Tetanus in a canine: clinical and therapeutic aspects

Abstract Tetanus is a serious and rare disease in small animals, of an acute nature and mediated by the action of the neurotoxin tetanospasmin, from the bacillus Clostridium tetani. This report describes a case of tetanus in a canine, with emphasis on its clinical and therapeutic aspects, in addition to its clinical recovery. A canine, female, Pitbull breed, five months old, in status epilepticus, was attended at the Veterinary Hospital of the University of Passo Fundo. After stabilizing the patient, the animal was found in a trestle position, with generalized spastic paralysis, risus sardonicus, trismus, erect tail and ears, and difficulty in expanding the thorax. The presumptive diagnosis of tetanus was established based on the anamnesis, clinical signs, and laboratory findings. The established supportive treatment included hydro electrolytic replacement, antitetanus serum, antibiotic therapy, analgesia, myorelaxant and anticonvulsant drugs. The patient's intensive management was carried out with urethral and gastroesophageal probing, changes of position every two hours, and reduction of environmental stimuli. Physiotherapy and acupuncture were also used to complement the treatment and accelerate recovery. The patient was discharged one month after the beginning of the treatment, presenting satisfactory evolution. In the present case, the clinical examination in association with the characteristic clinical signs of the disease, added to the detailed anamnesis, was essential for the presumptive diagnosis of tetanus. In addition, intensive management, drug treatment, physiotherapy, and acupuncture enabled the evolution of the clinical condition to cure.

破伤风（tetanus）是一种在小动物中发病的严重且罕见的急性疾病，由破伤风梭菌（Clostridium tetani）产生的神经毒素破伤风痉挛毒素（tetanospasmin）介导致病。本报告报道一例犬破伤风病例，重点阐述其临床特征、治疗方案及临床转归过程。一只5月龄雌性比特犬（Pitbull）因癫痫持续状态就诊于帕索丰杜大学（University of Passo Fundo）兽医院。对患者进行病情稳定处理后，可见该犬呈木马体位（trestle position），表现为全身性痉挛性瘫痪、苦笑面容（risus sardonicus）、牙关紧闭（trismus）、双耳及尾巴直立，且存在胸廓扩张困难。接诊医师结合病史（anamnesis）、临床症状及实验室检查结果，作出破伤风的初步诊断。制定的支持治疗方案包括水电解质补液、破伤风抗血清、抗生素治疗、镇痛、肌松及抗惊厥药物治疗。对患犬实施了强化护理：包括尿道及胃食管插管、每2小时更换一次体位，并减少环境刺激。此外辅以物理治疗与针灸（acupuncture），以促进治疗进程并加速康复。患犬于治疗开始后1个月出院，临床转归良好。本病例中，结合临床检查、疾病特征性临床症状与详尽病史作出破伤风初步诊断至关重要。此外，强化护理、药物治疗、物理治疗及针灸方案助力患犬临床症状完全痊愈。