Kaiya – A Neurology Case

Presentation

Kaiya, a five-month-old Border Collie, was presented to the neurology team as an urgent case with a 4-day history of progressive stiffness which started in the pelvic limbs. She had been completely healthy prior to this.

General physical examination showed a normal temperature, normal heart rate and normal respiratory rate. The rest of the examination was normal. There were no identifiable wounds on the paws or anywhere else on the body.  

Neurological examination revealed a normal mentation with an evident risus sardonicus (ears erected, lips and eyes drawn back). Kaiya had a rocking horse posture with increased muscle tone in all limbs, worse in the pelvic limbs. Cranial nerve examination was normal and no pain was found on palpation of the spine.

Full blood work including electrolytes and magnesium was normal.

These are diffuse central nerve system signs typical of Tetanus.

Treatment

Kaiya received 1000 IU/kg antitoxin following a sensitivity test. She was also prescribed 10 mg/kg metronidazole twice a day and diazepam 1 mg/kg three times a day.

Kaiya was still able to open her mouth and chew and so fortunately did not require any tube feeding. She was hospitalised for 5 days under the care of our Neurology, Critical Care, and Nursing teams and showed a gradual improvement. Kaiya was discharged with oral metronidazole and oral diazepam.

Ongoing Care

Thankfully, Kaiya should continue to improve, and we expect her to make a full recovery.

Clostridium tetani is found in soil and intestinal tracts. In most cases, it is introduced into the body through wounds, particularly deep puncture wounds. The incubation period varies from 1 to several weeks but usually averages 10 to 14 days and so often the point of entry cannot be found because the wound itself may be minor or healed.

Timely intervention and good nursing care are vital once signs have been identified, and thankfully this was the case for Kaiya.