In this article, the authors present a literary review on the etiology and pathogenesis of canine tetanus. Then they describe the clinical experiences during the treatment of 50 dogs. Between June, 1990 and May, 2001 10 518 dogs were admitted to the Clinic of Internal Medicine. The 50 dogs with tetanus yields 0.47% of all hospitalized dogs. The most relevant information regarding their history and clinical findings is outlined in the Table. The dogs were of different breeds, and mostly large breeds, which were kept mainly outdoors (93.5%). There were 72% males in the population and 64% of the dogs were younger than 7 months. The period of tooth changing proved to be the most significant risk of tetanus. In adult dogs, stab, deep wounds of the legs occurred as the primary potential risk of the disease. Most cases occurred from the spring till early autumn (Figure 1). The nervous signs observed at admission mainly resulted from the muscular stiffness and hyperexcitability. Stiffness usually developed on the muscles of the head and spread towards the muscles of limb and the trunk (Figures 2, 3, 4). The animals were placed on a soft mattress in a dark, quiet environment with a minimum amount of stimulation. From this point of view, it was important to provide immediate sedation and to use anticonvulsant drugs repeated several times. In the authors experiences, the most effective drug was diazepam. In case of severe, generalised tetanus pentobarbital should be administered supplementary of diazepam. Possible wound toilette and antibacterial treatment are integrated part of the treatment. To neutralize the circulating, unbounded toxin, antitetanus equine serum was given sc. Parenteral nutrition required continuous iv. infusion therapy. In addition, 4 dogs were fed via percutaneous gastrotomy (Figure 5), whilst in 3 cases a permanent gastric tube was inserted by pharyngostomy (Figure 6). The tube fixed in the oesophagus was more suitable, than the percutan gastric tube. Complications in dogs with tetanus occurred in 15 dogs (30%). Peptic stomach ulcers - not published earlier - were confirmed post mortem in 4 dogs. Stress due to pain and the long starvation might be possible causes of these ulcers. For prevention and treatment of gastric ulcers, H2-receptor blockers were given with some success. Other complications in some cases were decubital ulcers and catheter phlegmone, which could be avoided by keeping strict hygiene and by turning the dogs several times. Aspiration pneumonia was not observed in their cases. In contrast with other publications, hiatus hernia was not diagnosed as a sequel of tetanus. Prognosis was strongly related to the course of the disease. Dogs that could move, stand and could be fed per os, had good chances to survive (20 dogs, 40%). On the contrary, none of them survived who were hospitalized in an advanced state of severe generalised tetanus. By applying the aforementioned intensive medical care, 29 dogs (58%) were rescued. For preventing tetanus, it might be useful to vaccinate the predisposed dogs or to administer antitetanus serum in the period of tooth changing for puppies of large-breed dogs living outside. In case of injuries it is inevitable to apply tetanus-antiserum in addition to antibiotic therapy and wound management.
|Translated title of the contribution||Occurrence, clinical signs and treatment of tetanus - Experiences from 50 cases in dogs (1990-2001)|
|Number of pages||11|
|Journal||Magyar Allatorvosok Lapja|
|Publication status||Published - Dec 1 2003|
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