Retrospective evaluation of 155 adult equids and 21 foals with tetanus from Western, Northern, and Central Europe (2000-2014). Part 2: Prognostic assessment.

This research paper investigates the factors that determine the prognosis of adult horses and foals suffering from tetanus. The authors carried out a multicenter retrospective study on 176 cases in Western, Northern, and Central Europe. The goal was to understand what variables might predict survival rates. Overall, the prognosis for equine tetanus was found to be poor.

Methodology

The study was done retrospectively, looking at 155 adult equine and 21 foal tetanus cases from 20 different teaching hospitals and private referral centers across Central, Northern, and Western Europe. Variables from patient histories and clinical examinations were collected and statistically compared between cases that survived and those that did not.

• Nonsurvivors: 85 adults and 10 foals.
• Survivors: 49 adults and 7 foals.

Cases that were euthanized for financial reasons were excluded from the study.

Results

The mortality rates for adult equines and foals were 68.4% and 66.7% respectively.

• The survival variables for adults were: standing, normal intestinal sounds and defecation, voluntarily drinking, eating soft or normal food, lower heart and respiratory rates, high base excess on admission, longer diagnosis time, treatment and hospitalization delay, and mild severity grade.
• The prognostic variables of death in adults were: anorexia, dysphagia, dyspnea, low blood potassium concentration on admission, moderate and severe disease grading, development of dysphagia, dyspnea, recumbency and seizures during hospitalization, treatment with glycerol guaiacolate, intravenous fluids, and intravenous glucose solutions.
• The survival variables for foals were: standing on admission, voluntarily eating soft food and drinking, older age, and longer hospitalization delay.

The outcome between different dosages of the tetanus antitoxin(TAT) was not significantly different. However, there was a trend noted that the survival rate increased with higher TAT dosages. Cases with appropriate vaccinations prior to the development of tetanus were rare, but had better outcomes and shorter hospital stays.

Conclusions

Based on the study’s findings, the prognosis for equine tetanus is generally poor for both adults and foals. Several prognostic indicators were related to the ability to eat or drink and more severe clinical signs correlated to poor outcomes. Overall, the study provides valuable data that can guide future patient management and offers a foundation for further studies on high dosages of TAT and the positive trend identified associated with its use.