia
Cryptosporidium
Rabies
Cryptosporidiosis
Glanders
DrO
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Mary H. Schultz
Member
Username: Chip
Post Number: 43
Registered: 11-2000
| | Posted on Monday, Sep 27, 2004 - 1:28 pm: | |
Dr. O,
Thanks for the very complete information. Its not the first time I've been told I'm over-thinking things  - but hey, you gotta do something with your brain while your stuck in traffic, right?
Very interesting on the zoonosis topic. Fortunately the horse and I are both healthy so no problems there ... but still a good reminder to practice safe procedures when doing stuff like this.
Thanks again,
Mary |
