The most useful antibiotic in equine medicine is Penicillin. This works for most Gram positive bacteria and there is little resistance reported. If you can obtain procaine penicillin on it's own that is best. PenStrep is OK, but note that the streptomycin part is not very useful.
If you have a serious infection, then Penicillin in combination with Gentamycin is very good. You may find gentamycin available for human use which is OK to use. For the dose rates please look in the Technical Bulletin 6 on the subject of medicines.
The other useful antibiotic in equine medicine is potentiated sulphonamide drug. You now have Coliprim available by injection. This is particularly useful in cases of infection in the respiratory tract or the intestines.
So penicillin (and gentamycin), and coliprim are really the only antibiotics we need.
Amoxycillin drugs should not be used in equines.
Enrofloxacillin drugs are best kept only for very serious infections that have not already responded to Penicillin or coliprim. It is not a “first line” medicine. People are worried about bacteria developing a resistance to this drug which will not be good for human medicine. In any case enrofloxacillin should not be used in young growing animals.
2. Non steroidal anti inflammatory drugs (NSAIDS)
You now have a good selection in Syria:
Flunixin meglumine (Finadyne or Flunine)
Diclofenamic acid (Diclovic)
Of these drugs the most useful are Botasin and Flunine; Botasin for musculoskeletal problems and Flunine for internal pain such as colic or inflammation in the lungs.
Please read the information about dose rates in the Technical Bulletin. Note that the dose on the Botasin bottle is not correct, it is too high. The correct dose is approximately the same as for Ivomec, ie 1ml/50kg. Note that this is the dose for the first day of treatment, on following days the dose should be half that.
All NSAID drugs should be given by slow intravenous injections.
In Syria you have Dexasone. Please read the Technical Bulletin for more information on its use. Dexasone has very little use in equines. There are really only 2 cases when we use this drug:
- Allergy – maybe due to a bee sting, snake bite, or something the animal has eaten. Often one dose is enough, but depending on the symptoms of itching, swelling, pain, it may be necessary to give for 2 or 3 days.
- Shock – acute shock, for example after a road accident, particularly if there has been an injury to the head. We use a high dose of corticosteroids (Dexasone) just once to reduce shock and possible swelling of the brain.
With good NSAID drugs now, there is no need or benefit to using Dexasone for any other condition. Therefore we need to keep only a very small amount in stock.
3. Anti histamines
Anti histamine drugs only work for about 2 hours after the first signs of the allergic response are seen. After this there is no benefit to the animal of giving this drug (although it does not harm the animal). Therefore, again, we do not need to keep very much of this drug in stock. If a case is seen with an allergic reaction and it is more than 2 hours since it started, then it is better to give Dexasone (see above)
Frusemide is another medicine that is rarely used in equines. We use it really only for cases of cardiac (heart) disease, usually in older horses, where there is fluid build up in the lungs.
It should not really be used for subcutaneous oedema. This oedema is a symptom, not a disease and we need to identify what is causing it. This may be excess internal parasites or liver disease or blood parasites for example. The oedema itself is not a problem if it is under the skin.
The same thing with colic. There is no real disease as urinary retention. Many animals with colic stand as if they want to urinate and cannot urinate because the colic pain causes spasm of the urethra muscle. The treatment needed is a pain killer and anti spasmodic such as metalgen or flunine, NOT a diuretic such as frusemide.
If you give frusemide you are treating the owner and not the animal, and you may make the animal more ill if it already dehydrated!
5. Wound Management
Following discussions with Professor Knottenbelt the best protocol for wound treatment should be as follows:
- Put a piece of gauze/bandage with saline onto the wound to protect it.
- Shave around the wound with the new razors provided.
- Remove the saline gauze and flush the wound with plenty of saline spray. This can be made up with ½ teaspoon of salt in ½ litre water. The sprayer should be used as it is more effective at removing dirt and bacteria than wiping with a piece of gauze bandage.
- We are trying to reduce the amount of iodine used because it harms the normal healing process of a wound. However, if a wound is very infected (like an abscess) then it is OK to use iodine. The iodine must be very dilute (1% maximum); research shows that actually the more dilute the iodine is the better it works. The iodine should be normal iodine and not tincture iodine (as tincture iodine contains alcohol and should not be put onto wounds)
- After flushing the wound it can be blotted dry with a piece of gauze.
- Zinc oxide cream is the best for normal wounds.
- Only if a wound is very infected can you use some purple spray.
Note that it is good practice to cover wounds if possible with a dressing. This helps the healing process by keeping the wound moist and warm. Parafin gauze dressings containing small amounts of iodine or chlorhexidine are available in the pharmacies, but you can also use a piece of normal gauze bandage covered with Vaseline. If there is lots of exudate (pus) coming from a wound then a baby's nappy is a good dressing to absorb this. Wounds with lots of exudates need changing every day, but once the exudates dries up and the wound starts to heal, then dressings can be left on and changed only every 4 days or so.