First rule of thumb: No drug is completely safe!

Follow your veterinarians instructions

Proper use of drugs and medications can alleviate many conditions, but close monitoring is essential.

Drugs and medications come in many forms and are administered orally, intravenously, intramuscularly, subcutaneously or applied as a topical treatment. The chemistry of the drug and the physiology of horses dictate the route of administration of the drug. Drugs administered by different routes are absorbed in different ways and at different rates.

Some drugs can be deadly if administered in an incorrect way; others lose their effectiveness and may harm the horse if incorrectly administered. A competent veterinarian is your best line of defense when it comes to prescribing and administering medications to your horses.

Important guidelines for giving medications

• All medications and treatments should be prescribed by a veterinarian and instructions given including dosage rate, route of administration, and intervals between doses. Inappropriate use of medications can result in the death of your horse.
• Your veterinarian should allow you to watch the administration of medications and teach you the techniques associated with administering pills, capsules and tablets, pastes, liquids, the use of a balling gun or a stomach tube, correct procedures for giving injections including intravenous, intramuscular and subcutaneous.
• You must know how to maintain and handle medications correctly including awareness of precautions for their use, how and where to store them, how to read expiration dates, and what to do in case of a reaction to the medication.
• The approach for treating individual horses differs with breed, personality, and handling history.  Knowing your horse, knowing how much restraint is necessary, and using well-thought-out administration techniques based on firm, but gentle good horsemanship will build your confidence and create a relationship of trust with your horse.

Guidelines for administering different forms of medications

1. Pills, capsules, tablets
   Usually given orally by means of a balling gun or may be crushed or broken up and added to a small amount of feed such as rolled oats, inserted into a piece of apple or carrot, or mixed with a small amount of applesauce, molasses or other semi-liquid food and squirted onto the back of the horse's tongue with a syringe.
2. Pastes
   Make sure that the horse's mouth is empty to ensure that the horse won't spit out the paste along with a clump of food. Insert the end of the syringe into the horse's mouth through the space between the teeth and depress the plunger. The horse's head should be restrained to prevent pulling back and injuring the mouth.
3. Liquids
   Medications in liquid form and electrolyte solutions are usually given by a large-dose syringe, a drenching bottle or a stomach tube. When using a syringe follow the procedures for giving a paste. When using a drenching bottle, raise the horse's chin so that the nose is parallel to the ground to prevent the liquid from running back out of the mouth. When giving mineral oil or other oil-based medications, always use a stomach tube. If a horse inhales oil, fatal aspiration pneumonia may occur.
4. Stomach Tube
   A stomach tube is a plastic or rubber tube about 10 feet long. It is introduced through the nose and gently advanced into the esophagus. You can see the tube passing down toward the stomach by the ripple it produces down the side of the neck next to the jugular vein. Once the tube is just above the stomach, the medication is flushed down the tube with a large dose syringe or a hand pump. The medication should be followed by water to ensure complete delivery of the medication. Unless carefully done, the possibility of improper placement of the stomach tube into the windpipe with the potential for a medication being delivered into the lung exists. This mishap may result in the horse aspirating and possibly drowning; therefore, a stomach tube should be used only by a veterinarian or someone specifically trained in its use.
5. Injections
   Never give an injection until your veterinarian has demonstrated the correct procedure and walked you through the steps of giving the injection. Be sure to follow the directions with the product for the proper route of injection. An assistant in control of the halter and lead is required, and for some horses, a secure restraint is necessary. For all types of injections, the skin should be clean and swabbed with alcohol. The medication is drawn into the syringe and the needle pointed upward while pressing the plunger to expel air. The needle is removed from the syringe and the site for the injection is selected and swabbed with alcohol.

Giving injections

The three best sites for intramuscular injection are the side of the neck, the buttocks and the back of the thigh. For subcutaneous injections the skin along the side of the neck is a good place to use. Intravenous injections are given into the jugular vein.

To give an intramuscular injection, angle the needle so that it is vertical to the surface of the body. Insert the needle with a swift jab up to the hub. If the horse jerks back, wait a few seconds until the horse is calm, attach the needle to the syringe, draw back the plunger and look for blood. If you see any blood, the needle has entered a vein. Withdraw the syringe and needle and start over. Once you have the needle and syringe inserted correctly, depress the plunger and administer the medication. Withdraw the needle and rub the skin for a few seconds to disperse the medication.

To give a subcutaneous injection, grasp a fold of skin to form a ridge. Swab the skin with alcohol. Firmly push the needle through the skin fold into the subcutaneous fat. The angle of the insertion will be somewhat parallel to the surface of the body to prevent the needle from going into the muscle or coming out the other side of the skin fold. Repeat the same steps as shown for intramuscular injection.

Intravenous injections, while not difficult to give, have the most potential for ill effects and should be given only by a veterinarian or someone who has had extensive training both in technique and the serious consequences when the injection goes wrong.

Experience is necessary to locate the vein and enter it with a hypodermic needle. The horse must be thoroughly restrained and accuracy in injecting the medication into the vein is extremely important. Drugs that leak into surrounding tissue can cause pain, swelling and scar tissue formation.

Missing the jugular vein and injecting the medication into the carotid artery which runs directly behind the jugular vein, can result in collapse, seizures and death of the horse. Other complications can include thrombophlebitis or septic thrombophlebitis and damage to the nerve that controls the left side of the larynx resulting in partial paralysis of the larynx causing the horse to become a "roarer."

Fortunately, if a horse must be on long-term intravenous medication or on medication that must be given frequently such as IV penicillin, an intravenous catheter can be inserted in the jugular vein making it possible for the horse to be treated and monitored by the owner or handler.

Administering eye medications

Horse eye placement makes them susceptible to injury

Minor eye injuries are serious, but faily common. Learning to administer eye ointment is important for the horse owner.

Eye problems including disorders of the eyelids and conjunctiva are treated with appropriate ointments and drops. Make sure you consult with your veterinarian considering any prescriptive or over-the-counter eye preparations before treating your horse. In many cases, the owner can treat minor eye disorders.

The horse is restrained and a ribbon of ointment is run along the border of the upper eyelid. As the horse blinks, the medication dissolves and covers the surface of the eyeball.

Eye drops are dropped directly onto the eyeball of the restrained horse. Drawing up on the skin above the eye will help widen the opening of the eye. Package and insert directions should be followed. Eye medications are usually applied several times a day.

If no improvement in minor eye ailments is seen within 24 hours, contact your veterinarian. Serious eye disorders require intensive treatment to prevent blindness. At times it will be necessary to install a sterile tube/catheter into the space above the upper eyelid to permit ease in applying medication safely and at the times specified. A small pump may be connected for continuous infusion. When this is necessary, you can work with your veterinarian to monitor the situation on a daily basis.

Long-acting preparations may be injected beneath the conjunctiva to treat problems with deep inflammation or those that pose a serious threat to the eye. In cases of eyelid lacerations or injuries to the eye, surgery may be necessary with a course of antibiotics to prevent infection.

Treating minor wounds and skin conditions

The horse's skin appears to be remarkably strong and tough, but unfortunately, it is susceptible to injury, trauma, and skin disorders. Since it is the barrier that keeps out bacteria and other foreign agents, treatment of any wounds or skin conditions at the earliest sign of any problem is extremely important.

Fortunately, owners are in a good position, not only to note any problems, but also to actively prevent them, and treat them effectively when they do occur. In most cases it is important to consult with your veterinarian when any new skin condition appears. For minor wounds or recurring skin conditions, topical applications in the forms of liniments, poultices and shampoos are available.

Before treating any minor wound or skin condition consult with your veterinarian regarding possible prescriptive medications or over-the-counter products. Given your veterinarians advice, you will, most likely, be able to treat your horse with an appropriate product by following the label and package insert directions and adhering to the proper intervals for applying the medication.

Treatment of wounds or skin conditions with inappropriate topical medications can actually delay healing, so always make sure you are using the appropriate treatment for the problem at hand.

Recommendations for proper use of horse medications

1. Develop a good relationship with your veterinarian
2. Listen carefully to instructions being given and ask for written instructions if the treatment regimen is complicated.
3. Read all instructions accompanying medications carefully to make sure that the correct medication is being given in the correct strength for your horse. Note the route of administration, the frequency and the length of usage and what to do in case of reaction or overdose.
4. Read all precautions carefully including how the medication may affect people handling it and the proper protocol for usage.
5. Become conscious of proper disposal of products and packaging and act in an environmentally responsible way with all medications, drugs, and supplements.
6. Keep an on-going record of all medications administered to each horse for future referral.
7. Note that the barn or stall area is usually not a suitable storage area for medications.  Make sure that all medications are stored according to manufacturer's recommendations including refrigeration, prevention of freezing, protection of medications that are sensitive to light and storage at the correct temperature.

When treating your horse with any medication, as in all training experiences, make sure you end on a positive note with a pat on the shoulder along with some words of praise or a little reward for a job well-done.

Dig deeper^TM

Administering medications to your horse or other equine is an important part of horse ownership. Learning to administer medications yourself can greatly decrease your cost of horse ownership, and is highly recommended.

For hands-on learning, your veterinarian is the best resource. EquiMed provides a library of reference articles to help you learn more about common drugs and medications. Our general care health center is a great place to find articles that will help you with other hands-on activities that are rewarding, and that can save you money.