Epipen for dogs?

RE: Epipen for dogs?

shanley barber — Tue, 23 Feb 2016 20:15:13 GMT

I think, having read the guidelines (thank you, Michael), that she did have evidence of circulatory collapse (low blood pressure -> collapse) and skin changes, as well as vomiting, so she would fit the criteria for an IM adrenaline injection. I will certainly go back to the owners to see if they can recall if she had any breathing difficulties.

I admit, the owners are complete worriers, and I doubt they would ever use the Epi-pen if I explained that there were risks involved.

RE: Epipen for dogs?

grumpyoldman — Tue, 23 Feb 2016 00:42:22 GMT

This sounds like "spikes syndrome" , Epileptoid like seizure activity in border terriers . They get better on their own , certain diets need to be avoided . Its self limiting but need to avoid stressors if at all possible.

RE: Epipen for dogs?

Michael Woodhouse — Mon, 22 Feb 2016 22:26:47 GMT

[quote user="shanley barber"] I've been asked by a client with a very exuberant Labrador who gets stung at least once every summer. She will vomit and collapse, shake and clench her jaws! swollen face (wheals, urticaria) No loss of consciousness, no respiratory distress. ? Liquid antihistamines? Children's epi pen? [/quote]

All an epi-pen can do is delay the onset of life threatening anaphylaxis. It is not treating the allergic reaction per say.

Anti-histamine liquid, even a vial of chlorphenamine and a syringe?

From the RCUK guidelines (I will attach them):

Adrenaline should be given to all patients with life-threatening features.
If these features are absent but there are other features of a systemic allergic
reaction, the patient needs careful observation and symptomatic treatment using the
ABCDE approach

RCUK define 'life threatening features' as circulatory collapse or airway obstruction. I'm not sold you have either in this dog. Speaking to doctors and paramedics about this - the general belief is Epi-pens are often over-used and it's not an especially pleasant experience if you didn't need it (although preferable to cardiac arrest and death).

RE: Epipen for dogs?

shanley barber — Mon, 22 Feb 2016 22:09:33 GMT

Hello,

I'm resurrecting this post (again) in the hopes anyone has experience with epi-pens in animals. I've been asked by a client with a very exuberant Labrador who gets stung at least once every summer. She will vomit and collapse, shake and clench her jaws! swollen face (wheals, urticaria) No loss of consciousness, no respiratory distress. ? Liquid antihistamines? Children's epi pen?

Thanks,

Shanley

RE: Epipen for dogs?

Michael Woodhouse — Mon, 08 Feb 2016 17:06:44 GMT

[quote user="Stuart Jackson"]never crossed my mind that it wasn't my skill in drug choice [/quote]

I'm sure the owner thought you were a god!

RE: Epipen for dogs?

Stuart Jackson — Mon, 08 Feb 2016 16:54:21 GMT

[quote user="Michael Woodhouse"]sham treatment[/quote]

dex wasn't a sham treatment back then, but is now. Homeopathy has always been sham

RE: Epipen for dogs?

Stuart Jackson — Mon, 08 Feb 2016 16:50:23 GMT

[quote user="Michael Woodhouse"]

[quote user="Stuart Jackson"]It was carried in like a wet blanket - I gave it 20ml dex iv - before I had stood up it lunged at me with all teeth ready to eat me.[/quote]

That's a lovely anecdote, but nothing to do with the dex! In a similar vein many people treated with homoeopathy get better and falsely attribute the recovery to the sham treatment.

[/quote]

never crossed my mind that it wasn't my skill in drug choice - thanks for the laugh before evening consults.

RE: Epipen for dogs?

Michael Woodhouse — Mon, 08 Feb 2016 16:46:46 GMT

[quote user="Stuart Jackson"]It was carried in like a wet blanket - I gave it 20ml dex iv - before I had stood up it lunged at me with all teeth ready to eat me.[/quote]

That's a lovely anecdote, but nothing to do with the dex! In a similar vein many people treated with homoeopathy get better and falsely attribute the recovery to the sham treatment.

RE: Epipen for dogs?

Stuart Jackson — Mon, 08 Feb 2016 16:27:20 GMT

[quote user="Michael Woodhouse"]Dexamethazone (and all the corticosteroids) work by altering the expression of proteins at a gene level, so take a period of time to exert much effect. They are not a fast acting drug.[/quote]

A long time ago I had warning that a very nasty GSD had collapsed and the owner's were bringing it in NOW.

It was carried in like a wet blanket - I gave it 20ml dex iv - before I had stood up it lunged at me with all teeth ready to eat me.

RE: Epipen for dogs?

Busybee — Mon, 08 Feb 2016 16:09:45 GMT

Sorry to resurrect an old thread but was wondering where you got to with this Rebecca? A client has asked me to look into this for her very bee-allergic dog. Did you have any success with sourcing or using an Epi-pen?

Re: Epipen for dogs?

Stephen Courtney — Wed, 13 Aug 2014 23:09:04 GMT

Work out a suitable dose of adrenalin and see if there is a child sized epipen you can prescribe for him that matches that size. teach client where to bang it in( I like neck muscles, avoid rear limbs in shock cases as perfusion is much reduced_)

My friend's dog was a husky and the epipen was one prescribed for a child. It was also just out of date, so clearly my friend should be arrested as well...

Re: Epipen for dogs?

Rebecca MacMillan — Wed, 13 Aug 2014 16:46:56 GMT

(Nearly 5 years old)

Re: Epipen for dogs?

Rebecca MacMillan — Wed, 13 Aug 2014 16:46:31 GMT

Sorry, just spotted this reply! He's a border terrier, no other issues reported recently - nothing in history about suspected cardiac issues etc.

Re: Epipen for dogs?

Andrew Kent — Tue, 05 Aug 2014 10:49:22 GMT

Hi Rebecca,

What kind of breed is this dog? And does it have any other reported clinical signs?

The episode sounds more syncopal than anaphylactic so I might be inclined to pursue that possibility more than potential allergies.

Andy

Re: Epipen for dogs?

Rebecca MacMillan — Tue, 05 Aug 2014 09:57:30 GMT

So what would you suggest for this dog? I think the owner is worried about it happening again and wants to be able to administer something at the scene. I suggested anti-histamine already, but wondered if anyone would dispense anything more? It's difficult when it's just one of those on the 'off chance it happens again' cases!

Re: Epipen for dogs?

Stephen Courtney — Sun, 03 Aug 2014 22:41:23 GMT

A friend vaccinated her dog at home and he fell off the needle. A neighbour had an epipen. Banged into the neck muscles, the dog was up in 20 seconds. Probably saved his life, he was at least 40 minutes from the nearest open vet.

I now carry adrenalin with me in my visit box. steroids don't work quick enough, human anaphylaxis is treated with adrenaline, and especially serious events like angioedema need adrenaline immediately. Epipens have a set dose rate that suits a human - i think they come in various sizes, but i prefer to have my ampoules and my formulary.

Re: Epipen for dogs?

Michael Woodhouse — Sun, 03 Aug 2014 17:16:20 GMT

Dexamethazone (and all the corticosteroids) work by altering the expression of proteins at a gene level, so take a period of time to exert much effect. They are not a fast acting drug.

The dog isn't describing a typical anaphylactic reaction either. I'm not sure adrenaline would be of benefit - although fast acting even if given IM.

If the dog can drink then oral anti-histamine may be a viable option. Some are available in syrup formulations for children.