Plus-Hex CLINICAL
Grass seeds do not break down in the body ; they can become embedded and allow bacteria to enter the body via the tract they produce . A further 50 % of wounds in this case study were suspected foxtail tracts [ 6 ] . Therefore , even wounds from something as small as a grass seed can introduce C . tetani to an animal .
Case study
A week before Luther , a 3-year-old German pointer , was admitted to hospital , his owner presented him to his primary care practice ( PCP ) with swelling and mild trauma to the fifth digit on the left foreleg . The PCP assumed Luther had hurt himself on a walk and treated him with meloxicam , an anti-inflammatory and painrelief medication .
Figure 1 . Facial muscle spasm .
Over subsequent days , Luther ' s owner noticed a change in the dog ' s facial expression , so they returned to the PCP , where Luther was treated for an allergic reaction and given a dose of steroid . However , the changes to Luther ' s facial expression became more severe and he started to have difficulty eating . This prompted his owner to opt for Luther ' s referral for specialised medical treatment on 11 April 2023 .
Clinical signs
Figure 2 . Hyperextension of all four limbs .
Tetanus can take two clinical forms in dogs : localised and generalised : [ 2 ]
Localised tetanus
The effects are local to a single region of the body , which is often where the first signs are seen , with stiffness generally affecting the muscles or limb that is closest to the wound . The rigidity can develop into tremors and , with time , localised tetanus can develop into generalised tetanus . Luther was admitted to hospital with signs of localised tetanus .
Figure 3 . ‘ Sinister smile ’ ( risus sardonicus ).
Generalised tetanus
The effects are widespread , affecting many areas of the body ( Figures 1 – 4 ). Dogs may be unable to bend their legs effectively , with up to 80 % of dogs progressing to complete recumbency . The animal may hold its tail up and have its head and neck constantly extended .
The facial structure is also affected ; the lips are held back in an expression termed ‘ risus sardonicus ’, a Latin phrase that translates into English as ‘ sinister smile ’. While receiving treatment in practice , Luther developed risus sardonicus , which gradually improved .
Signs of generalised tetanus tend to appear around 24 hours after the signs of local tetanus , with spasms and hyperalgesia to touch becoming more evident [ 4 ] .
Figure 4 . Stiffening of the limbs , making movement difficult .
Volume 39 ( 2 ) • April 2024
41