Forskning ved Københavns Universitet - Københavns Universitet

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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Gaby van Galen
  • Joke Rijckaert
  • Tim Mair
  • Helene Amory
  • Lara Armengou
  • Barbora Bezdekova
  • Inge Durie
  • Rikke Findshøj Delany
  • Nathalie Fouche
  • Laura Haley
  • Michael Hewetson
  • Rene van den Hoven
  • Anna Kendall
  • Fernando Malalana
  • Jessika Muller
  • Tresemiek Picavet
  • Katja Roscher
  • Denis Verwilghen
  • C.M. Westermann
  • Saegerman Claude
Objective
To identify prognostic variables for adult equids and foals with tetanus.

Design
Multicenter retrospective study (2000–2014).

Setting
Twenty Western, Northern, and Central European university teaching hospitals and private referral centers.

Animals
One hundred fifty-five adult equids and 21 foals with tetanus.

Interventions
None.

Measurements and Main Results
Variables from history and clinical examination were statistically compared between survivors and nonsurvivors (adults: 49 survivors, 85 nonsurvivors; foals: 7 survivors, 10 nonsurvivors). Cases euthanized for financial reasons were excluded. Mortality rates in adults and foals were 68.4% and 66.7%, respectively. Variables associated with survival in adults included: 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. Variables associated with death included: 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. Variables associated with survival in foals included standing on admission, voluntarily eating soft food and drinking, older age, and longer hospitalization delay. Outcome was not different between different tetanus antitoxin (TAT) dosages, although there was a trend of increasing survival rate with increasing TAT dosages. Cases with appropriate vaccination prior to development of tetanus were rare, but had improved outcome and shorter hospitalization.

Conclusions
Prognosis for equine tetanus is poor with similar outcome and prognostic factors in foals and adults. The prognostic assessment of cases with tetanus provides clinicians with new evidence-based information related to patient management. Several prognostic indicators relate to the ability to eat or drink, and more severe clinical signs relate to poor outcome. Increasing intravenous dosages of TAT has no significant effect on outcome, but the positive trend identified may support a recommendation for high intravenous TAT dosages. Further evaluation is warranted.
OriginalsprogEngelsk
TidsskriftJournal of Veterinary Emergency and Critical Care
Sider (fra-til)697–706
ISSN1476-4431
DOI
StatusUdgivet - 2017

ID: 165390279