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  Discussion on Ivan injury - need Augmentin dosing
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Member:
36541

Posted on Sunday, Sep 19, 2004 - 12:51 pm:

Hi Dr. O.
I was on the eyewall of Ivan and a yearling went into the fence, scratching her front pastern up badly, but nothing stitchable, just as the storm hit. We made it through OK but are pretty much shut down with respect to services. Now 4 days out, she has swelling and heat in the posterior pastern, no definite fluid to drain off. I soaked her in Epsom for 20 min and would like to give her a dose of Augmentin since that is what I have lots of. She is afebrile, I can't get a vet out to her for two days. If you think this reasonable, what is the mg-kg dosing? Thanks, Stacy
Moderator:
DrO

Posted on Monday, Sep 20, 2004 - 8:30 am:

Hello Stacy,
There are no safety or efficacy studies of Augmentin in horses. In general amoxicillin is not considered as a good therapeutic agent when administired IV or IM because of rapid elimination. The slower uptake from the GI tract might further lower therapeutic efficacy.

Without fever and other signs than the swelling it is uncertain that infection is a problem: is this pastern growing more painful?
DrO
Member:
36541

Posted on Monday, Sep 20, 2004 - 10:43 am:

There was odor and heat yesterday, but both are better after the soak. She is a little less lame today so I think I will repeat the Epsom soak twice today and let her keep moving around. I have had an experience with another youngster who got septic tenosynovitis from scratches like this, so that was my thinking with the antibiotic. Good to know not to waste the expensive human meds this time!! Thanks, Stacy
Moderator:
DrO

Posted on Tuesday, Sep 21, 2004 - 6:15 am:

It is not the scratches that created a septic tenosynovitis: there was a very small deep puncture that introduce bacteria into the synovial sheath. And that is always a possibility with a wound. The fact that you have significant lameness, something you did not put in your first post, is very important and I don't like the fact there is a odor. Was the horse lame from the initial wound or did he acquire it several days later?

One thing I would avoid is "soaking the wounds on the pastern". To soak them you have to put the foot is a bucket of water so you contamnate those wounds with whatever is on the bottom of the feet and the Epsoms alone is not antiseptic.

If I could not hose the wounds, I presume water under pressure is not available. I would be polticing the wounds with either betadine ointment, nolvasan creme, or neosporin instead. Change the bandages and poltice daily.

If after evaluation you think you have infection that is not draining well you should find some antibiotic, perhaps trimetoprim sulfa or penicillin injections.
DrO
Member:
36541

Posted on Tuesday, Sep 21, 2004 - 7:58 am:

Yes, the filly was quite lame just after the injury(maybe an hour?). I had been watching them through the hole in the plywood as the winds approached 100mph, so I had a sense of the time. First she was sound, then obviously limping. I went out to see her(idiot!) from the fenceline, to see if any of her limbs were broken beyond repair, but had no way to bring her in or to bandage what appeared to be just moderate scratches on the back of the right front pastern. There was no safe way to treat her Thursday either, as the winds were still howling and the barn had been deroofed, but at that point she was not lame. There was still all that adrenaline for both of us, and I considered her soundness might be false, but still had limited options. At this point - the soaks have Betadine, then the foot is slathered with NFZ, bandages at all not an option due to a lot of standing water. Last night I started her on Penicillin IM as there was still a slight odor from the crusted drainage on the scratches, and she was still a little off. There is a moderate effusion in the pastern, but I am unable to get it draining. We're on the vet's call list for tomorrow, will keep you posted... Thanks, Stacy
Member:
36541

Posted on Tuesday, Sep 21, 2004 - 8:03 am:

Have to mention, just for the humor, that I am 39 weeks pregnant at this point and made it through the hurricane more worried about the horses than the possibility of precipitous delivery!! BTW, where do you get the livestock sticks? My spray paint didn't last the first 8 hours of the storm, but it was pretty impressive at first! My non-horse husband watched the decorated herd canter off and started with his equine version of "you might be a redneck if..."
Member:
Jojo15

Posted on Tuesday, Sep 21, 2004 - 9:59 am:

Hi there,
I hope your horse comes out ok from all this. Is it still bad up there? I just stopped feeding my mare from the garage and moved her stuff back into her shed.

I got the sticks at my feed store. If there is a farm/feed store in your area try them. Or a tractor supply store. More refined tack feed shops might not have them. Buy them now for next time. they last for ever. And make sure you wash, groom, curry before applying, going against the grain of the hair...

My neighbor gave birth to her son during a hurricane five years ago. You're lucky you didn't go into labor.

jojo
Member:
36541

Posted on Sunday, Sep 26, 2004 - 11:43 pm:

Hello to all, thanks for the help jojo. Things here are slowly getting back on line, although not for my parents who live in the Orange Beach area. Still NO BABY for me - waiting for the barometric pressure to DrOp again or the moon to wax full?! The filly's pastern has turned in the right direction with only the small effusion now, no heat or lameness. I did four days on penicillin IM once the vet and I could get together and am continuing the Uniprim for a 10 day course. Let's have a toast for the approaching end of the hurricane season! Stacy
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