Association between clinically probable REM sleep behavior disorder and tetanus in dogs

摘要

h3 class="article-section__sub-title section1" Background/h3 pAbnormal sleep behavior has been reported in 5 dogs during recovery from tetanus. h3 class="article-section__sub-title section1" Hypothesis/h3 pREM sleep behavior disorder (RBD) is a more common consequence of tetanus than previously reported in veterinary literature and easily confused for epileptic seizures. h3 class="article-section__sub-title section1" Animals/h3 pSixty‐one client‐owned dogs diagnosed with tetanus at 2 UK referral centers. h3 class="article-section__sub-title section1" Methods/h3 pA retrospective review of medical records was combined with a questionnaire sent to owners of surviving dogs, to identify cases that developed clinically probable RBD and determine its clinical progression and effect on quality of life of affected dogs and their owners. Descriptive statistical evaluation was performed. h3 class="article-section__sub-title section1" Results/h3 pEleven dogs (18%) died or were euthanized before discharge. At least 46% surviving dogs developed abnormal “dream enactment” clinically consistent with RBD. Twitching, running, and vocalization were new sleep behaviors in 53, 80, and 60% of affected dogs. Clinically probable RBD was described as violent or “nightmare”‐like in 36% affected dogs, and like an epileptic seizure in 40% affected dogs. When trialed, antiepileptic medications were ineffective. Onset occurred before discharge in 25% cases. For dogs that developed clinically probable RBD postdischarge, onset occurred within 2 weeks of discharge in 77% dogs. Clinically probable RBD did not worsen in severity or frequency in any dog, and spontaneously resolved within 6 months in 43% cases. h3 class="article-section__sub-title section1" Conclusions and Clinical Importance/h3 pClinically probable RBD is a common sequel to canine tetanus with many clinical similarities to epileptic seizure activity. Owners should be made aware of its potential development and care taken to avoid misdiagnosis with epileptic seizure activity.