CiCi the dog overcomes challenging case of severe generalised tetanus

Three weeks of specialist treatment and care at Davies Veterinary Specialists in Hertfordshire have saved a dog with a highly challenging case of tetanus.

CiCi, a ten-year-old small female crossbreed dog was rushed to Davies as an emergency when her local vet spotted general stiffness a couple of days after CiCi had cut her paw. Although the cut was small and hadn’t been causing CiCi much bother she had gone off her food and her owner had become very concerned.

Neurology Specialist Emilie Royaux together with a team of veterinary nurses provided treatment and round the clock care for CiCi.

“On the initial assessment, CiCi had risus sardonicus, muscle twitches worsening with excitement and a very stiff gait. CiCi also had a swelling of the toe of her right thoracic leg. The combination of these signs made tetanus the most likely diagnosis,” explained Emilie.

CiCi was immediately given intranvenous tetanus antitoxin without any side effects and was hospitalised to receive supportive treatment of intravenous fluids, sedation, muscle relaxants and antibiotics.

“We examined her paw and found a grass seed from the swollen toe which we removed together with some purulent discharge,” said Emilie. “Unfortunately, though, despite our quick work, CiCi deteriorated severely.”

The stiffness, tremors and muscle spasms got much worse and CiCi was no longer able to walk. Under a general anaesthetic a stomach tube and urinary catheter were placed and the muscle spasms, stiffness and tremors were managed with medication.

“CiCi remained in our intensive care unit, under close observation,” said Wards Head Nurse Laura Barham. “But unfortunately, her muscle spasms were not completely under control and she developed severe episodes of hyperthermia so we needed to   change her medication until we found a way to manage them adequately.”

After two weeks of very intensive care in the ICU unit, the dose of sedation and muscle relaxants was slowly tapered. After three weeks CiCi was finally well enough to return home.

“It was very uplifting to see CiCi’s stiffness improving which meant we could reduce her medication,” said Laura. “Once she was able to walk and eat unaided, we were able to discharge her. CiCi regained her personality and she and her owner were very happy to be reunited.

CiCi was a sweetheart and a true fighter. Tetanus patients are very emotionally challenging to nurse; they require constant observation and a full awareness of how quickly the patient’s condition can change.  Cici managed to pull through with the amazing hard work of Emilie Royaux, the wards nurses and intern team.”

About tetanus

Tetanus is caused by a toxin produced by the bacteria Clostridium tetani. These bacteria are fairly widespread, though dogs have a high natural resistance against it. The disease develops when a wound becomes infected, allowing bacteria to grow and the toxin to be generated and to seep into the nervous system. Once there, it interferes with nerve cell communication, preventing muscle relaxation and leading to uncontrolled muscle spasms.

In some cases, the muscle spasms can be quite localised, perhaps just affecting the leg where the infection has arisen or the face. In more severe cases, the muscle spasms become generalised affecting the entire body. The legs become stiff and walking becomes difficult, the small muscles of the face become tense, pulling the lips into a forced grin, wrinkling the forehead and pulling the ears into an upright position. Because of the muscle spasms dogs can often no longer open their mouth.

Treatment of a dog with tetanus involves neutralising toxin that is already in circulation, wound care, stopping further toxin and counteracting the impact of the toxin on the nervous system using muscle relaxants and sedative drugs. Dogs with severe generalised tetanus often need intensive care for a few weeks. This is the time that the nerves need to recover from the damage caused by the tetanus toxin. The prognosis for dogs with severe generalised tetanus is guarded. Once the dog has survived this difficult period, they can make a complete recovery.

CiCi’s owner Michelle Nixon said: “Emilie worked tirelessly for CiCi through the three weeks she was at the hospital and her knowledge and skills were absolutely outstanding.  She really went above and beyond and worked so hard to adapt the treatment when CiCi wasn’t doing as well as everyone hoped, and I had complete trust in her.

“Another huge part of CiCi’s recovery was the care she received from the wonderful team of nurses who watched over her 24 hours a day. Each one of them played a vital part in CiCi’s survival and their skill and dedication meant they were able to react immediately to any change in CiCi’s condition and quite frankly she would not be here without their amazing care and attention.

“After three weeks she came home and quickly recovered, so much so that just two months later we took her to the Norfolk coast for a week where she swam in the sea every day, she was full of energy and back to her usual happy self.

“It was clear right from the start that everyone involved in CiCi’s care was rooting for her and it’s wonderful that with the right treatment and care, a dog can not only overcome tetanus but live a happy health life afterwards.”

Click here to find out more about the Neurology service at Davies.