Tetanus is a usually fatal, notifiable infectious disease caused by the toxin produced by the bacterium Clostridium tetani. This disease, also known as lockjaw, has been known since ancient times and is widespread throughout the world. Both humans and horses are particularly susceptible to the toxin, whereas dogs have only a low sensitivity and therefore do not need to be vaccinated.
The pathogen responsible for the disease is the bacterium Clostridium tetani, whose highly resistant spores (the developmental stage of the bacteria) are found almost everywhere in the environment, including in the intestinal tract and on the skin of healthy animals and humans. The spores remain viable in the soil for many years.
Even the smallest skin injuries or wounds contaminated with soil, feces, or manure can serve as entry points for the pathogen's spores. The tetanus toxin is released as soon as the pathogen multiplies in the oxygen-depleted environment of deep or purulent, crusted wounds. The spores can also enter the organism via the foal's navel. The toxin reaches the nerve endings via the surrounding tissue and the bloodstream and travels along the nerve pathways to the central nervous system, where it blocks the transmission of stimuli and thus prevents the muscles from relaxing.
Depending on the sensitivity of the animal and the bacterial strain, it can take from a few days to several weeks from infection to the onset of clinical symptoms (incubation period). The incubation period is significantly shorter in foals. The first symptoms of the disease in horses are muscle stiffness, which begins in the head and then slowly spreads to the tail. The entire movement becomes increasingly stiff and the affected animals suffer from chewing and swallowing difficulties and extreme nervousness. A very noticeable and characteristic symptom in horses is the spread-eagle stance, also known as sawhorse stance. The muscles are severely tense, almost board-like, and the animals become so agitated that even the slightest excitement can lead to massive seizures. Shortly before death, the animal's body temperature rises sharply. In most cases, affected animals die three to ten days after the onset of the disease. The mortality rate for horses is 50 to 90%, and for foals it is almost 100%. In animals that survive the disease, the symptoms slowly begin to improve after about two weeks until they finally disappear completely.
The veterinarian can usually make a diagnosis based on the typical symptoms in combination with any previous history, such as an injury or missed vaccination. It is rarely possible to detect the pathogen in the blood, and toxin detection is only possible in animal experiments and therefore not practical in everyday veterinary practice.
If symptoms suggestive of tetanus are detected in a horse, it must be taken to a veterinarian immediately, as there is only a chance of recovery if the symptoms are not yet fully developed and treatment is started early.
First, the sick horse should be taken to a quiet stable with a darkened stall to protect the animal from further stress and excitement. The veterinarian will administer an antidote, but this will only bind the toxin that is freely available in the body. Toxin that has already bound to the central nervous system cannot be neutralized by the antidote.
In order to kill the pathogens and thus curb toxin formation, any wounds and injuries must be treated and high doses of antibiotics administered. Sedatives and infusions may also be administered to alleviate the increased nervousness and tendency to convulsions and to stabilize the circulation. Animals that are unable to swallow properly must be force-fed.
With a mortality rate of 50 to 90%, the prognosis is considered unfavorable. The chances of recovery depend on the location, type, and extent of the injury and the amount of toxin absorbed by the body. The further the injury is from the spinal cord and brain, the greater the chances of recovery. If a horse survives the first week after the onset of the disease, the prognosis for survival is favorable.
The protective vaccination, which has been successfully administered to humans and animals for many years, is the most effective prevention against tetanus. Given the high sensitivity of horses to tetanus toxin and the everyday risk of wound infection, the Standing Vaccination Commission for Veterinary Medicine (StiKo Vet, a committee of veterinary experts) recommends tetanus vaccination as a "core component," meaning that every horse should be protected against this disease at all times. Foals can be vaccinated from the age of five or six months, depending on the vaccine. For basic immunization, two vaccinations are given at intervals of four or six weeks. Depending on the vaccine, a third vaccination may be necessary. After that, the vaccination only needs to be refreshed every two to three years. There are combination vaccines that cover tetanus and influenza at the same time.
Horses that have not been vaccinated or have an inadequate vaccination status must always receive a passive protective vaccination with tetanus antitoxin in the event of injury or before surgery. However, active immunization should be started at the same time, as passive protection only lasts for about two to three weeks.
Your vet can send you a personalized vaccination schedule for your horse via petsXL, and you will automatically receive notifications when it is time to make another appointment.
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