Equine injury, Excede antibiotic, side effects warning

This post is about an injury, the treatment and after effects, finally the release of life. I don’t know for certain what the issues really were even tho I was right there but not in view when the injury occurred. Was it the injury or was it the Excede antibiotic? We’ll never know. Here is my story… and after 10 months I researched the meds and found others experiences with Excede – posted at the end.

3-26-18 HEARTBREAKING UPDATE: I discovered some information that research is providing strong backing for. The morning Shanti was injured, the vet gave her a shot of the antibiotic Excede. 4 days later, the follow up shot was given. That is when horrendous events started – edema, infection, whole body filled with air, etc. Fully documented and photographed and shared with my veterinarian. The trainer who alerted me to this drug Excede, shared her past week’s experience with me. Shame on me for not doing research, but it was an emergency – there was no pre-thought – only trust that vets know best.
Educate yourself on this medication.
Excede was introduced in 2010 and through research – there are MANY stories of horses dying or barely coming out of it alive… The reaction has been called ‘an allergic reaction’.
DO NOT ALLOW YOUR VET TO GIVE YOUR HORSE EXCEDE. There are many alternatives.
EXCEDE® | Zoetis US
“EXCEDE is the first and only FDA-approved antibiotic for horses that offers a full course of therapy in just two doses. EXCEDE reduces the treatment requirements from 10 once or twice daily doses of a comparative antibiotic, such as oral trimethoprim-sulfonamide (TMS), to just two doses.”

6-29-17 Original post:

“I’ve just earned “Masterson Method Certification” Integrated Equine Bodywork. I use many forms of healthy modalities and connection communication. Yet here I am faced with my own horse needing a healing method I can’t offer. For the past 6 weeks I’ve been dealing with the aftermath of a split second puncture wound. I was 10 feet away when it happened, fortunately.

May 18th I fed the 4 horses a pile of hay each – went in the hay barn 10 feet away – was opening another bale – heard a slight shuffle -went back out – blood was spurting out of Shanti’s chest – right armpit. This puncture is in the area of the Brachial Plexus – the nerve center of the horse. Compare this to the power panel in your house – Shanti has some damaged nerves – circuits in her body. She also has other issues that are hard to diagnose and treat. This is something many of us face who live far from veterinary centers with diagnosing equipment. Even situations when diagnosing is possible, treatment may not be possible. My innate, educated and developed support skills are focused on intent to help the body heal itself. This trauma is beyond my current support abilities, clearly there are other tools out there.

The small 1 inch puncture cut the small artery – blood spewed out with air bubbles… I called the vet at 6:30 am they came out 3 ½ hours later… I got the bleeding stopped, Vet came – gave antibiotic shots etc, semi routine, we didn’t know the extent…

Bizarre changes daily: Edema’s, nerve damage, Monday in 10 minutes time my horse moved around enough in a 12 x 12 stall after her buddies were out of sight to ‘suck air under the skin’ through the 1 inch gash or from her lungs… She ballooned up – (It felt like skin over an air cushion instead of solid muscle) – chest, shoulders – withers to elbow, on back – air then moved above lumbar area… It crinkled like bubble wrap in some places – air cushion, hollow – in others. She was in a lot of pain. Vet came out again – took xrays & ultrasound… inconclusive – clearly a different horse than 7 days earlier – he was shocked.

When the air dissipated over the next few weeks, what became visible was muscle atrophy on scapula and shoulder area – triceps… She put no weight on the leg, high pain level, I considered lung issue, puncture site, this all felt life threatening. Attempted to trailer her to vet, handled by myself then the highly skilled MEE service, she refused to trailer load. This wasn’t about fear or couldn’t – this was a clear calculated decision. Bottom line – she needs to heal and taking her to the vet isn’t an option.”

The end: 2 weeks later she took a turn for the worse and was in extreme discomfort. I called her previous owners to come say good bye. I also made sure my 3 horses said goodbye. My lead mare was with us all as we let Shanti go. They stayed with her  all night, then she was buried.

Video
Accident 5-18-2017 The following email recap 1 week after injury, doesn’t include the photos sent to the vet, watch the video to get an idea of the after effects of the injury.

I sent this email to the veterinary office to update as my call in hadn’t been returned. There was no reply to the images and email either…

“Can you please check with Dr ___ and see if this progression is normal? It seems like her chest area is getting larger.

I didn’t take picts Thursday.  Shanti is the perfect patient.  Shots went well Sunday – still on bute.

Picts showing progression – changes from Fri – Wed. Normal? red flag?

Monday morning (day after 2nd Excede shot) about 11 am is when she sucked air into her body when the horses went out of site. She was slightly emotional called a few times – was in the 12 x 12 – I went out right away and called the others back – and they came… I then noticed her body was an air pillow. The changes took less than 20 minutes – I called my vet, then found a video on youtube that showed what I was seeing… Felt better.

I then moved the horses to the winter small area – all within site of Shanti – set up a stall for Shanti.

Did an epsom salts on towel compress Tues morning, seemed to help.  I let Shanti out for an hour last evening to move to see if the edema would be absorbed – it appeared to help. Leg looked less swollen and belly edema by stifle looked better this morning.  She’s still moving slowly on the right front knee/leg. – hard to tell if there is damage and where at this point.

FRIDAY –

open wound on right front armpit: (scar on leg – I don’t remember reading about the story of this accident on her vet record’s. I read she’s been through a lot since she was three. )

right leg and knee swollen – edema on right pectoralis.

Sat – took her out of the 12 x 12 for picts: edema on the front right of horse- shot behind right elbow

Sunday – edema shifted to the front LEFT of horse

Monday – horse sucked air into the wound so her body is like an air pillow – from neck to withers to elbow to back.

Tuesday developed an edema on belly side in front of right stifle. Body still full of air.

Wednesday: body still full of air, front end is massive, edema still large on belly by right stifle. Let her out of the 12 x 12 for 3 hours as you see below to move to help the edema be absorbed.  Shanti not moving around much – her tail is swishing – other horses are not..

Compare below 2 picts with the first picts above , notice her chest is really swollen – there is no sternum crease between the pectoralis descendent.

I didn’t clean her leg this morning so you can see the area is still draining out through the wound. It is not infected as the drainage is clear – not pus.

Edema in front of right stifle – starts on the white patch – Picture as shown from her LEFT:

Please advise if anything is a red flag and not normal… Thanks.

Should I keep her standing still in a 12 x 12 or let her walk a bit? ”
(again, there was no response. I called again a few days later – frantic – The vet came out on Friday and couldn’t believe the changes in my horse)

Other peoples experience (via google search)  with Excede Antibiotic:

The antibiotic ‘Excede’, manufactured by Pfizer, is causing lethal allergic reactions in horses. What is Pfizer doing about this? In one particular case they only sent $250 to the grieving owner. How about pulling this off the shelves?!

This is what Pfizer posts on their own website:

As with all drugs, the use of EXCEDE is contraindicated in animals with known allergy to ceftiofur or the the β-lactam group (penicillins and cephalosporins) of antimicrobials. Do not use EXCEDE in horses intended for human consumption. The administration of antimicrobials in horses under conditions of stress may be associated with diarrhea, which may require appropriate veterinary therapy. Though safe in cattle when properly administered, inadvertent intra-arterial injection is possible and fatal. https://animalhealth.pfizer.com/…/…/Pages/Excede_Equine.aspx


Chance began another round of Excede to get his scratches under control- it is a never ending battle.  A while back, I had a skin scrape of Chance’s scratches due to their chronic nature.  The scrape results showed a number of bacteria, all commonly seen with this type of infection, that were resistant to most antibiotics.  Thus why we decided to try Excede.

Administering Excede is pretty straight forward- 1 shot IM every 4 days for about a month.  Easy enough….or so I thought.  The first shot was administered by the vet when I was not present.  The second shot the vet also administered while I was there.  Thirty minutes after the shot was given to Chance I noticed he seemed off but not in his “normal” post-acupuncture relaxed state. He suddenly became lethargic, he wouldn’t eat his dinner, and the gut noises became almost nonexistent. I commented to the vet my concerns and she came over and reexamined him.  Sure enough something was wrong.  She proceeded to administer 10cc of Banamine (just in case it was colic) and told me to walk him around outside for about 20-30 minutes.  Then see if he would eat 2 cups of feed only.  We walked and Chance began to act like his normal happy go lucky self.  Once inside he started to eat!

Part of me felt that his reaction was a fluke.  However, the third dose proved me wrong.  Four days later, Chance received his shot and went outside to enjoy the first beautiful, warm day.  I sat in the field watching him.  He was sluggish, lethargic, stiff..he looked 10 years older and barely moved from one spot under a tree.  He wasn’t eating grass nor did he run around and play- he didn’t even run up to me like he normally would. I decided to bring him inside and give him a warm bath since it was in the high 70’s.  He was non responsive to his bath- no playing with the hose or even accepting peppermints.  I placed a cooler on him to ensure he stayed warm until he was out in the sunshine.  I figured after a bath he would perk up- again, I was wrong.  At dinner time I went to bring him in and typically I will open up the gait and he will canter into his stall- he slowly walked instead. He wouldn’t eat his feed (he normally whinnies and makes a fuss until he gets his feed and devours it) or his hay…I stayed and watched him for a while and he just slept.  I spoke to John, the guy who helps me with Chance and Lucky, and he confirmed that Chance hadn’t been finishing his feed and wasn’t running when he brought him in for dinner.

My concerns grew and I decided to do some research on Excede. That strange thing is I usually do extensive research before changing or administering anything with my animals.  But, for some reason I did not do so this time and I wish I had.

According to a number of reputable websites, Excede can cause significant and dangerous side-effects such as; diarrhea, severe acid reflux, blood coming from mouth, loss of appetite, lethargy, muscle and gait stiffness, and more.

The most troubling of everything that I read wasn’t what was posted on the Pfizer (the manufacturer) website but from the countless statements given by horse owners and the studies done by outside companies.

According to drugs.com, “in the PK study, several horses developed clinical signs consistent with foot pain (stiff in the front limbs when turned in tight circles, and increased pulses and heat to the front feet). One horse in the NAXCEL group and one horse in the 6.0 mg/lb (2X) EXCEDE group were euthanized due to laminitis. Clinical signs of foot pain (stiff front limbs and increased heat and pulses in feet) affected more horses, for a longer period of time, in all EXCEDE-treated groups as compared to the NAXCEL-treated group. The study housing (multi-horse pens on concrete slabs) and diet (free choice alfalfa/grass mix and once a day pellets) may have contributed to the development of foot pain. The prevalence and severity of injection site reactions in EXCEDE-treated horses may also have contributed to the development of a stiff gait. A causal relationship between ceftiofur and foot pain could not be definitively determined.”

The research has revealed that Excede should be used with caution and the horse receiving the medication must be monitored. Make sure to weigh the benefits and risks before starting Excede.  This drug can be lifesaving for many horses but for others, it can be life-threatening.
https://chanceswetake.com/tag/excede/

The FDA recently (Feb. 2010) approved a new long-lasting injectible antibiotic for horses called Excede. I have heard of problems with this (diarrhea, acid reflux and death). You may wish to do some homework before using it on your horse.

Extreme caution on Excede!!
My twenty five year quarter horse was given 16cc of Excede six days ago and seemed fine until about the second day, started with loose stools and some swelling of his neck. I refused to give second dose after four days and soooo glad I did as of today the swelling in neck has now gotten so bad that both sides are huge and very hard all the way down to his chest area. The time release of the drug is the scariest part due to the length of time in the system so if a reaction happens it takes days to peak and up to eighteen days to clear out. I truly believe my horse would have died if I would have given the second dose. I have always been leary of new drugs and will always follow my gut instinct from now on. Hope this helps anyone else that might have to make the decision.

I lost my 2 y/o gypsy filly to this drug. She was treated with Excede and developed projectile stools and a 106.2 fever on the third day after the injection. We rushed her to the main surgical hospital in New Jersey where they tried to stabilize her. She died April 28 after surgery from cardiac arrest due to the endotoxemia produced by her necrotic large intestine. We were there with her during her surgery and were permitted to see the damage to her colon but hoped she could survive the surgery because she was a big, healthy 2 y/o baby. The treating veterinarian filed a claim with Pfizer stating that the drug side effects caused her death. We are heartbroken. By the time the side effects become apparent d/t the long acting nature of this drug, it is too late and not easy to reverse. This drug is dangerous and should be used with extreme caution.

Last week, my 10 yo quarterhorse mare came down with a upper respiratory infection accompanied by a low grade fever. The vet put her on Excede, 16 im on each side of her neck on mon, repeated on sat both followed by a im shot of Dex. Wednesday, her fever spiked to 102.6, her white blood cell was triple normal and both sides of her neck swelled badly; she remained in the clinic for 3 days. She was released last night saying her temp was normal, apply DMSO to he swollen neck area and take her temp every day; we’re still waiting for the culture results, but tonite, her temp is back up to 102.6 with the only symptoms being she cant raise her head and no neck flexation. I can only link all of this back to Excede and from what I’m reading, I’m really wishing I hadn’t given her the 2nd dose. Does anyone know of anything other than the DMSO I can use on her to help with the swelling – the vet is now thinking the temp is related to the inflammation…I dont know how or what to do to help her!
(No update was posted.)

Subject: Bad Horse Drug

This afternoon my Peruvian Horse, LEA Apolo, died from a bad horse drug. He was given a shot of Excede by Pfizer (antibiotic) because he had a fever. He died instantaneously after the shot, like a heart attack with seizure. The vet who gave the shot was in shock and struggled to keep him from landing on me because I went down with him. She called Pfizer and they said some other horses had had the same allergic reaction. They are sending me $250 for my trouble…..can you imagine?

The problem is, Apolo was a one-in-a-lifetime horse and friend and only 10 years old. I could ride him anywhere and he was safe, forgiving, and special. I cannot stop crying and will never get over his loss. I loved showing him and we won many times. He was my reason for going to the barn, and I really loved this horse. I am so grateful I had him since he was young.

Please do not use this medication in shot form. Please be aware of its possible danger. I do not want others to suffer the pain it has brought me.

Yes – my horse had severe swelling in his neck when given Excede. I felt so bad for him – his neck was swollen from almost his ears to his shoulder on both sides, and he couldn’t put his head down at all. Won’t use that one again!

I’ve only seen it used on one horse, for a puncture wound. No diarrhea but several hours after the second dose the horse went into shock. It was very weird – not normal colic symptoms at all. Vet said impaction or twist and put her down. I can’t blame it on the antibiotic but even so I am deathly afraid of Excede now and would be hard pressed to use it on my horse.

My horse was prescribed excede while at a boarding stables for a couple of months for a deep bite wound (from another horse). I was there when the vet arrived but was not asked about what antibiotic to use and the excede was administered. I had never heard of it before and would have elected for oral uniprim administered in feed 2x a day. It seems that the barn uses excede a lot – probably because there is no need to dose in feed 2x a day and delivery is guaranteed. The injection was split in 2 doses, one on each side of his neck. He did get some mild swelling from the first shot on his neck but his stools seemed normal and his overall behavior seemed normal. He got the second shot 6 days later. Same thing – split in 2 doses , one on each side of his neck. This time, the next day I discovered his neck swelled hugely (12 x 6 inches of swelling about 2-3 inches deep). He had his turn out sheet with neck cover on so Ii did not see it immediately. I noticed he looked very “sad” just standing over his hay not eating. I went up to see him and discovered the swelling. He looked at his hay longingly and tried to put his head down to eat it, but could not! then I googled and found all of the warnings about this antibiotic. I put him on bute and banamine and benadryl at nite. By afternoon he could move his neck enough to lower his head to eat hay and next day he seemed more himself. He was Trotting and cantering around the field a bit like he usually does. I continued the bute/banamine/benadryl regime. Swelling is much reduced to prob 3 inch round area – but still there a week later now! I WOULD NOT RECOMMEND THIS ANTIBIOTIC UNLESS THERE ARE EXTENUATING/COMPELLING CIRCUMSTANCES THAT REQUIRE THE ADMIN OF A SLOW RELEASE FORM OF ANTIBIOTIC LIKE THIS ONE THAT ARE WORTH THE POTENTIAL SIDE EFFECTS (WHICH I AM TOLD INCLUDE IRREVERSIBLE COLITIS). IT IS SO MUCH SAFER TO USE SOMETHING LIKE UNIPRIM THAT DOES NOT HAVE THESE ADVERSE REACTIONS. IF YOUR HORSE GETS GRAINED 2X A DAY IT IS VERY EASY TO MIX THE POWDER IN…

My horse had a violent allergic reaction to Excede at a horse show. A vet from a well-known hospital had been treating her for scratches the entire horse show. The last week of a four-week show, she said we should just go ahead and give her a shot of exceed. The next morning when I arrived to hack her before my classes, her neck was swollen at the injection site. I showed the vet who happened to be driving by and she thought it was not a big deal. I put her in her stall, and left to get breakfast. I received a phone call 15 minutes later from my trainer saying that it looked like the mare had broken her leg. When I got back to the showgrounds, the vet was already there doing x-rays. One of her front knees was swollen larger than I have ever seen a horse’s joints swell. But then I looked at the injection site from the night before, and the entire neck was swollen. And, all other leg joints were beginning to swell. The vet immediately started administering different meds, as the horse’s breathing was now getting difficult as well. She let me know that we may need to put the horse down. This was a beautiful five-year-old baby green mare… I was heartbroken. They pulled fluid from joints and sent them to a lab, and stayed with the horse until the meds helped her stabilize. It took her a month to recover, but she was fine. I called the company that makes the drug and filed a report so that it would be on record, but the mare was simply allergic to it… Violently.

There are more testimonials – do your own research… Use Excede antibiotic with caution.