Clinical case of botulism in three dogs
Botulismus is an intoxication caused by the neurotoxin of Clostridium botulinum. Clinical signs are characterized by progressive, symmetric, generalized LMN (lower motor neuron) dysfunction. The severity of the illness depends on the amount of neurotoxin in the circulation and on the susceptibility of the animal. The incubation period may vary from a few hours to 6 days, and the course may last about 14-24 days. In case of recovery, muscle weakness dissolves in a descending way, starting from the muscle of the head, through the front legs, and the trunk to the hind legs. The diagnosis of botulismus can be based on the detection of the toxin in serum, faeces, vomitus or contaminated feed. The most widespread method is the toxin isolation and neutralization test performed in mice. In their 3 patients, ataxia beginning with the weakness of the hind legs occurred one day before hospitalization. The three foxterriers came from the same household, thus all the circumstances: nutrition, environment were the same. Flaccid tetraplegia developed within five hours after admission, following an ascending route, including the paralysis of the neck and head muscles, as well as the eyelids (Figure 1). Anamnesis and the results of the clinical examination arose the suspect of botulism, whilst no characteristic alterations of the blood count, blood chemistry and acid-base analysis were found (Table 1). Toxin isolation from the serum using mice inoculation toxin-neutralization test confirmed the diagnosis, and revealed Type C toxin. List of differentials included polyradiculoneuritis, tick paralysis, monensin toxicosis, and traumatic spinal cord lesions (Table 2). No antitoxin preparation was available to provide adequate serum therapy. Supportive treatment consisted of parenteral nutrition (Figure 2) and parenteral amoxicilline-clavulanic acid therapy to reduce any potential intestinal population of C botulinum. Besides placing a permanent urinary catheter to ensure urination, soft bedding was provided, and the animals were turned regularly to prevent haemostasis in the lungs. One dog died on the 4(th) and an other on the 8(th) hospitalization day, but the third one left the hospital in improving status due to intensive therapy on day 18(th).