Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Top Companion Anim Med. 2021 Aug;44:100535. doi: 10.1016/j.tcam.2021.100535. Epub 2021 Apr 29.
Tetanus in dogs is a relatively uncommon neurological disease caused by the sporogenic bacillus Clostridium tetani. This disease is associated with prolonged hospitalization and mortality rates from 8%-50%. A 2-year-old, neutered male King Charles Spaniel and an approximately 8-months-old female Mongrel dog presented to Companion Animal Clinic with symptoms of muscle rigidity and generalized stiffness. A tentative diagnosis of generalized tetanus was made in both dogs. Treatment consisted of IV fluids, antibiotics (metronidazole), human tetanus antitoxin, analgesics and supportive care. Muscle relaxation was provided by midazolam. Acetylpromazine meleate was added to the treatment of the second dog to better control excitability. Each dog received magnesium therapy on the 10th and 3rd days, respectively; which was provided per os to the first dog and constant rate infusion (4 mg/kg/h) to the second dog. The addition of magnesium helped to increase muscle relaxation and increased the time interval between acetylpromazine administration. On the tenth day, magnesium sulfate was discontinued from the second dog and magnesium aspartate (12 mg/kg), twice a day, per os was administered in both animals. Further muscle relaxation was noted in both dogs with a substantial reduction of tetanus symptoms. Both dogs were discharged from Intensive Care Unit on the 14th and 13th day respectively with sole treatment of magnesium aspartate (12 mg/kg) orally, twice a day. Magnesium aspartate was continued for 14 days and 12 days respectively. Both dogs had progressive reduction of muscle rigidity and the first dog recovered completely. The second dog presented again with muscle rigidity and increased spinal reflexes after the discontinuation of magnesium aspartate, thus therapy with magnesium aspartate was started again and symptoms subsided after the second oral dose of magnesium. Therapy was continued for two more weeks during which muscle rigidity subsided and then was stopped. At that time, tetanus symptoms did not relapse and the dog was considered fully recovered. According to the findings of this case series, magnesium therapy may provide further muscle relaxation during the standard therapeutic protocol of tetanus in dogs. In addition, long term symptoms of the disease were adequately managed with the administration of magnesium aspartate, orally.
犬破伤风是一种相对少见的神经系统疾病，由产芽梭菌 Clostridium tetani 引起。这种疾病与长时间住院和 8%-50%的死亡率有关。一只 2 岁、已绝育的雄性查理士王小猎犬和一只大约 8 个月大的杂种狗因肌肉僵硬和全身僵硬到伴侣动物诊所就诊。两只狗都被初步诊断为全身性破伤风。治疗包括静脉输液、抗生素（甲硝唑）、人破伤风抗毒素、镇痛药和支持性护理。咪达唑仑提供肌肉松弛。乙酰丙嗪马来酸盐被添加到第二只狗的治疗中，以更好地控制兴奋性。第一只狗每天口服接受镁治疗，第二只狗接受恒速输注（4mg/kg/h）。镁的加入有助于增加肌肉松弛，并增加乙酰丙嗪给药之间的时间间隔。第十天，第二只狗停止使用硫酸镁，每天两次口服给予天冬氨酸镁（12mg/kg）。两只狗的肌肉进一步松弛，破伤风症状明显减少。两只狗分别在第 14 天和第 13 天从重症监护病房出院，仅接受口服天冬氨酸镁（12mg/kg），每天两次。天冬氨酸镁分别持续使用 14 天和 12 天。两只狗的肌肉僵硬逐渐减轻，第一只狗完全康复。第二只狗在停止使用天冬氨酸镁后再次出现肌肉僵硬和增加的脊髓反射，因此再次开始使用天冬氨酸镁治疗，第二次口服剂量后症状缓解。又进行了两周的治疗，肌肉僵硬减轻后停止治疗。此时，破伤风症状没有复发，狗被认为已完全康复。根据本病例系列的结果，镁治疗可能在犬破伤风的标准治疗方案中提供进一步的肌肉松弛。此外，通过口服给予天冬氨酸镁，可以充分管理疾病的长期症状。
