Pen G Vs. Bicillin

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bunnymommy76

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Hi everyone,

I got some bad news at the vet today. Pidgey's abcess has come back.

I opted not to do surgery again, he's getting old, I worry about him being sedated so much. Anyway, I mentioned the Pen G to the vet which they did know about, and are willing to try. However as I'm doing more research here I see that there is also Bicillin. I thought they were the same drug. What exactly is the difference between the two and Is one better than the other, which oneshould pidge be put on?

julie
 

ra7751

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Hi Julie,

It's the same drug. You want to use the form that contains 150K units of Procaine and 150K unitsof Benzathine for a total of 300K units of active drug per mL. This drugis a cattle drug and can be purchased without prescription at farm supply stores. This drug is safe only when injected. It should be buffered with something like lactated ringers solution to ease the burn and lessen the risk of some skin issues at the injecton point. Also move the injection points around and don't do them in the same area each time. I do most of my injections on the flank. This drug should be refrigerated but warm up the dose before injecting. This treatment is very effective when used concurrently with Zithromax. I have been using this combination of drugs for quite some time with perfect success (so far anyway). I even have my primary vetusing this drug protocol now. I do use an anti-inflammatory for the first few days. Aggressive pain meds (narcotics) will also aid in the treatment. I do a "full boat" support therapy that includes sub-q fluids and nutritional supplements....anything to help the immune system.

You might also ask about using a drug called Chloramphenicol. It is a highly effective drug. I also use it quite a bit. There are some precautions when using this drug....but not for the rabbit, for the human giving the drug. Has been some bone marrow issues in humans (rare). This drug should not be used if the penicillin is used.

Randy
 

Haley

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Randy,isnt the difference between Bicillin and PenG that Bicillin is PenG + Benzathine? I was under the impression that PenG alone has to be given every day whereas in Bicillin (TwinPen, ComboPen etc) it has the Benzathine which helps it last longer so its every other day.

Julie. Ive used Bicillin in my boy who had a severe jaw abscess and it worked wonders. He actually had surgery to remove the abscess twice. The first time we didnt use Bicillin and the abscess came back. After the second surgery we used Bicillin for about 6 months and hes been fine for over a year.
 

ra7751

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It appears that most of that stuff has kinda morphed together. There is or was a Bicillin LA and a Bicillin CRand then there was the thing that the Bicillin (capital B) was a human version and bicillin (lower case b) was the animal version. The bottle I have in front of me says Pen G Procaine and Pen G Benzathine. All of these different versions is why I am specific about the concentrations. 150K of Procaine and 150K of Benzathine. No confusion that way.
 

Haley

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That makes sense, Randy. I know when my vets speak of the two they call PenG Procaine just PenG. When they are referring to PenG Procaine plus PenG Benzathine its called Bicillin, TwinPen or Combo Pen because it has the "two" Penicillins in it.

Youre right, its important to discuss the concentration since the names seem to vary.
 

bunnymommy76

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Thanks guys!

I'm taking him to this new vet that I was referred to by my vet on thursday to talk about non-surgical treatment. I was just trying to get my facts straight on the Pen G/ Bicillin before talking to the vet about it. I think Im just going to print this thread out and let the doctor read randys explaination.

I feel so sorry for the little guy, I knew it was going to come back!! From the very begining Randy kept telling me that he needed a more aggressive treatment, i told my vet this and they didnt want to do it, now that it came back they are sending me somewhere elsebecause I want to try the injections., Ugh, gotta love those vets!

thanks again guys

julie
 

ra7751

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Hi Julie,

I understand your frustrations with the vet. In their defense, they get very little training on exotics in vet school. That is why I get called often to take my critters up for students doing clinicals. The students I have worked with have been exposed to real world problems with real world bunnies....nothing like they would see in a lab animal. What the students get from myanimals isas real as it gets. The doctors rely on reference material that might be a bit out of date. There are also legality issues in some states...something like veterinary malpractice. That would be an interesting claim since no drugs are certified for use in rabbits by the FDA. Any treatment of a rabbit (and most other exotics) are considered "off label". There are also limits placed on treatment by the owners of the clinic. If the doctor is a staff doctor, he/she has to follow the rules of the boss if they want to continue to work there. It puts the doctors in a bad spot sometimes. I have worked side by side with many vets..and in many cases of wildlife the doctor has worked as my "tech"....I rarely see any vet that is not a top notch professional. And I understand their situation completely when it comes to exotics.

The treatment for abscesses is very challenging. Just a few years ago, an abscess in a rabbit was a death sentence. Then, especially with mandibular absesses, there was surgery and anti-biotic laced beads. It has been pretty much a failure. Expensive, painful and rarely successful. Many of the earliest beads had clindamycin in them....a great drug that can handle most any bacteria....but it tends to migrate to the GI tissue and does a number on that bacteria too. And we all know what happens then.

The treatment I am using was actually developed right here....I did it myself several years ago. I amsure thatsome of those talented vets out there have also discovered this....I just lucked up...but luck counts. I have a very handsome Blue Eyed White dwarf named Finlay. He had a hole in his jaw. I "burned the midnight oil" researching drugs that might help him since we knew his health would not allow surgery....and the Pen G/Zithromax did the trick. I have used it successfully many times. Chloramphenicol might also be a possibility. And I am doing some investigation of using another drug, Metronidazole (Flagyl) against the anaerobic core of dental abscesses. I use that drug quite a bit in stasis situations....but it has some interesting properties that allow it to pass thru the blood/brain barrier, it can penetrate the thick pus and it appears that it can penetrate bone. This might be interesting but time will tell on this one.

Keep us posted...and healing vibes are headed to Pidge from our warren.

Randy
 

bunnymommy76

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I took Pidge to the new vet today. The bottom line was that the doctor put him on the regular penicillin G not the bicillin. I'm a little confused as to why He only has him taking it once a week though, I thought this was an every day injection???

I don't know what the dosage was that the doctor gave him, could this be why he is only getting it once a week, because maybe the dosage is higher? I'ma little confused,I am going to question this when I take him next Thursday. (The doctor is doing the injections, home injections wasn't even mentioned)

What is all of your take on this, if your bunny was on Pen-G, how often were you giving it?

julie
 

Haley

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Julie,

I should edit the thread because maybe this part is unclear:

*****MISUSES AND INACCURACIES *****

Bicillin is in the blood for 7 days so once/week is enough

Pen–G Procaine is bicillin

Maintenance dose every 3 days

Leave Bicillin out for over an hour to warm


Marcy isnt saying this stuff is true, shes sayingtheseare misuses/innaccuracies that shes hearing a lot of. You need to either call your vet asap or findanother vet. The once a week dose of PenG is for treating syphillis in rabbits. If you give your bunny PenG once a weekit will be ineffective or could create resistent bacteria. Heres Marcy's quote:

"Many rabbits have done very well on daily injections for 1 month then
on every other day for another month or two or until cured. If your
rabbit has an abscess it is treated aggressively until the abscess is
GONE/ERADICATED/CURED. It could take 8 weeks or it could take 8
months. DO NOT go to every 3 days. This protocol was tried and
failed. The most dangerous thing you can do is a maintenance dose
with antibiotics. The idea is to eradicate the infection not create
resistant bacteria"

My vet tried the same thing when I first put Max on Bicillin. I had to go buy the stuff myself and give the injections.

 

bunnymommy76

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Oh okay, I read it wrong. So I was right in my original thinking, it should be given every day?!?

Hmm, I had a appt with the other vet for tomorrow and canceled it, I wonder if I could still get him in.

Im nervous now, what if I can't get him in, I dont want him to get resistant to this, this is the one potential drug that could finally help him.

Where is everyone getting this on their own, even if I do get him in I dont know if the vet is going to go for it, I may have to do it on my own too.

Im going to be climbing the walls until 8am tomorrow when the vet opens, I hope I can get him in and they can give him another injection or show me how to do it. Im going to be a nervous nelly all night!!!

Thanks so much for clarifying that for me!!!



 

Haley

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Not a problem. Have you checked our list of recommended vets to see if there's anyone in your area? I know how frustrating it is to have to deal with vets who arent as up to date on rabbit care.

Do you have a Tractor Supply Co. near you? Bicillin (150k units PenG Procaine + 150k unitsPenG Benzathine) can be purchased at most TSCs and maybe even other feed stores. It is marketed for cattle and is labeled usually as CombiPen, Twin Pen, Pen BP 48 and is an injectable subQ antibiotic. Theimportant thingtolookfor is the concentration. Bicillin is meant to be given SubQ every other day.

Its best if you can try to find a good vet to work with, but sometimes we have to take things into our own hands for the health of our bunnies.

Did you print out that study by Marcy Moore to show to your vet? The link has case studies and everything. I dont know how a vet can ignore that.

http://www-unix.oit.umass.edu/~jwmoore/bicillin/bicillin.htm

Heres Marcy's email as well: petlabrabbits@webtv.net Maybe she would call your vet or something if you contact her and tell her whats going on?


 

bunnymommy76

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Thank you so much Haley!

I dont have a tractor supply company near me.

I have printed out the Bicillin study and brought it to the vet on thursday, he didnt even want to read it. He told me no, just have him take the PenG once a week. This vet I am talking about getting him into tomorrow is a different vet again, I am on my 4th vet now. If I can get him in tomorrow I am going to bring the article. This Doctor was familiar with it and said she went to a seminar on it, she had all kinds of notes on dosage and such, she just sent me to this other doctor for a 2nd opinion, but it seems that she is more familiar with it!


 

Haley

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Let us know if you get ahold of anyone in the morning. It might be difficult being Easter weekend though.

Heres our link to IL rabbit savvy vets in case you want to have a look around.

Hope that helps a little. If you only have enough PenG for once a week I think I would just hold off for now. Make sure your vet knows it has to be Bicillin (PenG Procaine plus PenG Benzathine) and not just the PenG.

Haley
 

bunnymommy76

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Will do! just one more question, you said to watch for the right concentration, what should it be? is this the 150 K of each Pen G procaine and Pen G benzathine. Does anyone know of a good website to purchase this from, if I have to take that route?
 

Haley

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Yup, its 300,000 units (150k PenG Procaine and 150k PenG Benzathine). I found an online site once you could order from but the problem is Im not sure how it would be shipped and still be effective since it has to be refridgerated.

Do you have any other farm/feed stores near you? Hopefully this other vet can get it for you. Did they show you how to do injections at home?
 

bunnymommy76

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I found a tractor supply co about 45 mins from me, I would have to go into indiana to get it. 45 mins isnt too bad, besides my boy is worth it! No, I was never shown how to give an injection, but this vet I am going to try to get him into tommorrow did say that they could show me, so thats good!! Hopefully they will have the bicillin too!

well, im going to try and get some sleep, I will call the vet first thing 8AM, and let ya know whats going on. thanks for everything!

julie
 

ra7751

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Hi Julie,

A little more information about using Pen G. I was using this drug before this doctor wrote this article (I also use some other drugs that are considered "off limits" to rabbits and have been for years). I would make the trip to the TSC. The product I purchased from them is called Combi-Pen-48. I think I paid a bit over $10 for a 100mL bottle. As mentioned, it does require refrigeration.

When I use this drug, I pull the amount I need into a syringe. I also buffer this drug with a sterile solution like Lactated Ringers. This does a couple of things. First, the drug is very thick. The smallest needle that you can effectively use is 21g. The Lactated Ringers will thin this drug to make it easier to inject. It will also buffer the "sting" as this drug burns like h-e-double hockey sticks.....us old folks have had penicillin injections. In severe infections, it can be administered every day but I normally do it every other day. The two components act in different ways....one is a "blitzkrieg" type operation in which it enters the blood and starts to work very quickly and the other component is a long duration drug that takes longer to establish but stays at a working level for a longer period of time.

A couple of tips on injecting....I use a little different method so you will need a sympathetic and supportive vet (or human medical person) to help with this. I do not use the normal syringe for injections unless it is a small enough dose to use an insulin syringe (U100). I use a 21g "Winged Catheter" aka Butterfly. This has a needle that has wings and a tube. This allows some "wiggle room" when doing the injections. As opposed to a stiff syringe, if the rabbit suddenly hops backward, the catheter just flexes instead of having a hard syringe possible tear the skin. It should be used with the screw on type lock...known as a "Luer Lock". There is also something called a "Luer Slip" but that requires the needle to be pushed on....the screw on is much better. You can use any size syringe you are comfortable with as long as it has the screw type lock. You would also want to move the injections around. Hitting the same area all the time will usually result in some ugly skin abscesses....most of the time they are not a huge problem but they just don't look good. If you know of anyone in the medical profession be it animal, human or even EMTs or paramedics....they can teach you how to sub-q in just a few minutes. Learning to do injections...both how and especially when...opens an entirely new world of treatment possibilities.

And a couple of final thoughts. I have has success in using the Pen G in combination with Zithromax in treating abscesses.That combination really packs a punch (and that is exactly what itdoes...punchesholes in the cell walls of the bacteria) Couple of things to watch for....some of the "tag along" infections. This is where a culture would come in handy. While these infections are not the core of the abscess, which is what to go after, a couple of secondary infections may require follow up treatment. We have seen Pseudomonas "which can be a little testy to treat) and recently, and for the first time in a rabbit that I have seen, we had a jaw abscess with a strain of Strep as a tag along. But these were "mop ups" that we worked after resolving the primary core of the abscess. In other words, this may take a while.

I would really try to find a vet that looks "outside" the box. In your vet's defense, if they don't own the practice, they might be limited by clinic policy on what they can do that is not available in their publications they use. And unfortunately, I see a lot of outdated information that is available in vet clinics as far as rabbits and other "exotics".

And the correct concentration of the drug you need is 150K units of Procaine and 150k units of Benzathine for a total drug concentration of 300K units per mL. There are other concentrations so read the label carefully.

Randy
 
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