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Under "Acute Effects"

"As for benzyl penicillin sodium, severe, usually transient reactions with symptoms of severe anxiety and agitation, psychotic reactions, including visual and auditory disturbances, seizures, tachycardia and hypertension, cyanosis, and a sensation of impending death have occasionally been reported with procaine penicillin and may be due to accidental intravascular injection. Procaine has been implicated as a cause of these reactions, especially after injection of high doses. This reaction has been termed non-allergic, pseudoallergic, pseudoanaphylactic, or Hoigne’s syndrome. Procaine penicillin should not be injected intravascularly since ischaemic reactions may occur."

This says to me that if injected into the vasculature, procaine can cause death similar to how Hans died. But I think that SB did the injection right and didn't get it into a vein...
 
"Inadvertent intravascular administration, including inadvertent direct intra-arterial injection or injection immediately adjacent to arteries, of Penicillin G Procaine Injectable Suspension and other penicillin preparations has resulted in severe neurovascular damage, including transverse myelitis with permanent paralysis, gangrene requiring amputation of digits and more proximal portions of extremities, and necrosis and sloughing at and surrounding the injection site. Such severe effects have been reported following injections into the buttock, thigh, and deltoid areas. Other serious complications of suspected intravascular administration which have been reported include immediate pallor, mottling, or cyanosis of the extremity, both distal and proximal to the injection site, followed by bleb formation; severe edema requiring anterior and/or posterior compartment fasciotomy in the lower extremity. The above-described severe effects and complications have most often occurred in infants and small children. Prompt consultation with an appropriate specialist is indicated if any evidence of compromise of the blood supply occurs at, proximal to, or distal to the site of injection.1-9 (See [#section-9 PRECAUTIONS], and [#section-11 DOSAGE AND ADMINISTRATION.])"

"Immediate toxic reactions to procaine may occur in some individuals, particularly when a large single dose is administered (4.8 million units). These reactions may be manifested by mental disturbances, including anxiety, confusion, agitation, depression, weakness, seizures, hallucinations, combativeness, and expressed “fear of impending death.” The reactions noted in carefully controlled studies occurred in approximately one in 500 patients who received large doses of penicillin G procaine. Reactions are transient, lasting from 15 to 30 minutes. "

This is about penicillin g procaine for people, meant to be an IM injection. Doesn't say anything about death. ( http://wiki.medpedia.com/Penicillin_g_procaine_(Penicillin_G_and_procaine) )
 
Ok, so intravascular administration (into a blood vessel) of procaine is really dangerous. However, the symptoms are a bit more extreme than Hans experienced--namely, seizures preceding cardiotoxicity or respiratory failure.

http://emedicine.medscape.com/article/167309-overview

Pen G benzathine can also cause cardiotoxicity if injected intravascularly.
http://www.docstoc.com/docs/document-preview.aspx?doc_id=577859

I found the LD50 for iv procaine--it's 35-45mg/kg (mice/rats). Sub-q, it's around 300mg/kg (guinea pigs). If SB was giving 0.2mL, which is what I can tell from the post, that's 34 mg of procaine. Assuming Hans is 1kg, that is in the range of the LD50 for an in injection.
 
http://www1.agric.gov.ab.ca/$Department/deptdocs.nsf/all/hrs3718
This relates to horses , scroll down to penicillin...reaction from hitting a vein ; there would have been a much more violent reaction.

Anaphylaxis is a severe allergic respone to components in the drug; this would causereactions like severe edema and swelling, including the throat , hives etc and could be life threatening.
 
There is anaphylaxis from penicillin, but procaine itself acts on sodium channels which could cause the heart to have arrhythmias and stop if injected IV. However, I would expect to see seizures from IV injection of procaine as well. I guess it's possible it caused arrythmia and heart failure without seizures, but it would be rare.
 
I think I may have injected into a blood vessel, and the drug travelled to his heart :( I'm so sorry, Hans.

Fluffies, benacillin was working for Hans. After 1.5wks, the abscess started to shrink. I was going to take a photo to show the improvements, but then Hans went to the bridge. If I were faced with an abscess again, I would still use Benacillin, or any other suitable version of bicillin. I'm still convinced that bicillin is the best way to treat an abscess. The vet wanted to operate on Hans but I refused to subject him to another round of operations (he had been sedated a couple of times before to have his incisors trimmed, and later on he went for an operation to remove his incisors. I just felt that he has had enough procedures done on him throughout his short life).

Just be careful with the injections. I used to pull the syringe back to see if any blood came back up, indicating that I had hit a blood vessel. But I've never seen any blood come back up and after a few times, I got too confident and injected without checking. That's my mistake and I feel so guilty for that.
 
I just heard from Marcy, I wrote to her about Hans' passing. She says that "an allergic reaction to penicillin would be more reactive and would take more than a few seconds. Subcutaneous pretty much eliminates hitting any vein or artery."

Marcy too had a rabbit that passed away during a sub-q injection. At that point, her rabbit was only getting the sub-q saline and the drug hadn't been injected yet. But somehow, the injection of the needle into her skin caused some sort of reaction, and she passed away.
 
Well that would make me feel somewhat relieved ...
it's nothing you did
I had a link above that won't open; it described giving penicillin accidentally ( in a vein)to a horse and the horse had seizures and a very violent reaction.

Idon't think you hit a vein either.


 
Now that I hear more about Hans's passing (in your other thread), it sounds like there was something else going on with him. You said that he was easier to catch in his pen, so he was probably lethargic to begin with. You said that he had his head tilted, he laid down, and gently took his last breaths. This really doesn't sound like the reactions I read about with either penicillin or procaine IV injections--they always involve seizures. It would be very strange to have a heart attack from these drugs without any twitching of the other muscles. They act on heart muscle the same way that they act on peripheral muscle, causing spastic contractions, which can lead to heart attack and seizures. I don't think you can have one without the other.

The tilt makes me worry that he had an infection elsewhere, perhaps in his inner ear or brain stem. It's also possible that he had an infection somewhere else and it got into the blood and caused sepsis, which can lead to death quickly like that.

I really don't think it's your fault, Streisand. First of all, it probably wasn't the injection that killed him--after reading your account of it, it sounds different from what I'd expect from an IV injection. And, even if it was the injection (which I now don't think is the case), it wouldn't be your fault. Anything that happened to him, you were doing the very best you could for him. You're not a vet, and you had the very very best of intentions. I don't think it was the injection that caused it, but even if it were, it wouldn't be your fault.

I really think there was something else going on health-wise with Hans that you couldn't see and the vet didn't know about. Perhaps he had an infection somewhere else deep in his body that spread to the blood. Perhaps he had disease of one of the other main organ systems (liver, kidney, lung etc) that you couldn't tell from looking at him.

I'm so sorry that you lost him, but you cannot blame yourself. You went above and beyond to help him; you did more than most people would or could do for their animals. His death was out of your control--there must have been something else going on for him to pass away in that manner. Sometimes, even when we try our hardest, the result is not what we want. It is easy for me to think this way because in science it happens all the time (I do research): you may spend years trying to get something to work in the lab that makes sense based on the scientific theories we already know, but it never happens because there are things we don't know about at work.

So, back to the topic at hand. I think it's safe for you to use Benacillin on Dino, the fluffies. Getting training in how to do Sub-Q injection will help make sure you do it correctly. We always need to remember that even with the best treatment and diagnosis, we can't always save our animals, because there may be things going on we don't know about.
 
It has been a long time since i update about Dino.

This is the photo taken on 23 July 2009

p72301621.jpg


The lump was burst, and there's a lot of pus. But a few weeks later, it just dried up itself and healed.

It was more than a year ago.

Now, he is totally fine.. No abscess since my last update. I'm keeping my fingers crossed and hope it will never come back. :pray:
 
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