Plus-Hex CLINICAL
Introduction
This case study describes the onset of clinical signs, diagnosis, treatment and recovery of the author ' s 9-year-old domestic shorthair cat following a diagnosis of tetanus. Tetanus is a disease that is rarely seen in clinical practice and even less commonly in cats, due to their resistance to the bacterium responsible for it, Clostridium tetani.
Spores of C. tetani can enter through a wound and germinate. They produce a bacterial toxin, tetanospasmin, which binds at the neuromuscular junction and travels along motor nerves to the spinal cord and potentially to the brain. It is taken up by inhibitory interneurons in the spinal cord and brainstem, where it irreversibly blocks the release of the inhibitory neurotransmitters glycine and gamma-aminobutyric acid. The consequent loss of inhibition results in muscle rigidity and spasms, which may be localised or generalised [ 1 ]. In cats, tetanospasmin appears to have relatively poor binding within the central nervous system, which may contribute to the apparent resistance of the species to tetanus [ 2 ].
In cats, tetanus may present as either localised or generalised disease. Generalised tetanus involves more widespread muscle rigidity across the body [ 3 ]. Localised tetanus typically causes rigidity in the limb or muscles near the wound, sometimes with tremors. It may progress to generalised tetanus over time, although this does not always occur. Localised tetanus is more common in cats, with stiffness and rigidity initially affecting one limb and potentially progressing to other limbs [ 4 ]. The prognosis may differ depending on whether the disease is localised or generalised [ 2 ].
Diagnosis of tetanus is often based on the patient ' s recent history and clinical signs [ 5 ]. Although the initial onset of clinical signs of tetanus can take up to 3 weeks, their progression thereafter is rapid. Early diagnosis and treatment of the disease is therefore critical to improve the patient ' s prognosis. Loss of ambulatory function secondary to unilateral or bilateral hindlimb paralysis commonly persists for approximately a month, with complete recovery often requiring several months, thereby complicating clinical management. Managing owner expectations on recovery time and the emotional and financial implications associated with the disease is crucial.
Tetanus is an uncommon condition in cats, and the available literature on its presentation, treatment and prognosis is limited. Although reports in other species such as horses and dogs are more common, feline cases are rarely documented. The majority of veterinary professionals never encounter a case of tetanus in a cat throughout their career. Whereas, the purpose of this case study is to provide a detailed day-by-day account of a patient ' s treatment and recovery, and to give guidance to those in clinical practice when managing similar cases.
Learning outcomes
• Understand the cause of tetanus and its disease progression in cats
• Become familiar with the clinical signs, diagnosis and treatment of tetanus
• Recognise potential complications associated with the treatment of tetanus
Patient signalment
Name Species Breed
Sybil Cat Domestic shorthair Sex Female( neutered) Age Weight
9 years
4 kg Body condition score 4 / 9
Presentation
On presentation, the patient ' s heart rate was 180 beats per minute with sinus rhythm, her respiration rate was 34 breaths per minute and her temperature was 39.2 ° C.
No adventitious lung sounds were auscultated, although intermittent open-mouth breathing was noted. Mentation and proprioception were normal. Marked right hindlimb lameness was present, with reluctance to bear weight and reduced extension of the right hip. Pain was most evident on palpation of the medial thigh and stifle. Muscle mass and hip prominences were symmetrical, although mild sensitivity was detected on palpation of the lumbosacral spine. No limb swelling, joint effusion, wounds or external tissue injury were identified.
Sybil was up to date with preventative healthcare, fed a commercial diet and had no known pre-existing health conditions. Her appetite and urinary and faecal output were normal. She lived adjacent to a disused farmyard and had constant outdoor access, so was at an increased risk of injury. The only recent environmental change was the introduction of a new cat to the neighbourhood.
Investigations
Sybil was initially prescribed methadone 0.3 mg / kg, administered intramuscularly( Comfortan, Dechra, 10 mg / ml) and meloxicam 0.2 mg / kg, administered subcutaneously( Loxicom, Norbrook, 5 mg / ml) as a single dose, followed by meloxicam 0.05 mg / kg orally
Volume 41( 4) • August 2026
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