Banamine IM

[wsmoak]

I have a tube of banamine paste on hand because the vet is an hour away and the old horse likes to do his “I’m going to die” routine when the vet is closed. Which he did on Saturday the 1st when they were closed for the holiday and not taking emergency calls. He’s fine now.

But when I called to get another tube the message went to a different vet and they said if it’s colic they prefer the injectable over the paste in case the gut isn’t moving. I know they have given it IV when I have them out for an emergency call.

But I was aghasted when I sent my husband to pick it up and he returned with a syringe labeled to give it IM in the neck. I thought we did not DO THIS because [see horrible picture of horse with drains all up its neck] https://www.foxvalleyequine.com/risk-of-administering-banamine-intramuscularly/

Is the dosage the same if I discard the needle and squirt it under his tongue as discussed in this thread? Should I wear gloves when dealing with the liquid this way?

Administering Banamine

THIS! Reason is there is quicker absorbtion through the tissues/mucosa under the tongue AND less drug destruction from gastric fluids (if drug is swallowed) . It does taste vile, so sublingual also minimizes contact with tastebuds. ETA: Apologies @LCDR - had not read your excellent post before I chimed in. I am no pharmacologist - nor do I play one on TV - but I have tasted banamine when giving it sublingual to my 16H horse ETA#2 Will not attem…

[NaturallyHappy]

You are right- never give Banamine IM in the neck…or anywhere else, for that matter. We give 10ccs by mouth (after removing the needle😉). I usually use 12 ccs because some dribbles out. I did clear using 12 ccs w my vet.

[ThreeWishes]

Yep never IM. I haven’t heard that the paste is not preferable to the liquid. Unless you mean IV versus either sublingual liquid versus paste.

[NancyM]

Get your vet to give you a lesson in hitting the jugular vein. Give the injection IV. Works the best that way. Not difficult to learn how. Really!

[JB]

It’s been proven that liquid banamine, given orally, is as effective in about the same timeframe as IV. It doesn’t really go through the digestive process, it’s absorbed by the mucus membranes.

Even 15cc doesn’t really get swallowed much as it gets distributed around the mouth and absorbed.

[NaturallyHappy]

Yes, and it is without the danger of missing. I’ve seen vets miss on a horse who is thrashing about… I would be afraid of that mistake. I know a Standardbred trainer who routinely gives Banamine IV after a race. He nicked a nerve and now has a roarer. I know NancyM is right w respect to easy, but I’m a coward when it comes to that kind of an error.

[BigMama1]

IV injections are simple in a well behaved horse who is standing still - I used to sedate my guy every 6 weeks for the farrier. But I would not want to try it in an emergency where the horse is agitated or acting unpredictably. Oral is almost as effective and so much safer.

[2DogsFarm]

I am IV-phobic, needle abcess scares the out of me.
Sublingual is easy for me & despite the chance of nasty taste, for the horse too.

Draw up your dose, remove the needle, squirt through the space created by the bar, angled toward the base of the tongue & done!
Effective in IV time.
No gloves needed.

[wsmoak]

So… if we are all aware of this why do vets still prescribe it IM?

Sadly I think they are restricted by the labeling which only allows IV or IM in horses. And since the average owner is not going to do IV then they only have the one choice.

https://merckusa.cvpservice.com/product/basic/view/1047018

So I guess Merck just hasn’t gone back to the FDA with evidence that it works sublingually to get this changed. I’m not sure what would be involved. It’s probably not worth it to them.

[starsandsun]

Yes, just heard from my vet the other day when I reported I had Banamine for injection on site, and she said no, never, use the paste. I was surprised at how strongly she advised against any IM injections of Banamine.

[Feathered_Feet]

@wsmoak

So I guess Merck just hasn’t gone back to the FDA with evidence that it works sublingually to get this changed. I’m not sure what would be involved. It’s probably not worth it to them.

I work in drug development for a pharmaceutical company and I can tell you with 95% certainty this is exactly correct. They would have to do an equivalence study, and because vets know they can use it orally, Merck is definitely not going to spend the money (understandably, since they are probably spending it on developing other drugs for our critters)

[Incantation]

My vets recommend using it sublingually.

[JB]

@wsmoak

So… if we are all aware of this why do vets still prescribe it IM?

I don’t knoooooowwwwwww And there are vets who GIVE it IM!

@wsmoak

Sadly I think they are restricted by the labeling which only allows IV or IM in horses.

If that’s their excuse, it’s a poor one. Bute is labeled for max 14 days, but obviously vets prescribe it for longer if the situation warrants it.

[wsmoak]

@ThreeWishes

I haven’t heard that the paste is not preferable to the liquid. Unless you mean IV versus either sublingual liquid versus paste.

I believe she meant that in a bad colic when the gut isn’t working correctly, the medicine in the paste wouldn’t be effective? But if it’s absorbed via the mucosa in the stomach vs being digested then that might not make sense either.

I dunno. I will ask her the next time I’m talking to her directly. Maybe something got lost in translation between her, the office staff, and my husband.

Meanwhile I will keep my fingers crossed that the pony stays right side up and I don’t even need to use it.

[ThreeWishes]

Anhhhh that makes perfect sense. Thank you.

[JB]

@wsmoak

I believe she meant that in a bad colic when the gut isn’t working correctly, the medicine in the paste wouldn’t be effective? But if it’s absorbed via the mucosa in the stomach vs being digested then that might not make sense either.

Paste gets digested and takes longer to work.

Liquid used orally is effectively the same as liquid use IV.

All this means, is that there is zero reason to use liquid IM. I honestly can’t think of an exception to this. Thrashing horse? How are you going to stick and inject it IM anyway? Horse can’t eat or drink? Liquid just has to be squirted in the mouth to be absorbed

If there’s some weird rare reason you would do it IM, and it was that, or a dead horse, obviously, go IM. I just can’t think of how that would come into being.

[Feathered_Feet]

@JB

Bute is labeled for max 14 days, but obviously vets prescribe it for longer if the situation warrants it.

Really? I don’t see that in the label - the only reference I find for “14 days” is for blood counts in the event of monitoring for specific adverse events.

[JB]

Dang, you’re right, my mistake, it’s Equioxx that’s only labeled for 14 days.

[trubandloki]

OP, If your regular vet does not give Banamine IM, it is probably worth having a discussion with your usual vet about the fact that this vet gave you this with the instructions to give it IM. Maybe this is something that they need to discuss as a group so it does not happen to someone not in an informative horse forum to read otherwise.

[FjordBCRF]

I have spring shots tomorrow and we have a history of fever/increased respiratory rate with them. Last fall per the vets recommendation, I gave him banamine paste the night before, they gave him IM banamine before the shots, and I gave him the paste the day after. This helped A TON on the reaction side of things.

Tomorrow is the same drill. After reading about how the IM can go very wrong, couldn’t I just give him the paste again tomorrow an hour or so prior to his shots and bypass the IM route totally?

EDIT! Im a dumb dumb. We did IV last time not IM! I got my I’s mixed up in my head