Bicillin and Zithromax

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12354somebunny

12354somebunny

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My rabbit Hans has an abscess and I'm trying to treat it with Bicillin + Zithromax.

It's not easy to find bicillin here but my vet finally managed to get hold of a bottle. It is called Benacillin and it contains 150mg/ml procaine penicillin, 150mg/ml benzathine penicillin and 20mg/ml procaine hydrochloride. I understand that I'm supposed to look for bicillin which contains 150k units procaine and 150k units benzathine. Is 150mg/ml equivalent to 150K units? Is it ok that the mixture contains procaine hydrochloride as well?The vet gave Hans 0.2ml of the drug yesterday. Hans weighs 1kg.

As for Zithromax, has anybun had side effects from consuming it? The Zithromax I have is a powder, to be mixed with water into a liquid suspension which will contain 200mg/5ml. So Hans should get 1ml zithromax a day. I split the dosage into two i.e. 0.5ml twice a day, about 12 hours apart. Last night Hans got his first 0.5ml dose. Immediately after that he became very subdued, staying hidden in his cardboard box. He refused his favourite treats. He has watery poo.. not bad enough to leave poo puddles on the floor, but enough to cover his bum area in brownish liquid. It was about 4 hours later before he started eating again. When he got his 0.5ml dose this morning, again he became subdued, lost his appetite and had watery poo. I'm very concerned. Should I stop giving him the zithromax and just treat him with the penicillin alone?

 
somebunny wrote:
My rabbit Hans has an abscess and I'm trying to treat it with Bicillin + Zithromax.

It's not easy to find bicillin here but my vet finally managed to get hold of a bottle. It is called Benacillin and it contains 150mg/ml procaine penicillin, 150mg/ml benzathine penicillin and 20mg/ml procaine hydrochloride. I understand that I'm supposed to look for bicillin which contains 150k units procaine and 150k units benzathine. Is 150mg/ml equivalent to 150K units? Is it ok that the mixture contains procaine hydrochloride as well?The vet gave Hans 0.2ml of the drug yesterday. Hans weighs 1kg.

As for Zithromax, has anybun had side effects from consuming it? The Zithromax I have is a powder, to be mixed with water into a liquid suspension which will contain 200mg/5ml. So Hans should get 1ml zithromax a day. I split the dosage into two i.e. 0.5ml twice a day, about 12 hours apart. Last night Hans got his first 0.5ml dose. Immediately after that he became very subdued, staying hidden in his cardboard box. He refused his favourite treats. He has watery poo.. not bad enough to leave poo puddles on the floor, but enough to cover his bum area in brownish liquid. It was about 4 hours later before he started eating again. When he got his 0.5ml dose this morning, again he became subdued, lost his appetite and had watery poo. I'm very concerned. Should I stop giving him the zithromax and just treat him with the penicillin alone?
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Ido not do not know how procaine hydrochloride will affect the rabbit as you are right that we are giving it in units /ml in the US and that our bicillin has 150unit /ml procaine and 150 units /ml Benzathine penicillin with a total of 300,00 u per ml
Iwill haveto look into the K which could be a unit as I am unsure of it's meaning

We had problems with zithromax from another forum member almost identical to you although if this drug is tolerated it is a good drug

medi-rabbit would dose it at 30-50 mg/kg to be given once perday .
http://rabbitsonline.net/view_topic.php?id=48114&forum_id=16
Iprobably will agree it is the zithromax causing the problem here

You need to call the vet and talk to him as we are not vets here.

I personally would stop the zithromax and continue the bicillin but this is my personal unprofessional opinion
if you can get a probiotic (beneficial bacteria that is sold for pets) that would be great. you want to find a probiotic that contains the microorganism lactobacillus casei
In the us it is called benebac and you can also use the type for horses sold as a gel at farm stores ..over here it is called probios.



 
Thanks for your replies, angieluv.

The concentration is stated as mg/ml. I've been trying to google for conversions of mg/ml to unit/ml but haven't had any luck.

As for the 150k units/ml, I think the K represents a unit of 1,000 i.e. 150K units/ml = 150,000 units/ml.. but I may be wrong, it's just my own guess. The Benacillin is refrigerated. It's a thick, white liquid, which sounds similar to bicillin.

I've also decided to stop giving the Zithromax. I'm afraid I can't check with my vet. We're using this treatment for Hans based on what I've learnt from this forum and from Randy. My vet has not used this protocol before.. but I'm glad she's open to trying it.
 
I just gave Hans his dose of Benacillin for today, my first time giving a jab.. It looked so much easier when my vet was doing it. First, I had problems tenting the skin, there just doesn't seem to be much skin to tent.. then I accidentally pierced the needle too far out, it went through the other side of the skin and the drug was dripping on Hans' body.

I tried again at another site, this time I managed to get the needle in properly and was slowly pushing the drug in, but suddenly the plunger on the syringe just wouldn't budge anymore. I removed the syringe from Hans, it seemed as though the needle was blocked. I had to push really hard to get the plunger moving again and the drug shot all over my table. :( I hope I get it right the next time :(
 

I have been trying to find conversions also but am getting lost in them also..


I am having some trouble figuring out why people have been having these issues with zithromax; the type that you used and also that Amy used is the same kind that I used.

I would send this to Randy in a heartbeat butI know that he is not available now....

You cannot get Convenia can you?
Your vet could write aprescription and you could order on-line from the US. the only thing is that I don't know the rabbit dosage. :expressionless

maybe by the time it came we could get a hold of Randy

Pm Flashy as she has used Convenia ; she lives in the UK


 
somebunny wrote:
I just gave Hans his dose of Benacillin for today, my first time giving a jab.. It looked so much easier when my vet was doing it. First, I had problems tenting the skin, there just doesn't seem to be much skin to tent.. then I accidentally pierced the needle too far out, it went through the other side of the skin and the drug was dripping on Hans' body.

I tried again at another site, this time I managed to get the needle in properly and was slowly pushing the drug in, but suddenly the plunger on the syringe just wouldn't budge anymore. I removed the syringe from Hans, it seemed as though the needle was blocked. I had to push really hard to get the plunger moving again and the drug shot all over my table. :( I hope I get it right the next time :(
Click to expand...
be sure and wipe the drug off your bun as if he grooms it himself it is the same as is the same as giving it orally
 
he dosage that my vet used for Convenia was as it was labelled (I believe that's what he said). He said it's given to cats by their weight, and that is what he did for Tilly. We started off giving it every two weeks (which is how it is dosed in cats), but it became clear on day 2 it started to work, on day 9 it stopped working (it was easy to see because we were using it for head tilt so we could see the improvement in her head). We gradually cut down the time in between injections and found that once a week (every seven days) worked eprfectly for her and she was kept on that for 2 months of weekly injections. It changed her life.

However, at the time we did that Randy had only used it for head tilt and had not, at that time, tried it in abscesses I believe, or any other kind of infection. If he has now, I don't know, he may have done, but equally, it may still be an unknown in anything other than head tilt.

The hardest thing with Convenia is that because there is a long time inbetween injections if there are any side effects you have to ride the week out as best you can. The risks seem to mainly be gut issues (cecal dysbosis, chronic diarrhoea, etc) and there is not way to stop it once the drug has bee injected. With Tilly, we saw no side effects at all. We did use Fibreplex during that time until we were sure that she was going to show no side effects. That is basically giving her additional fibre and can potentially be useful in some gut situations but not others (I personally don't think it should be used in a blockage situation, but in this situation I had no issue with it at all and would use it again).

Not sure how helpful that is for you.

I'm sorry you're having a rough time with your buns and hope it improves soon.

x
 
Oh, I just wanted to say that I wondered if it was hard to tent his skin and inject successfully if he was dehydrated due to the diarrhoea he suffered? Have you tried baby rehydration salts? In the Us it's called pedialyte, and in the UK its called Dioralyte, not sure what you would call it over there.
 
I've actually emailed Randy, but haven't received a reply from him yet.

I'm not sure if we have Convenia here. It has the same function as Zithromax?

The Zithromax that I managed to get is for children. I'm not sure if that makes any difference? I didn't expect the watery poo.. I only expected some appetite loss. The watery poo really got me worried.

Thanks for the caution, I've wiped him clean :)

Now I just need to figure out if I'm giving him the right dose of Benacillin..
 
Convenia is a cephalosporin (but I have no idea if that's how you spell it), and is another antibiotic. Those that know more could explain the different groups, etc, but there are basically a whide range of antibiotics around that have different uses, or that can be used in replacement of another.
 
I have previously tried looking for Pedialyte or something similar here but we don't have electrolyte drinks specifically for kids. We have the normal oral rehydration salts for adults, which seem to have quite a high content of sugar.

I'm not sure if tenting was difficult because I wasn't doing it properly or whether its because Hans is dehydrated (that's a good point, didn't occur to me earlier). I'll try to make sure he drinks more. Someone posted on RO ages ago on a homemade pedialyte recipe. I've saved that, and will try it if necessary. Thanks, Tracy!
 
This is how I give bicillin; first of all it has to be diluted as if it is not diluted it will cause sterile abscesses at the site of injection and/ or it is just difficult to push in the thick liquid . Ask your vet for a liter of lacted ringers solution and also a big supply of 23 gauge sterile needles ( any length) and a supply of 25 gauge needlesX 5/8 in. you will also need sterile syringes (3 cc is OK)

If your vet can show you how to use a butterfly this is what Randy uses; I have not been able to get them for use on rabbits so am more comfortable explaining howI do it.

Take the bottle of bicillin (or whatever) out of the refrigeratorfor at leasr 1/2 hr before using it. You need to roll the bottle in order to prevent air bubbles from forming in the bottle and also to uniformly mix the drugs which will separate . Mix this drug very well .

You will also need a bottle of alcohol to wipe off and sterilize the tops of bottles
Wipe off the top of the bicillin bottle with alcohol . take a sterile syringe and attach a 23 gauge needle . pull the plunger out to the amount that you are going to withdraw from the bicillin bottle .insert the needle into the bicillin bottle and push the air intothe bicillin bottle (to equalize the air pressure in the bottle) and then turn the bottle up and withdraw the amount you want .

Withdraw thesyringeand replace the 23 gauge needle with a 25 gauge needle which is smaller and then take the bottle of lactated ringers which will have a place to insert a needle, clean the insertion pont with alcohol and withdraw maybe 1 ml of lactated ringers into the syringe with the penicillin . The pencillin will then be thin and milky
Put the top back on the needle and now you are ready to give it
I will give you a video on giving subq's

this is a subqutaneous injection but is the same principle . You should try to rotate places on the body (I think Randy goes up and down the back but not too close to the spine)

When you insert the needle into the rabbit make sure to pull back on the plunger just a little to make sure that you don't get a blood return
if you get blood return it means that you have hit a vein ; in that case remove the needle and start over.

I have given a lot of bicillin and there are times I have had to try 3 times to get it in. In those cases i have shot it all over the bun and had to wipe him off. it is not always easy to know that you have an actual tent . The idea is to pull up on the rabbit's skin and pretend that you are putting the needle into the front opening of a tent . it takes some time and practice so don't get frustrated.
never forget to place the bottle into the fridge as it cannot remain out and remain good ; you can also store the lacted ringers in the fridge as it will be good for a few weeks before you need another liter. if it begins to look cloudy ; get another liter

Just found a whole article on medirabbit so read and print this out; if it differs from my explanation go with theirs

http://www.medirabbit.com/EN/Injection/Extracting_medication.pdf

this is on sub q fluids ..still looking for a video

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=469

this is a video but i can find a better one (remember this is not an injection but just giving fluids

[ame=http://www.youtube.com/watch?v=HfH7TPFbk-U]http://www.youtube.com/watch?v=HfH7TPFbk-U[/ame]
 
somebunny wrote:
I have previously tried looking for Pedialyte or something similar here but we don't have electrolyte drinks specifically for kids. We have the normal oral rehydration salts for adults, which seem to have quite a high content of sugar.

I'm not sure if tenting was difficult because I wasn't doing it properly or whether its because Hans is dehydrated (that's a good point, didn't occur to me earlier). I'll try to make sure he drinks more. Someone posted on RO ages ago on a homemade pedialyte recipe. I've saved that, and will try it if necessary. Thanks, Tracy!
Click to expand...

You can use something like gatotade but dilute it and it isn' really that highly recommendedd but better than nothing

and better than the home made concotion unless you are absolutely sure that it is correct...
 
In terms of the rehydration salts, the Dioralyte that we use over here says 'safe for babies' on it and gives slightyl different instrutions. We have no specific baby one either. If you have one that says safe for babies, that should be safe and ok for bunnies :)

Maureen, that's an ace description :D
 
Thanks Tracy but afterI wrote the whole thing outI found the medirabbit printout !!!

It would be a good idea for this bun to get subqutaneous fluids also as long as the vet is willing to do what you ask....
 
Somebunny I would printout the medi-rabbit article and bring it to your vet who then may feel more comfortable giving you lactated ringers to dilute the bicillin.

one reason the plunger maystick is that the drug is too thick to go through the lumen of the needle
 
Maureen & Tracy,

You've both taken a lot of effort to help me, I'm so grateful for that :)

I did print out information on administration of bicillin for my vet to read. She gave me a bottle of sodium chloride to mix the drug with. I draw the bicillin into the syringe first, then draw in an equal amount of sodium chloride to dilute it. You're probably right, angieluv, about the needle possibly being blocked by the thick drug. I will dilute it further when I do the next injection.

Thanks for your explanation and the medirabbit article. It's really helpful. I didn't know I wasn't supposed to shake the bottle. That's what the vet did yesterday yikes!
 
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