Gathering up my Courage….CDT Event #2!

CDT EVENT #2!

I am stunned, very disturbed and terribly frightened and I have 20 more CDT injections yet to give over the next 2 weeks.  PARANOID would be a mild description.  Here’s what happened and I feel compelled to share it so you will be very aware and on high alert for reactions to CDT vaccinations or any other injections you may give your herd.  Perhaps you are already well experienced with this scenario or perhaps you have never seen it.  My hope is you will never see it but that you will take away a new awareness and will be ready.

Monday, January 2nd was another beautiful and warm day.  The weather report advised a cold front would be moving in tonight and temps would drop to the 20’s.  I wanted to finish hoof trimming and CDT injections for the boys and I had two boys to go. I had recovered somewhat since Sam’s event on New Year’s Eve although it still haunted me – I needed to take care of Freedom and Jack.

Phil went out with me for moral support, and to help with these two, as they are really big boys and often very difficult for me to manage alone.  It’s around 2 pm.  Pretty routine – Jack (our wether) was first and today, for whatever reason, Jack was just awesome.  I was done with Jack in about 30 minutes and he didn’t hit the deck when he saw the injection coming.

Freedom was up next and he was spun up – as usual.  Blubbering, pawing, doing the neck pushing thing – being “bucky ( his year round status…high on testosterone 24/7).   Routine – back feet first since he’d just hosed down his front legs just for me (I do wear nitril gloves).  Usual trim all around.  His feet look great – no issues.  CDT injection – no problem.  Phil and I sit at a table nearby in the sunshine for about 30 minutes and watch the boys.  Everything seems hunky – dunky.  Sigh of relief.    We head back to fill the water tanks and make sure the heaters get plugged back in for the deep freeze coming.

(4:15 or so).  I’m running late –  time for evening feeding.  Food cart’s prepped – it’s closing in on 4:45.  Phil’s going to help and feed the boys for me. Freedom and Jack are always the first to get fed.   Phil heads off to feed the boys side and I head off to feed the girls.  I see Phil looking around.  I shout “is everything ok?”  No answer.  Phil’s jumped the rails into the pen.  I run.  OMG – Jack’s at the rail ready to eat and Freedom is motionless – stone still.  It’s happening all over again!  NOT POSSIBLE! I climb in the buck house.  Shout his name, he doesn’t look up – nothing, nothing.  Phil stays with Freedom and I run in to call the feed store to find out if they have any Tetanus Antitoxin.  Yes. 3 vials. We switch – I stay with Freedom and Phil heads for town -20 miles to to the store  – 20 miles home.  Store is open till 8.  Thank God.  Now let’s complicate the situation.  Phil has just had cataract surgery on his one good eye.  He has been blind in his right eye for the past year and a half (optic nerve compression/stroke in the eye).  This is a permanent condition.  This will be his first nighttime drive since cataract surgery -20 miles to town at near dusk and a return home in the dark.  These facts just slap me in the face…. after he’s gone!  He has astigmatism too- in the surgery eye.  OMG – Phil’s driving to town and Freedom’s in crisis.  Highway 48 is 2 lane with no shoulder for the first 10 miles and deer will be on the move.  Can it get any worse?

For the next hour I sit on the ground in the straw in the buck house and talk to God, my buck, and pray for Phil and for Freedom.  Freedom never moves.  I don’t force him to walk.  I don’t want to drive the CDT  absorption out any faster into his circulatory system. (I think that may have been a mistake with Sam). Finally I hear a vehicle coming down the gravel road.  It’s Phil.  I have the lamp out in the pen, the needle and syringe ready on the table, the alcohol and wipe good to go.  Phil’s got the vial and I draw it up, climb the fence rails and inject.  IM in the neck – full dose/5mls.  Freedom still has not moved and its been an hour now since the tetanus anti-toxin injection.  He’s never even acknowledged my presence.  I’ve been less than 5 feet away from him the entire time and given him an IM in the neck! Again – wait, watch, talk to my buck and talk to God. Finally Freedom slowly turns his head and looks over at me.  He yawns a little, he yawns again – bigger – really a stretching yawn.   He shakes out and stretches out his back and then takes two steps very slowly in my direction.  This is very encouraging but I’m not leaving – not until I see him eat something.  I wait and I talk to him.  He moves very slowly toward me and the feeder and stands there a second or two and finally takes a mouthful of Chaffhaye.  The event is over. I just stand next to him, hand on his shoulder and watch him eat while I cry.

Here is what I have learned from the manufacturer:

I gave them the Lot number on the vial and have requested testing.  They will test their repository sample of this lot (I still have 2 unused vials – same lot,  in the refrigerator that I will not be using).  The testing takes 21 days and guinea pigs.  They will notify me of their findings.  I spoke at length with the head Veterinarian of the pharma company for well over an hour.  I told the stories of both boys.  He listened with respect.  He told me the following:  He said symptoms both bucks displayed were delayed anaphylactic reactions.  He said they were classic.  These symptoms can occur several hours after an injection.  In some cases the goat will recover on its own in 12 to 24 hours.  In some cases they will die even with treatment.  He felt the tetanus antitoxin had no impact on their recovery –  “coincidental”.  He also said he had never heard of anyone giving tetanus antitoxin in this situation and reminded me of the risk of anaphylaxis with the use of tetanus antitoxin (or any other drug).  I told him I was well aware of the risk – but I felt I was dealing with tetany – and I was and still am convinced their recovery was not coincidental.  Nonetheless, he told me the following which I will pass on:  Anaphylaxis can occur several hours after the injection. When you see any hyper-salivating (which Sam did to a small degree – and Freedom did not do) and the shaking (which Sam had severely but Freedom did not exhibit) is to proceed with Banamine 1cc per 100#, followed with epinephrine.   He felt that Banamine was the most beneficial treatment. He told me that in goats the lungs fill with blood and the anti-inflammatory action of Banamine helps inhibit a course of death by drowning (he said it is unlike anaphylaxis in humans where the course is swelling & closure of the esophagus).  He told me that the tetanus portion of the CDT is derived from the toxoid created by tetanus bacteria and it has been inactivated. He reminded me of the strict protocols that drug manufacturers use – as required by the FDA.  He said the motionless stance was classic in anaphylactic reactions.  He said he receives more reports from Nubian owners over all other dairy breeds.

All I know for certain is this:

Today Sam seems to be 100%.  Freedom is 90 % .  I gave tetanus anti-toxin IM in the neck – (in neither instance was their time or opportunity to reach and collaborate with my veterinarian – late hour and holiday)  Both bucks turned around and survived – with Sam it took 3 hours to turn post tetanus anti-toxin injection.  With Freedom he turned in just over an hour post tetanus anti-toxin injection.   I gave CDT to a total of 8 goats (Sam’s event was on New Years Eve and Freedom’s on January 2nd) and two bucks had delayed life threatening reactions (25%!).  I have never had this before.  I will not use this brand of CDT again in my herd.  Apparently they are allergic? to something in it (be it an antibody or an agent in their specific CDT vaccine or something else was at work).  Perhaps my boys survived in spite of the tetanus anti-toxin.  I am convinced otherwise.  I will remember the symptoms, I will watch more closely over several hours after giving vaccines, antibiotics or even topical treatments – not just 30 minutes.  I will never ever vaccinate an entire herd all on one day.  I will treat incrementally and have enough Banamine and epinephrine on hand to cover those injected.  I will have enough tetanus anti-toxin on hand when I give CDT vaccinations to cover those vaccinated.  I don’t know the causative agent of the event. I may never know.  I  just know that everything went wrong and somehow everything worked out.

Now I have 20 left to do.