Diagnosis
Severity of procaine reactions vary with amount absorbed and individual variation [29]. Clinical signs range from hyper‐reactivity to seizures to death [26, 28, 29]. Inadvertent intravenous administration of milk was associated with acute signs of collapse and respiratory distress, consistent with anaphylaxis. Peripheral pulses were weak and mucous membranes were congested.
Treatment
Personnel should be moved away from the affected horse and the horse should be moved to a safe, quiet place (stall) and sedated, if possible [26]. External stimulation should be minimized by reducing light and sound. If seizure activity occurs, benzodiazepines and phenobarbital may be administered, if safe to do so [26]. The inadvertent administration of milk was treated by immediate removal of the contaminated intravenous catheter and aggressive supportive therapy, including epinephrine, corticosteroids, intravenous fluids, antimicrobial therapy, and inotropic support.
Expected outcome
Horses typically recover from procaine reactions, but fatal reactions can occur. More commonly, self‐trauma may result from the hyper‐excitability and seizures. The foal with inadvertent intravenous administration of milk did recover with aggressive treatment and no long‐term consequences were noted.
References
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3 Complications of Intravascular Injection and Catheterization
Julie E. Dechant DVM, MS, DACVS, DACVECC
School of Veterinary Medicine, University of California–Davis, Davis, California
Overview
Intravascular injection is commonly used to intermittently administer small volumes of medication to horses. Intravascular catheterization is employed to administer large volumes or frequent administrations of medications, provide continuous administration of intravenous fluids, or secure vascular access during situations when immediate access is needed (i.e. anesthesia)