Successful management of severe generalized tetanus in two dogs

Objective: To describe the clinical course and successful outcome of severe generalized tetanus in 2 dogs. Case series summary: Two dogs presenting with severe muscle rigidity, opisthotonus, and trismus were diagnosed with tetanus. In both cases, generalized convulsions, respiratory compromise, and autonomic dysfunction necessitated emergent interventions followed by intensive treatment and monitoring. In the second case, transient mechanical ventilation was required. Both dogs survived and were discharged after 19 days (first case) and 18 days (second case) of hospitalization. Although costly and time‐consuming, treatment for severe generalized tetanus was successful in these 2 dogs. New information provided: Severe generalized tetanus with convulsions, respiratory compromise, and autonomic dysfunction can have a successful outcome with intensive care and appropriate treatment.     

Risk factors associated with outcome in dogs with tetanus: 38 cases (1987-2005)

OBJECTIVE: To assess the clinical course of disease and risk factors associated with outcome in dogs with tetanus. DESIGN: Retrospective case series. ANIMALS: 38 dogs with tetanus. PROCEDURES: Data were collected from medical records of dogs with tetanus, including signalment; wound characteristics; initial clinical signs; severity of worst clinical signs; time to wound management, antimicrobial treatment, and antitoxin administration; and 28-day survival rate. Statistical analyses were performed to evaluate relationships between the potentially predictive variables and disease progression and outcome. RESULTS: The 28-day survival rate was 77% (among 35 uncensored dogs). The most common initial clinical signs in affected dogs were ocular (n = 18) and facial (11) abnormalities. Nineteen dogs progressed to recumbency with severe muscle spasms, and 14 dogs had high or low heart rate or blood pressure values. Eight dogs died or were euthanized because of complications of tetanus. There was a significant association between younger age and development of more severe clinical signs. Furthermore, a significant inverse relationship between development of severe clinical signs and survival was identified. There was no association between earlier initiation of wound management, antimicrobial administration, or antitoxin administration and either progression of signs or 28-day survival rate. Wound type was not associated with 28-day survival rate. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that younger dogs with tetanus may be more likely to develop severe clinical signs. The prognosis for survival in dogs with tetanus is good if abnormalities in heart rate or blood pressure values do not develop.     

Respiratory complications in dogs with tetanus: A retrospective study of 53 cases

Tetanus can lead to respiratory complications, and the outcome of dogs affected by this disease is still largely unknown. This retrospective study aimed to evaluate the frequency and outcome of 53 dogs with tetanus and respiratory complications between February 2006 and January 2019.Medical records from dogs diagnosed with tetanus admitted to a referral teaching hospital were reviewed. Fifty-three dogs were diagnosed with tetanus and respiratory complications were observed in 26.4% (14/53) of dogs; 8 developed aspiration pneumonia (AP), 5 developed upper airway obstruction (UAO) and 1 dog developed both. A total of 5 AP dogs were mechanically ventilated. Three dogs with UAO had tracheostomy tubes placed. Dogs with respiratory complications had a poorer outcome, with only 14.3% (2/14) surviving to discharge, compared to 94.8% (37/39) for dogs with no respiratory complications. Respiratory complications such as AP and UAO were common in dogs with tetanus, and this was associated with a poorer outcome.     

Esophageal hiatal hernia and megaesophagus complicating tetanus in two dogs

Two dogs with tetanus developed transient megaesophagus and hiatal hernia associated with gastroesophageal reflux and regurgitation. The megaesophagus and hiatal hernia were diagnosed radiographically and resolved with resolution of the tetanus. These 2 cases, plus previously reported cases, indicate that tetanus can cause megaesophagus and esophageal dysfunction. Therefore, thoracic radiography should be included as part of the diagnostic evaluation of dogs suspected of having tetanus.     

Myopathy associated with hyperadrenocorticism in the dog

Naturally occurring or iatrogenic hyperadrenocorticism was associated with myopathy in six dogs. One dog had muscle weakness and muscle atrophy but normal electromyographic findings. Five dogs had muscle stiffness, proximal appendicular muscle enlargement, and myotonic discharges on electromyography. Histologic, electron microscopic, and histochemical findings in the musculature of dogs that were examined were characteristic of noninflammatory degenerative myopathy. Clinical signs of the myopathy improved to varying degrees in five dogs that were treated for the hyperadrenocorticism.     

Effect of fenbendazole on Toxocara canis larvae in tissues of infected dogs.

The effect of fenbendazole therapy was studied in six dogs fed 10,000 embryonated Toxocara canis eggs. At 47 days after they were fed T canis, four dogs were given fenbendazole in two divided doses totaling 50 mg/kg of body weight each day for 14 days. Two infected dogs were not given fenbendazole. All dogs were necropsied at the end of treatment and the foci were counted in the lungs; their skeletal muscles were digested in 1% trypsin for the recovery of larvae. The T canis larvae were not recovered from the skeletal muscle of the four infected dogs treated with fenbendazole; 15 and 42 larvae/100 g of skeletal muscle were recovered from the two nonmedicated infeected dogs. The number of grossly visible foci on surfaces of lungs in treated dogs was markedly less than in the nonmedicated infected dogs. The results indicate that fenbendazole might be effective in preventing prenatal infection in dogs.     

Locked jaw syndrome in dogs and cats: 37 cases (1998-2005)

A consecutive series of cases of dogs and cats with locked jaw syndrome (inability to open or close the mouth) are reported in this study. Dogs were significantly overrepresented (84.0%) and adult dogs were more frequently affected (81.0%). Temporomandibular joint ankylosis due to fracture was the most common cause (54.0%) of locked jaw syndrome. Additional potential causes of locked jaw syndrome are masticatory muscle myositis, neoplasia, trigeminal nerve paralysis and central neurological lesions, temporomandibular joint luxation and dysplasia, osteoarthritis, retrobulbar abscess, tetanus, and severe ear disease. Treatment of locked jaw is directed towards the primary cause. It is important to treat the tonic spasm in order to minimize periarticular fibrosis. Surgical intervention is recommended for temporomandibular joint ankylosis. Masticatory muscle myositis treatment is initiated by gradually opening the mouth, with medical treatment based on immunosuppressive therapy. Fracture and masticatory muscle myositis are associated with a relatively good prognosis in regard to short-term outcome as compared to animals with central neurologic lesions or osteosarcoma which have a poor prognosis.     

Effect of Two Muscle Sling Techniques on Early Morbidity after Femoral Head and Neck Excision in Dogs

Femoral head and neck excision was performed on the left coxofemoral joint of 18 dogs. The osteotomy site was padded with a partial-thickness biceps femoris muscle sling in one group of six dogs, and with a deep gluteal muscle flap in another group of six dogs. In a third group of six dogs, a partial-thickness biceps flap was created and sutured back in its original location. The dogs were monitored daily for 3 weeks for degree of lameness, range of motion, fever, and postoperative complications. Dogs with intra-articular muscle pads were less lame and had a greater range of motion in the treated hip than dogs without intra-articular muscle pads. Dogs with biceps slings showed more improvement in limb function and range of motion than did dogs with deep gluteal flaps. There were no significant differences in mean temperature elevations and no clinically significant postoperative complications. Use of a partial-thickness biceps muscle sling or a deep gluteal muscle flap decreased the chances of early postoperative morbidity and provided an earlier return to function. The partial-thickness biceps sling appeared to be more beneficial than the deep gluteal flap.     

Polymyositis in two German wirehaired pointer littermates

Two cases of polymyositis in German wirehaired pointer littermates are described. The seven-month-old dogs were presented with a history of acute vomiting, weakness and drooling from the mouth. Examination of the dogs disclosed muscle weakness, dysphagia, megaoesophagus, elevated serum muscle enzyme levels and abnormal electromyographic and muscle biopsy findings. Both dogs were treated with prednisolone and made a complete recovery. The dam, and two littermates, were also examined, but no signs of polymyositis were seen in these.     

Studies on the Pathophysiology of Infraspinatus Muscle Contracture in the Dog

Contracture of the infraspinatus muscle has been recognized as a cause of shoulder lameness in hunting dogs. Electrophysiologic studies of four affected dogs indicated that infraspinatus contracture was a primary muscle disorder rather than a neuropathy. Histologically, affected tissues from six dogs showed degeneration and atrophy of skeletal muscle with fibrous tissue replacement. These findings supported the hypothesis that an acute traumatic event caused incomplete rupture of the infraspinatus muscle, leading to fibrosis and contracture. Seven dogs were successfully treated by infraspinatus tenotomy.     

Tetanus in a dog

A three month old dog with tetanus was treated with antitoxin, antibiotic, a sedative and a muscle relaxant. A pharyngotomy tube was placed to facilitate feeding. The dog recovered after 23 days of therapy.     

'Continuous muscle fibre activity' in six dogs with episodic myokymia, stiffness and collapse

Continuous muscle fibre activity was observed in a crossbred dog, a Yorkshire terrier, a border collie and three Jack Russell terriers. The clinical signs consisted of episodes of generalised myokymia which developed into muscle stiffness and delayed muscle relaxation and generally led to the dogs collapsing into lateral recumbency. These episodes were preceded by intense facial rubbing in three of the dogs, and were associated with severe hyperthermia in five of them. All three Jack Russell terriers showed continuous ataxia. The dogs had above normal activities of aspartate aminotransferase, alanine aminotransferase and creatine kinase, but their cerebrospinal fluid was normal. Myokymic discharges were observed by electromyography in two of the dogs. Two of them were treated with membrane-stabilising agents, with variable results.     

Clinical and imaging findings,treatments, and outcomes in 27 dogs with imaging diagnosed trigeminal nerve sheath tumors: A multi‐center study

The clinical behavior of canine trigeminal nerve sheath tumors and benefits of previously reported treatments are incompletely defined. Aims of this retrospective, multicenter, observational study were to describe clinical signs, tumor localization characteristics, treatments, and clinical outcomes in a group of dogs with this neoplasm. Databases at four hospitals were reviewed for dogs with a trigeminal nerve sheath tumor diagnosis, magnetic resonance imaging (MRI) studies, and presentation between 2004 and 2014. A single observer recorded medical record findings and two observers recorded MRI characteristics by consensus. A total of 27 dogs met inclusion criteria (15 treated with stereotactic radiation therapy and 12 unirradiated). Two unirradiated dogs were excluded from outcome analyses. The most common presenting signs were masticatory muscle atrophy (26 dogs), neurologic signs referable to intracranial disease (13), and ocular disease (12). Based on MRI findings, all dogs had disease extending centrally at the level of the brainstem. The most commonly affected trigeminal nerve branches were the mandibular (26 dogs), maxillary (22), and ophthalmic (10). Of 15 dogs treated with stereotactic radiation therapy, one had improved muscle atrophy, and six had poor ocular health after treatment. Neurologic signs improved in 4/5 dogs with intracranial signs. Overall median survival time for the 10 unirradiated dogs with available follow‐up was 12 days and 441 days for the 15 stereotactic radiation therapy dogs. Mean survival times between these groups were not significantly different (mean 95% CI for unirradiated dogs was 44–424 days and mean 95% CI for stereotactic radiation therapy dogs was 260–518 days).     

Muscle cramps in two standard poodles with hypoadrenocorticism

Two standard poodles were evaluated for painful, episodic muscle cramps affecting their thoracic and pelvic limbs. Both dogs had been diagnosed with hypoadrenocorticism and were being treated with fludrocortisone acetate and prednisone when evaluated for muscle cramps. However, the muscle cramping started approximately 1 month prior to the diagnosis of hypoadrenocorticism. Findings on general physical examination included lethargy and dehydration. Neurological examination was normal between episodes. Serum biochemical abnormalities included hyperalbuminemia, azotemia, hyponatremia, hypochloremia, and hyperkalemia. Altering treatment to desoxycorticosterone pivalate resolved the electrolyte abnormalities and the episodes of muscle cramping in both dogs. The authors conclude that hypoadrenocorticism can be associated with episodes of painful muscle cramping in standard poodles.     

Thirteen cases of tetanus in dogs

The records of 13 dogs with tetanus were reviewed, 12 of the dogs survived and were discharged, but the other died as a result of the acute onset of hyperthermia. Long-term follow up was available for 10 of the survivors of which nine were reported to be normal. One case was euthanased after a cervical spine fracture four months after it was discharged. Complications encountered during management included aspiration pneumonia in three cases, urinary tract infection in two cases, and upper respiratory tract obstruction, hiatal hernia, coxofemoral luxation, seizures and respiratory arrest in one case each. None of the dogs required ventilatory support, and the complications were managed successfully. The dogs were nursed intensively and monitored carefully.     

Brunfelsia spp (yesterday, today, tomorrow) toxicity in four dogs

Four dogs were treated for acute toxicity following ingestion of the popular garden shrub 'Yesterday, today, tomorrow' (Brunfelsia spp). Clinical signs included vomiting, diarrhoea, muscle tremors, anxiousness, opisthotonus and seizures. All dogs recovered following treatment with any or all of general anaesthetic, gastric lavage, enema, diazepam, phenobarbitone or propofol sedation. Brunfelsia spp toxicity should be considered in young, previously healthy dogs presenting with gastrointestinal signs that rapidly progress to muscle tremors and seizures. Examination of faeces was required for diagnosis in all cases. Owners should also be questioned thoroughly about their dogs' access to such plants.     

Clinical Course of Acute Canine Polyradiculoneuritis Following Treatment with Human IV Immunoglobulin

Treatment of dogs with acute canine polyradiculoneuritis (ACP) is restricted to physical rehabilitation and supportive care. In humans with Guillain-Barré syndrome, the counterpart of ACP, randomized trials show that IV immunoglobulin (IVIg) speeds recovery. The authors of the current study hypothesized that dogs with ACP would tolerate IVIg well and recover faster than dogs managed with supportive treatment only. Sixteen client-owned dogs with ACP were treated with IVIg, and 14 client-owned dogs served as a retrospective control group. Diagnosis was confirmed using clinical features, electrodiagnostics, cerebrospinal fluid analysis, and muscle/nerve biopsies. The duration of the initial progressive phase, the time from IVIg administration until the dogs were ambulating without assistance, and the duration of the complete episode were evaluated. Adverse reactions (anaphylaxis, mild hematuria) were observed in two dogs. Dogs treated with IVIg were ambulating without assistance after a median of 27.5 days (range, 15-127 days) from onset of clinical signs. The control group was ambulatory without assistance at a median of 75.5 days (range, 5-220 days). Even though this result is not statistically significant, there is a clear trend toward faster recovery in dogs treated with IVIg.     

Tissue gamma-glutamyl transpeptidase activity and hepatic ultrastructural alterations in dogs with experimentally induced glucocorticoid hepatopathy

Glucocorticoid hepatopathy was induced in 2 Beagle dogs with IM injections of prednisone, 4.4 mg/kg, given once daily for 14 consecutive days. Serum enzymatic activities were monitored and percutaneous hepatic biopsy materials were collected. A placebo-treated group of 2 Beagle dogs was given saline solution injections. Treated dogs showed clinical signs of Cushing's disease and alterations in mean serum enzymatic activities consistent with glucocorticoid hepatopathy. The gamma-glutamyl transpeptidase activities in placebo-treated dogs were highest for kidney, less (but marked) for pancreas, and least for liver, gallbladder, jejunum, duodenum, spleen, heart, lung, skeletal muscle, and erythrocytes. In treated dogs, the gamma-glutamyl transpeptidase activities were highest for pancreas and were decreased for kidney and slightly increased for the other tissues. Results of hepatic biopsy and necropsy examinations of treated dogs showed swollen, pale, friable hepatic parenchyma with hepatocytic cytoplasmic vacuolation and glycogen accumulation. Extrahepatic lesions included gastric ulceration, catarrhal enteritis, splenic and lymph node atrophy and lymphocytolysis, and vacuolation of adrenal cortical cells in the zona fasciculata. Ultrastructural study of liver from dogs with glucocorticoid hepatopathy indicated that the principle alterations were abundant glycogen accumulation and few mitochondria in hepatocytes.     

A Technique for Management of Bite Wounds of the Thoracic Wall in Small Dogs

Bite wounds of the chest wall in small dogs can extend into the thorax and can be associated with severe damage to chest wall muscles, ribs, and lungs. Two major problems associated with the management of these wounds are lack of sufficient muscle tissue for chest wall reconstruction, and difficulty draining the extensive dead space created in the chest wall. We describe a simple method to overcome these problems. The bite wound areas were surgically explored and all devitalized soft tissue was debrided. The pleural cavity was explored, intrathoracic injuries repaired, and a thoracic drainage tube was placed. Ribs in the injured area were stabilized in anatomic position by means of heavy gauge sutures passed around pairs of adjacent ribs, thus creating a scaffolding for soft tissues. Viable muscle and subcutaneous tissues were apposed as much as possible and the skin closed over the defect. Eleven small dogs were treated using this technique. All dogs had severe injuries to the thoracic wall muscles and eight dogs had multiple rib fractures. There was no evidence of chest wall instability in any of the dogs after surgery. Nine dogs survived the injury and were reevaluated 3 to 32 months after surgery. All were clinically normal. One dog developed wound infection and pyothorax, caused by insufficient debridement of injured muscle tissue, and died 10 days after surgery. A second dog died 24 hours postoperatively of undetermined causes.     

Factors Responsible for Smaller Pelvic Muscle Mass in Dysplastic Dogs

Pectineus muscles of 23 German shephard dogs were studied. 10 dogs had normal hips, 13 dogs had hip dysplasia. The relative weight of each pectineus muscle was determined, when the dogs were 24 months old. Cryostat sections were stained for demonstration of ATPase, thereby differentiating muscle fibres into type I (slow twitch), type II (fast twitch) and intermediate fibres. The results (Tables 1–3) shows, that the relative pectineus muscle weight was smaller in dysplastic dogs and there were significantly fewer type I muscle fibres in the pectineus muscles of dysplastic dogs.