29 Apr 2022
The 10-year-old small female cross-breed was rushed to Davies as an emergency when her local vet spotted general stiffness a couple of days after CiCi had cut her paw.
Vet Times
Job Title
Three weeks of specialist treatment have helped save a dog suffering with a challenging case of tetanus.
CiCi, a 10-year-old small female cross-breed, was rushed to Davies Veterinary Specialists in Hertfordshire as an emergency when her own vet spotted general stiffness a couple of days after she 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 concerned.
Neurology specialist Emilie Royaux, together with a team of VNs, provided treatment and round-the-clock care for CiCi.
Miss Royaux said: “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.”
CiCI was given IV tetanus antitoxin without side effects and was hospitalised to receive supportive treatment of IV fluids, sedation, muscle relaxants and antibiotics.
Miss Royaux added: “We examined her paw and found a grass seed from the swollen toe, which we removed together with some purulent discharge. Unfortunately, though, despite our quick work, CiCi deteriorated severely.”
No longer able to walk because her stiffness, tremors and muscle spasms had worsened, CiCi was fitted with a PEG tube under general anaesthetic, and placed together with a central line in the jugular and an indwelling urinary catheter.
Initially, the muscle spasms, stiffness and tremors were managed with constant rate infusions (CRI) of medetomidine and midazolam, as well as boluses of ACP. CiCi was also given magnesium to maintain a supraphysiological concentration.
Laura Barham, wards head nurse at Davies, said: “CiCi remained in our intensive care unit (ICU) under close observation. But unfortunately, her muscle spasms were not completely under control and she developed severe episodes of hyperthermia secondary to the muscles spasms.
“As a last resort, a propofol CRI was started, which proved to be effective in controlling the muscle spasms and preventing further episodes of hyperthermia.”
After two weeks of care in the ICU, the dose of sedation and muscle relaxants was slowly tapered. After three weeks, she was well enough to return home.
