Changes

==Diagnosis==

==Diagnosis==

As described above, a history of trauma and unrelenting muscular spasm in a localised area is often described in cases of tetanus in dogs. An obvious wound may help to increase suspicion of tetanus, particularly if the wound is necrotic or infected. In this species, diagnosis is often based on clinical judgement rather than laboratory tests, as these may add little helpful diagnostic information. In occasional cases, ''C. tetani'' may be cultured from a wound, but this may be impossible if healing has occurred or a wound is not apparent. An important clinical feature of tetanus in dogs that may aid diagnosis in hindsight is that of slow but complete resolution of muscular spasm over a lengthy period of time (weeks or months).  

As described above, a history of trauma and unrelenting muscular spasm in a localised area is often described in cases of tetanus in dogs. An obvious wound may help to increase suspicion of tetanus, particularly if the wound is necrotic or infected. In this species, diagnosis is often based on clinical judgement rather than laboratory tests, as these may add little useful diagnostic information. In occasional cases, ''C. tetani'' may be cultured from a wound, but this may be impossible if healing has occurred or a wound is not apparent. An important clinical feature of tetanus in dogs that may aid diagnosis in hindsight is that of slow but complete resolution of muscular spasm over a lengthy period of time (weeks or months).  

Other neurological diseases causing limb spasticity may need to investigated; myelography for example will assist in ruling out an extramedullary lesion. A complete blood cell count, serum biochemistry, survey radiographs of the thoracic spine and serology for protozoal diseases should also be performed in order to exclude other neurological differential diagnoses.  

Other neurological diseases causing limb spasticity may need to investigated; myelography for example will assist in ruling out an extramedullary lesion. A complete blood cell count, serum biochemistry, survey radiographs of the thoracic spine and serology for protozoal diseases should also be performed in order to exclude other neurological diagnoses.  

Electromyography may be used to help to support a presumptive diagnosis of tetanus. Abnormalities relating to a defect in glycinergic inhibition, including the presence of "doublets" (double discharges of the same motor unit at

Electromyography may be used to help to support a presumptive diagnosis of tetanus. Abnormalities relating to a defect in glycinergic inhibition, including the presence of "doublets" (double discharges of the same motor unit at

short intervals) and simultaneous activity in both flexor and extensor muscles.

short intervals) and simultaneous activity in both flexor and extensor muscles, may be detected.

==Treatment==

==Treatment==

The approach to treatment in the dog is the same as that described for the horse. It is important however to exercise caution in the intravenous administration of equine tetanus antitoxin, as this may cause anaphylaxis if used in dogs. An intradermal test may be performed prior to the administration of the antitoxin in order to prevent anaphylaxis. Metronidazole and amoxcillin-clavulanic acid PO have been used successfully to treat tetanus in the dog. Corticosteroids are contraindicated in localised tetanus and may worsen clinical signs if administered.

The approach to treatment in the dog is similar to that described for the horse. It is important however to exercise caution in the intravenous administration of equine tetanus antitoxin, as this may cause anaphylaxis if used in dogs. An intradermal test may be performed prior to the administration of the antitoxin in order to prevent this. Metronidazole and amoxcillin-clavulanic acid PO have been used successfully to treat tetanus in the dog. Corticosteroids are contraindicated in localised tetanus and may worsen clinical signs if administered.

Noise and external stimuli should be kept to a minimum, and the dog should be kept in a quiet, darkened kennel. Acetylpromazine has also been reported to reduce sensitivity to external stimuli and its administration is likely to be beneficial in these cases. Supportive nursing care such as catheterisation and/or enemas may be required, as well as assistance with eating and drinking. Bedding should be thick and changed regularly, and the patient should be turned regularly in order to prevent decubital ulcer formation. Physiotherapy may be benefical during the recovery period.

Noise and external stimuli should be kept to a minimum, and the dog should be kept in a quiet, darkened kennel. Acetylpromazine has also been reported to reduce sensitivity to external stimuli and its administration is likely to be beneficial in these cases. Supportive nursing care such as catheterisation and/or enemas may be required, as well as assistance with eating and drinking. Bedding should be thick and changed regularly, and the patient should be turned regularly in order to prevent decubital ulcer formation. Physiotherapy may be benefical during the recovery period.

==Prognosis==

==Prognosis==

The long-term prognosis for dogs with tetanus is good.  

The long-term prognosis for dogs with tetanus is good, from 50% up to 90% in dogs hospitalised in an intensive care unit.

* De Risio, L., Zavattiero, S., Venzi, C., Del Bue, M., Poncelet, L. (2006) '''Focal canine tetanus: diagnostic value of electromyography''' ''Journal of Small Animal Practice 2006 May 47(5):278-80''

* De Risio, L., Zavattiero, S., Venzi, C., Del Bue, M., Poncelet, L. (2006) '''Focal canine tetanus: diagnostic value of electromyography''' ''Journal of Small Animal Practice 2006 May 47(5):278-80''

* Matthews, B.R and Forbes, D.C. (1984) '''Tetanus in a Dog''' ''Canadian Veterinary Journal May; 26(5): 159–161''

* Matthews, B.R and Forbes, D.C. (1984) '''Tetanus in a Dog''' ''Canadian Veterinary Journal May; 26(5): 159–161''