Plus-Hex CLINICAL more often develop the localised form of tetanus rather than the generalised form( which can cause added complications such as lockjaw).
Once the patient ' s pain has been managed, complementary therapies such as physiotherapy can be helpful for improving the range of movement in the affected limb( s) [ 16 ]. It is vital that pain levels are controlled before commencing physical therapy, otherwise it will not be tolerated and could lead to secondary stress-induced pyrexia and inappetence. Sybil received both passive and active physiotherapy, including controlled assisted walking, stretching, and range-of-motion and massage therapy, in hospital. As her mobility improved, she attended chiropractic sessions, which provided support and specialist knowledge for her owners. Any complementary physical therapy sessions provided by a properly trained and qualified practitioner will be beneficial for the patient ' s recovery and will also improve owner compliance in performing physical therapy techniques at home.
Discussion
Tetanus is caused by the neurotoxin tetanus toxin, also known as tetanospasmin, produced by the bacterium C. tetani, which is most commonly found in the soil [ 2 ]. These bacteria enter the body via wounds. In cats, these wounds have often healed by the time clinical signs of tetanus occur, as disease onset in this species can take up to 3 weeks after infection [ 2 ]. Tetanus is especially rare in cats, with the localised form of the disease being more commonly seen than the generalised form; therefore, vaccination against tetanus is not recommended in this species [ 17 ]. However, vaccinations are recommended in more susceptible species, such as horses and sheep [ 2 ]. There is currently no specific diagnostic test for tetanus in cats, so diagnosis of the disease relies on the clinical signs and history. In this case, tetanus was considered likely due to the localised swelling, rapid progression of hindlimb rigidity and the cat ' s access to the outdoors in a rural setting.
Due to the rarity of the disease in cats, there is limited literature on treatment and outcomes. However, from the few pieces of literature available, it seems that the prognosis is favourable, especially in cats that develop the localised form of tetanus and receive treatment early on in the development of clinical signs [ 3 ].
It is, however, important to mention that treatment of the disease is expensive, as the likelihood of the patient requiring hospitalisation is high, so financial considerations must be discussed with owners before treatment commences. In addition, studies suggest an average of 25 days until recovery of ambulatory status and, even then, it is likely that further supportive care will be required from the owners for several months until the patient is back to full health [ 1 ]. Therefore, owner compliance is essential to the successful recovery of these patients. The temperament of the patient should also be considered, as treatment is intensive and may not be well tolerated by fractious cats. Having said that, there are few reports of unfavourable outcomes where the right conditions were met, and the vast majority of documented cases report successful recoveries from localised tetanus, as in the case described here.
Key takeaways
• In cats, tetanus is usually localised, affecting either one or both hindlimbs.
• Specific diagnostic tests are not available to confirm tetanus in cats, so diagnosis must be based on the patient ' s history, clinical signs and disease progression.
• Prognosis is favourable in cats that develop the localised form of tetanus and receive treatment early in the development of the disease.
• Return to mobilisation can take up to 3 – 4 weeks, with complete recovery taking several months to a year.
Assessment of learning
1. How long does the onset of clinical signs of tetanus typically take in a cat?
a) 48 hours b) 5 days c) 1 week d) 3 weeks
2. What is the most common clinical sign seen in cats with tetanus?
a) Vomiting and diarrhoea b) Hindlimb paralysis c) Weight loss d) Polydipsia / polyuria
3. Where is the bacterium Clostridium tetani most commonly found?
a) Soil b) Parasites c) Urine d) Blood
1. d) 3 weeks 2. b) Hindlimb paralysis 3. a) Soil
Answers
Volume 41( 4) • August 2026
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