A Case Report of Generalized Tetanus in a Shelter-Housed Puppy

Abstract

On April 7, 2025, Arvin, a 5-month-old male mixed-breed dog housed in a animal shelter in Israel, presented with acute generalized muscle rigidity, trismus, a sardonic facial expression, rigid ear carriage, and a ‘rocking horse’ stance. Hematology, serum biochemistry, abdominal ultrasonography, and serology for Toxoplasma gondii and Neospora caninum were unremarkable. Generalized tetanus was diagnosed based on the characteristic clinical presentation and exclusion of relevant differential diagnoses. Treatment included antimicrobial therapy, sedation, analgesia, equine tetanus antitoxin administered after a negative intradermal sensitivity test, and intensive nursing care, including assisted feeding, manual bladder expression, ocular lubrication, and a quiet, darkened environment to minimize stimulation. Care was shared between the shelter clinic during the day and shelter staff homes overnight, allowing continuous observation during the critical period. Clinical signs resolved gradually over approximately 10 weeks. At 10-month follow-up, before adoption, the dog had recovered fully with no observable deficits. This case illustrates that generalized canine tetanus can be managed successfully within the resource constraints of an animal shelter when early recognition, sustained supportive care, and close team collaboration are achievable.