Simmonds Erin E, Alwood Amy J, Costello Merilee F
AVETS, Monroeville, PA 15146, USA.
J Vet Emerg Crit Care (San Antonio). 2011 Oct;21(5):542-6. doi: 10.1111/j.1476-4431.2011.00674.x. Epub 2011 Sep 14.
To describe the use of magnesium sulfate in a case of generalized tetanus in a dog.
A 1.5-year-old golden retriever was presented for a digital wound on the right thoracic limb and clinical signs associated with generalized tetanus. Initial case management consisted of wound debridement, treatment with metronidazole, tetanus immunoglobulin, methocarbamol, airway management via tracheostomy, and nursing care. Sedation to control severe muscle spasms became insufficient despite increasing doses of benzodiazepine, methocarbamol, and barbiturate continuous rate infusions. A magnesium sulfate continuous rate infusion was instituted on day 7 and muscle rigidity improved within 16 hours allowing discontinuation of sedative infusions over the subsequent 2 days. Clinical improvement continued and the dog was discharged on day 14.
This case demonstrates the use of supraphysiologic magnesium in the treatment of severe generalized tetanus with a positive outcome. No clinical signs associated with magnesium toxicity were noted during the course of therapy. Magnesium sulfate should be considered as a potential adjunct therapy in the management of spastic paralysis caused by severe tetanus in dogs.
描述硫酸镁在一只犬全身性破伤风病例中的应用。
一只1.5岁的金毛猎犬因右前肢趾部伤口及全身性破伤风相关临床症状前来就诊。初始病例管理包括伤口清创、甲硝唑治疗、破伤风免疫球蛋白、美索巴莫、通过气管切开进行气道管理及护理。尽管增加了苯二氮䓬类药物、美索巴莫和巴比妥类药物持续静脉输注的剂量，但控制严重肌肉痉挛的镇静效果仍不充分。在第7天开始硫酸镁持续静脉输注，16小时内肌肉强直得到改善，随后2天可停止镇静剂输注。临床症状持续改善，该犬于第14天出院。
本病例证明了超生理剂量的镁在治疗严重全身性破伤风中的应用取得了积极效果。治疗过程中未发现与镁中毒相关的临床症状。硫酸镁应被视为犬严重破伤风所致痉挛性麻痹管理中的一种潜在辅助治疗方法。
