One of the things that makes practicing equine medicine unique is the frequency with which horse owners may be expected to give injections to their horses. Sometimes horses require medication for certain conditions for several days; sometimes medication needs are ongoing. For some obvious reasons, most horse owners aren’t keen to pay their veterinarians to come out simply to give their horse a shot day after day (and busy veterinarians may find it difficult to make time to do so). As a result, it’s not at all uncommon for horse owners to be asked to assist in administering medications to their horses,
While there are lots of different ways to give medications to horses, giving medicine to a horse isn’t always easy, particularly when they have to be administered by injection. Fortunately, learning how to give injections is not the most daunting challenge and it’s something that can be fairly quickly learned if one has the inclination. However, regardless of one’s best intentions there are two facts that persist:
- Some people don’t like to give injections and don’t particularly like needles
- Some horses don’t like to get injections and don’t particularly like needles
ASIDE: Honestly, I’m generally amazed that horses ever let people stick them with needles, but that speaks mostly to the wonderful, tolerant nature of most horses.
Anyway, sometimes the combination of horse and owner fear of needles gets a bit overwhelming (for both), and, in some cases, it can even mean that horses may not get prescribed medications.
NOTE: When I was in veterinary school, one of my professors told me that 50% of the medication prescribed by a veterinarian will never be given. I didn’t believe him then, thinking, “If somebody pays for medicine, they’re surely going to give it to the animal that they love.” Nope. I was wrong. Fortunately, horses tend to want to get better anyway, in spite of not receiving their medications.
ANOTHER NOTE: The overwhelming, extreme fear of medical procedures that involve needles is call Trypanophobia (trih-PAN-o-foe-bee-uh). Take that with you to Trivia Night.
Happily, there may be a solution, at least in some circumstances. Turns out that a number of medications intended for intravenous or intramuscular injection in the horse are effective when administered orally. Otherwise stated, “If you can’t stick it in the vein or muscle, you can squirt it in their mouth.” While this isn’t written on the labels (perhaps understandably, the drug companies don’t want to pay to test for every possible route of administration when they’ve already paid to show that a couple of them will work), other folks have done testing and published the results in scientific journals. As a result, in some cases, a needle-shy person may still be able to give a needed medication to a needle-shy horse: by mouth.
DISCLAIMER: You shouldn’t go about squirting medication into your horse willy-nilly. You should really only give your horse medication if he needs medication, and then only after consulting with your veterinarian: not only about what to give, but also how to give it.
WHY ORAL?
The oral route of drug administration offers horse owners several advantages over intravenous and intramuscular routes of administration. As I mentioned, many horses aggressively resent needles (as in, bite, kick, strike, run away etc.). So, for many horses, the oral route of administration is not only non-invasive, it may also be safer. For many horses – although there are certainly exceptions – oral routes of administration may also be easier administer. Another thing is that the injectable products are usually less expensive and you might be able to get more bang for your therapeutic buck. Lastly – and I think this is a really important advantage – orally administered medications don’t have to be sterile, mostly because nothing that the horse puts in his mouth is sterile anyway.
Of course, there are also disadvantages to trying to give horses medicine in their mouths. For one, you probably never realized just how high a horse can lift his head until you’ve tried to give an oral medication to a horse that resents it. More practically, when you give a drug by mouth, the absorption of the drug can be a bit less predictable, to factors such as how well the gut is moving (gastrointestinal motility) or whether or not there’s food in the gut. Lastly, in general, drugs given orally work more slowly than those given by IV or IM routes, but that’s not necessarily a problem as long as they medication gets in the horse.
Let’s looks at a few common substances that can be given in the horse’s mouth, even though the bottle on the label says that they should be injected.
DEXAMETHASONE
Dexamethasone is a cortiocosteroid medication that’s used to treat many different problems in horses, including allergies and conditions where inflammation is a prominent feature. In horses with equine asthma (also known as “heaves”), IV dexamethasone has been shown to have a rapid onset of action and help horses breathe. But at a slightly higher dose, the same dexamethasone solution when given orally was just as good as when it was given IV. In addition, orally administered dexamethasone lasted longer. The study also showed that oral treatment was more effective when the horses were fasted first. CLICK HERE to see the study.
KETOPROFEN
Ketoprofen is one of many non-steroidal anti-inflammatory drugs that is sometimes used for treatment of pain an inflammation associated with musculoskeletal problems, especially in performance horses. The injectable compound has been shown to be well-absorbed orally. However, if you’re giving oral ketoprofen to a show horse (where, in my experience, it’s most commonly given, mostly due to expense), you should be aware that the withdrawal and restricted administration times may be longer when the injectable product is given orally. CLICK HERE to see the study.
ACEPROMAZINE
Acepromazine (“ace”) is a tranquilizer. It was used in humans during the 1950s as an antipsychotic medication, but its use in human medicine has long since been replaced by more effective medications. Ace is now almost exclusively used on horses as a mild sedative. For example, ace is often used for cleaning the sheath of geldings because it not only sedates the horse, but it also relaxes the penis, causes it to drop, and makes it somewhat easier (albeit no less disgusting) to clean. Believe it or not, for as long as it’s been used, the exact way that ace works is still not known. Nevertheless, in an experimental trial where effectiveness was based on measuring the distance from the horse’s chin to the ground, sedative effects were noted by 15 min following oral administration of the IV product, and no adverse effects were noted. Sedation lasted approximately 2 hours. CLICK HERE to see the study.
NOTE: I want to repeat that you shouldn’t give any drug to your horse, including ace, without talking to your veterinarian first. For example, in the case of ace, there’s a rarely reported side effect of penile paralysis following administration.
FLUNIXIN MEGLUMINE
Flunixin meglumine (more commonly known as Banamine®), has been shown to have anti-inflammatory, antiendotoxic, and mild pain-relieving properties in horses. It is commonly administered for treatment of horses with colic, probably because of a really effective advertising effort when the product was released in the 1980’s. You can get Banamine® is many different formulations: oral granules, oral paste, and, of course, liquid for injection. Oral administration of the injectable flunixin solution has been shown to be a reasonable alternative to oral granules or paste formulations. CLICK HERE to read the study.
DETOMODINE
Detomomdine, most commonly sold as Dormosedan® is another commonly administered tranquilizer, with sedatives and analgesic effects. It’s much more potent than acepromazine and its a very effective pain reliever if horses have colic. Detomidine solution, alone or mixed with either of two commonly available food items and given orally produced a profound head droop in treated horses in approximately 45 minutes. There’s now a paste that can be given orally, as well. CLICK HERE to read the study.
CONCLUSIONS
I don’t want you to walk away from this article thinking, “Oh great, now I can go give my horse a bunch of medication more easily!” The fact is that while there may be many possible routes by which drugs can be administered to a horse, there are not necessarily any easy ones. Some horses will balk at the idea of a paste put in their mouths, sift through a pile of grain to get every kernel, leaving a pile of drug powder at the bottom of the bucket, or bite, strike, or kick when approached with a needle. However, if your horse has been prescribed one of the above medications, and you don’t like the idea of sticking a needle in your horse – or, if your horse doesn’t like getting stuck with needles – good clinical research does give you some options. If your veterinarian recommends one of them, and you don’t want to inject him with a needle, ask him or her about just squirting stuff in your horse’s mouth. It might make life easier for everybody.
