TETANUS

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Causative Agent(s)

Exotoxin: tetanospasmin, elaborated by the vegetative stage of Clostridium tetani - a spore forming anaerobe.

Clinical Presentation and Epidemiology

Initially there is increase in muscle stiffness accompanied by muscle tremor; trismus with restriction of jaw movement (lock jaw); prolapsed of the third eyelids; unsteady and straddling gait; tail is held out stiffly, ears stand erect, and nostril dilated; tetany of masseter muscle prevents eating; and drooling of saliva. Constipation is usual and urine is retained. Temperature, pulse, and respiratory rate are normal initially but increase later. Bloat is an early sign in young animals. As the disease progresses, tetany increases, and animal adopts a “saw-horse” posture. Opisthotonos is marked. There may be a transient period of improvement before final severe tetanic spasm during which respiration is arrested and death occurs. Cattle may die in 5-10 days; sheep at 4-4 days; mild case which recover do so slowly with stiffness disappearing gradually over weeks or months.

Diagnostic Considerations

Clinical evaluation: Tetanus is mainly diagnosed using clinical signs such as abnormally prominent third eyelids, rigid jaw muscles, bloat, and muscle stiffness.

In cases in which the wound is apparent, detection of the bacterium in gram-stained smears and by anaerobic culture may be attempted.

The causative agent can be confirmed by PCR assay of wound tissue.

Management and Treatment
  • Tetanus antitoxin 10,000-50,000 IU for cattle and 3,000-15,000 IU for goats
  • Tranquilizer such as Acepromazine 55-1.1 mg/kg IV, IM or SC
  • Antibiotics of choice is Penicillin 22,000-44,000 IU/kg IM bid X 7/7
  • The identified wound or infection site should be thoroughly cleaned to remove all dead tissue and should be flushed with hydrogen peroxide
  • The animal should be placed in a dark, quiet stall, and interaction with the patient should be kept to a minimal.

The animal's hydration status should be monitored closely, and animals may require intravenous fluid support.

  • Cephalosporins such as ceftriaxone can be used in very severe cases after bacterial culture and sensitivity tests have been performed.