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Treatment may be attempted but consideration must be given to severely affected cases (e.g. recumbency, severe muscle spasms) which carry a grave prognosis. Horses should receive as little external stimuli as possible, ideally by keeping them in a darkened, quiet stable. Packing of the ears with cotton wool may help to minimise auditory stimulation. Administration of acetylpromazine may provide both sedation and a reduction in muscle spasm. Diazepam may be used alone or in combination with other sedatives to reduce severe muscular spasm.The use of an intravenous catheter is recommended to further reduce external stimulation. Any obvious wounds should be thoroughly debrided and flushed using 1% hydrogen peroxide, and parenteral penicillin should be administered. Tetanus antitoxin may be adminstered intravenously at the onset of clinical signs and is especially important in horses with no history of tetanus vaccination, foals and horses with obvious wounds.  
 
Treatment may be attempted but consideration must be given to severely affected cases (e.g. recumbency, severe muscle spasms) which carry a grave prognosis. Horses should receive as little external stimuli as possible, ideally by keeping them in a darkened, quiet stable. Packing of the ears with cotton wool may help to minimise auditory stimulation. Administration of acetylpromazine may provide both sedation and a reduction in muscle spasm. Diazepam may be used alone or in combination with other sedatives to reduce severe muscular spasm.The use of an intravenous catheter is recommended to further reduce external stimulation. Any obvious wounds should be thoroughly debrided and flushed using 1% hydrogen peroxide, and parenteral penicillin should be administered. Tetanus antitoxin may be adminstered intravenously at the onset of clinical signs and is especially important in horses with no history of tetanus vaccination, foals and horses with obvious wounds.  
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Affected horses may require intensive supportive and nursing care. Intravenous fluid and electrolytes should be administered if the horse is unable to drink or dehydrated. Dysphagic horses may require feeding via a nasogastric tube, particularly in the case of foals.  Adequate bedding consisting of peat or shavings must be provided, particularly in the case of recumbent horses when decubital ulcers must be avoided. In severe cases the use of slings may be employed to provide support and prevent self-trauma. Catheterisation of the bladder may be required as well as manual evacuation of faeces from the rectum.  
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Affected horses may require intensive supportive and nursing care. Intravenous fluid and electrolytes should be administered if the horse is unable to drink or dehydrated. Dysphagic horses may require feeding via a nasogastric tube, particularly in the case of foals.  Horses that are able to eat may be fed soft and moist feed in order to aid prehension and swallowing. Feed and water containers should be raised above ground height. Adequate bedding consisting of peat or shavings must be provided, particularly in the case of recumbent horses when decubital ulcers must be avoided. In severe cases the use of slings may be employed to provide support and prevent self-trauma. Catheterisation of the bladder may be required as well as manual evacuation of faeces from the rectum.  
    
==Prognosis==
 
==Prognosis==
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The prognosis is variable according to the severity of clinical signs. Horses that are able to drink have a good prognosis providing nursing care is available. Recumbent horses carry a grave prognosis with a mortality rate of approximately 80%. Horses that recover may be normal but some may be left with persistent neurological deficits.  
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The prognosis is variable according to the severity of clinical signs. Horses that are able to eat and drink generally have a favourable prognosis providing nursing care is available. Recumbent horses with severe muscular spasm and trismus carry a grave prognosis with a mortality rate of approximately 80%. Horses that recover may be normal but some may be left with persistent neurological deficits.  
    
==Prevention==
 
==Prevention==
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* Pearce, O. (1994) '''Treatment of Equine Tetanus''' ''In Practice'' November 1994 pp 322-325.  
 
* Pearce, O. (1994) '''Treatment of Equine Tetanus''' ''In Practice'' November 1994 pp 322-325.  
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* Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
    
[[Category:To_Do_-_Clinical]]
 
[[Category:To_Do_-_Clinical]]
 
[[Category:To_Do_-_SophieIgnarski]]
 
[[Category:To_Do_-_SophieIgnarski]]
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