Retrospective evaluation of 155 adult equids and 21 foals with tetanus in Western, Northern, and Central Europe (2000-2014). Part 1: Description of history and clinical evolution.

The research article discusses a thorough study conducted over 14 years (2000-2014) in Europe on 155 adult horses (equids) and 21 foals who were diagnosed with tetanus. It aims at understanding the various clinical developments and history of these cases to provide early detection and treatment options for future similar occurrences.

Study Design and Objective

• This is a multicenter retrospective study. This means the researchers looked back at past cases of tetanus in horses to gather their findings. Specifically carried out in 20 universities and private referral centers across Western, Northern, and Central Europe.
• The primary objective was to gather information on the geographic, annual, and seasonal data of these cases, their demographics, management-related data, clinical history, blood analysis at admission, complications, treatments, and eventual outcomes.

Results from Retrospective Review

• It was observed that tetanus commonly affected young horses. The disease also developed in 4 adult horses despite vaccination and 2 foals despite preventive tetanus antitoxin administration at birth.
• Common gateways of the tetanus infection were found to be castration, hoof abscesses, and wounds for adult horses, and wound and umbilical cord infections for the foals.
• Stiffness was the most frequently first observed clinical sign. Additional clinical indications included an inflammatory response, muscle damage, azotemia (increased level of waste product urea in the blood), liver damage, and electrolyte and acid-base disturbances.
• Common complications during hospitalization included swallowing difficulty (dysphagia), difficulty breathing (dyspnea), the inability to get up (recumbency), high body temperature (hyperthermia), seizures, high lipid levels in the blood (hyperlipemia), blockage of the gut (gastrointestinal impactions), difficulty urinating (dysuria), and spasms of the voice box (laryngeal spasms).

Treatment and Success Rate

• Treatments involved wound debridement (cleaning the wound to prevent infection), antimicrobial treatment (to treat bacterial infection), tetanus antitoxin (an antibody that provides immediate protection against the toxin produced by the bacteria causing tetanus), control of muscle spasm and seizures, pain relief (analgesia), anti-inflammatory drugs, fluid therapy, and nutritional support.
• The success rate was measured by the survival rates, which were 31.6% in adult horses and 33.3% in foals. This indicates high mortality rates, 68.4%, and 66.7% respectively.

Conclusion and Implications for Practice

• The study concludes that neonatal and adult tetanus in horses should be considered as distinct syndromes, similar to human medicine.
• As the first large-scale study describing a population of equids affected by tetanus, the data gathered could be useful for clinicians to recognize and manage tetanus cases in adult horses and foals efficiently in the future.